Socioeconomic status, marriage, and physical health: The moderating effects of marriage on socioeconomic status -health associations.

摘要

This study examined how education and income stratification affect physical health in combination with marital status and marital quality. Research has consistently documented an inverse association between socioeconomic status (SES) and health. Other scholarship has suggested a positive association between being married and better health. Guided by a bioecological systems perspective, this study evaluated whether micro-level determinants of health such as marital status and marital quality might condition the effects of macro-level factors such as education and income stratification on mortality, self-rated health, and functional limitations.;Using three waves of the National Survey of Families and Households (1987--2002), this study estimated logistic regression models for mortality analyses, and hierarchical linear models for analyses of within-person change in self-rated health and functional limitations among U.S. adults aged 30+. To evaluate a broad spectrum of marital experience, this study examined marital status continuity and change, marital status in conjunction with marital disagreement, and variation in marital disagreement among the married. Gender differences were also systematically examined.;Overall findings confirmed that first, lower education and lower income were independently associated with higher rates of mortality, greater declines in self-rated health, and greater increases in functional limitations over time. Second, this study confirmed that being married compared to being single of all subtypes was associated with lower odds of mortality. However, few significant main effects of marital status transitions were found for mortality, change in self-rated health, or change in functional limitations. Third, few gender differences emerged in the main effects of SES, marital status continuity, and marital status transition on health outcomes. Fourth, when the moderating effect of marriage on the SES-health association was tested, being married compared to being single was found to be protective against the negative effects of lower income on survival and change in functional limitations particularly for men. In addition, being in a high-disagreement marriage compared to being single was found to buffer the income-mortality gradient for men. Among the married, both men and women experiencing an increase in marital disagreement were more vulnerable to the negative effects of education and income stratification on change in functional limitations.