Marriage and Health in Malawi

项目摘要 迄今为止，绝大多数关于婚姻和健康的研究几乎都集中在 欧洲或北美。尽管婚姻在撒哈拉以南非洲的社会生活中占有中心地位， (SSA)在这方面，关于其与健康关系的研究仍处于初期阶段。而 这些早期的研究证明，婚姻和健康确实是相互关联的， 很少考虑非洲背景的其他关键特征的影响， 不同的婚姻模式和习俗（例如，早婚、一夫多妻制）、持续的 传统的性别规范和艾滋病毒/艾滋病的流行，婚姻与健康之间的联系。 在撒哈拉以南非洲进行的有限的研究表明，这是一个独特而重要的 研究婚姻与健康的关系，具有社会规范性、感染性 疾病和婚姻习俗，这些与大多数关于婚姻和 健康状况已经确定。在这项拟议的研究中，我们打算使用丰富的纵向数据集， 研究马拉维婚姻与健康之间的联系。在此过程中，我们解决了几个问题。 方法上的挑战影响了对这种关系的研究。我们使用纵向 数据和统计方法，以减少在审查 婚姻和精神和身体健康，如未观察到的特征， 婚姻与健康的关系，以及选择不同健康状况的个体进入婚姻 改变（主要是再婚和解散）。我们利用详细的回顾 婚姻历史，以确定婚姻的开始和结束日期，婚姻状况（仍然已婚， 离婚/分居和丧偶）、离婚/分居的原因和一夫多妻制结合。我们 还将丈夫和妻子的数据联合收割机组合起来，生成一个夫妇级别的数据集， 进行二元分析。我们使用经过验证的工具（SF-12）， 心理和身体健康的维度，以及每个维度的具体分量表（例如， 抑郁、焦虑、身体机能）。我们分析了15岁到80岁以上的个人的数据 年，这使我们能够解释不同的婚姻健康关系， 生命历程最后，我们利用从已经离开研究的移民那里收集的数据， 这一领域旨在最大限度地减少自然减员偏见，并说明婚姻与移民之间的联系。

PROJECT SUMMARY To date, the vast majority of research on marriage and health has almost exclusively focused on Europe or North America. Despite the centrality of marriage to social life in sub-Saharan Africa (SSA), research on its relationship with health is still in its nascent stages in this context. While these early studies have documented that marriage and health are indeed interrelated, there has been little consideration of the implications of other key features of the African context, such as different marriage patterns and customs (e.g., early marriage, polygyny), persistence of traditional gender norms, and the HIV/AIDS epidemic, for the link between marriage and health. The limited body of research in sub-Saharan Africa suggests that it is a unique and important setting to study the relationship between marriage and health, with social norms, infectious diseases, and marital practices that differ from contexts where most research on marriage and health have been set. In this proposed study, we intend to use a rich, longitudinal dataset to examine the link between marriage and health in Malawi. In doing so, we address several methodological challenges that have affected research on this relationship. We use longitudinal data and statistical approaches to reduce common biases in examining the connection between marriage and mental and physical health, such as unobserved characteristics associated with both marriage and heath, and the selection of individuals with different health status into marital change (mainly remarriage and dissolution). We take advantage of detailed retrospective marriage histories to identify union start and end dates, status of marriage (still married, divorced/separated, and widowed), reasons for divorce/separation, and polygynous unions. We also combine data from husbands and wives to produce a couple-level dataset that is used to conduct dyadic analyses. We use a validated instrument (the SF-12) that measures multiple dimensions of mental and physical health, as well as specific subscales of each (e.g., depression, anxiety, physical functioning). We analyze data from individuals aged 15 to over 80 years, which allows us to account for differences in the marriage-health relationship across the life course. Finally, we take advantage of data collected from migrants who have left the study area to minimize attrition bias and account for the connection between marriage and migration.