Physical health conditions and subsequent union separation: a couple-level register study on neurological conditions, heart and lung disease, and cancer

Abstract

BackgroundStudies that assess the role of physical health conditions on separation risk are scarce and mostly lack health information on both partners. It is unclear how the association between physical illness and separation risk varies by type of illness, gender of the ill spouse and age of the couple.MethodsWe used Finnish register data on 127 313 couples to examine how neurological conditions, heart and lung disease, and cancer are associated with separation risk. The data included information on medication, hospitalisations, separations and sociodemographic characteristics. Marital and non-marital cohabiting couples aged 40–70 years were followed from 1998 to 2003 for the onset of health conditions and subsequent separation, and Cox regression was used to examine the associations.ResultsCompared with healthy couples, the HR of separation was elevated by 43% for couples in which both spouses had a physical health condition, by 22% for couples in which only the male spouse had fallen ill, and by 11% for couples in which only the female had fallen ill. Among older couples, the associations between physical illness and separation risk were even clearer. The association with separation risk was strongest for neurological conditions, and after incidence of these conditions among males, separation risk increased over time. Adjustment for sociodemographic characteristics had little effect.ConclusionsOur findings suggest that poor health may largely strain relationships through disability and associated burden of spousal care, and this should be taken into consideration when planning support services for couples with physical health conditions.

Neurological conditions and subsequent divorce risk in the Nordic countries: the importance of gender and both spouses’ education

“…The effect sizes are similar to the findings of an earlier study among middle-aged Finnish marital and nonmarital couples. 9 A husband's illness is expected to result in more substantial losses in household income, 16 18 which may lead to the husband's illness having a stronger influence on divorce risk. 4 Some previous research supports this expectation, as work disability increased divorce risk among US middle-age men 18 but not women.…”

“…[3][4][5][6][7] However, there seems to be variation between illnesses. While register-based studies have not found an association between cancer and divorce risk, [8][9][10] other severe diseases such as multiple sclerosis (MS) and stroke, which often lead to functional disabilities, have been shown to increase union instability. [11][12][13] Neurological conditions are a major cause of disability in Europe 14 and the USA, 15 and a recent register-based study among Finnish middle-aged couples observed an increase in divorce risk following any neurological illness.…”

“…[11][12][13] Neurological conditions are a major cause of disability in Europe 14 and the USA, 15 and a recent register-based study among Finnish middle-aged couples observed an increase in divorce risk following any neurological illness. 9 Given the high prevalence of neurological conditions, the impact on union stability may be considerable at the population level. This effect might be mediated through multiple mechanisms, including changes in psychological distress, family responsibilities, participation in paid work and financial strain.…”

Union Status and Disability Pension

“…Syse and Kravdal ( 2007 ) reported no increased divorce rates following a cancer diagnosis, except among those diagnosed with testicular or cervical cancers, and Joung et al ( 1998 ) found a heightened risk of divorce only among those who reported having multiple subjective health complaints or chronic conditions. Research into sex differences in the link between health and later divorce has shown diverging results (Karraker & Latham, 2015 ; Lam et al, 2020 ; Metsa-Simola et al, 2021 ; Monden & Uunk, 2013 ; Teachman, 2010 ).…”

Coping target checklist for home‐based older adults living with disabilities and their spousal caregivers

“…Spousal caregivers have been found to report significantly poorer quality of life compared to adult children caregivers (Wu et al., 2021). When combined with the burden of caring for an older adult with a disability, this can lead to strained intimacy in the caregiving relationship (Metsä‐Simola & Einiö, 2020). Our previous study established a strong correlation between the quality of life of older adults living with disabilities and that of their spousal caregivers, indicating a closely interdependent relationship (Yang et al., 2023).…”