Researchers say that although studies conducted in high income countries show that marriage is associated with a lower risk of death, they fail to account for other relationships that exist between men and women.
“The higher degree of social connections within a shared household environment that characterises conjugal relationships affords men and women greater protection against mortality.”
Authors, Journal of Epidemiology and Community Health
Using population-based data collected from 2001 to 2011 in KwaZulu-Natal, South Africa, researchers categorised rural dwellers as belonging to one of three groups — those without partners, partners living in the same household who they described as being in conjugal relationships and partners not living in the same household — and assessed their health outcomes.
The researchers say it is the first study conducted in Africa that links the influence of relationships — whether marital or not — to health outcomes.
Nuala McGrath, a co-author of the study and a senior epidemiologist at the Africa Centre for Health and Population Studies in South Africa, says her team recorded the relationships and marital statuses of 89,000 men and women, at least 20 years old.
For men living in the same households with their partners, their likelihood of dying was reduced by 38-66 per cent whereas for women their risk of dying was cut by 37–80 per cent, according to the study published in the Journal of Epidemiology and Community Health on 7 August.
The study explains: “The higher degree of social connections within a shared household environment that characterises conjugal relationships affords men and women greater protection against mortality [death].”
The findings imply that health interventions that target couples can be valuable in improving community health and offer a complementary approach to targeting individual men and women separately in such efforts as HIV counselling, chronic disease management, and support for couples experiencing ill-health, McGrath says.
She adds that the study is not advising people whether they should be in conjugal relationships or not but it highlights the importance of social connectedness in reducing deaths, noting that the study is relevant in Sub-Saharan Africa and elsewhere because being in a relationship is an important life process for people in all countries.
McGrath, who is also a professor of epidemiology and sexual health at the UK-based University of Southampton, says the finding that social connectedness can promote health outcomes is important for health practitioners and policy makers.
Estelle Sidze, an associate research scientist at the Kenya-headquartered African Population Health Research Center, who was not involved in the study, agrees and says the study has huge implications for marriage regulations and health policies in South Africa and other countries in Sub-Saharan Africa.
She tells SciDev.Net that some studies in countries such as Japan and the United States have shown that marriage status affects the risk of women and men having cardiovascular diseases, cancer, mental health issues and sexually transmitted diseases. But Sidze explains that the findings of such studies, including the new one conducted in South Africa, could be linked to self-selection such as healthy people being more likely to marry than people with health problems.
She adds that many legislative bodies in African countries recognise consensual unions nowadays and provide room for full rights for both partners and children. “The emphasis should also be on cohabiting ‘under the same roof’ rules for protecting not only the legal and social rights of citizens but also their health,” she says.
It would be also interesting to include encouragements to marry or at least to have stable cohabiting relationships when counselling patients, especially those susceptible to cardiovascular diseases, which represent a growing threat to health in Africa, according to Sidze.
This article has been produced by SciDev.Net's Sub-Saharan Africa desk.