Life-course partnership history and midlife health behaviours in a population-based birth cohort

Katherine Keenan, London School of Economics and Political Science (LSE)
Richard Silverwood, London School of Hygiene and Tropical Medicine (LSHTM)
George B. Ploubidis, University College London
Emily Grundy, London School of Economics and Political Science (LSE)

Background: Marital and partnership history is strongly associated with health in mid and later life. However the role of health behaviours as an explanatory mechanism remains unclear. The aim of this study was to investigate prospective associations between life-course partnership trajectories (taking into account timing, non-marital cohabitation, remarriage and marital transitions) and health behaviours measured in midlife. Methods: We analysed data from the British National Child Development Study (NCDS), a prospective cohort study which includes all people born in one week of March 1958 (N=18858). This study included men and women with prospective data on partnership history from age 23 to 42-44 and health behaviours collected at ages 42-46 (2000-2004). Results: After adjustment for a range of potential selection factors in early life and early adulthood, we found that problem drinking, heavy drinking and smoking were more common in men and women who experienced divorce or who had never married or cohabited. Women who married later had a lower prevalence of smoking and were less likely to be overweight than those who married earlier. Overall marriage was associated with a higher body mass index. Individuals who never married or cohabited spent less time exercising. Conclusion: Life-course partnership history is associated with a range of unhealthy behaviours in midlife; these are in opposite directions for smoking and drinking on the one hand and weight gain on the other. Despite these offsetting influences, differences in health behaviours probably account for much of the association between partnership trajectories and health found in previous studies.