“In sickness and in health.”

Happier marriages make for healthier spouses, whether they’re still honeymooning or they’re approaching their golden wedding anniversary.

So says a new study that examined the marriages of 1,681 people over the course of 20 years, the longest timeframe yet for observing how marital happiness – or its opposite – affects physical health.

The most detailed previous study on the connection between health and marital quality covered an eight-year time frame.

Co-author Cody Hollist, a marriage and family therapy expert at UNL, says health and marital happiness go hand-in-hand, though it’s not clear which comes first.

Does a good marriage lead to good health? Does a bad marriage make you sick?

“There is no way to tease out what caused what,” he said. “But it is clear that marital quality and health run in tandem.”

That knowledge can aid medical doctors as well as marriage counselors, said Hollist, who is director of UNL’s Marriage and Family Therapy program.

Marriage-building activities like regular “date nights” with a spouse could help improve an ailing patient’s health, while easing physical maladies also could relieve a couple’s marriage problems.

Richard B. Miller of Brigham Young University was the study’s lead author. Other co-authors included Joseph Olsen of Brigham Young University and David Law of Utah State. They developed a growth curve analysis using nationwide data collected between 1980 and 2000 by Penn State researchers for federally funded research of the causes of marital instability. Led by Alan Booth, the Penn State effort involved detailed surveys (with more than 5,000 variables) of more than 2,000 married people at six points in time during the two-decade span.

Published in June’s Journal of Marriage and Family, the analysis by Hollist and his colleagues looked only at those participants who remained married to the same person.

To pinpoint aging’s health effects, they broke the group into two cohorts – those ages 18 to 39 at the start of the Booth study and those ages 40 to 55. They separately compared the upsides of a healthy marriage and the downsides of a troubled one.

Some of the findings:

• A strong connection between good health and marital happiness for both age groups.
• At the start, the younger group tended to have better health, but more marital problems and less happiness than the midlife group.
• The connection between increased marital happiness and improved health was particularly significant for the younger group.
• Decreases in marital problems over time were significantly linked to improved health for the midlife group.

“We wanted to compare the health trajectory with the happiness trajectory,” Hollist said. “As health worsens, do their marriages stay stable? What we found is that there’s a relationship between health and happiness for both age groups. If their health is good, their happiness is up.”

One surprising finding was that individuals who began the study with troubled marriages reported improved health as time passed.

One possible explanation: those people were resilient in the face of adversity.

“Stressful circumstances can be a wake-up call that motivates healthier and more adaptive pathways of behavior over time,” the study authors wrote.

On average, the younger group was 30 years old and had been married a little less than eight years at the study’s start. The older group’s average age was 46 and their average length of marriage nearly 22 years.

Marital happiness was measured through an 11-question scale that asked respondents how happy they were with various aspects of their relationship – such as whether their spouse understood them, did activities with them, agreed with them, and provided love and affection.

Marital problems were measured by 13 questions about how much the couple struggled with issues like jealousy, anger, financial irresponsibility and infidelity. Health status was measured by asking participants to rank their health as excellent, good, fair or poor.

The study’s findings diverged somewhat from those of a 2006 study that found older people in stressful marriages were at greater risk for health problems than younger people. The earlier study examined 1,059 married individuals over an eight-year time span. Those researchers suggested that the social support of a strong marriage helped protect people against the harmful effects of stress – while a troubled marriage can cause chronic stress that’s particularly harmful to aging people.

Hollist and his fellow researchers said the previous study involved an older cohort of people aged 70 or older.

“Our findings indicated no cohort differences between the younger and midlife cohorts which is consistent with the findings (of the previous researchers), who also found no differences between their 30-year-old and their 50-year-old cohorts.”