Declining Health and Marital Quality

Using a national sample of 1,298 married persons, we examined the effect of a change in health over a 3-year period on shifts in marital quality. The analysis suggests that decrements in health have an adverse influence on marital quality. Changes in financial circumstances, shifts in the division of household labor, declines in marital activities, and the problematic behavior of the afflicted individual account for much of the health-marital quality relationship. The increase in the number of disabled persons and chronically ill elderly in the United States, and subsequent primary care by the spouse, demonstrate the importance of understanding factors that may influence the quality of the care provided. One of those factors may be the extent to which declines in health affect marital quality. Studies of the possible relationships between declines in health and marital quality have conflicting results and leave a number of issues unresolved. Most research is disease-specific (e.g., Alzheimer's, cancer, low back pain, diabetes, head or spinal cord injury). While this approach provides patients with information that helps them to cope with their particular ailment (see Peyrot, McMurry, Johnson, 1985; Swensen Turk, Wach, Wright 1991), the methodological weaknesses of this research make it problematic to advance a hypothesis on the relation between defines in health and marital quality. If marital quality does decline, four explanations are possible. First, declines in health typically involve some impairment in everyday functioning, meaning fewer hours of work and decreased income, or the diversion of income from normal household expenses to medical expenses. Declines in income and financial hardship are known to have adverse effects on marital quality. A second explanation entails a change in the division of labor in the household. The healthy individual might have to take on more of the cleaning, cooking, repairs and maintenance, and child care, while the afflicted individual performs fewer household tasks. The change in the division of labor, like most change, is in itself stressful and may be a source of marital unhappiness, especially if the healthy individual regards the new responsibilities as unfair. Third, a person in declining health may decrease shared activities that the couple finds rewarding. Shopping, visiting friends, household projects, and going out may decrease due to infirmities in the afflicted person or a decline in income. …