August 3rd, 2009
06:15 PM ET

Fighting divorce: An endemic public health crisis

By Akash Goel
CNN Medical intern

New research contradicts the age-old adage, "'Tis better to have loved and lost, than never to have loved at all."

A study, “Marital Biography and Health at Mid-Life” appearing in the September issue of the Journal of Health and Social Behavior found that the middle-aged divorced or widowed have 20 percent more chronic health conditions such as heart disease and diabetes and 23 percent more mobility limitations such as difficulty climbing stairs.

While it may seem odd to think of it as such, divorce can be viewed as a public health crisis with national rates estimated by the Centers for Disease Control and Prevention to be nearly 50 percent nationally.

A large field of research suggests that people who are in close, social relationships are healthier. When marriages are functional, they are perhaps the ideal form of social and emotional support. When marriages fail, however, these mental health bedrocks crumble (among other parts of your life.)

Kristi Williams, a professor of sociology at Ohio State University, believes changes in societal perceptions of the idea of marriage are influencing rising divorce rates.

"We've come to view marriage as a source of individual satisfaction whereas in the past marriage was viewed largely as an institution that was necessary in order to raise a family," she says. "When that goes away, it is much easier to dissolve the marriage."

Tal Ben-Shahar, positive psychologist and former Harvard professor, argues instead that we're philosophically less committed to relationships.

"In the past, people stayed together even when they were not happy together — for religious reasons, because of convention, or because they had no real choice," he says, "Today, both men and women have more choice, and it’s more acceptable to divorce — hence easier. And when they face challenges in their relationships, instead of dealing with these challenges, they opt to leave."

Williams suggests that many studies have linked poor marriage quality to poor health outcomes, and thus improving marriage quality should be a worthy public health pursuit.

One example of this is the Department of Health and Human Services’ support of the “Healthy Marriage Initiative,” which provides $150 million each year towards relationship education to help strengthen families.

However on an individual level, one of the most important things we can do to ensure a successful marriage according to Ben Shahar, is learn how to handle gridlock: a term coined by sex therapist David Schnarch that refers to the point at which couples feel stuck in a conflict surrounding issues of children, in-laws, money, or sex and see no way out. While gridlock is often the tipping point leading to divorce, Schnarch believes we should embrace these "the drive wheels and grind stones of intimate relationships" as essential stepping stones towards realizing a successful marriage.

"Marriage operates at much greater intensity and pressure than we expect," Schnarch writes, "so great, in fact, couples mistakenly assume it’s time for divorce when it’s really time to get to work.”

Have you been through a divorce? Did you feel unhealthy as result?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

soundoff (423 Responses)
  1. ruchi

    Very nice article .

    August 3, 2009 at 22:17 | Report abuse | Reply
  2. CMWP

    My insurance BCBS-HMO (IL) does not cover marriage counseling. How "sick" is that?

    August 4, 2009 at 00:28 | Report abuse | Reply
  3. Hilda

    A board-certified internist released a book recently detailing the pathophysiologic mechanisms that explains how a divorce causes the 3D’s – DEATH, DISEASE AND DISABILITY. The book contains at least 125 peer-review citations, is well written and is in the hands of such eminent medical leaders as Dr Chopra at Harvard. Look for Caxton Opere, MD on facebook. We have known divorce can kill but how much do our physicians put into practice based on what they know. The book has helped me heal so man y open wounds.

    August 4, 2009 at 11:48 | Report abuse | Reply
  4. Alex Lickerman, M.D.

    Interesting article. Marriage is, of course, difficult. Is it that people in the past were better at managing its difficulties or equally as bad as we are now but less willing to divorce? Perhaps if we looked at marriage a little differently, as a relationship that we enter into partly as a business, we might all succeed a little more commonly at making it work. For those who are interested, the article below outlines this approach.


    August 4, 2009 at 13:52 | Report abuse | Reply
  5. ChrissySeptember

    I feel mentally unhealthy in marriage. Wondering if I will feel even more unhealthy in divorce....Am I digging my own grave? Hmmmm

    August 5, 2009 at 13:56 | Report abuse | Reply
  6. Sandra

    I have been through a divorce and I actually eat better now and exercise routinely. When my marriage was failing, I found that I either skipped meals entirely, or when I did finally eat, I did not make wise choices. I also believe that couples can get into a comfort zone with one another that leads them to over indulge and skip the exercise, especially if neither partner is inspiring the other to lead a healthy lifestyle. Furthermore, the mentality of "well, if he's not going to the gym tonight then why should I?" can kick in at some point during a marriage and then before you know it, you're both sitting on the couch watching t.v. every night. I think that leading a healthy lifestyle has more to do with inner happiness rather than marital status.

