This study is the first to explore the relationship between cohabitation and U.S. adult mortality using a nationally representative sample. Using data from the National Health Interview Survey-Longitudinal Mortality Follow-up files 1997-2004 (N = 193,851), the authors found that divorced, widowed, and never-married White men had higher mortality rates than cohabiting White men, and never-married Black men had higher mortality rates than cohabiting Black men. In contrast, the mortality rates of nonmarried White and Black women were not different from those of their cohabiting counterparts. The results also revealed that mortality rates of married White men and women were lower than their cohabiting counterparts and that these mortality differences tended to decrease with age. The authors found no significant mortality differences when they compared married Black men or women to their cohabiting counterparts. The identified mortality differences were partially-but not fully-explained by income, psychological, or health behavior differences across groups.
Key Words: age, cohabitation, gender, marriage, mortality, race.
The prevalence of nonmarital cohabitation in the United States has steadily increased, from 0.4 million cohabiters in 1960 to 7.6 million in 201 1 (U.S. Census Bureau, 201 1). Given a substantial literature showing that participation in marriage may protect health and longevity (for a review, see Carr & Springer, 2010), one central concern related to this rising rate is that cohabiters may not receive the same health and longevity benefits as married individuals. In general, research suggests that married people are healthier and live longer than nonmarried people (Waite & Gallagher, 2000), yet studies tend to analyze nonmarried individuals as one homogeneous group that includes cohabiting, nevermarried, divorced, and widowed people. Thus, very little is known about how the mortality of cohabiters differs from other union status groups (Carr & Springer). At least on some dimensions, recent research suggests that cohabitation is similar to marriage: Intimate partners in both married and cohabiting unions share a home; engage in emotional and sexual intimacy; and act as a potential confidant, caregiver, and financial supporter (Musick & Bumpass, 2012). Therefore, cohabitation and marriage may promote health and longevity in analogous ways. Alternatively, some research suggests that cohabitation is dissimilar to marriage: Compared to married individuals, cohabiters are more likely to engage in risky health behaviors (Horwitz & White, 1998), report strain in their relationships (Skinner, Bahr, Crane, & Call, 2002), experience more psychological distress (Brown, 2000), and have shorter relationship durations (Heaton, 2002). Thus, cohabiting partners may not receive the same longevity benefits as married spouses.
The present study is the first to explore the relationship between cohabitation and adult mortality in the United States using a nationally representative sample. We compared the mortality rates of cohabiters to the mortality rates of married, unpartnered never-married, divorced/separated, and widowed individuals. We further examined whether family income, psychological distress, and health behavior - the most frequently documented mechanisms linking union status and health (Waite & Gallagher, 2000) - explain union status differences in mortality. Given the long-standing observations about gender and racial differences in family and mortality processes (Brown, Van Hook, & Glick, 2008) we, for the first time, pay special attention to the intersections of gender and racial differences in the link between cohabitation and mortality.
Cohabitation and Mortality: Empirical Evidence
Empirical evidence on the link between cohabitation and mortality is sparse and based on data from European populations. European studies suggest that individuals who cohabit with others face a higher mortality risk than married people but a lower mortality risk than those who live alone (e. …