Marriage has been around for thousands of years — and was once “almost universal,” according to Dr. Andrew J. Cherlin. But marriage rates are falling, and that means some people could be missing out on a potential health benefit.
“It’s like we’ve split into two different societies,” said Cherlin, a professor emeritus at Johns Hopkins University who studies the sociology of the family — emphasizing the advantages that marriage can bring.
A study published Wednesday in the journal Cancer Research Communications suggests that marriage may be linked to a lower risk of cancer, adding to a growing body of research linking it to better health outcomes.
Among men who have never married, cancer rates are 68% higher than those who have been married, a group that also includes those who are divorced or widowed. The incidence is even higher – 83% – for women who have never married.
“When it comes to developing cancer, wearing a ring may offer more protection for women,” said Dr. Brad Wilcox, a professor at the University of Virginia who studies marriage. Wilcox, who was not involved in the new study, added: “This is surprising.”
Research on marriage generally suggests that men benefit more than women in heterosexual relationships. This study suggests the opposite.
The study authors say the finding likely has several causes. For some types of cancer, such as endometrial and ovarian cancer, the trend may be linked to reproductive mechanisms. Women who have never given birth are at higher risk for these cancers.
In older adults in the observational study, the link strengthened, suggesting that the effect of marriage “accumulates” over time, said Dr. Paulo S. Pinheiro, the study’s lead author and an epidemiologist at the University of Miami Health System.
When the data was analyzed by race and ethnicity, black men appeared to benefit the most from marriage. Dr. Jarrod A. Carrol, a geriatrician who treats patients at Kaiser Permanente in Southern California, said the finding shows “the strength of black women.”
“They provide support and encourage black men to seek treatment and evaluation earlier,” said Carrol, who was not involved in the new study. “As a result of the black woman’s role as a support center for the entire family, this shows how committed they are to caring for their husband.”
Why does marriage bring benefits?
Although the concept of marriage is constantly changing, Cherlin said, a fundamental question remains: Does marriage make people healthier, or are the healthier people the ones who get married?
Marriage typically offers advantages such as better access to health care and social support. The study authors also argue that people who have been married are less likely to engage in risky behaviors, citing data showing that marriage is strongly associated with lower rates of lung and cervical cancer. These cancers are linked to risky behaviors such as unprotected sex, smoking, and alcohol consumption.
Also, “if you are single and more isolated, you are less likely to … participate in preventive checkups,” Pinheiro said.
However, Dr. Joan DelFattore, who has spent the past decade writing about cancer and marital status in academic journals and the media, argues that the benefits of marriage often reflect the systems that favor it, rather than marriage itself. For example, many health insurance plans cover spouses but not other people.
DelFattore, who was not involved in the new study, said such policies contribute to the misconception that marriage itself is what leads to better outcomes.
“People start with the assumption, ‘Marriage: good. No marriage: bad,’ and interpret things in ways that don’t make sense based on the real data,” she said. This bias, she said, is rooted in research and medical training, often leading to “oversimplified” conclusions.
Single with cancer
DelFattore was diagnosed with stage IV gallbladder cancer 15 years ago. During a visit with her oncologist, DelFattore — who is not married — said she was not given the same level of care that a married person would have received.
The oncologist “was absolutely convinced that as a single woman … I couldn’t have the social support to afford aggressive treatment,” said DelFattore, who told her story in The New England Journal of Medicine. But she says the doctor’s assumption was wrong.
“I tried to tell him about the cousins and friends who provide me with a very strong support system. He cut me off. I couldn't even finish the sentence.”
Studies show that single people treated for cancer have poorer outcomes, and DelFattore said these disparities are exacerbated by stereotypes that doctors often hold.
“There is this assumption that there is a strong divide between being married and being single,” she said.
Looking ahead, Pinheiro said more research needs to be done on ways to support single people. DelFattore added that the focus should not only be on encouraging more people to get married, but also on removing barriers that put single patients at a disadvantage.
Pinheiro said this is also an opportunity for doctors to spend more time counseling patients who don't have internal support at home. Those who choose to remain single should build strong support networks, he said.
These networks are strongest when people step in to provide accountability, periodically check in on the situation, and help manage care when needed. DelFattore added that these relationships can be as strong as marital ones, he writes. CNN.
“A neighbor can really help you get into the shower,” DelFattore said. “There’s a much more intimate care … that’s not limited to just your spouse. Support outside of the marriage can be just as effective.”
