NCHS Data Brief ■ No. 154 ■ June 2014

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Marriage, Cohabitation, and Men’s Use of 

Preventive Health Care Services

Stephen J. Blumberg, Ph.D.; Anjel Vahratian, Ph.D., M.P.H.; and Joseph H. Blumberg, M.S.

Key findings

Data from the National 

Health Interview Survey, 

2011–2012

• Among men aged 18–64, 

those who were married were 

more likely than cohabiting 

men and other not-married men 

to have had a health care visit 

in the past 12 months.

• Marriage was associated 

with greater likelihood of 

a health care visit for both 

younger and older men, and for 

men with health insurance.

• Among those for whom 

blood pressure, cholesterol, 

and diabetes screenings are 

recommended by the U.S. 

Preventive Services Task 

Force, married men were more 

likely than cohabiting men to 

have received these clinical 

preventive services in the past 

12 months.

• Cohabiting men were less 

likely than other not-married 

men to have had a health care 

visit, cholesterol check, or 

diabetes screening. 

Previous research has demonstrated that married men are more likely than 

not-married men to seek preventive health care services because their 

spouses encourage them to do so (1,2). It was not known, however, whether 

cohabiting partners of not-married men play a health-promoting role similar 

to that of spouses. With data from the 2011–2012 National Health Interview 

Survey (NHIS), selected measures of preventive health care service use were 

compared for three groups of men aged 18–64: married men (defined as those 

living with a spouse), cohabiting men (defined as those living with a partner 

who is not a spouse), and other not-married men. The consistency of observed 

differences by age and health insurance coverage status was also investigated.

Keywords: men’s health • health care utilization • doctor visits • screening

Married men were more likely than cohabiting men and other 

not-married men to have had a health care visit in the past 

12 months.

Figure 1. Percentage of men aged 18–64 with at least one health care visit in past 12 months,

by marital status: United States, 2011–2012

Total Married Cohabiting Other not-married

Percent

65.1

60.3

76.3

70.5

0

20

40

60

80

100

NOTE: Estimates for the three groups of men were significantly different from each other.

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2012.
NCHS Data Brief ■ No. 154 ■ June 2014

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Marriage and cohabitation were related to men’s use of health care. Among men aged 18–64, 

those who were married (76.3%) were more likely than cohabiting men (60.3%) and other 

not-married men (65.1%) to have had a health care visit within the past year. Cohabiting men 

were less likely than other not-married men to have had a health care visit within the past year 

(Figure 1).

Regardless of age, married men were more likely than cohabiting men and 

other not-married men to have had a health care visit in the past 12 months.

Men aged 45–64 (79.6%) were more likely than men aged 18–44 (64.1%) to have had a health 

care visit in the past 12 months. However, the association of marriage and cohabitation with 

men’s use of health care was generally consistent regardless of age. Among both age groups, men 

who were married were more likely than cohabiting men and other not-married men to have had a 

health care visit within the past year. Cohabiting men were less likely than other not-married men 

to have had a health care visit within the past year (Figure 2).

0

20

40

60

80

100 Other not-married

Aged 18–44 Aged 45–64

Percent

Total Married Cohabiting

Figure 2. Percentage of men aged 18–64 who had at least one health care visit in past 12 months, by age and marital 

status: United States, 2011–2012

64.1

68.6

57.1

61.7

1

79.6 83.0

68.5

73.6

1

Significantly different from men aged 18–44.

NOTE: Within each age group, estimates for the three groups of men were significantly different from each other.

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2012.
NCHS Data Brief ■ No. 154 ■ June 2014

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Married men were more likely than cohabiting men and other not-married 

men to have had a health care visit in the past 12 months only if they were 

insured.

Among men aged 18–64, those with health insurance coverage (78.6%) were more likely than 

those without coverage (42.6%) to have had a health care visit within the past 12 months. The 

association of marriage and cohabitation with men’s use of health care was observed only for 

insured men. For insured men, marriage was associated with higher likelihood of a health care 

visit, and cohabitation was associated with lower likelihood of a health care visit. For uninsured 

men, neither marriage nor cohabitation was associated with having had a health care visit 

(Figure 3).

0

20

40

60

80

100

Uninsured3 Insured2

Percent

Figure 3. Percentage of men aged 18–64 who had at least one health care visit in past 12 months, by health insurance 

coverage and marital status: United States, 2011–2012

Total Married Cohabiting Other not-married

78.6 81.7

70.7

75.3

1

42.6 44.6 42.4 41.3

1

Significantly different from insured men. 2

Estimates for the three groups of men were significantly different from each other. 3

None of the estimates for the three groups of men were significantly different from each other.

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2012.
NCHS Data Brief ■ No. 154 ■ June 2014

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Married men were more likely than cohabiting men and other not-married 

men to have received recommended clinical preventive services in the past 

12 months.

The U.S. Preventive Services Task Force recommends that, on a regular basis, all adults have 

their blood pressure checked, men aged 35 and over have their blood cholesterol checked, and 

adults with hypertension be screened for type 2 diabetes (3). Marriage and cohabitation were both 

related to men’s receipt of these clinical preventive services. Among men for whom the service 

was recommended, receipt of each service was more likely for those who were married than for 

those who were cohabitating or not married. Cholesterol and diabetes screenings were less likely 

for cohabiting men than for other not-married men (Figure 4). 

Figure 4. Percentage of men who received selected clinical preventive services in past 12 months, by marital status: 

United States, 2011–2012

0

20

40

60

80

100

Percent

Total Married Cohabiting Other not-married

Men aged 18–64 who

had their blood pressure checked1

Men aged 35–64 who

had their blood cholesterol 

checked2

Men aged 18–64 with diagnosed 

hypertension3 who had a diabetes 

screening2

73.4

79.7

65.1 66.7 64.5

68.9

52.0

56.9

64.5

69.8

47.9

57.1

1

Estimates for married men were significantly different from estimates for the other two groups. 2

Estimates for the three groups of men were significantly different from each other. 3

Defined as having been told they had hypertension by a doctor or other health professional on two or more visits.

