Jul 29, 2021

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Men – if you are unhappy with your marriage, you should do all you can to fix it if you’re interest in living longer. Researchers at Tel Aviv University (TAU), basing themselves on extensive health data from more than 30 years of research that tracked the deaths of 10,000 Israeli men, have found that dissatisfaction with marriage is a predictor of strokes in particular and premature death from a variety of causes in general – as much as physical indexes, including smoking and a sedentary lifestyle.

According to the findings, just published in the Journal of Clinical Medicine under the title “Dissatisfaction with Married Life in Men Is Related to Increased Stroke and All-Cause Mortality,” the risk is higher among relatively young men aged 50 and under.

The study was led by researchers from TAU’s School of Public Health at the Sackler Faculty of Medicine – Prof. Uri Goldbort from the department of epidemiology and preventive medicine who initiated and managed the long-term study; Dr. Shahar Lev-Ari, the head of the department of health promotion; and Dr. Yiftah Gapner of the department of epidemiology and preventive medicine. 


As part of the study, the researchers conducted statistical analyses of a database that started gathering data in the 1960s and – for 32 years –

tracked the health and behavior of 10,000 men, all Israeli state employees, with special attention paid to death from strokes and premature death in general. 

At the beginning of the study, most of the participants were in their 40s. Since then, 64% died from a range of illnesses. “We wanted to analyze the data gathered longitudinally using various parameters to identify behavioral and psychosocial risk factors that can predict death from a stroke (CVA or cerebrovascular accident) and premature death for any reason,” explained Lev-Ari, who obtained his master’s degree in TAU’s pharmacology and physiology department and subsequently earned his doctorate at the Sackler Faculty of Medicine. 


Lev-Ari then established the herbal medicine and cancer research lab at the oncology institute at Tel Aviv Sourasky medical center. He was appointed as director of Center of Complementary and Integrative Medicine there. In 2009, he joined the Faculty of Medicine.


The researchers say that, early in the 32-year-long study, participants in the longitudinal study were asked to rank their level of marriage satisfaction on a scale of 1 (marriage is very successful) to 4 (marriage is unsuccessful). 


To the researchers’ surprise, the analysis showed that this scale was a predictive factor relating to life expectancy, very similar to smoking and lack of physical activity. For example, the number of deceased from a stroke was 69% higher among those who ranked their marriage satisfaction at 4 (whose marriage is unsuccessful) compared to those who ranked their marriage satisfaction very highly – 40.6 dead among the very dissatisfied versus 24.0 among the very satisfied. The statistical comparison conducted over 30 years referred to the rate per 10,000 person-years 


When it came to death from any cause, the gap was 19% in favor of the happily married. The data show that while among the unhappily married there were 295.3 deaths for any reason, among the very happily married there were only 248.5.  The researchers note that the gaps were even greater among men who were relatively young (under 50) at the beginning of the study. 


In addition, the researchers conducted a statistical analysis of all known risk factors contributing to death from cardiovascular diseases, such as diabetes, hypertension, excessive BMI, and socioeconomic status. Here, too, the data was highly surprising. It turns out that the relative risk for death for any reason among the unhappily married versus the happily married was 1.21 higher among those dissatisfied with their marriages. This rate is similar to data in the literature regarding smokers and those leading a sedentary life. 


“Our study shows that the quality of marriage and family life has health implications for life expectancy. Men who said they regarded their marriage as failure died younger than those who experienced their marriages as very successful. In other words, the level of satisfaction with marriage has emerged as a predictive factor for life expectancy at a rate comparable with smoking (smokers versus non-smokers) and physical activity (activity versus inactivity),” said Lev-Ari.


“Furthermore,” he added, “it’s important to note that we observed a higher risk among relatively young men under the age of 50. At a higher age, the gap is smaller, perhaps due to processes of adjustment that life partners go through over time. These findings were consistent with other studies that have shown the effectiveness of educational programs fostering good life partnerships as part of a national strategy to promote health and wellness for the public at large.”


Whether women who have unsatisfactory marriages were also at higher risk of a stroke or premature death was not mentioned.