Skip to content
Life Guide U.S. essentials
English

Count the health benefits of marriage, but discount them because the data are observational

  • Moderate value
  • Evidence A
  • Buys life
  • Disputed
  • Free
  • Takes minutes
  • No willpower

In plain words

Married people have about 12% lower odds of dying in the same period than unmarried people, and people who have never married have about 24% higher odds than married people. But these are only two things appearing together, not marriage doing the work. People who are already healthy, high-earning and socially connected are both more likely to marry and more likely to live long. The figures come mostly from Europe and America, so for China treat them only as an order of magnitude.

Cost

Free, and it takes no time. Just remember one thing: these figures say that death rates are lower among married people, two things that show up together, not that marriage makes you live longer.

What you get

A meta-analysis on older adults, which pooled and recalculated many studies, with 53 comparisons and more than 250,000 (25万余) people. For married versus unmarried, all-cause mortality RR 0.88, 95% CI 0.85–0.91 (RR is the risk ratio, CI is the confidence range), meaning about 12% lower odds of dying in the same period. In the same analysis, widowed was 1.11, divorced or separated 1.16 and never married 1.11, meaning about 11%, 16% and 11% higher. There was no difference between men and women. The most conservative estimate was RR 0.94, only about 6% lower. Another meta-analysis compared unmarried (never married) with married, using 95 papers and more than 500,000,000 (5亿余) people. The result was HR 1.24 (1.19–1.30), about 24% higher odds of dying in the same period. And the older the age, the smaller the gap. A further meta-analysis split by sex, with 21 studies and more than 7,890,000 (789万余) people: for both men and women, being unmarried appeared together with higher total mortality, cancer mortality and cardiovascular mortality. For men the gaps in cardiovascular and total mortality were larger. Compared with unmarried women, unmarried men had 31% more stroke deaths and 9% more all-cause deaths

Notes

The dispute is that people who marry were already selected: those who are healthy, high-earning and socially connected are both more likely to marry and more likely to live long. All three meta-analyses used observational data from existing populations, only tracked and recorded, without controlled groups. The authors themselves wrote of publication bias or methodological limits. Roelfs also found that the more rigorous the study, the smaller the gap it calculated. These figures are mainly from European and American populations, so for China treat them only as an order of magnitude

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Manzoli L, et al. (2007). Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med 64:77–94. https://doi.org/10.1016/j.socscimed.2006.08.031
  2. Roelfs DJ, et al. (2011). The rising relative risk of mortality for singles: meta-analysis and meta-regression. Am J Epidemiol 174(4):379–389. https://doi.org/10.1093/aje/kwr111
  3. Wang Y, et al. (2020). Sex differences in the association between marital status and the risk of cardiovascular, cancer, and all-cause mortality: a systematic review and meta-analysis of 7,881,040 individuals. Glob Health Res Policy 5:4. https://doi.org/10.1186/s41256-020-00133-8

Mentioned in

Translated from the Chinese original. Original book, section 10, tip 8. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer