Spousal concordance in health behavior change

Being a good role model can truly help a spouse to adopt a healthy lifestyle.

When one spouse quits smoking or drinking, gets a cholesterol screening or rolls up a sleeve for a flu shot, the other spouse is more likely to follow suit, according to a new study published in the journal Health Services Research .

“We consistently find that when one spouse improves his or her behavior, the other spouse is likely to do so as well,” said study co-author Tracy Falba, Ph.D.

“It isn't clear which spouse drives the change, but it is clear that these things happen together,” said Falba, a visiting assistant professor in Duke University's Center for Health Policy, Law and Management.

The study found that a spouse's influence differed depending on the health behavior. The sway of the positive role model was strongest when it came to smoking and drinking and weaker for things like getting more vigorous exercise and having a cholesterol test.

In the case of flu shots, a spouse's influence can be “quite striking,” Falba said. Husbands whose wives start getting the yearly shot have a 60 percent likelihood of getting the shot themselves, compared with a 21 percent likelihood among husbands whose wives do not get the shot.

Many studies have shown that a spouse's habits — and sometimes even marriage itself — can influence individual health behaviors. A 2006 study from researchers at Northwestern University found that marriage tends to make young men and women “clean up their act” and indulge in less binge drinking and marijuana use.

Unlike some previous research on positive health behavior, the new study tracked changes in both spouses at the same time.

The findings could point toward a new strategy for doctors looking to improve the health of married patients, Falba said.

“For example, interventions to increase exercise or reduce abusive drinking might provide explicit tips about how to get the spouse involved in exercise or how to get the spouse to help reduce drinking cues in the couple's lives,” Falba said.

The study was supported by the Robert Wood Johnson Foundation and the National Institute on Aging.

Health Services Research is the official journal of AcademyHealth and is published by Blackwell Publishing on behalf of the Health Research and Educational Trust. Contact Jennifer Shaw, HSR Business Manager, at (312) 422-2646 or [email protected]. HSR is available online at http://www.blackwell-synergy.com/loi/hesr.

Falba TA, Sindelar JL. Spousal concordance in health behavior change. Health Services Research online, 2007.