In sickness and in health? How a medical condition impacts your chances of finding and keeping love

A person’s health can shape their romantic trajectory, acting as a filter for who gets married and who stays married. A recent study published in the Journal of Health and Social Behavior found that poor health reduces the chances of forming a romantic union and elevates the risk of those partnerships ending. The results indicate that the association between physical well-being and marital status flows in both directions, layering social disadvantages onto those already experiencing medical issues.

Prior research has heavily focused on the protective effects of marriage, showing that being married correlates with better outcomes over a lifespan. Considerably less attention has been directed at the opposite sequence of events. A person’s medical status might predict their ability to find a partner or maintain a supportive network.

Researchers want to know if medical adversity is linked to damaged relationships or limited options in the dating market. If poor health coincides with relationship breakdown, aging populations might risk losing social support right when they need it most. This dynamic is highly relevant today, as longer lifespans mean more people will eventually manage chronic illnesses.

At the same time, marriage patterns are shifting globally. People are marrying less, divorcing more, and frequently repartnering at older ages. In this environment, partner selection has become highly competitive, elevating the importance of perceived physical vitality.

Several theoretical mechanisms attempt to explain how illness might be linked to romantic status. During the dating phase, health may function as a screening criterion alongside education, income, and personality. People might consciously or unconsciously select partners based on their ability to offer resources and protection during a long term commitment.

Free daily newsletter

Once a union is formed, chronic illness can reduce a person’s mobility and increase their need for care. This dynamic can cause an emotional and practical burden on the healthier partner. Routine conflicts, reduced communication, and withdrawal tendencies become more common as couples navigate these new challenges.

Matthijs Kalmijn, a demographer and professor at the University of Groningen in the Netherlands, designed the project to explore these ideas. Kalmijn utilized long-term survey data from multiple countries to test whether a person’s self-assessed condition has an association with the formation and dissolution of their romantic unions.

Kalmijn evaluated data from annual household surveys conducted in Australia, Germany, South Korea, Russia, Switzerland, and the United Kingdom. This harmonized dataset provided information on over a quarter of a million adult respondents. The analysis tracked these individuals over several years to observe transitions in their relationship status.

The observed transitions included entering a first romantic union, deciding between marriage or living together unmarried, experiencing a separation or divorce, and finding a new partner after a previous marriage ended. The key variable of interest was self-rated health. This metric asks respondents to classify their well-being on a five-point scale ranging from excellent to poor.

Self-rated health is a widely accepted measure in demographic research. The simple five-point scale correlates strongly with mortality rates and a wide range of actual mental and physical conditions. Using this metric allowed for a consistent comparison across the different national surveys.

Kalmijn used statistical models to calculate the probability of individuals making relationship transitions in a given year based on their prior health ratings. The models accounted for age, education, religious affiliation, and other demographic factors to isolate the specific role of an individual’s wellbeing.

The analyses revealed that poor health was associated with negative outcomes across every type of relationship transition studied. Individuals dealing with poor health were less likely to enter a first union. When they did find a partner, they were less likely to get married, opting instead to simply live together.

The link was even stronger for dissolving a relationship. Survey participants with worse health scores faced a much higher risk of separation and divorce compared to their healthier peers. This aligns with the idea that ongoing medical demands put a strain on established routines.

For those who had already gone through a divorce or the death of a spouse, health issues posed a barrier to finding love again. Poor health reduced the odds of repartnering in almost all the countries surveyed. This trend highlights a vulnerability among older populations who are searching for companionship late in life.

Kalmijn estimated these events with and without accounting for employment status and household income. Health problems often lead to job loss or reduced income, which can put financial strain on relationships. Including these economic factors slightly reduced the observed association between health and marriage.

Even after controlling for money and employment, the direct associations with health status remained robust. The severity of the health penalty depended on the type of union transition. The negative link with poor health was consistently stronger on the dissolution of relationships than on their formation.

This suggests that while medical issues might not always be apparent during the early dating stages, they become highly visible once a union is established. A decline in a couple’s relationship quality can also negatively affect a person’s mental state. This creates a reciprocal loop that accelerates the path to separation.

Similarly, poor health had a stronger negative relation to getting married than it did to cohabitation. Marriage implies a longer time horizon, meaning individuals may evaluate a partner’s health more stringently before taking that step. Cohabitation often functions as a trial period, accommodating a higher degree of uncertainty about a partner’s future care needs.

The pattern of results remained strikingly similar across the six countries, suggesting that these social dynamics are not isolated to specific cultures. One exception was South Korea, where poor health was an especially strong predictor of marital dissolution. This outcome might be related to local dating market structures and heavy family involvement in matching couples.

Age also introduced variation to the findings. The link between poor health and relationship dissolution was strongest among younger adults. As people age, health problems become more common and socially expected.

Older couples have also typically invested more time in their relationship. This creates a sense of loyalty that makes them better equipped to stay together through an illness. At younger ages, a severe diagnosis introduces intense uncertainty about the future course of the partnership.

The researcher looked for differences between men and women but found very few instances where health penalized one gender more than the other. The assumption that a man’s health matters more for securing a marriage due to traditional earning roles was not supported by the data. Both men and women faced similar obstacles when dealing with poor health.

The study has some limitations that point to avenues for future research. The broad measure of self-rated health combines physical and mental well-being into a single metric. Future projects will need to separate specific physical ailments from psychological conditions to see how different illnesses relate to a partnership.

The current analysis only looked at individual survey responses, which prevented a study of how both partners’ health statuses interact. Researchers would need couples-based data to determine whether having two ailing partners amplifies relationship instability.

The data also lacked complete information regarding the exact starting dates for some marriages. Knowing the exact duration of a relationship helps researchers understand separation risks because couples tend to build resilience over time. While the researcher used specialized data out of Germany to confirm this omission did not bias the primary results, future studies could benefit from more detailed timelines.

The study, “Effects of Self-Rated Health on Union Formation and Dissolution in Six Countries,” was authored by Matthijs Kalmijn.