Marriage and Health in Malawi

项目总结 到目前为止，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处于中心地位 在这一背景下，关于其与健康的关系的研究仍处于初级阶段。而当 这些早期的研究证明，婚姻和健康确实是相互关联的， 几乎没有考虑到非洲背景的其他关键特征的影响，如 由于不同的婚姻模式和习俗(如早婚、一夫多妻制)， 传统的性别规范，以及艾滋病毒/艾滋病的流行，将婚姻与健康联系起来。 撒哈拉以南非洲有限的研究表明，这是一个独特而重要的 背景研究婚姻与健康的关系，具有社会规范、传染性 疾病和婚姻习俗，这与大多数关于婚姻和婚姻的研究 健康已经设定好了。在这项拟议的研究中，我们打算使用丰富的纵向数据集来 研究马拉维婚姻和健康之间的联系。在这样做时，我们解决了几个问题 影响对这种关系的研究的方法论挑战。我们使用纵向 数据和统计方法，以减少在检查两者之间的联系时的常见偏差 婚姻和身心健康，如未被观察到的与 婚姻和健康，以及选择不同健康状况的个人进入婚姻 变化(主要是再婚和解体)。我们利用详细的回顾 用于识别结合开始和结束日期、婚姻状况(仍处于已婚状态， 离婚/分居和丧偶)、离婚/分居的原因以及一夫多妻的结合。我们 还将来自丈夫和妻子的数据组合在一起，以产生用于 进行二元分析。我们使用经过验证的仪器(SF-12)来测量多个 心理和身体健康的维度以及每个维度的特定分量表(例如， 抑郁、焦虑、身体机能)。我们分析了从15岁到80岁以上的个人数据 几年来，这让我们能够解释不同国家之间婚姻健康关系的差异 生命历程。最后，我们利用从离开研究的移民那里收集的数据 最大限度地减少自然减员偏见，并考虑到婚姻和移民之间的联系。

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.