Saturday, February 12, 2005

Marriage Penalty?

BrooklynDodger noted this huge and decidedly peculiar study of 80,000 women in relation to life transitions.

Compared with women who remained married, women who divorced/widowed lost weight. Compared with women who remained unmarried, women who remarried gained weight. Women who divorced increased physical activity compared with women who stayed married. Among non-smokers and past smokers, women who divorced/widowed had more than a twofold increased risk of relapsing/starting smoking than women who stayed married. Divorced and widowed women had decreased vegetable intake relative to women who stayed married.

So BrooklynDodger concludes that women who lose or get rid of their guy start smoking, eat less vegetables, exercise more and lose weight. The Dodger thinks this sounds like going out on the town partying. Definitely “Sex in the City.” There’s literature that smoking helps weight control. The Dodger wonders at the biological plausibility of finding that marriage leads to weight gain.

Another thought. The latest front of the CDC-corporate blame the victim campaign is obesity. BrooklynDodger thinks this is an early salvo aimed at denying health care and health insurance to "guilty victims" of illness, in this case people who are heavy. In this study, marriage [actually remarriage] causes weight gain in women, which moves opposite to the notion of marriage as protective.

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International Journal of Epidemiology 2005 34(1):69-78; doi:10.1093/ije/dyh258
Effects of marital transitions on changes in dietary and other health behaviours in US women

Sunmin Lee1,2, Eunyoung Cho1, Francine Grodstein1,3, Ichiro Kawachi1,2,4, Frank B Hu1,5 and Graham A Colditz1,3,6

1 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA2 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA3 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA4 Harvard Center for Society and Health, Boston, MA, USA5 Department of Nutrition, Harvard School of Public Health, Boston, MA, USA6 Harvard Center for Cancer Prevention, Boston, MA, USA
Correspondence: Sunmin Lee, 33 Pond Avenue, 708, Brookline, MA 02445, USA. E-mail : slee@hsph.harvard.edu

Background Previous studies have indicated that married people have lower mortality and are generally healthier. Most previous studies have been cross-sectional and few studies investigated the effect of marital transition on health. With a prospective design and repeated measures of variables, we sought to analyse the temporal relation between marital transition and change in health behaviours.

Methods We followed up 80 944 women aged 46–71 for 4 years (1992–1996). All information was self-reported. We used multivariate-adjusted linear and logistic regression models to examine the impact of changes in marital status on concomitant changes in health behaviours, controlling for potential confounders and baseline health behaviours.

Results Compared with women who remained married, women who divorced/widowed had body mass index (BMI) decreases of 0.65 kg/m2 (P < 0.001) and 0.44 kg/m2 (P < 0.001), respectively. Compared with women who remained unmarried, women who remarried had an increase in mean BMI of 0.41 kg/m2 (P < 0.001). Women who divorced increased physical activity by 1.23 metabolic equivalent hours (MET)/week (P = 0.07) compared with women who stayed married. Among non-smokers and past smokers, women who divorced/widowed had more than a twofold increased risk of relapsing/starting smoking (OR = 2.47, 95% CI: 1.56, 3.89; OR = 2.08, 95% CI: 1.56, 2.76, respectively) than women who stayed married. Divorced and widowed women had decreased vegetable intake relative to women who stayed married (–2.93 servings/week [P < 0.001] and –1.67 servings/week [P < 0.001], respectively).
Conclusions These patterns suggest both health-damaging and health-promoting changes accompanying divorce and widowhood, and generally health-promoting changes following remarriage.

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