    August 5, 2009 at 16:18 | Report abuse | Reply
    • EDDC

      I didn't read the actual medical study, but It didn't seem to me in the article that they correlated divorce and lack exercise or eating unhealthy. So perhaps it has more to do with the mental and emotional wear and tear on your physiology than whether it turns you into a couch potato.

      October 29, 2010 at 15:18 | Report abuse |
  7. Anne

    Divorce causes disease & death, h-m-m-m. Actually, living causes disease and death - just think, if we were't alive, we wouldn't get diseases and we wouldn't die! Gee, what a news shock, people are happier and healthier in a positive marriage! Improving the state of individual marriages is a worthwhile societal goal, but please do not suggest or imply in any way that staying in a bad marriage is better than ending it. I grew up in a disfunctional family, and each parent, and sibling in that family would have been better off if the parents had divorced.

    August 5, 2009 at 17:00 | Report abuse | Reply
  8. Kevin

    I just got a divorce. I feel so much better no more stress, sleeping through the night. Eating good. Big weight off my shoulders. Suck's For the kid's, There 13. But I will do my best with them

    August 5, 2009 at 17:15 | Report abuse | Reply
  9. Sharon

    I'm now 67 and have been divorced for 28 years after a 20-year abusive alcoholic marriage. I feel great thie year after last years bout with cancer and cancer treatment. I expect to live a long healthy happy life. I enjoyed the article but do not understand why 23% have mobility problems – from what? not enough sex?

    August 6, 2009 at 00:48 | Report abuse | Reply
  10. Denise

    Interesting correlation..but don't buy it. I know all to well how negatively health can be impacted when a marriage is unhealthy. Just because one is married doesn' t make it a good relationship. Two very separate things.

    August 6, 2009 at 09:58 | Report abuse | Reply
  11. Sean

    Being married and almost recently divorced – I can say that we live in a disposible society and with it comes high divorce rates. Oh – u have problems in your mariage – divorce him or her and move on. Too funny – this attitude is the same one that makes this society eat fast foods, get fat and unhealthy. It's sad that we, this society, have come down to the aforementioned attitude and lifestyle. If we only woke up and realized that with some hard work – yeah hard work and hard faith – we could all be happier and healthier.

    August 6, 2009 at 12:12 | Report abuse | Reply
  12. Max

    I married and was unhappy. We separated and then divorced. Five years later I had cancer, and now have diabetes, high blood pressure, ITP, NASH, and on and on. We had children and I happily raised my children by myself. My wife was not who I thought she was and it took little time to find out. Afterward the divorce, I was in a number of serious relationship that I ended out of my fears. Now that my children are grown, I am in a stable relationship but my children do not like her at all. I wish things were different. I ate and slept better when I was single. Oh, well.

    August 6, 2009 at 22:08 | Report abuse | Reply
  13. Frank

    Take in consideration what happens to a good Dad when his wife leaves him: he gets to see his kids whenever she wants, has to give lots of money for "her" (it is hers since he cannot control how she spends it), it is promoted by the laws of this country for women to get divorced due to the benefits they get from it....

    So I'd say: it is pretty healthy for women, and it is killing lots of good Dads!

    August 6, 2009 at 23:44 | Report abuse | Reply
  14. Eliza

    The opposite is also true. A bad marriage can make you sick and often the only thing that will 'cure' you is to leave. Not every relationship can be fixed. And not every partner is willing to make the changes necessary to improve a relationship.

    August 7, 2009 at 13:46 | Report abuse | Reply
  15. Anne

    I know a failing marriage is unhealthy, and that if one or both partners do not want to work at the marriage, it will destroy them both. Asking family physicians to help in failing marriages when most of the physicians do not have "healthy" bedside/office manners is not realistic. My parents stayed together and worked hard at their marriage, and it is revealed in my siblings/myself also working hard at marriage. (No divorces yet.) Unfortunately, the spouses need to be from that type of background as well. I see my siblings, and myself struggle to hang on to marriages that are constant battlegrounds and almost always causing great pain. I cherish good times, but never know when the auto-responses from my partner will just tear me apart. His parents stayed together, but with cheating and nagging and insults. My health is suffering, but I just cannot give up. With this type of situation, I experience the increased "stress" related health issues, as does my spouse (and it is my fault, always). The research is obviously not broad enough to encompass all family situations. It does not take into account that the average physician is not interested in getting involved that manner, and that it takes willing partners to repair a marriage.

    August 7, 2009 at 13:49 | Report abuse | Reply
  16. lawyermommy

    We have romanticized the notion of marriage and taken individual responsibility out of it. When two people make a commitment to each other, it is a supportive and healthful choice which should create stability, hope and good health for both parties.

    I also believe that children do best when they have both parents in the home. I do not have anything against single parents who are forced to be single by circumstance, but sometimes, the notion of equality has caused some women to make choices to become single mothers because they believe it is an index of their independence.
    Are there good single parents, absolutely! But it is better to have two parents in a home if possible.

