In Sickness and In Health

Just two weeks ago, the US Supreme Court struck down the Defense of Marriage Act, which barred federal recognition of same-sex marriages even if they took place in one of the 13 states or in the federal district where such weddings are legal. In a 5–4 decision, the Court ruled that key sections of the Act were unconstitutional because they deprived same-sex couples of liberties protected by the Fifth Amendment.

The Defense of Marriage Act, or DOMA as it is colloquially known, was passed in 1996 when it appeared that Hawai’i was about to legalize same-sex unions. Fearing that other states would be forced to recognize those marriages, Republican and Democratic politicians alike quickly and overwhelmingly voted to limit the federal definition of marriage to unions of heterosexual couples. The Act also allowed states to refuse to recognize same-sex marriages granted in other states.

Despite Congressional haste in passing DOMA, same-sex marriage did not become legal in the US until nearly eight years later. In May of 2004, Massachusetts became the first state to allow such unions. So it was only then that the law’s effects became apparent. Specifically, the federal government provides nearly 1,200 different rights, benefits or privileges to married couples, including health insurance, pension and disability benefits, financial aid, immigration status, and survivor benefits. Until last month, these rights, benefits and privileges were denied to same-sex married couples.

One thing that supporters and opponents of legalizing same-sex marriage can agree on is this: the institution of marriage matters. The federal rights, benefits and privileges denied to same-sex couples until last month are important. Should I need to, my husband of 5 days – yes, I got married this past Saturday and yes, I married a dude – can be put on my health insurance plan without my paying a financial penalty. Should I be confined to a nursing home or long-term care facility in my later years, he will also have full visitation rights. And when I die, he will inherit my albeit-meager estate without being forced to pay inheritance taxes.

But getting married has benefits that go above and beyond what the government offers. For instance, married couples tend to be happier. A recent survey of nearly 100,000 couples found that getting married had a greater positive effect on individual happiness and wellbeing than religious faith, a stable job, or having children. On average, married people were happier than those who are cohabitating, single, divorced or widowed.

Other studies have found a strong correlation between marriage and mental and physical health. People who never marry are far more likely to die at a younger age. They are also more likely to suffer from cardiovascular disease, diabetes, cancer, long-term illness and disability, mental illness or substance abuse. This is true even for couples that live together for a long time but never marry. Cohabitating couples don’t see the same health benefits as those who wed. There’s just something about being married.

There are any number of reasons to explain why this may be the case.  For example, married couples tend to have greater economic and financial stability, which is not only less stressful but enables them to eat better and see a doctor regularly. Because most health insurance plans cover spouses, marriage increases the likelihood of having insurance. It also reduces the likelihood of becoming uninsured after a job loss or other major catastrophic event. Finally, married couples have higher levels of social support, both within the relationship itself and from family and friends. This may encourage them to make healthier choices, but also provide a mental and emotional buffer when dealing with personal challenges.

Of course, correlation is not causation. Moreover, it’s the quality of the relationship that matters. A troubled or tumultuous marriage can adversely affect the wellbeing of those within it; it’s no misnomer to call these relationships ‘unhealthy’.  For most of us, however, marriage is likely to lead to better health and a longer life.

Most of us marry for love, some of us marry for money, and still others marry for a variety of personal and family reasons. I got married because I love my husband and because I want my friends, family and the rest of society to recognize that commitment. I didn’t get married for the government benefits. Nor did I get married for the boost to my health. That’s just an added bonus and, since I want to spend the rest of my life with the man of my dreams, gives me that many more years to enjoy his company.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on July 11, 2013. It is also available on the WAMC website.]

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About Sean Philpott-Jones

A public health researcher and ethicist by training, Sean holds advanced degrees in microbiology, medical anthropology, and bioethics. He is currently Chair of the Bioethics Department at Clarkson University's Capital Region Campus and Director of the Bioethics Program of Clarkson University-Icahn School of Medicine at Mount Sinai, and Director of two Fogarty-funded programs to provide research ethics education in Eastern Europe and in the Caribbean Basin. Until his term expired in August 2012, he served as Chair of the US Environmental Protection Agency’s Human Studies Review Board, an advisory panel that reviews the scientific and ethical aspects of research involving human participants submitted to the EPA for regulatory purposes.
This entry was posted in Discrimination, Health Care, Homosexuality, Mental Health, Policy, Politics, Public Health. Bookmark the permalink.

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