Adding to the discussion on women’s health, a recent survey reported that 40.2 percent of women – compared to 29.5 percent of men – reported an unmet medical need due to costs within the last year (*note, however, this is a biased figure and the disparity is actually lower). There is much speculation on the causes for this disproportionate need of women, but identifying a driver is quite simple: the deterioration of marriage. Marriage lifts women out of poverty. Divorce and cohabitation keep women in poverty.
Marriage provides a number of (intuitive) economic benefits to women. Married women share income with their husbands, and are able to optimize the division of labor for a household. Married couples enjoy, on average, larger incomes, greater net worth, and greater year-to-year net worth growth. Not surprisingly, marriage raises the long-run family income of children born to single parents by 45 percent.
Divorce does the opposite. Divorce causes women to disproportionately bear the brunt of poverty. Family income falls by 41 percent and family food consumption falls by 18 percent in the year following a divorce. Divorce is the main factor in determining the length of “poverty spells,” particularly for women whose pre-divorce family income was in the bottom half of the income distribution.
Although it might seem that cohabitation can provide the same economic benefits as marriage, it in fact cannot truly alleviate the feminization of poverty. Cohabitation is temporary (with a roughly 50% failure rate), and the men in cohabitation are less attached to the labor market than married men. Cohabiters share fewer resources, since their bonds are less assured. Cohabitation, therefore, lacks all the natural gains of marriage (security, labor market benefits such as insurance, and the pooling of resources). Preferring cohabitation over marriage in our policies means preferring a modality of life that cannot deliver the benefits to women’s health coverage that marriage can.
If we want to promote women’s health, we really must discourage divorce and cohabitation. and encourage marriage. Studies have already shown that married women rate their health better than divorced, separated, widowed, and never-married women do. Married women’s ability to cover their medical costs is one of the many reasons why.
*According to the Urban Institute: “Questions on unmet need for contraceptive prescriptions or other family planning services were only asked of female respondents. Respondents may report an unmet need because of cost for more than one type of service, so sums may exceed the share reporting any unmet need because of cost.”