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Marriage Education and Health Care Reform: What’s the Connection? Workshop #320. Smart Marriages Conference, 2009 Jana Staton, Ph.D., LCPC Marriage Works Learning Center Patty Howell, Ed.M., A.G.C. California Healthy Marriages Coalition Lara Rezzarday, MPA
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Smart Marriages Conference, 2009
Jana Staton, Ph.D., LCPC
Marriage Works Learning Center
Patty Howell, Ed.M., A.G.C.
California Healthy Marriages Coalition
Lara Rezzarday, MPA
National Multiple Sclerosis Society
Definition: Consequences for Adults, Children
America’s Families & Living Arrangements, US Census Estimates, 2008.
of Divorce and Unwed Childbearing
Framework: ME/RE = A preventive intervention to reduce chronic illness and promote well-being in families & couples.
Waite, L. (2005).“Marital biography and health.” Plenary address, Smart Marriages and Happy Families Conference, Dallas, TX: Coalition for Marriage, Family and Couples Education. Charts used by permission of the author., based on Lillard, L.A. & Waite, L.J(1995). ‘Till death do us part: Marital disruption and mortality. American Journal of Sociology, 100, 1131-1156.
Children are healthiest growing up with 2 biological parents, compared to other family arrangements(Bramlett & Blumberg, 2003).
Marital quality, not marital status, explains health benefits - and risks - of marriage for both children & adults:
Epigenetics: The study of gene-environment
Healthy family processes suppress the expression of genetic tendencies such as aggression, early sexual activity, substance abuse(Halpern, et al., 2007;Guo, Roettger, Cai, 2008).
Families that eat together suppress the expression of gene variants (MAOA & DRD2) associated with delinquent/violent adolescent behavior (BOTH male & female) Guo, Roettiger, Cai, 2008).
Married men & women are less likely to die from heart attacks, more likely to return to health (Zhang & Hayward, 2006; Johnson, et al., 2000).
Men and women in ‘high-quality’ marriages live longer with CVD, independent of severity of illness, than do those in ‘low quality’ marriages (Coyne, et al., 2001; Rohrbaugh, et al., 2006).
Women are more likely to develop early signs of heart disease (metabolic syndrome) if they are in less satisfying relationships (Gallo, et al., 2003).
Support from husband (holding a hand) blocks pain and lowers stress response in happily married wives undergoing experimental electric shocks.(Coan, et al., 2006)
“Warm Partner Support” in stressful experimental conditions lowers blood pressure and heart rate, and increases oxytocin, protecting the cardiovascular and immune system. (Grewen, et al., 2003-2005), Light, et al., 2005)
The big finding!
Marital Adults Chronic Major
Conflict Chronic inflammatory chronic
& Distress Stress response illnesses
Sources of Stress
Based on Dr. Janice Kiecolt-Glaser presentation “Families & Health: Inflammation
as a Central Pathway.” Families & Health Conference, NCMR/NIH, June 2, 2009
Accessed online at http://ncmr.bgsu.edu/events/families_and_health.html
Chronic Illness and Relationship Education in Practice National Multiple Sclerosis Society: Relationship Matters
in-person, teleclasses and online.
ME/RE Education More safe, stable healthy marriages
& mental illnesses (social support, adherence)
residents, physicians, nurses.
“Innovative approach to addressing health care problems in the U.S.”
“SAFE, stable, healthy families”
(PREP is listed in SAMHSA NREPP for mental health)
“Marital quality”—directly affects adult health
“Prevention” of family breakdown
Health now recognized as being created through an ongoing interrelationship between bio-psycho-social factors
Therefore, the family is a primary place where health is created, or health is damaged
The quality of the marital relationship is key to the quality of health created within the family context
Inclusiveness for all couples is REQUIRED in health care.
Skeptical about marriage: many have been through distressed, low-quality marriage and divorce.
Many don’t know the research connecting marital/relationship quality to health outcomes, esp. adult physical health.
They cannot afford to be wrong.
BE VERY SPECIFIC:
ME/RE targets negative interactions linked to poorer physical & mental health;
These targets are difficult and expensive to address downstream and much easier and less costly to address upstream;
ME/RE is a timely and innovative approach for addressing numerous health care problems;
ME/RE helps couples provide long-term and effective social support associated with numerous health outcomes.
Blanchard , Hawkins, et al, 2009
Butler & Wampler, 1999
Carroll & Doherty, 2003
Coan et al, 2006
Coyne et al, 2001
De Vogli et al, 2007
Fagan et al, 2002
Feinberg et al, 2007
Felitti & Anda, 2008
Furstenberg & Kiernan, 2001
Gallo et al, 2003
Giblin, Sprenkle, Sheenan, 1985
Gottman & Katz, 1989
Grewen et al, 2003-2005
Guo, Roettger & Cai, 2008
Halpern et al, 2007 Harknett, 2005
Hawkins et al, 2008
Hawkins & Booth, 2000
Johnson et al,2000
Kaye et al, 2009
Light et al, 2005
Lillard & Waite, 1995
Maier & Lachman, 2000
Markman et al, 1993
Rohrbaugh, Schoham & Coyne,2006
Umberson & Williams, 2005
Umberson et al, 2006
Wood et al, 2007
Zhang & Hayward, 2006