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2012.

Summary

Married men were more likely than not-married men to have had a health care visit within the 

past 12 months. This association was observed for both younger and older men, but only among 

men with health insurance. When men have the means to access health care, spouses may play 

a role in their use of health care by directly encouraging men to seek preventive care and by 

indirectly evoking in men a sense of economic and social obligation to the family (1,2). 

The results suggest that cohabiting partners do not play a similar health-promoting role. 

Compared with both married men and other not-married men, cohabiting men were less likely to 

have had a health care visit. They were also less likely to have had selected clinical preventive 

services in the past 12 months, including blood pressure checks and screenings for elevated 

cholesterol and diabetes. In fact, cohabiting men are a group particularly at risk of not receiving 

clinical preventive services recommended by the U.S. Preventive Services Task Force. Only about 

one-half of men in this group for whom cholesterol and diabetes screenings are recommended had 

received these screenings in the past 12 months.
NCHS Data Brief ■ No. 154 ■ June 2014

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Definitions

Blood pressure screening: Based on responses to the survey question, “During the past 12 months, 

have you had your blood pressure checked by a doctor, nurse, or other health professional?”

Cholesterol screening: Based on responses to the survey question, “During the past 12 months, 

have you had your blood cholesterol checked by a doctor, nurse, or other health professional?”

Diabetes screening: Based on responses to the survey question, “Have you had a fasting test for 

high blood sugar or diabetes during the past 12 months?”

Health care visit: Based on responses to the survey question, “During the past 12 months, how 

many times have you seen a doctor or other health care professional about your own health 

at a doctor’s office, a clinic, or some other place? Do not include times you were hospitalized 

overnight, visits to hospital emergency rooms, home visits, dental visits, or telephone calls.”

Health insurance status: Insured men include those who, at the time of interview, had any private 

health insurance, Medicare, Medicaid, Children’s Health Insurance Program, state-sponsored or 

other government-sponsored health plan, or military plan. Men were defined as uninsured if they 

did not have any of these coverage types, had only Indian Health Service coverage, or had only a 

private plan that paid for one type of service, such as accidents or dental care.

Hypertension: To be classified with diagnosed hypertension, also called high blood pressure, 

respondents had to report that they had been told by a doctor or other health professional that they 

had hypertension on two or more different visits. 

Marital status: Not-married men include those reported to be widowed, divorced, separated, or 

never married. Cohabiting men are those reported to be living with a partner. For men identified 

as married, a separate survey question asked if their spouse was living in the household. Married 

men whose spouse was not in the household and men with unknown marital status were excluded 

from all analyses. Spouses and partners may be of any gender and age.

Data source and methods

NHIS is a multipurpose health survey conducted continuously throughout the year by the Centers 

for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS). 

Interviews are conducted in respondents’ homes, but follow-ups to complete interviews may be 

conducted over the telephone. One knowledgeable person from each family answered questions 

about each family member, including age, marital status, and health insurance coverage. One 

randomly selected “sample adult” from each interviewed family answered questions about 

himself or herself, including health care use. Active-duty Armed Forces personnel were not 

eligible to be selected as the sample adult, but they were included when determining marital 

status. For further information about NHIS, visit the NHIS website at: http://www.cdc.gov/nchs/

nhis.htm.

Analyses in this report were based on NHIS data collected in 2011 or 2012 from 24,310 sample 

adult men aged 18–64. Analyses were limited to sample adults under age 65 because nearly all 

adults aged 65 and over have had a health care visit in the past 12 months (4). Sampling weights 

were used to produce national estimates that are representative of the civilian noninstitutionalized 
NCHS Data Brief ■ No. 154 ■ June 2014

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U.S. population (5). Point estimates and statistical tests were calculated using SUDAAN software 

(version 11.0; RTI International, Research Triangle Park, N.C.) to account for the complex sample 

design of NHIS. All estimates shown in this report have a relative standard error (RSE) less than 

7.7% and meet the NCHS standard for reliability (RSE of 30% or less). All comparisons were 

evaluated for statistical significance at the 0.05 level using two-sided tests.

About the authors

Stephen Blumberg and Anjel Vahratian are with CDC/NCHS, Division of Health Interview 

Statistics. Joseph Blumberg is Executive Director of the Men’s Health and Wellness Center, Inc., 

in Atlanta, GA.

References

1. Norcross WA, Ramirez C, Palinkas LA. The influence of women on the health care-seeking 

behavior of men. J Fam Pract 43(5):475–80. 1996.

2. Stimpson JP, Wilson FA. Cholesterol screening by marital status and sex in the United States. 

Prev Chronic Dis 6(2):A55. 2009.

3. U.S. Preventive Services Task Force. USPSTF A and B recommendations. 2014. Available 

from: http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm.

4. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: National 

Health Interview Survey, 2012. National Center for Health Statistics. Vital Health Stat 10(260). 

2014.

5. Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health 

Interview Survey, 2006–2015. National Center for Health Statistics. Vital Health Stat 2(165). 

2014. 
NCHS Data Brief ■ No. 154 ■ June 2014

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NCHS Data Brief ■ No. 154 ■ June 2014

Suggested citation

Blumberg SJ, Vahratian A, Blumberg JH. 

Marriage, cohabitation, and men’s use of 

preventive health care services. NCHS data 

brief, no 154. Hyattsville, MD: National 

Center for Health Statistics. 2014.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

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