Marriage boosts survival following coronary artery bypass surgery

Married adults who undergo heart surgery are more than three times as likely as single people who have the same surgery to survive the next three months, a new study finds.

"That's a dramatic difference in survival rates for single people, during the most critical post-operative recovery period," says Ellen Idler, a sociologist at Emory University and lead author of the study, which appears in the March issue of the Journal of Health and Social Behavior. "We found that marriage boosted survival whether the patient was a man or a woman."

While the most striking difference in outcomes occurred during the first three months, the study showed that the strong protective effect of marriage continues for up to five years following coronary artery bypass surgery. Overall, the hazard of mortality is nearly twice as great for unmarried as it is for married patients about to undergo the surgery.

"The findings underscore the important role of spouses as caregivers during health crises," Idler says. "And husbands were apparently just as good at caregiving as wives."

Tying the knot has been associated with longer life since 1858, when William Farr observed that marriage protected against early mortality in France. The evidence keeps accumulating that the widowed, never married, and divorced have higher risks of mortality. Much of the research, however, has looked broadly across populations during an entire lifespan, or relies only on medical records.

"We wanted to zero in on a particular window of time: a major health crisis," Idler says, "and we wanted to add the in-person element of patient interviews, in addition to the full record of their medical history and hospitalization."

The major study involved more than 500 patients undergoing either emergency or elective coronary bypass surgery. All of the study subjects were interviewed prior to surgery. Data on survival status of the patients were obtained from the National Death Index.

While the data are inconclusive for what caused the striking difference in the three-month survival rate, the interviews provided some possible clues.

"The married patients had a more positive outlook going into the surgery, compared with the single patients," Idler says. "When asked whether they would be able to manage the pain and discomfort, or their worries about the surgery, those who had spouses were more likely to say, yes."

Patients who survived more than three months were approximately 70 percent more likely to die during the next five years if they were single. An analysis of the data showed that smoking history accounted for the lower survival rates in the single patients over this longer term.

"The lower likelihood that married persons were smokers suggests that spousal control over smoking behavior produces long-term health benefits," Idler says.

When it comes to healing hearts, marriage may be powerful medicine, but it's in increasingly short supply, Idler says, which does not bode well for aging baby boomers.

Barely half of U.S. adults are currently married, the lowest percentage ever, according to the Pew Research Center.