Relationship status

Being in a committed long-term relationship is linked to lower all-cause mortality and modest gains in life expectancy (often ~2–5 extra years), especially for men and younger adults, while repeated unmarried status or living alone is associated with higher mortality.

Summary

• Large cohort studies and meta-analyses show that married or stably partnered people have ~10–20% lower all-cause mortality than those who are never-married, divorced, or widowed.
• In some cohorts, being unmarried at age ~60 is linked to ~4–5 years shorter life expectancy compared with married peers, especially in men and people with cardiovascular disease.
• Living alone and weak social ties add extra risk, particularly in men and adults under 65.
• Relationship quality matters: unhappy or high-conflict marriages do not offer the same protection as supportive relationships.
• KamaLama score range (relationship status factor):
  • In a committed relationship → +2 years
  • Single/divorced/widowed/other → 0 years (baseline)

1. Why relationship (marital) status matters

Relationship status is a simple proxy for several deeper mechanisms:

• Social support and care
  Partners often remind about medications, notice early symptoms, and accompany to medical visits.

• Health behaviours
  On average, married or partnered people:

  • Smoke less
  • Are more physically active
  • Adhere better to treatment plans
    (Ben-Shlomo et al., 1993; Kaplan & Kronick, 2006; Bourassa et al., 2019)

• Economic and practical stability
  Shared housing, shared income and routines can reduce chronic stress and financial strain.

• Emotional well-being
  Close, supportive bonds buffer loneliness, depression and stress, which are independently linked to mortality.

These mechanisms help explain why, at the population level, marriage or long-term partnership is associated with lower mortality and modestly longer life expectancy, even after adjustment for age, income and health behaviours.

2. What large studies show

2.1. Mortality risk by marital status

• A systematic review and meta-analysis of over 250,000 older adults found that married people had about 12% lower all-cause mortality than non-married (RR 0.88, 95% CI 0.85–0.91). Widowed, divorced/separated and never married individuals all had 11–16% higher mortality than married peers (RRs 1.11–1.16). (Manzoli et al., 2007)
• A classic US cohort showed that never-married men had the highest premature mortality, with differences between married and unmarried partly explained by smoking and other risk factors, but not fully eliminated. (Ben-Shlomo et al., 1993; Kaplan & Kronick, 2006)
• Large Asian cohorts (Japan Collaborative Cohort, multi-country Asian data) also show higher mortality in unmarried people, particularly men and those <65 years. (Ikeda et al., 2007; Leung et al., 2022)

Across populations:

• Married/partnered vs non-married: roughly 10–20% lower all-cause mortality.
• Effects are consistently stronger in men than in women in many studies. (Staehelin et al., 2011; Frisch & Simonsen, 2013; Nielsen et al., 2019)

2.2. Life expectancy differences (years of life)

Some cohorts convert these relative risks into years of life:

• In a Swedish population-based study of people undergoing coronary artery bypass grafting, unmarried women at age 60 had 4.8 years shorter median life expectancy, and unmarried men had 5.0 years shorter life expectancy than married peers. (Nielsen et al., 2019)
• Population studies in Europe and Asia suggest that, depending on age and health status, being unmarried vs married can correspond to ~1–5 years difference in remaining life expectancy, with the largest gaps in middle age and among those with existing disease. (Kaplan & Kronick, 2006; Leung et al., 2022; Frisch & Simonsen, 2013)

These differences are meaningful but smaller than those seen for major risk factors such as smoking, severe physical inactivity or uncontrolled hypertension.

2.3. Living alone, cohabitation and social isolation

Relationship status overlaps with living arrangements and social connection:

• A systematic review and meta-analysis found that living alone was associated with 15% higher mortality overall (RR ~1.15), with a stronger effect in adults <65 years (RR ~1.41) and in men. (Zhao et al., 2022)
• In a Chinese registry of young and middle-aged patients after acute myocardial infarction, living alone was linked to higher all-cause mortality compared with living with others. (Jiang et al., 2024)
• A national Danish cohort of 6.5 million people followed for up to three decades showed that cohabitation offers some protection vs being single, but in many settings marriage remains the most protective category. (Frisch & Simonsen, 2013)
• UK Biobank and other cohorts confirm that low social contact and weak social relationships are linked to higher mortality, partly overlapping with relationship status. (Foster et al., 2023; Gronewold et al., 2020; Boen et al., 2018)

3. How KamaLama measures this factor

3.1. KamaLama question

“Which option best describes your current romantic relationship status?”

