Assess emotional support through relationship quality, not a simple yes-or-no checklist
Better marriage quality is associated with better health, but the association is small, comparable to those involving habits such as diet. Judge quality through months together and actual disagreements. This chapter found no direct data showing that a bad marriage is worse for health than remaining unmarried.
What it takes
Free. Before marrying, observe several conflicts and several months together instead of simply matching attributes on a list. Resisting checklist judgments is the difficult part.
What you may gain
A meta-analysis of 126 studies and over 72,000 people associated higher marital quality with better health, with effect sizes r = 0.07–0.21. The correlation coefficient r describes how closely two things vary together: 0 means no relationship and 1 means perfect positive correspondence. The mortality association was r = 0.11 and cardiovascular reactivity during conflict r = −0.13. These magnitudes resemble associations between health behaviors such as diet and health. Studies explicitly testing sex differences generally found none. A cardiovascular review found significant effects of marital dissatisfaction and marital quality on cardiovascular risk.
Context & considerations
Disputed because the association is weak, some results show publication bias, and most studies are cross-sectional, preventing conclusions about causal direction. Robles explicitly lists these limitations. This chapter found no meta-analysis directly comparing mortality in low-quality marriages with unmarried people. The claim that a bad marriage is worse than no marriage is therefore an inference, not a numerical finding.
Research & references
Robles TF, et al. (2014). Marital quality and health: a meta-analytic review. Psychol Bull 140(1):140–187. https://doi.org/10.1037/a0031859; Dhindsa DS, et al. (2020). Marital status and outcomes in patients with cardiovascular disease. Trends Cardiovasc Med 30(4):215–220. https://doi.org/10.1016/j.tcm.2019.05.012