Marriage and Women's Health in Japan
| Date | 01 June 2016 |
| DOI | http://doi.org/10.1111/jomf.12298 |
| Published date | 01 June 2016 |
| Author | James M. Raymo,Sojung Lim |
S L Utah State University
J M. R University of Wisconsin–Madison∗
Marriage and Women’s Health in Japan
In this study, we evaluate alternative hypotheses
about the potentially harmful or benecial
effects of marriage on women’s health and
examine the factors underlying observed rela-
tionships between marriage and health. Using
data from the Japanese Panel Survey of Con-
sumers, an annual survey of a nationally
representative sample of Japanese women
(N=1,610), our study advances current schol-
arship on marriage and health by focusing on
a context characterized by a high degree of
gender inequality. Results from models employ-
ing different approaches to the potential role
of health-related selection into marriage con-
sistently indicate that marriage is associated
with better mental and physical health and that
the lower levels of employment among married
women play an important role in explaining this
relationship. Our ndings highlight the impor-
tance of considering how the specic pathways
linking marriage and health may vary across
societies with different gender and institutional
contexts.
Theories of “his and her marriage” and views
of marriage as a patriarchal institution harmful
to women’s health have a long and inuential
history in sociology (e.g., Bernard, 1972/1982;
Department of Sociology, Utah State University, 0730 Old
Main Hill, Logan, UT 84322-0730 (sojung.lim@usu.edu).
∗Center for Demography and Ecology, Universityof
Wisconsin–Madison, 1180 Observatory Drive,Madison,
WI 53706.
This article was edited by Linda Waite.
Key Words: gender,health, Japan, marriage, second shift.
Gove & Tudor, 1973). However, empirical
studies have consistently demonstrated that
marriage is associated with better health for
both men and women (see Carr & Springer,
2010, and Wood, Goesling, & Avellar, 2007,
for reviews). Explanations for this gap between
theory and empirical evidence include the
institutionalized benets of marriage (Waite,
1995), health-related selection into marriage
(Wood et al., 2007), and the increasingly egal-
itarian nature of marriage in the United States
(Williams, 2003). An important limitation
of most previous research on marriage and
women’s health is its focus on the United States
and other Western countries (Kaplan & Kron-
ick, 2006; Manzoli, Villari, Pirone, & Boccia,
2007; Weissman et al., 1996). The substantial
changes in gender attitudes and relations that
these countries have experienced in recent
decades (e.g., Liu & Umberson, 2008) raise
questions about whether the documented health
benets of marriage are generalizable to more
gender-inegalitarian societies.
We address this limitation by examining how
marriage is associated with women’s health
in Japan, one of the most gender-inegalitarian
wealthy countries (World Economic Forum,
2014). Our primary goal is to evaluate two
alternative hypotheses: (a) marriage is bad for
women’s health as suggested by earlier theories
of “his and her marriage,” and (b) marriage is
good for women’s health as suggested by recent
research on the United States and other Western
societies. On the one hand, pervasive gender
inequality (Brinton, 2001) suggests that Japan
is one contemporary society in which marriage
may be detrimental to women’s health. On the
other hand, the institutionalized advantages of
780 Journal of Marriage and Family 78 (June 2016): 780–796
DOI:10.1111/jomf.12298
Marriage and Women’s Health in Japan 781
marriage, including greater access to economic
resources and emotional and social support
(Cherlin, 2004; Waite & Gallagher,2000; Wood
et al., 2007), may play a particularly important
role in enhancing women’s health in a society
like Japan, where alternatives to marriage are
limited and economic independence is dif-
cult for women to achieve (Brinton, 2001;
Ogasawara, 1998; Yu, 2009).
A second goal is to examine factors that
contribute to the observed relationships between
marriage and women’s health. Understanding
why marriage is associated with better or worse
health in a gender-inegalitarian society like
Japan is important to be able to modify and
extend existing theory in ways that allow for
contextual specicity. To this end, we analyze
longitudinal data collected between 1993 and
2002 and make explicit efforts to account for the
potential endogeneity of marriage and health by
comparing the results of three different model
specications: (a) simple cross-sectional models
of health, (b) panel models that include lagged
health, and (c) xed-effects models that control
for time-invariant, unobserved characteristics.
This analytical approach will help us evalu-
ate the extent to which observed relationships
between marriage and women’s health reect
the inuence of marriage on health rather than
health-related selection into marriage. Our
ndings shed new light on long-standing ques-
tions about the impact of gender-inegalitarian
marriage on women’s health and contribute to
our understanding of variation in the health
benets of marriage across different social
contexts.
B
Previous Research on Marriage and Health
In the years since Bernard (1972/1982) depicted
marriage as an institution detrimental to
women’s mental health, numerous studies
have examined the health implications of mar-
riage. Early scholarship suggested that the
implications of marriage for health differ by
gender (e.g., Gove & Tudor, 1973), but the
cumulative body of empirical evidence clearly
suggests that both men and women drive health
benets from marriage. The health benets of
marriage are not limited to mental health (the
main focus of Bernard’s study), but also include
a broad range of physical health outcomes,
including mortality (Murray, 2000), self-rated
health status (Williams & Umberson, 2004),
chronic health conditions (e.g., heart disease,
hypertension), and physical functioning (e.g.,
Prigerson, Maciejewski, & Rosenheck, 2000).
Evidence that marriage is associated with both
mental and physical health is not surprising
given that different dimensions of health often
share common causes and affect each other
(Bruce & Leaf, 1989; Ross, Mirowski, &
Goldsteen, 1990).
Family scholars have proposed several expla-
nations for the observed health benets of
marriage. First, as a social institution, marriage
provides rights and responsibilities that are
reinforced by normative and legal structures
(Cherlin, 2004). Second, marriage is eco-
nomically benecial, providing economies of
scale, higher household income, and a higher
likelihood of home ownership (Waite, 1995).
Third, marriage may enhance health via the
social support provided by spouses (e.g., House,
Umberson, & Landis, 1988), an increased sense
of meaning and purpose in life, and the multiple
social roles associated with marriage (e.g.,
Burton, 1998). Fourth, married people are also
more likely than their unmarried counterparts
to engage in healthy behaviors, presumably as
a result of spousal monitoring that encourages
self-regulation (Umberson, 1992).
However, it is important to recognize that
a positive association between marriage and
health does not necessarily imply that marriage
is good for health if healthier individuals are
more likely to marry and to remain married
(Wood et al., 2007). The use of cross-sectional
data, and the failure to account for selection
into marriage, is thus considered a major lim-
itation of earlier studies (Waite & Gallagher,
2000). More recent studies employ longitudinal
data and statistical methods that account for
health-related selection into marriage (e.g.,
controlling for premarital health conditions,
estimating xed-effects models). These stud-
ies nd that, even after accounting for health
selection into and out of marriage, marriage
appears to confer health benets on both men
and women (Horwitz, White, & Howell-White,
1996; Marks & Lambert, 1998; Simon, 2002).
The relationship between marriage and health is
also robust to controls for several characteristics
related to both marriage and health. These
include age, a strong predictor of marriage that
is negatively associated with physical health and
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