By: Adaora Ntukogu
A few years ago, I was in Port Harcourt, Nigeria, visiting my grandparents. I could not wait to taste the local dishes and spices that my grandmother promised she’d cook for me. My first meal in Port Harcourt was a traditional dish, okra soup and garri. I was surprised at the taste (sorry mawmaw) and discovered that my grandmother does not add any salt to her dishes. She said it was because my grandfather has high blood pressure and it was easier to make one meal for the both of them. I really admired how she cared for him, although I was left with a couple questions. Would he do the same for her? Would my grandfather be able to manage his chronic illness on his own or does his marriage make the condition less stressful?
It has been widely documented that social relationships are beneficial for our overall health. In fact, a study found that a lack of strong relationships increased the risk of premature death from all causes by 50%. Social support groups come in many forms such as family members, sports clubs, religious organizations, volunteer groups, and marriages. Marriage is one of the most powerful forms of social support; couples encourage each other to make better lifestyle choices, as well as assist each other during health issues. A study done by Emory sociologist Ellen Idler and colleagues showed that after the first 3 months of cardiac surgery, there was a very sharp drop in survival for non-married individuals. However, experts now believe viewing social support as beneficial to an individual’s wellbeing is too simplistic, especially when viewing familial and spousal support. Families are not a static bank of resources that a seriously ill person can continue to collect desirable social support. Families experience emotional and physical strain, which is seen with the effects of serious illness on marriage.
When a spouse becomes seriously ill (e.g. cancer, heart disease, kidney failure etc.), a major strain is put on the marriage. Spouses experience emotional strain, physical demands, uncertainty, fear of their partner’s death, altered roles and lifestyles, financial strain, and the need to support their partner. All of this can be very demanding for the well spouse and they can quickly become a source of stress for the ill individual. Eventually, the illness can lead to the dissolution of the marriage. However, the relationship between spousal health and divorce may vary by gender.
Some clinical studies have found a larger risk of divorce when wives become ill than when husbands do. For example, a study done by oncologist Michael Glantz and colleagues found higher divorce risks when wives experience cancer. Although the study was relatively small, this variation by gender is consistent with the high prevalence of remarriage in men over the life course and with findings that husbands find caring for an ill spouse more taxing than do wives. Women are socialized to be caregivers throughout their lives and this extends to caring for ill husbands.
Further, it seems that caregiving is not fully reciprocated by husbands for ill wives; wives receiving care were more likely to report experiencing gaps in needed caregiving from their spouses than husbands. In fact, ill wives are more likely to receive assistance from adult children and other relatives along with their husbands, while sick husbands receive help mainly from their wives.
It is crucial to understand how lackluster caregiving by the husband and heightened familial stress levels affect the health of the ill wife. Heart Sisters, a blog site dedicated to women living with heart disease, featured the testimonials of married women dealing with heart disease and a bad marriage.
I feel very alone in my illness. I understand that what my husband says is emotionally damaging to me. I am jealous when my friends have a little cold, and talk about how well their husbands take care of them during it. This is my second marriage. Divorce is hard, but it’s not impossible. That being said, you have to decide what you can and cannot live with. Certainly if there is psychological abuse, it could move to physical abuse. My last husband was very abusive psychologically, and I knew if I stayed it would end violently for one of us. —Anonymous
My husband has been unable to be a supportive spouse for me since the very beginning of this journey. He did not stay with me the night of my diagnosis, and he has rarely accompanied me to doctor’s appointments or treatments. He stays away from me most of the time, sleeps in another bed, and spends most of his non-working hours sleeping. My supportive friends are extremely angry with my husband and are encouraging me to leave him. This is a second marriage for us – we’ve been married eight years. I am very torn. —Anonymous
It has been stated that social ties are a strong indicator of health and longevity. However, the potential positive effects of social support on patient outcomes may be weakened or even cancelled out by these negative social interactions. Inadequate caregiving, income strain, and a plethora of intrapersonal issues leaves little room for the patient to focus on her diagnosis. In the long run, these social conflicts can exacerbate her condition. She may even be motivated by her illness to leave her broken marriage.
 Idler, E. L., Boulifard, D. A., & Contrada, R. J. (2012). Mending broken hearts: marriage and survival following cardiac surgery. Journal of Health and Social Behavior, 53(1), 33-49.
 Ell, K. (1996). Social networks, social support and coping with serious illness: the family connection. Social Science & Medicine, 42(2), 173-183.
 Glantz, M. J., Chamberlain, M. C., Liu, Q., Hsieh, C. C., Edwards, K. R., Van Horn, A., & Recht, L. (2009). Gender disparity in the rate of partner abandonment in patients with serious medical illness. Cancer, 115(22), 5237-5242.
 Karraker, A., & Latham, K. (2015). In sickness and in health? Physical illness as a risk factor for marital dissolution in later life. Journal of health and social behavior, 56(3), 420-435.
 Allen, S. M. (1994). Gender differences in spousal caregiving and unmet need for care. Journal of Gerontology, 49(4), S187-S195