A new study suggests that the link between a person’s health and the quality of their marriage may be less straightforward than we might assume. It finds that – compared with happily married peers – men in unhappy marriages are less likely to develop diabetes, and if they do, it arises later and is better managed.

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One explanation the researchers suggest is having a wife that nags him about his diabetes monitoring may benefit a man’s health, even if it puts a strain on his marriage.

The study, led by Hui Liu, an associate professor in sociology at Michigan State University in East Lansing, is published in the Journals of Gerontology: Social Sciences.

In 2012 there were 29.1 million Americans – or 9.3 percent of the population – living with diabetes. This figure includes 8.1 million undiagnosed people.

However, among older Americans, the prevalence of diabetes is much higher: 25.9 percent of adults aged 65 and over – 11.8 million seniors – are thought to have the disease.

In this context, the goal of the study was to examine the link between marital quality and both the risk of developing diabetes and how well it is managed after it develops in later life.

The study uses data from the first two waves of the National Social Life, Health and Aging Project (NSHAP).

The NSHAP data – which includes biomeasures and survey responses collected in interviews and in self-reports – covers many facets of social life, health, aging, and relationships in older, community-dwelling Americans.

The data set that Prof. Liu and colleagues analyzed covered 1,228 married men and women who were aged 57-85 at the time of the first wave survey (conducted 2005-2006). At the time of the second wave survey (2010-2011), 389 of the participants had diabetes.

The survey data collected were not specifically designed to assess marital quality, so the researchers used a statistical approach called “factor analysis” to construct positive and negative marital quality scales from relevant survey items.

For example, the survey includes items on satisfaction with current relationship, behavior with partner, intimacy, attitude to partner, and sexual contact.

When the team compared the survey data with the diabetes information collected from the participants, they made some surprising discoveries.

The most surprising finding was that for men, negative marital quality was linked to lower risk of developing diabetes and better management of the disease once diagnosed.

One explanation might be that, because diabetes is a condition that needs careful and constant monitoring, persistent nagging from a wife might boost a husband’s health just through effect on health behavior, although it may also appear to increase marital strain over time.

For women, it was positive marital quality that was linked to a lower risk of developing diabetes over the course of the study.

Prof. Liu suggests this could be that women are more sensitive to marital quality and thus more likely to experience this as a positive effect on health.

These results also prompt questions about how to define negative and positive marital quality, and to what extent they may differ between the sexes.

The study challenges the traditional assumption that negative marital quality is always detrimental to health. It also encourages family scholars to distinguish different sources and types of marital quality. Sometimes, nagging is caring.”

Prof. Hui Liu

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