A person’s health status can act as a filter for who gets married and who stays married, shaping the trajectory of a romantic relationship. Recent research published in Journal of Health and Social Behavior We found that poor health decreased the likelihood of having a romantic relationship and increased the risk of that partnership ending. The results show that the association between physical well-being and marital status runs in both directions, stacking social disadvantages on people who already experience medical problems.
Previous research has focused on the protective effects of marriage, showing that being married correlates with better outcomes over the lifespan. The reverse sequence of events has received considerably less attention. A person’s health status may predict whether that person will be able to find a partner or maintain a supportive network.
Researchers want to know whether medical adversity is associated with poorer relationships and limited options in the dating market. When poor health and relationship breakdown occur together, aging populations may be at risk of losing social support when they need it most. This dynamic is critical today because increasing lifespans will ultimately allow more people to manage their chronic diseases.
At the same time, marriage patterns are changing globally. People are marrying less, getting divorced more, and remarrying more often at older ages. In this environment, partner selection has become highly competitive and the importance of physical vitality has increased.
Several theoretical mechanisms attempt to explain how illness and romantic status are related. At the dating stage, health may serve as a screening criterion alongside education, income, and personality. People may consciously or unconsciously choose partners based on their ability to provide resources and protection during long-term commitments.
Once a bond is formed, chronic illness can reduce a person’s mobility and increase their need for care. This dynamic can cause emotional and practical strain on the healthier partner. As couples navigate these new challenges, daily conflicts, decreased communication, and withdrawal tendencies become more common.
Matthijs Kalmijn, a demographer and professor at the University of Groningen in the Netherlands, designed this project to explore these ideas. Dr. Kalmin used longitudinal survey data from multiple countries to test whether individuals’ self-rated status was associated with the formation or dissolution of romantic relationships.
Kalmin assessed data from annual household surveys in Australia, Germany, South Korea, Russia, Switzerland and the United Kingdom. This harmonized dataset provided information on over 250,000 adult respondents. The analysis followed these individuals over several years and observed their relationship status over time.
Changes observed include entering into a first romantic relationship, deciding to marry or live together unmarried, experiencing separation or divorce, and finding a new partner after a previous marriage ends. The key variable of interest was self-rated health status. This measure asks respondents to rate their level of well-being on a five-point scale from excellent to poor.
Self-rated health status is a widely accepted measure in demographic research. A simple five-point scale has strong correlations with mortality rates and a variety of actual mental and physical conditions. The use of this indicator allowed for consistent comparisons between different national surveys.
Kalmin used a statistical model to calculate the probability of a relationship change in a given year based on an individual’s previous health assessment. The model took into account age, education, religious affiliation, and other demographic factors to isolate their specific role in an individual’s well-being.
Analyzes revealed that poor health was associated with negative outcomes across all types of relationship changes examined. People in poor health were less likely to join their first union. Even if they found a partner, they were unlikely to get married and simply chose to live together.
In the case of dissolution of the relationship, the bond became even stronger. Study participants with poor health scores had a much higher risk of separation and divorce compared to healthier participants. This is consistent with the idea that ongoing medical demands are straining established routines.
For those who had already experienced divorce or the death of a spouse, health problems were an obstacle to finding love again. In nearly all countries surveyed, poor health was associated with a lower likelihood of repartnering. This trend highlights the vulnerability of older adults seeking companionship in later life.
Kalmin estimated these events with and without taking into account employment status and household income. Health problems often lead to job loss or loss of income, which can put financial strain on relationships. Including these economic factors slightly reduced the observed health-marriage association.
Even after controlling for money and employment, the direct association with health remained strong. The severity of health penalties varied depending on the type of union transition. The negative relationship with poor health was consistently stronger for relationship dissolution than for relationship formation.
This suggests that medical problems may not always be obvious in the early stages of dating, but become very noticeable once marriage is established. A decline in the quality of a couple’s relationship can also have a negative impact on a person’s mental state. This creates a reciprocal loop that accelerates the path to separation.
Similarly, poor health had a stronger negative relationship to marriage than cohabitation. Marriage represents a long-term period, meaning individuals may more closely assess their partner’s health before taking that step. Cohabitation often serves as a trial period to accommodate the high level of uncertainty regarding a partner’s future care needs.
The pattern of results is strikingly similar across the six countries, suggesting that these social dynamics are not limited to any particular culture. One exception is South Korea, where poor health was a particularly strong predictor of marital dissolution. This result may be related to the structure of the local dating market and the heavy involvement of family members in matching couples.
There was also variation in findings depending on age. The association between poor health and relationship dissolution was strongest among young people. As people age, health problems become more common and socially expected.
Also, older couples typically spend more time in their relationship. This creates loyalty and makes them more prepared to stay together even when they get sick. Receiving a serious diagnosis at a young age creates strong uncertainty about the future direction of the partnership.
Researchers looked at differences between men and women, but found few instances where health conditions put one gender at a disadvantage over the other. The assumption that men’s health is more important for securing marriage because of their traditional breadwinner role is not supported by the data. Men and women faced similar obstacles when dealing with poor health.
This study has several limitations that provide avenues for future research. Broad measures of self-rated health combine physical and mental health status into one indicator. Future projects should separate out specific physical illnesses and psychological conditions to see how different illnesses relate to the partnership.
The current analysis focused only on individual survey responses and was not able to study how the health status of both partners interacted. Researchers will need couple-based data to determine whether having two sick partners amplifies relationship instability.
The data also lacked complete information on the exact start dates of some marriages. Couples tend to build resilience over time, so knowing the exact duration of a relationship can help researchers understand separation risk. The researchers used specialized German data to ensure that this omission did not bias the primary results, but future studies could benefit from a more detailed timeline.
The study, “The influence of self-rated health on trade union formation and dissolution in six countries” was authored by Matthijs Kalmijn.
