Should doctors give marriage advice?

Doctors have no trouble or compunction giving these good pieces of advice:

  • stop smoking
  • lose weight
  • eat less saturated fat
  • wash your hands
  • vaccinate
  • schedule your mammogram
  • get a colonoscopy

These all likely can augment both life quality and expectancy.

Do doctors, then, (in appropriate situations obviously) go the extra mile and tell a patient to get married? There are reasonable reports church-going adds to longevity, but with sensitivity to broaching religious beliefs, doctors may be reluctant to suggest Dr. Daniel Hall’s advice, “take two prayers and call me in the morning“, even though actuarial death rates found that weekly worship service attendance could add up to three years to a person’s life.

But what is holding them back about advising marriage? We are certainly at a juncture where this advice could prove a crucial difference in how well our society holds up in the upcoming decades. Even Social Security is worried about the relatively poor health of the unmarried, and never married.

Studies show that people live longer married. And that’s not even a joke (you remember this one: “Do married people live longer? No, it only feels that way” ). That’s the sentiment of the popular culture: movies, TV shows, magazines, and mainstream media. Marriage is there to be mocked.

Not only does do people live longer married, but they live wealthier and happier, and this conclusion remains even after you factor out preselection towards marriage people you could argue that maybe those destined for poorer life expectancies never marry in the first place but probably the opposite is true, people who need care and caring tend to marry at a higher frequency.

A 22-year-old woman was in my office recently. She has a 1.5-year-old baby, lives with her own mother, is on state-benefits. The infant’s father lives in the next town over, works, and had asked to marry her. She said, “I’m thinking of going back to school at some point … so, I’m not ready yet.”

But is her baby ready, yet? Children in married households have more resources, not just physical resources, but emotional, instructional, and familial. In this case we’re not talking just about the patient’s health, harmful activity avoidance and longevity; but, in the long-run, probably those of the offspring as well.

So, “take two wedding-rings and call me in the morning.”

 

Postscript: This note was partly inspired by the occasion of the visit of the 22-year-old quoted above. She was in for a visit to “meet the doctor.” She had a little bit of back pain and a fair amount of obesity, which we addressed with standard medical advice. It was during this visit that I tried the “health intervention” advice of suggesting to this young lady to consider the beneficial social and general health aspects of solidifying her ongoing relationship with the child’s father. She seemed to acknowledge this and consider it in a reasonable fashion, and we had what I had thought was a productive conversational visit. She called a couple of days later announcing she will never be coming back, so perhaps take what I say above with a grain of salt until this concept percolates through to society with the same weight and force of other standard medical advice dicta, or don’t attempt this until many visits have transpired.

Randall S. Bock is a primary care physician who blogs at
Doctoring the Evidence.

 

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