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The European Journal of Public Health Advance Access published online on April 6, 2006
The European Journal of Public Health, doi:10.1093/eurpub/cki221
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received February 3, 2005
Accepted November 9, 2005

Article

Official marital status, cohabiting, and self-rated health--time trends in Finland, 1978-2001

Kaisla E. Joutsenniemi 1 *, Tuija P. Martelin 1, Seppo V. Koskinen 1, Pekka T. Martikainen 2, Tommi T. Härkänen 1, Riitta M. Luoto 3, and Arpo J. Aromaa 1

1 National Public Health Institute (KTL), Department of Health and Functional Capacity, Finland
2 Population Research Unit, Department of Sociology, University of Helsinki, Finland
3 The UKK Institute for Health Promotion, Finland

* To whom correspondence should be addressed.
Kaisla E. Joutsenniemi, E-mail: kaisla.joutsenniemi{at}ktl.fi


  Abstract

Background: Married persons are healthier and live longer than single, divorced, and widowed persons. Time trends in self-rated health (SRH) by marital status and cohabitation have remained largely unstudied. We aim to assess the levels and trends of SRH by official marital status and cohabitation, and to study the causes of these differences. Methods: Two nationally representative cross-sectional surveys were conducted 20 years apart in Finland. Data on self-reported marital status, SRH, education, smoking, and long-standing illness were collected from Finns aged 30-64 years in 1978-80 (Mini-Finland Health Survey, N = 6102, response rate 96%) and 2000-01 (Health 2000 Survey, N = 5871, response rate 92%). Results: SRH has improved in the last 20 years, but differences between marital status groups have not reduced. In 2000-01, non-married persons reported worse SRH than married persons. Among men, single [cumulative odds ratio (COR) = 1.55; 95% confidence interval (95% CI) 1.22-1.99] and divorced (COR = 1.55; 95% CI 1.17-2.05) persons showed the poorest SRH, while among women widows (1.53; 95% CI 1.04-2.26) were the most disadvantaged group. The SRH of cohabiting persons did not significantly differ from that of married persons. Differences in educational structure, smoking, and the prevalence of long-term illness explain part of the marital status differences in SRH among men, but less so among women. Among both single men and women as well as among widowed women, SRH had improved slightly less than in the other groups. Conclusion: The challenges on public health posed by growing numbers of currently not married people are likely to increase.

Keywords: marital status; cohabitation; self-rated health; time trend.
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