HEALTH BEHAVIORS EXPLAIN PART OF THE DIFFERENCES IN SELF-REPORTED HEALTH ASSOCIATED WITH PARTNER MARITAL-STATUS IN THE NETHERLANDS

Study objective - To describe the differences in health behaviours in disparate marital status groups and to estimate the extent to which these can explain differences in health associated with marital status. Design - Baseline data of a prospective cohort study were used. Directly age standardised percentages of each marital group that engaged in each of the following behaviours - smoking, alcohol consumption, coffee consumption, breakfast, leisure exercise, and body mass index - were computed. Multiple logistic regression models were fitted to estimate the health differences associated with marital status with and without control for differences in health behaviours. Setting - The population of the city of Eindhoven and surrounding municipalities (mixed urban-rural area) in The Netherlands in March 1991. Participants - There were 16 311 men and women, aged 25-74 years, and of Dutch nationality. Main Results - There were differences in relation to marital status for each health behaviour. Married people were more likely to practise positive health behaviours (such as exercise and eating breakfast) and less likely to engage in negative ones (such as smoking or drinking heavily) than the other groups. Control for all six health behaviours could explain an average of 20-36% of the differences in perceived and general health and subjective health complaints. Conclusions - Differences in health behaviours explained a considerable amount, but not all, of the health differences related to marital status. Longitudinal data are necessary to confirm these findings; to determine whether the differences in health behaviours related to marital status are caused by selection effects or social causation effects; and to learn how social control, social support, and stress inter-relate to reinforce negative or to maintain positive health behaviours.