The was a recent groundbreaking study examining relationships and health outcomes of couples over a 20-year span.

These results may surprise some. This study included how several factors link relationship quality with our health outcomes. The study looked at data from 1995 through to 2011, using several thousand participants. They looked at people who were married or in a long-term relationship.

The study found a connection between positive health outcomes with good relationship quality and negative health outcomes with poor relationship quality. We do know that those living in a positive and happy long-term relationship have lower illness rates with far better physical and emotional health.

It was reported that poor relationship quality was associated with individuals dying younger and with more frequent physical and mental health problems. No single study has looked at specific health issues that are affected when individuals experience a poor relationship.

Researchers in this study looked at how factors unfolded over the 20 years:

Three main factors that were identified within this study. They considered all the possible ways that different factors can fit together to connect the quality of relationships and determine which of the factors accounted for any observed connections among relationship quality, the behaviours which affect health and participants’ health[1].

These three factors were:

1) Marital dysfunction

2) Anxiety and depressive disorder

3) Physical health at the end of the period studied

The study surveyed positive and negative behaviours which can affect general health such as smoking, eating, alcohol consumption, sleep quality and exercise. They also surveyed for anxiety disorders, depressive disorders, physical health issues, chronic conditions, number of prescriptions, and marital dysfunction.

Overall the emotional components of bio-behavioural reactivity was a significant factor in how relationship dysfunction in the 1995 group predicted overall physical health in the 2011 group. Couples determining the extent of how healthy or unhealthy they are as they grow older together, they need to include their emotional health, in the form of coping, stress reactivity and other psychological factors. This seems logical because couples who have good individual and shared coping styles and healthy approaches to self-care and care for others are likely to benefit one another’s healthy behaviours while gently but effectively discouraging unhealthy behaviours. It was found that building shared resilience and strengthening relationship efficacy was valuable for the overall health of each individual and the relationship.

Healthy behaviour can really pay off

The factors the study considered included – smoking, alcohol consumption, eating habits, sleep quality, physical activity. Any or all of these can affect and influence future relationship health.

What specific behaviours affect relationship function

In the study, researchers found that only eating and physical exercise were significant arbitrators between relationship dysfunction and physical health. It was also determined that sleep quality was a very important factor relating to relationship health.  Smoking and alcohol consumption can also affect couples’ relationship. The significant interactions between relationship dysfunction, eating and physical activity, remained constant even after researchers factored out the effects of depression and anxiety. This showed these factors are independently important to couples, especially if one objected to their partner’s behavioural choices.

Another point they found was stress relating to the financial position of the couple. We know that when both individuals are on the same page with their spending and saving habits, their relationship is often less strained. Being able to acquire wealth and financial stability can be a major asset to relationships.


While the research concentrated on more physical and behavioural issues, the study did not include the manner in which couples spoke to each other, considered their partner, time spent together, respect afforded or kindness shown. The results are of course interesting, particularly those relating to behaviours such as eating, smoking and drinking, however, over the many years of relationship counselling I do find the main issue is that of communication respect and interest each person demonstrates for their partner.

Therefore to remain in a happy and harmonious relationship that is physically and emotionally healthy, we must consider our partner, our own behaviours and the way we speak to our partner every day. Being kind, attentive and respectful can not only improve the integrity of your relationship, it can also lead to better health and a longer and happier life.

Read more articles from Dr Karen 

  1. Roberson P., Shorter R., Woods S. & Priest J. (2018). How health behaviors link romantic relationship dysfunction and physical health across 20 years for middle-aged and older adults. Social Science & Medicine 201, 18-26.
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