The Protective Effect of Marriage on Health and Survival: Does It Persist at Oldest-Old Ages?

While the positive effects of marriage on health and survival are well documented among adults and younger elders, research
systematically examining the effects of marriage in terms of its length, quality, and dissolution is rare, and little is known
about whether such protective effects persist for the oldest-old. Using data from the first four waves (1998, 2000, 2002,
and 2005) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this paper is the first to examine associations between
marriage and health (in terms of cumulative deficit index) and associations between marriage and survival at the oldest-old
ages after adjusting for various confounders. The CLHLS is a nationwide survey specially designed to focus on the oldest-old
(ages 80+) with more than 25,600 oldest-old interviewees and more than 41,500 records. Overall, we find a continuing prevalence
of the protective effects of marriage on reduction of the risk of dying among oldest-old Chinese, particularly among men,
even after we control for demographics, socioeconomic status, family/social support, health practice and health condition.
Good quality of a marriage and longer duration significantly improve survivorship, yet associations between marital quality
and survival and between marriage length and survival are largely diminished once overall health at the previous wave and
other covariates are controlled for. Widowhood, even when it occurs long before the time people are studied, tends to increase
mortality risk, especially among men. We further find that health likely plays some mediating role in diminishing the association
between marital quality and survival at oldest-old ages. Interpretations for these findings and their implications are discussed.