THE SCIENTIFIC CASE FOR MARRIAGE AND COUPLES EDUCATION IN HEALTH CARE

* Poor social relationships are as damaging to physical health as cigarette smoking . The mortality rates of individuals with poor social relationships are higher than those who smoke cigarettes for many years (House et al., 1988).

* For adults, a stable, happy marriage is the best protector against illness and premature death, and for children, such a marriage is the best source of emotional stability and good physical health . Decades of research have clearly established these links (Burman & Margolin, 1992; Dawson, 1991; Verbrugge, 1979).

* Marital distress is an important health hazard for adults and children. Marital distress leads to depression and reduces immune system functioning in adults. In addition, chronic marital conflict harms the emotional and physical well-being of children (Emery, 1982; Gottman & Katz, 1989; Kiecolt-Glaser et al., 1993).

* Divorce is a major health risk for American adults and children. In addition to well-established links between divorce and mental health problems, adults who experience divorce more than double their risk of earlier mortality. And children who experience a parental divorce have their life expectancy shortened by an average of four years, according to a fifty-year longitudinal study (Dawson, 1991; Cherlin et al., 1991; Doherty & Needle, 1991; Tucker et al., 1996; Schwartz et al., 1995). These effects are comparable to those of cigarette smoking.

* Marriage education is effective in promoting marital quality and stability. Well-researched marriage education programs have demonstrated that brief, skills-based educational programs for couples increase couple satisfaction, improve communication skills, reduce negative conflict behaviors including violence, and may prevent separation and divorce (Markman et al., 1993; Wampler, 1990).

REFERENCES

Burman, B., & Margolin, G. (1992). Analysis of the association between marital relationships and health problems: An interactional perspective. Psychological Bulletin, 112 , 39-63.

Cherlin, A.J., Furstenberg, F.F. et al. (1991). Longitudinal studies of effects of divorce on children in Great Britain and the United States. Science, 252 , 1386-1389.

Dawson, D.A. (1991). Family structure and children's health and well-being: Data from the 1988 National Health Interview Survey on Child Health. Journal of Marriage and the Family, 53 , 573-584.

Doherty, W.J., & Needle, R.H. (1991). Psychological adjustment and substance use among adolescents before and after a parental divorce. Child Development, 62 , 328-337.

Emery, R.E. (1988). Marriage, divorce, and children's adjustment. Newbury Park, CA: Sage Publications.

Gottman, J.M., & Katz, L.F. (1989). Effects of marital discord on young children's peer interruption and health. Developmental Psychology, 25 , 373-381.

House, J.S., Landis, K.R., & Umberson, D. (1988). Social relationships and health. Science, 241 , 540-544.

Kiecolt-Glaser, J.F., Malarkey, W.B., et al. (1993). Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine, 55 , 395-409.

Markman, H.J., Renick, M.J. et al. (1993). Preventing marital distress through communication and conflict management training: A 4-and 5-year follow-up. Journal of Consulting and Clinical Psychology, 61 , 70-77.

Schwartz, J.E., Friedman, H.S., et al. (1995). Sociodemographic and psychosocial factors in childhood as predictors of adult mortality. American Journal of Public Health, 85 , 1237-1245.

Tucker, J.S., Friedman, H.S., et al. (1996). Marital history at midlife as a predictor of longevity: Alternative explanations to the protective effect of marriage. Health Psychology, 15 , 94-101.

Verbrugge, L.M. (1979). Marital status and health. Journal of Marriage and the Family, 41 , 267-285.

Wampler, K.S. (1990). An update of research on the Couple Communication Program. Family Science Review, 3 , 21-40.