KamaLama groups answers into categories that work across countries and cultures:

• In a committed relationship
  Married or in a long-term, stable partnership (including cohabiting).
• Not in a committed relationship
  Single, divorced, separated or widowed.
• Prefer not to say / other

Relationship status is one of several social-connection related factors in KamaLama, alongside:

• Relationship satisfaction (quality of the bond)
• Social activity (quality time with friends/family/colleagues)
• Happiness and stress

This reflects the evidence that status alone is not the whole story.

4. KamaLama score in years (relationship status)

Because relationship status has a modest but consistent impact compared with “heavy-hitters” like smoking or blood pressure, KamaLama keeps its range small and focuses on the extra protection of a committed partnership.

4.1. Score ranges

How to read this:

• Being in a committed relationship gives a small positive bonus in the KamaLama model (up to +2 years).
• Being single is not punished directly. Risk related to loneliness, low social activity or high stress is captured via separate factors.
• This matches the science: relationship status is one signal among many, and quality + social network often matter as much as the legal form.

5. How to move into a lower-risk pattern (without pressure)

You cannot “force” a relationship (and no one should feel pressured to). But there are practical ways to move closer to the lower-risk pattern that married/partnered people often have.

5.1. If you are in a relationship

• Invest in relationship quality

  • Studies show that marital dissatisfaction in men is linked to higher stroke and all-cause mortality, even when married. (Lev-Ari et al., 2021)
  • Use regular check-ins about needs and expectations.
  • Use “soft start-ups” in conflict (e.g., “I feel … when …”).
  • Consider couples therapy if conflict is frequent or unresolved.

• Protect shared health behaviours

  • Plan regular physical activity together (walks, classes, sports).
  • Align on smoking and alcohol goals; couples who quit together often do better.
  • Build shared routines for sleep and meals.

• Use your partnership as a health ally

  • Remind each other about screenings, vaccinations and medications.
  • Attend important medical visits together when helpful.

5.2. If you are not currently in a relationship

Evidence suggests that overall social connection is what matters most:

• Strengthen your wider social network

  • Prioritise regular quality time with friends, family or colleagues (tracked in KamaLama’s Social activity factor).
  • Join groups that match your interests (sports, volunteering, classes).

• Work on mental health and stress

  • High stress and low happiness are independent risk factors and can also affect relationship chances.
  • Small, repeatable routines (sleep, activity, relaxation, therapy or coaching where accessible) can improve mood and reduce stress.

• Stay open to future partnership, without self-blame

  • These findings are population-level averages, not guarantees.
  • Many single people with strong friendships, good health habits and low stress do very well in terms of life expectancy.

6. What this does not mean (myths vs nuance)

Myth 1: “Marriage is the biggest longevity factor.”

• Reality: Effects are meaningful but modest compared with smoking, physical inactivity, obesity or blood pressure. It is one factor, not the main one.

Myth 2: “Single people are doomed to die early.”

• Reality: Risk is average, not deterministic. Strong friendships, good health behaviours and emotional well-being can offset much of the statistical gap.

Myth 3: “Any marriage is better than no marriage.”

• Reality: Poor-quality, high-conflict relationships do not clearly protect health and may be harmful. (Lev-Ari et al., 2021)

Myth 4: “Relationship status is purely causal.”

• Reality: Healthier and wealthier people are often more likely to marry and stay married (health selection). Even with adjustment, some of the observed difference may be due to underlying traits (e.g., personality, income, baseline health). (Manzoli et al., 2007; Chen et al., 2025)

7. Methods & evidence used in KamaLama

For this factor, KamaLama prioritised:

• Systematic reviews & meta-analyses of marital status and mortality in elderly and general populations. (Manzoli et al., 2007; Zhao et al., 2022)
• Large national cohorts (Japan, Denmark, US, multi-country Asia) with long follow-up and clear marital status categorisation. (Ikeda et al., 2007; Frisch & Simonsen, 2013; Kaplan & Kronick, 2006; Leung et al., 2022)
• Special-population cohorts where life expectancy differences can be estimated directly (e.g., cardiac surgery, cancer patients). (Nielsen et al., 2019; Martínez et al., 2017)
• Studies of living alone, cohabitation and social relationships to separate status from social isolation. (Zhao et al., 2022; Jiang et al., 2024; Foster et al., 2023; Gronewold et al., 2020)
• Studies on relationship quality, to distinguish legal status from satisfaction and chronic conflict. (Lev-Ari et al., 2021; Boen et al., 2018)

Relative risks were then translated into an approximate years-of-life impact at population level and down-scaled into KamaLama’s unified scoring system, where each factor has a small-to-large impact band and overlaps with others (social connection, stress, mood, behaviours).

8. Key claims and evidence (KamaLama view)

References

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