The Effect of Marital Satisfaction on Lifespan

Social relationships, directly affect people's health and well-being. Epidemiological (population health) studies show that social isolation, meaning not meeting other people, is an important risk factor for death compared with health risk factors such as smoking, blood pressure, cholesterol, obesity and physical activity. In addition, in societies with strong social relationships - for example, Blue Zone residents - social relationships are clearly one of the factors extending lifespan.

For most adults, marriage is at the center of social relationships. Many surveys and studies show that marriage contributes positively to health among people with high marital satisfaction; conversely, unhappy marriages with low satisfaction negatively affect health and lifespan.

Marriages therefore occupy a place important enough to ultimately influence our lifespan, both through the positive or negative relationships couples maintain with each other and through their chosen social environments and relationships.

According to 2018 data, America alone has more than 61 million married couples (%56 of adults), meaning more than 120 million married people.

Many studies have examined marriage and health. Some found higher all-cause mortality among people who had never married, were separated or were widowed than among married people. Among the causes of death in these individuals, cardiovascular diseases and cancer are common, but causes such as pneumonia, chronic obstructive pulmonary disease (COPD) and liver disease (cirrhosis, etc.) also play an important role.

Long-term studies showing the relationship between marriage and mortality rates are similarly consistent. These studies found that marriage had a % 50 greater protective effect against death in men and a % 250 greater effect in women compared with unmarried people. However, the main factor influencing such a positive outcome should be noted to be marital satisfaction rather than marriage itself (the level of fulfillment).

Marital satisfaction is more important than marriage itself

Higher mortality was observed among couples in unsatisfactory marriages than among those in marriages with high satisfaction. In the largest study to date on marital satisfaction and lifespan, in middle-aged Caucasian men, unsatisfactory marriage was associated with an increased risk of sudden cardiac (heart-related) death was the finding (see the graph below). Sudden cardiac death is an important cause of death worldwide, with 4 to 5 million cases annually.

The study, completed in Finland with middle-aged men (aged 40-62), a total of 2.262 participants, collected detailed information using questionnaires about education, occupation, smoking status and years of regular smoking, alcohol consumption and past medical conditions. At baseline, risk factors including diabetes, high cholesterol, high blood pressure, body mass index and family history of disease were assessed. Questions about marriage and marital satisfaction among married participants at baseline were also included in this detailed questionnaire. The study also assessed married couples' health and general well-being according to their negative (such as friction and conflict) and positive (such as love and support) views of marriage.

The study began in 1984 with 3343 people, was completed with 2262 people and lasted an average of 25.9 years. Men who were quite satisfied with their marriages accounted for the highest percentage of participants (% 55,2), and 239 sudden cardiac deaths occurred during the study period.

In this study investigating the relationship between marital satisfaction and sudden cardiac death (SCD), Caucasian men dissatisfied with their marriages had a %86 higher risk of sudden cardiac death than those in very satisfying marriages. Similarly, even those with moderate satisfaction experienced %43 more SCD than those in very satisfying marriages.

Through what mechanism does marital satisfaction affect health?

The study observed that when conflicts among couples with negative views of marriage continued regularly or remained unresolved, activation of the sympathetic nervous system increased blood pressure (hypertension) and the risk of other cardiovascular diseases. The study also showed that quite (moderately) satisfied and dissatisfied marriages combined were associated with a higher risk of sudden cardiac death than very satisfied marriages, after adjustment for similar variables.

Interactions between spouses are thought to affect health through physiological events involving the cardiovascular, endocrine and immune systems. Friction and conflicts experienced by couples with low marital satisfaction can also activate the cardiovascular system and dysregulate stress-related hormonal and immune functions. This showed how chronic (long-term) stress related to marital satisfaction may negatively affect health in the long term through the physiological changes mentioned above.

Besides the hormonal reactions caused by stress in the body, modifiable negative behavioral factors (such as weight gain, smoking and alcoholism) may be potential triggers of increased sudden cardiac death risk among those without marital satisfaction.

Ultimately, although the mechanism underlying the relationship between marital satisfaction and survival is not fully understood, men dissatisfied with their marriages should be considered a group at high risk of death compared with men very satisfied with their marriages. Although this study was completed with middle-aged male participants, it is known that middle-aged and older women are more affected by stress and that the immune and defense systems are more fragile in older people. Similar findings in other, as yet unstudied groups are considered highly likely in the future.