Health Status and Transitions in Cohabiting Relationships of American Young Adults

DOIhttp://doi.org/10.1111/jomf.12572
Published date01 August 2019
Date01 August 2019
AuthorBrandon Wagner
B W Texas Tech University
Health Status and Transitions in Cohabiting
Relationships of American Young Adults
Objective: This study examines whether individ-
ual health predicts cohabiters’ union transitions
to marriage in American young adults.
Background: Associations between health
and subsequent marital transitions are well
documented, but less is known about how health
inuences transitions of cohabiting relation-
ships. As cohabitation has become a common
relationship experience, understanding how
health may inuence cohabiters’ union transi-
tions is an important component of how health
shapes relationship exposures more broadly.
Method: Data were taken from Waves III and IV
of the National Longitudinal Study of Adolescent
to Adult Health, including the supplemental col-
lection of relationship partners conducted dur-
ing Wave III. Competing-risk regressions for the
transition of cohabiting unions to marriage were
estimated in two samples: individuals and a
smaller sample of cohabiting couples with infor-
mation from both partners.
Results: Healthier cohabiters are more likely
to marry than are their less healthy counter-
parts, but only women’s health is signicantly
associated with the transition to marriage. In
the dyadic sample with information from both
partners, the signicant association between
the female partner’s health and the transition
Department of Sociology, Anthropology,and Social Work,
TexasTech University, 63 Holden Hall, Lubbock, TX 79409
(brandon.wagner@ttu.edu).
Key Words: cohabitation, demography, health, marriage,
transitions, young adulthood.
to marriage is robust to male partner character-
istics, including health.
Conclusion: Health is an important predictor
of cohabitation transitions in early adulthood,
but these transitions may only be sensitive to the
female partner’s health.
A long line of research has shown that health pre-
dicts marriage: when compared with their less
healthy counterparts, healthy people are more
likely to marry (Averett, Argys,& Sorkin, 2013;
Fu & Goldman, 1996; Goldman, 1993; Lipow-
icz, 2014; Mastekaasa, 1992; Waldron, Hughes,
& Brooks, 1996) and stay married (Joung, van
de Mheen, Stronks, van Poppel, & Mackenbach,
1998; Karraker & Latham, 2015; Teachman,
2010; Wilson & Waddoups, 2002). Neverthe-
less, this dichotomy of married and unmarried
individuals neglects the normalization of cohab-
itation and the ways that widespread cohabita-
tion have changed the landscape of relationship
development. Despite the increased prevalence
of cohabitation (Copen, Daniels, & Mosher,
2013), no work to date has specically examined
whether and for whom health status inuences a
cohabitation’s transition to marriage.
This empirical uncertainty matches the uncer-
tain expectations for the relationship between
health and cohabitation outcomes. On one hand,
existing explanations for health selection into
marriage suggest health may inuence the out-
come of cohabiting unions. Previous work has
suggested positive health selection into mar-
riage could arise from either a general preference
for healthier partners or an association between
health and other attractive behaviors (e.g., Fu
Journal of Marriage and Family 81 (August 2019): 847–862 847
DOI:10.1111/jomf.12572
848 Journal of Marriage and Family
& Goldman, 1996). Alternatively, health may
be positively associated with marriage because
less healthy cohabiters are more likely to expe-
rience relationship dissolution than are their
healthier counterparts. In marriage, poor spousal
health is associated with a higher likelihood
of divorce (Blekesaune & Barrett, 2005; Joung
et al., 1998; Waldron et al., 1996; Wilson &
Waddoups, 2002), and so it make sense to antic-
ipate a similar association in cohabitations. If
either process applied similarly to cohabiting
couples, we would anticipate that health is pos-
itively associated with the likelihood of transi-
tioning from cohabitation to marriage. However,
assuming we can generalize previous work to
cohabiting unions ignores the numerous differ-
ences that exist between marriage and cohab-
itation. For example, cohabiting relationships
may drift into marriage by “inertia” (Stanley,
Rhoades, & Markman, 2006), which could mean
that the transition to marriage is less sensitive
to health status for cohabiting rather than non-
residential partners. Individuals who choose to
cohabit are also different from those who do not
on a number of characteristics (Copen, Daniels,
Vespa, & Mosher, 2012; Goodwin, Mosher, &
Chandra, 2010). Another difference between
these groups could be how relevantthey see part-
ner health for future relationship decisions.
Thus, there remains an open question as to
whether health is associated with the transi-
tion to marriage for opposite sex cohabiters
and, if so, whether the association is specic
to either the male or female partner’s health.
Given the potential benets of marital status,
understanding the role of health in structuring
transitions to marriage provides insights into
how early life health disparities may result in or
recreate social stratication. In other words, if
health predicts transitioning from cohabitation
to marriage and marital status confers bene-
ts for individuals, then health selection into
marriage represents a potential mechanism by
which early life social disparities associated with
health are perpetuated into adulthood. Toanswer
these questions, this study examines the rela-
tionship between self-reported health and transi-
tions in different-gender cohabitations of Amer-
ican young adults from the National Longi-
tudinal Study of Adolescent to Adult Health
(Add Health; http://www.cpc.unc.edu/projects/
addhealth).
B
Health and Marriage
Health disparities differentiate the accumulation
of advantages or disadvantages during the life
course. For example, healthier children acquire
more education (Case, Fertig, & Paxson, 2005;
Haas, 2006), accumulate more wealth (Haas,
2006), earn higher wages (Haas, 2006), and ulti-
mately attain a higher social class (Case et al.,
2005; Palloni, Milesi, White, & Turner, 2009)
than their less healthy counterparts. In addition
to these direct markers of social class, health
may indirectly stratify individuals by affect-
ing access to benecial environments, such
as marriage. By conditioning access to the
potential myriad benets ascribed to marital
status, the health of young adults may have
implications for social stratication processes
in America. Because health status conditions
exposure to benecial environments, including
marriage, researchers must “not just adjust or
correct for [health selection] but understand it
thoroughly” (Palloni, 2006, p. 596).
Despite its implications for social stratica-
tion, research on health selection has been pri-
marily motivated by attempts to estimate the
effect of marriage on health. That married indi-
viduals are healthier, on average, than their
unmarried counterparts (for a review, see Carr
& Springer, 2010) could arise from either an
effect of marriage or the selection of healthy
individuals into marriage. However, many have
argued that the effect of marriage on general
health is minor or nonexistent, either because
of methodological limitations in studies docu-
menting such an effect (for a review, see Wood,
Goesling, & Avellar, 2007) or because of lim-
ited evidence from studies addressing selection
into marriage (e.g., Tumin, 2018). An important
explanation for the association between mar-
riage and health then is health selection. This
selection of healthier individuals into marriage
could arise either because healthy individuals are
more likely to marry (Averett et al., 2013; Fu
& Goldman, 1996; Goldman, 1993; Lipowicz,
2014; Mastekaasa, 1992; Waldron et al., 1996),
less likely to divorce (Joung et al., 1998; Kar-
raker & Latham, 2015; Teachman, 2010; Wil-
son & Waddoups, 2002; cf. Charles & Stephens,
2004), or both.

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