Debra Umberson

Gender, marital status and the social control of health behavior☆

Mortality rates are lower for married individuals than they are for unmarried individuals, and marriage seems to be even more beneficial to men than women in this regard. A theoretical model of social integration and social control is developed to explain why this may occur. Drawing from this model, I hypothesize that marriage may be beneficial to health because many spouses monitor and attempt to control their spouses health behaviors. Furthermore, the provision, receipt, and consequences of these social control efforts may vary for men and women. These hypotheses are considered with analysis of a national panel survey conducted in 1986 (N = 3617) and 1989 (N = 2867). Results show that: (1) marriage is associated with receipt of substantially more efforts to control health for men than women, (2) those who attempt to control the health of others are more likely to be female than male, (3) there is some support for the social control and health behavior hypothesis among the married, and (4) the transition from married to unmarried status is associated with an increase in negative health behavior while the transition from unmarried to married status seems to have little effect on health behavior. A theoretical explanation is developed to explain these marital status differences.

Family status and health behaviors: social control as a dimension of social integration.

Age-adjusted mortality rates are higher for the unmarried and nonparents than for the married and parents. The effects of marital and parental status on mortality are usually attributed to the positive effects of social integration or social support. The mechanisms by which social support or integration is linked to health outcomes, however, remain largely unexplored. One mechanism may involve health behaviors; the family relationships of marriage and parenting may provide external regulation and facilitate self-regulation of health behaviors which can affect health. The present study employs a national sample to examine the relationships of marital and parenting status to a variety of health behaviors. Results indicate that marriage and presence of children in the home have a deterrent effect on negative health behaviors. It is suggested, within the theoretical framework of social integration, that family roles promote social control of health behaviors which affect subsequent mortality.

Social Relationships and Health A Flashpoint for Health Policy

Social relationships—both quantity and quality—affect mental health, health behavior, physical health, and mortality risk. Sociologists have played a central role in establishing the link between social relationships and health outcomes, identifying explanations for this link, and discovering social variation (e.g., by gender and race) at the population level. Studies show that social relationships have short- and long-term effects on health, for better and for worse, and that these effects emerge in childhood and cascade throughout life to foster cumulative advantage or disadvantage in health. This article describes key research themes in the study of social relationships and health, and it highlights policy implications suggested by this research.

Marital status, marital transitions, and health: a gendered life course perspective.

We work from a life course perspective to assess the impact of marital status and marital transitions on subsequent changes in the self-assessed physical health of men and women. Our results suggest three central conclusions regarding the association of marital status and marital transitions with self-assessed health. First, marital status differences in health appear to reflect the strains of marital dissolution more than they reflect any benefits of marriage. Second, the strains of marital dissolution undermine the self-assessed health of men but not women. Finally, life course stage is as important as gender in moderating the effects of marital status and marital transitions on health.

The effect of social relationships on psychological well-being: Are men and women really so different?

We assess evidence for gender differences across a range of relationships and consider whether the form and quality of these relationships affect the psychological functioning of men and women differently. Data from a national panel survey provide consistent evidence that mens and womens relationships differ. However, we find little evidence for the theoretical argument that women are more psychologically reactive than men to the quality of their relationships : Supportive relationships are associated with low levels of psychological distress, while strained relationships are associated with high levels of distress for women and for men. However, if women did not have higher levels of social involvement than men, they would exhibit even higher levels of distress relative to men than they currently do. We find little evidence for the assertion that men and women react to strained relationships in gender-specific ways-for example, with alcohol consumption versus depression

Widowhood and depression: explaining long-term gender differences in vulnerability.

Results from a 1986 national survey (N = 3,614) show that having ever been widowed is associated with current levels of depression and that this association is greater for men than women. Some of this apparent gender difference occurs because men have been widowed for a shorter average period of time than women and the effects of widowhood appear to lessen over time. Widowhood also is associated with different types and amounts of life strain for men and women. The results suggest that the primary mechanism linking widowhood to depression among women is financial strain. Among men, the more critical mechanisms seem to be strains associated with household management. When specific strains occur, they appear to have different effects on respondents who have ever been widowed and those who have not. Taken together, these results suggest that what appears on the surface to be a gender difference in vulnerability to the same life event turns out upon closer examination to occur because widowhood does not affect men and women in the same way.

You Make Me Sick: Marital Quality and Health Over the Life Course*

We work from a life course perspective and identify several reasons to expect age and gender differences in the link between marital quality and health. We present growth curve evidence from a national longitudinal survey to show that marital strain accelerates the typical decline in self-rated health that occurs over time and that this adverse effect is greater at older ages. These findings fit with recent theoretical work on cumulative adversity in that marital strain seems to have a cumulative effect on health over time—an effect that produces increasing vulnerability to marital strain with age. Contrary to expectations, marital quality seems to affect the health of men and women in similar ways across the life course.

GENDERING VIOLENCE Masculinity and Power in Men's Accounts of Domestic Violence

This article examines the construction of gender within mens accounts of domestic violence. Analyses of in-depth interviews conducted with 33 domestically violent heterosexual men indicate that these batterers used diverse strategies to present themselves as nonviolent, capable, and rational men. Respondents performed gender by contrasting effectual male violence with ineffectual female violence, by claiming that female partners were responsible for the violence in their relationships and by constructing men as victims of a biased criminal justice system. This study suggests that violence against female partners is a means by which batterers reproduce a binary framework of gender.

The Times They Are a Changin': Marital Status and Health Differentials from 1972 to 2003∗:

Although the meanings and rates of being married, divorced, separated, never-married, and widowed have changed significantly over the past several decades, we know very little about historical trends in the relationship between marital status and health. Our analysis of pooled data from the National Health Interview Survey from 1972 to 2003 shows that the self-rated health of the never-married has improved over the past three decades. Moreover, the gap between the married and the never married has steadily converged over time for men but not for women. In contrast, the self-rated health of the widowed, divorced, and separated worsened over time relative to the married, and the adverse effects of marital dissolution have increased more for women than for men. Our findings highlight the importance of social change in shaping the impact of marital status on self-reported health and challenge long-held assumptions about gender, marital status, and health.

Parenthood and Psychological Well-Being: Theory, Measurement, and Stage in the Family Life Course

There are theoretical foundations in sociology for two seemingly incompatible positions: (1) children should have a strong negative impact on the psychological well-being of parents and (2) children should have a strong positive impact on the psychological well-being of parents. Most empirical analyses yield only a modest relationship between parenthood and psychological well-being. Usually, but not always, it is negative. In this study we consider the relationship between parental status and several dimensions of psychological well-being. Our analysis is based on data from a large national survey. It suggests that children have positive and negative effects on the psychological well-being of parents. The balance of positive and negative effects associated with parenthood depends on residential status of the child, age of youngest child, marital status of the parent, and the particular dimension of psychological well-being examined. When compared with nonparents, parents with children in the home have low levels of affective well-being and satisfaction, and high levels of life-meaning; parents with adult children living away from home have high levels of affective well-being, satisfaction, and life-meaning. The widowed appear to benefit most from parenthood and the divorced appear to experience the greatest costs.