    No relationship is without its ups and downs. The romantic notions of relationships foisted on us by the media has done an incredible disservice to us, Americans.

    Sometimes, I catch myself thinking what I would do if my handsome, tall husband became overweight and awful. I usually banish the thought pretty quickly. However, it shows that despite my disdain for romanticizing the idea of marriage, I too have absorbed some rather unrealistic notions of what is required to sustain a healthy and stable relationship.

    Happiness is something a partner brings into a relationship. No one else can provide it to you. However, a melding of two happy committed people creates a wonderful, joyous and peaceful life.

    I have been single and have been married. I like being married way better! 🙂

    August 7, 2009 at 20:30 | Report abuse | Reply
  17. Karen

    At age 18 I entered a one-year marriage with my high-school sweetheart that was "Hell on earth" for me. He was never home. I cried every day. I was an emotional wreck. I prayed for deliverance. Divorce was out of the question due to my religious beliefs. When he died unexpectedly in an automobile accident, I was so relieved. It felt as if God had wrapped up the world, tied it in ribbon, and handed it to me as magnificent gift. I had my whole life ahead of me and could start all over again. I was euphoric with the sense of relief that engulfed me. I plunged ahead with my college education, and then on through law school with no financial assistance from anyone. I swore that I would never get married again and that no one would ever treat me like that again. Although I have been in many serious relationships since then and have received several marriage proposals, I would never remarry. Having once tread the paths of Hell, I would sooner die than do it again. Am I happy? Yes. I have forged my own way and am proud of my accomplishments. I see the heartbreak my divorcing clients go through and it is a constant reminder to me of how lucky I am to have my own life back. I am the captain of my own ship, and it feels wonderful. Do not listen to the whisperings of your culture telling you that you are not fulfilled unless you have a husband and children. It is a siren call to be avoided. Take it from me – you can have an extremely happy life if you will only step out and create it for yourself!!!

    August 7, 2009 at 22:13 | Report abuse | Reply
  18. Maddy

    My husband went through 18 years of a very tough marriage. He stayed in it for religious reasons, children and his innate sense of caring and hope for the better. However, he reached a breaking point and finally sought a divorce.

    When we met, he told me I was getting involved with a broken man - emotionally and physically. I didn't listen - didn't want to believe him. We married and I have learned that he was right.

    I love my husband and it saddens me to see him still struggling even after all this time.

    August 8, 2009 at 15:25 | Report abuse | Reply


    August 9, 2009 at 08:36 | Report abuse | Reply
  20. BellaTerra66

    I was married for 22.5 years and then divorced for 4-5 years. Married again for 4 years. Then divorced a second time. I left both times. I'm now 60, been divorced for the last 11 years now, and I've never been happier and healthier (I'm not on any meds - nothing is wrong with me - BP, heart rate, sugar, O2 Sats - everything is perfect). I keep reading these articles about getting old and being lonely and becoming sick - it hasn't happened to me yet. Knock on wood. I work FT, go to college PT, own my own home. Don't have much family but have a few real good friends. Not a church-goer. I should be dead by now. 🙂 But, I'll tell ya, I sure was miserable when I was married. I had a real knack for picking the wrong partner and being the wrong partner. The last 11 years have been the best years of my life.

    August 9, 2009 at 21:17 | Report abuse | Reply
  21. Jack

    Were these people unhealthy because of the divorce, or because of the marriage? My health is not good, and I'm married. I'm confident I'll become healthier if I get a divorce and rid myself of this burden called a wife.

    August 10, 2009 at 05:23 | Report abuse | Reply
  22. CAO

    A bad marriage, and not just a divorce, can alter body physiology, to the point where a person develops sustained high blood pressure and other measurable or non-measurable changes as seen in posttraumatic stress disorder for example. Bad marriages do create psychological trauma. In addition, here are some other findings –

    1. The April 2000 Journal of Epidemiology and Community Health shows divorced and separated men were twice more likely to commit suicide than married men. That's one way divorce can kill.

    2. There is an increase in panic attacks following a negative life event such as a divorce according to an article published in a 2003 issue of Archives of Internal Medicine and another article in the April 2005 Journal Psychiatry and Clinical Neurosciences. Divorce remains one of the most traumatic negative life events as does a bad marriage and panic attacks do increase after a divorce or separation. The exact link to divorce-related deaths needs more clarification.

    The October 2007 issue of the Archives of General Psychiatry reported on a study of 3369 women showing that panic attacks are an independent risk factor for cardiovascular death. So after a divorce the risk of dying of a heart attack increases.

