The Protective Effect of Marriage and Labor Force Participation on Mortality. A Comparison between the United States and Five European Countries

Karen van Hedel, Erasmus Medical Centre, Rotterdam
Frank Van Lenthe, Erasmus Medical Centre, Rotterdam
Johan P. Mackenbach, Erasmus Medical Centre, Rotterdam

Both marriage and employment are independently associated with better health across different populations. It is unknown to what extent marriage and employment affect health through similar or unique pathways. We hypothesize that marriage protects against the negative effect of not participating in the labor force, that labor force participation protects against the negative effect of being unmarried on mortality and that this interaction differs between countries. Data from the U.S. National Health Interview Survey linked to the National Death Index were harmonized with census data linked to national mortality registries in Finland, France, Norway, Slovenia and Switzerland. A similar interaction effect of marital status and labor force participation is found in all countries, where it is stronger for women than for men. Our results confirm our hypothesis that marriage protects against the negative effect of labor force inactivity and activity protects against the negative effect of being unmarried on mortality.