Changes in marital status and links to self-rated health: A study of temporal relationships

This study examines whether self-rated health (SRH) changes predict marital status changes or vice versa, and tests whether changes in trust mediate the relationship between marital transition and SRH change. A logistic regression model and a mediation analysis method are used separately to analyze the longitudinal data on 2,042 respondents from the Panel Study of Family Dynamics (PSFD) in Taiwan. The survey achieves response rates above 70%. The findings show that none of health status at either time point predict the three types of marital transitions including never married to married, married to divorced/separated, and married to widowed. Bonding trust plays a more important role than generalized trust in mediating the adverse effect of remaining widowed status on health change within a context of Confucian culture. Those who maintain a widowed state have a lower likelihood of sustaining high levels of bonding trust, which in turn leads to poor SRH. Hence, the findings provide more support for a social causation hypothesis rather than a health selection hypothesis.