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How Marriage Affects Health in Older Adults

The role of marital support and strain in long-term well-being.

Plenty of research shows that being married is generally good for your physical and psychological health. Spouses aren’t just companions and intimate partners; they also help each other maintain healthy habits, and they provide emotional support in times of need.

However, there’s also plenty of research showing that bad marriages are far worse for people’s health than not being married at all. Even when there’s no physical or psychological abuse, the frequent tensions that arise from conflicts and complaints can lead to considerable physical and psychological harm.

As people enter their senior years, marriage becomes even more important in their lives. When they retire, they tend to lose the network of relationships that can help offset some of the tensions at home. Likewise, grown children leave home and often move far away, while friendships shrink in number due to loss of mutual interests, health problems, or death.

In a recent article published in the journal Research on Aging, Baylor University psychologists Yingling Liu and Laura Upenieks explored the relational dynamics of older couples in long-term marriages. In particular, they were interested in exploring which aspects of marriage promote health in old age and which ones harm it.

Marriage researchers generally lump marital dynamics into two categories: support and strain. Support refers to any interaction in the marriage that boosts physical or psychological well-being. For instance, a wife can plan meals and limit the purchase of junk food to encourage her husband to eat healthily. Likewise, a husband can drive his wife on her errands, easing her anxiety behind the wheel and providing companionship to boot.

In contrast, strain refers to interactions that damage physical or psychological well-being. Even small confrontations can lead to significant stress for both partners. Liu and Upenieks point out that nagging and complaining are the chief sources of strain in marriages, particularly those of long-married seniors. Always having to walk on eggshells to avoid setting the other person off keeps partners in a steady state of anxiety that has grave impacts on both physical and psychological health.

However, it’s important to understand that support and strain aren’t just the positive ends of a single positive-negative dimension. Rather, each works independently to boost or harm long-term well-being, and they can also interact to produce particular effects. While marriages that are high in support and low in strain are the happiest and generally lead to the best health outcomes for both men and women, other combinations of support and strain are also possible.

With this in mind, Liu and Upenieks devised a scheme that divides marriages into four types, depending on whether support and strain are either high or low:

  • Supportive marriages are high in support and low in strain. Spouses have each other’s back, and they also know better than to harp on each other’s faults.
  • Ambivalent marriages are high in support but also high in strain. Partners are often highly dependent on each other emotionally, and yet they’ve also fallen into a pattern of nagging and complaining. Both positive and negative interactions are common, and they’re almost always intense.
  • Indifferent marriages are low in support and also low in strain. Partners generally ignore each other, providing few opportunities for positive interactions but also minimizing confrontation. While they may attend some social events as couples, they mostly lead independent lives, separate from each other.
  • Aversive marriages are low in support but high in strain. These marriages are characterized by constant bickering, nagging, and complaining, with few if any positive interactions.

Prior research has already established that couples in supportive marriages generally fare much better, both physically and psychologically, than those in aversive ones. However, Liu and Upenieks wondered about health outcomes in ambivalent and indifferent marriages. They also looked at whether there were differences between men and women in each of the marriage types.

To explore these questions, Liu and Upenieks used data from the National Social Life, Health, and Aging Project, which interviewed thousands of senior citizens in the United States about a variety of topics. These interviews were collected in two waves, 2005-2006 and 2010-2011. Among those who took part, 1,250 individuals remained married to the same person across both waves, and these provided the data for the current study. All participants rated their level of depression, happiness, and general health, and they also reported the degree of support and strain in their marriage.

As expected, couples in aversive marriages were the least happy of those in any other marriage type. Furthermore, men in these marriages suffered greatly in their physical health, but this was not the case for women. The researchers speculated that this was because men rely mostly on their wives for emotional support, whereas women usually rely on social networks outside the marriage instead.

Another surprising finding was that persons in ambivalent marriages fared no worse than those in supportive marriages, for both men and women. This was unexpected, since previous research has shown that the harm of strain typically outweighs the benefit of support. As a general rule, one negative interaction costs more than one positive interaction, and marriage counselors having been advising their clients for years that they should keep the ratio of positive to negative at least 3 to 1 if not 5 to 1.

Liu and Upenieks speculate that the reason why ambivalent marriages yield similar health outcomes to supportive ones has to do with cognitive reappraisal. This occurs when we reinterpret a negative event as “not so bad after all.” It’s quite likely that persons in long-term ambivalent marriages have grown used to their partner’s nagging and nitpicking, seeing it as a minor irritation rather than a major threat to the relationship. And other than that, they’re still getting the same positive interactions that those in supportive relationships receive.

In general, lack of support and excess of strain had a greater impact on men than women. While the lack of support in an indifferent marriage led to poor health outcomes for men, the additional strain of an aversive marriage had an even heavier impact on their well-being. Although men in indifferent marriages don’t get the support they need from their wives, those in aversive marriages also suffer the consequences of frequent conflict.

Liu and Upenieks’s marriage typology should have practical applications for both marriage counselors and the general public. For instance, those in ambivalent marriages show us both partners can be happier if they increase the number of positive interactions, even if the number of conflicts remain high. After all, it’s a good idea anyway for us all to look past our partner’s faults when we can, and to focus on the positive aspects of the relationship instead.

Facebook image: KomootP/Shutterstock


Liu, Y. & Upenieks, L. (2020). Marital quality and well-being among older adults: A typology of supportive, aversive, indifferent, and ambivalent marriages. Research on Aging. Advance online publication. DOI: 10.1177/0164027520969149