    3. Mental stress reduced the amount of blood pumped out of the heart with each heart beat according to a 1996 article published in the Hypertension journal. In a later article published in a 2001 journal of Vascular Medicine, mental stress was shown to reduce blood flow to the forearm, probably explaining why patients with angina have pain in the forearm.

    Divorce as well as abusive bad marriages, are two of the worst types of mental stress you can enter and divorce ranks second to the death of a loved one according to the Rahe-Holmes Scale.

    One of the predominant emotions in divorcees and those going through a bad marriage is hostility. The following may help:

    In 1999, Dr Linda Gallo and Dr Timothy Smith showed that hostile marital interactions increase blood pressure. An earlier article in a 1995 issue of the American Journal of Epidemiology from Denmark by Dr. Barefoot and colleagues reported that hostility increases the likelihood of premature death and heart attack by 50 percent. In the same year, another article by Dr Mittleman showed that anger could triple the risk of a heart attack. How angry are those who are divorced and those who are still in abusive marriage where their spouses abuse and take advantage of them?

    In addition, two separate studies, the NHANES in the US and the GAZEL study in France showed divorcees and separated individuals had more than double the risk of violent and accidental deaths.

    While escaping from a bad marriage can save you from further abuse, you have to get out early before other physiologic resulting from such a bad marriage becomes permanent or pathological. I recommend escaping from a bad marriage before it destroys your health. The real question is at what point does this damage occur and who is most vulnerable?

    A divorce has many ways it can kill and the process may begin from the time wrong couples marry or the day right couples stop being good to each other. It is a poor marital state that destroys health and it may do so long before a couple file for divorce. Anyone who escapes before permanent damage is done to their health (this varies depending on individual susceptibility) ought to feel better after the divorce. But creating unnecessary stress and trouble in a marriage because of the possibility of making money out of it is bound to create unnecessary stress for both vampire and victim. The latter may explain why some ex-spouses put a contract out on their former spouses during or prior to the divorce court proceedings.

    Dr. Noreen Goldmann's studies on an international scale with Dr Hu showed that divorced persons had the highest death rates, affecting men more than women.

    The book How Divorce Kills will be helpful to those interested.

    August 11, 2009 at 02:17 | Report abuse | Reply
  23. Hilda

    I still think the only quaified expert on the medical complications of divorce ought to be interviewed live so everyone can learn something and do smething. People are eing destroyed for lack of knowledge no matter which way we look at it. The 3 recent killings by fathers nd the sparse comments that shed no real insight into how to prevent such familicide and how many silently brooding men are still out there should warn us. Get Dr. Opere, already acknowledged as an expert on divorce prevention to share his wisdom with us live on nationwide TV. I think the world would be a better place for that one interview.

    August 12, 2009 at 05:29 | Report abuse | Reply
  24. Stacy

    "Williams suggests that many studies have linked poor marriage quality to poor health outcomes, and thus improving marriage quality should be a worthy public health pursuit."

    Not only does poor marriage quality link to poor health outcomes, but health issues also lead to poor marriage quality. So many with chronic conditions end up divorced because the spouse could not handle the other's medical condition. Focusing on preventative care AND care for those with chronic illnesses could help encourage health marriages. All too often the patients and their caregiver/spouse are left to deal with all of the things that have changed because of the illness and the aftermath of serious illness (debt, pain, etc). There are very few emotional resources for those with chronic health conditions and their partners.. therefore, marriages suffer.

    August 17, 2009 at 10:07 | Report abuse | Reply
  25. Diran

    What does these all imply for a single young man like me: eager to marry soon yet skeptical of what the outcome would be. Maybe proper pre-marital counselling would do alot of good and not pre-nups

    August 23, 2009 at 23:24 | Report abuse | Reply
    • Amanda

      Definitely, do some counseling on your own-namely getting to know your intended's family. Families act a lot alike. If there are a lot of divorces in a family, possibly look elsewhere. Make sure that you think alike, have the same ideas about raising children, money, and religion. Invest time BEFORE and it will be well worth it. I have been happily married for 37 years. So I do know what I am talking about.

      July 12, 2010 at 20:29 | Report abuse |
  26. Gabriel Ellis

    Divorce is always a bad news among married couples. Some couples just cannot iron out their differences.':`

    July 9, 2010 at 12:22 | Report abuse | Reply
  27. Amanda

    So as a greater health risk, divorced folks should have to pay higher premiums for health insurance. That would give them another thing to think about before they threw in the towel.

    July 12, 2010 at 20:25 | Report abuse | Reply
  28. Adrian Morgan

    Divorce will always lead to depression and anger towards the other party. As much as possible avoid divorce",~

    July 16, 2010 at 01:41 | Report abuse | Reply
  29. Ewan Matthews

    divorce is always not a good news but it maybe necessary if relationships aren't going in the right direction~"-

    August 31, 2010 at 04:51 | Report abuse | Reply
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