Marital Status and Self-Rated Health in China: A Longitudinal Analysis

Research has shown that there exists a positive correlation between marriage and good health, but the reasons for this association are disputed. Scholars acknowledge that the key to answering these questions lies in understanding the role of marriage in specific social contexts. This paper utilizes marital protection, marital selection, and life course perspectives to investigate the relationship between marriage and health in China, a society characterized by nearly universal marriage, strong societal pressure to marry, especially for women, and a distinct rural and urban divide in family life. I analyze the China Health and Nutrition Survey (CHNS) with lagged dependent variable models and fixed-effects linear regression models, to predict self-rated health and control for baseline health status and time-invariant omitted variable bias. The health status difference between those who are single and those who are married is primarily explained by marital selection, while marital protection explains the health differences between married and widowed rural women. The health differences between widowed and married rural women vary over age, consistent with the prediction of the life course perspective. Health differences associated with marriage are found mainly among the rural population and less among the urban population. The selection, protection, and life course perspectives each contribute to understanding different pieces of the marriage–health relationship in China. Marriage, gender, and age intertwine with the rural–urban divide to shape self-rated health in different ways and directions for different groups. Most notably, marriage effects on health are mainly a rural phenomenon in China.