What Queen Elizabeth’s 73-year marriage has to do with mental health

The death of Britain’s Queen Elizabeth II has drawn the attention of citizens around the world. Obligation. Grace. Unity. All of which are fitting characteristics of the United Kingdom’s longest-reigning monarch. But the Queen’s lasting legacy extends beyond her political and diplomatic role and must also include her marriage to Prince Philip, a 73-year partnership that illustrates the value and benefit of lifelong communication.

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Queen Elizabeth II and Prince Philip married on November 20, 1947, aged 21 and 25 respectively. For decades, he remained her “strength and support”. The Queen’s death, just over a year after Prince Philip’s, sadly coincides with research findings on what is often called the ‘widowhood effect’, the well-known finding that losing a partner increases the risk of death for the surviving spouse. This increased risk illustrates the enormous impact that marriage and other committed partnerships have on a person’s health.

Marriage affects life expectancy and physical health

The total life expectancy of married men and women in the US exceeds that of matched controls who have never married. The reasons for this are multifactorial, but cohabitation is consistently cited as a means by which marriage has positive benefits on both physical and mental health. For example, living alone is associated with an increased risk of heart disease, stroke and other chronic diseases. A 2020 systematic review and meta-analysis of more than 7 million individuals revealed a 12 percent and 9 percent increased risk of cancer death among unmarried men and women, respectively. Losing a stable marriage has similar consequences. 2021 survey c International Journal of General Medicine revealed that dissolution of marriage through divorce, separation, or widowhood led to a statistically significant increase in the development of diabetes mellitus.

It should be noted that the benefits of long-term partnership and marriage are not strictly gender related. Emerging research shows that the health benefits of marriage seen in heterosexual couples also apply to lesbian, gay, and bisexual male-female couples compared to never-married adults.

Marriage can protect against mental illness

Long-term conjugal partnerships also provide protection against mental illness. The classic sociological text from 1897 Suicide and subsequent work by the French sociologist Emile Durkheim found that marriage was protective against suicide, although this finding was more pronounced among men than among women. Cross-cultural studies show that this relationship still holds, with South Korea reporting increased rates of major depression, obsessive-compulsive disorder, and suicidality among individuals who remain single past the median marriageable age in the general population. More recent analyzes during the Covid-19 pandemic suggest that the psychological benefits of marriage buffered against the effects of pandemic-related coercion, including unpredictable financial uncertainty.

Of course, not all marriages are successful. As a practicing psychiatrist for 17 years, I have certainly encountered patients who believe that divorce is beneficial to both parties. The definition of “marriage” is also embedded in different political and sociocultural contexts, meaning that the legal status of marriage alone is likely to be less meaningful for physical and mental health without the corresponding sense of friendship and deep belonging that often come with such an alliance. Nor is marriage the only means by which social intimacy can develop.

Social connectivity has been constantly challenged in recent years, most recently by Covid-19. Many may feel that communication and close relationships with others are “out of reach” and that they are “out of practice.” But the benefits to personal well-being are obvious. While many may choose to focus on the political implications and future direction of the monarchy following Queen Elizabeth II’s death, we can also embrace the enduring example of conjugal affection and tenderness embodied by Her Majesty.

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