Demand for Spousal Health

This paper explores the importance of health for marital transitions and as a dimension for assortative mating. We present new empirical patterns on marriage, divorce, and assortative mating in relation to health, constructed over time and by race using US data from 1996-2023. We document that high fractions of unhealthy individuals are single, lack health insurance, and relatively small fractions have healthy spouses. Unhealthy men have become significantly more likely to be single over time. Unhealthy individuals are also more likely to be divorced and remain single. When married, unhealthy individuals have high rates of unhealthy spouses (40-45%), higher probabilities of “marrying down†in terms of education, and women have husbands with lower incomes (conditional on everything else) compared to their healthy counterparts. These findings have important implications for the design of health and social insurance programs which interact closely with intra-household insurance. Preliminary analysis shows the ACA is associated with a lower penalty of bad health in the marriage market. Finally, the gain to marriage for females with low education but good health surpasses that of females with high education but poor health. Conversely, the gain to marriage for males exhibit the opposite pattern. This asymmetry was noticeable in the mid-’90s but has since diminished in recent years. We develop a multidimensional matching model of education and health status to reveal the driving forces behind changes in the demand for spousal health.