Although empirical work has shown that personal and spousal education are both related to health, the nature of these associations has been harder to establish. People select into marriages on the basis of observed and hard-to-observe characteristics, complicating the job of the researcher who wishes to make causal inferences. In this article, we implement a within-sibling-pair design that exploits variation within pairs in spousal education to generate estimates of spousal crossover effects. Results—based on a long-term study of siblings and their spouses—suggest that spousal education is positively related to health, but to a greater degree for women than men. Sensitivity analyses show that these patterns are unlikely to derive from measured differences between individuals or unmeasured characteristics that sort them into unions. These results are consistent with network-based theories of social capital, which view education as a resource that can be mobilized by network ties to enhance health.
AminVikeshBehrmanJere R.KohlerHans-Peter. 2015. “Schooling Has Smaller or Insignificant Effects on Adult Health in the US Than Suggested by Cross-Sectional Associations: New Estimates Using Relatively Large Samples of Identical Twins.”Social Science & Medicine127(2015):181–89.
2.
AndersonChristy M.BurnsDavid M.DoddKevin W.FeuerEric J.2012. “Birth-Cohort-Specific Estimates of Smoking Behaviors for the U.S. Population.”Risk Analysis32(S1):S14–S24.
3.
AshenfelterOrleyKruegerAlan. 1994. “Estimates of the Economic Return to Schooling from a New Sample of Twins.”American Economic Review84(5):1157–73.
4.
BakerDavid P.LeonJuanSmith GreenawayEmily G.CollinsJohnMovitMarcela. 2011. “The Education Effect on Population Health: A Reassessment.”Population and Development Review37(2):307–32.
5.
BanksJamesKellyElaineSmithJames P.2014. “Spousal Health Effects—the Role of Selection.” Pp. 255–82 in Discoveries in the Economics of Aging, edited by WiseD. A., Chicago, IL: University of Chicago Press.
6.
BehrmanJere R.KohlerHans-PeterJensenVibeke M.PedersenDorthePetersenIngeBingleyPaulChristensenKaare. 2011. “Does More Schooling Reduce Hospitalization and Delay Mortality? New Evidence Based on Danish Twins.”Demography48(4):1347–75.
7.
BerkmanLisa F.GlassThomas. 2000. “Social Integration, Social Networks, Social Support, and Health.” Pp. 137–73 in Social Epidemiology, edited by BerkmanL. F.KawachiI.New York, NY: Oxford University Press.
8.
BerkmanLisa F.GlassThomasBrissetteIanSeemanTeresa E.2000. “From Social Integration to Health: Durkheim in the New Millennium.”Social Science & Medicine51(6):843–57.
9.
BerkmanLisa F.SymeS. Leonard. 1979. “Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-Up Study of Alameda County Residents.”American Journal of Epidemiology109(2):186–204.
10.
BrownDustin C.2021. “Spousal Education and Mortality Risk among Married Adults in the United States.”Department of Sociology, Mississippi State University, MS. Unpublished manuscript.
11.
BrownDustin C.HummerRobert A.HaywardMark D.2014. “The Importance of Spousal Education for the Self-Rated Health of Married Adults in the United States.”Population Research and Policy Review33(1):127–51.
12.
CarmelliDoritSwanGary E.HuntSteven C.WilliamsRoger R.1989. “Cross-Spouse Correlates of Blood Pressure in Hypertension-Prone Families in Utah.”Journal of Psychosomatic Research33(1):75–84.
13.
CasselJohn. 1976. “The Contribution of the Social Environment to Host Resistance: The Fourth Wade Hampton Frost Lecture.”American Journal of Epidemiology104(2):107–23.
14.
ChiapporiPierre-AndréOrefficeSoniaQuintana-DomequeCliment. 2017. “Bidimensional Matching with Heterogeneous Preferences: Education and Smoking in the Marriage Market.”Journal of the European Economic Association16(1):161–98.
15.
CobbSidney. 1976. “Social Support as a Moderator of Life Stress.”Psychosomatic Medicine38(5):300–14.
16.
CourtenayWill H.2000. “Constructions of Masculinity and Their Influence on Men’s Well-Being: A Theory of Gender and Health."Social Science & Medicine50(10):1385–401.
17.
De NeveJan-WalterKawachiIchiro. 2017. “Spillovers between Siblings and from Offspring to Parents Are Understudied: A Review and Future Directions for Research.”Social Science & Medicine183(2017):56–61.
18.
DeSalvoKaren B.BloserNicoleReynoldsKristiHeJiangMuntnerPaul. 2006. “Mortality Prediction with a Single General Self-Rated Health Question.”Journal of General Internal Medicine21(3):267–75.
19.
DiMaggioPaulGaripFiliz. 2012. “Network Effects and Social Inequality.”Annual Review of Sociology38:93–118.
20.
DomingueBenjamin W.FletcherJasonConleyDaltonBoardmanJason D.2014. “Genetic and Educational Assortative Mating among US Adults.”Proceedings of the National Academy of Sciences111(22):7996–8000.
21.
DupreMatthew E.2007. “Educational Differences in Age-Related Patterns of Disease: Reconsidering the Cumulative Disadvantage and Age-as-Leveler Hypotheses.”Journal of Health and Social Behavior48(1):1–15.
22.
EgelandGrace M.TverdalAageMeyerHaakon E.SelmerRandi. 2002. “A Man’s Heart and a Wife’s Education: A 12-Year Coronary Heart Disease Mortality Follow-Up in Norwegian Men.”International Journal of Epidemiology31(4):799–805.
23.
EmmonsWilliam R.KentAna H.RickettsLowell R.2019. “Is College Still Worth It? The New Calculus of Falling Returns.”Federal Bank of St. Louis Review101(4):297–329.
24.
FanWenQianYue. 2019. “Rising Educational Gradients in Mortality among U.S. Whites: What Are the Roles of Marital Status and Educational Homogamy?”Social Science & Medicine235(2019):1–9.
25.
FayersPeter M.SprangersMirjam A. G.2002. “Understanding Self-Rated Health.”The Lancet359(9302):187–88.
26.
FrankenbergElizabethJonesNathan R.2004. “Self-Rated Health and Mortality: Does the Relationship Extend to a Low Income Setting?”Journal of Health and Social Behavior45(4):441–52.
27.
FreeseJeremyLutfeyKaren. 2011. “Fundamental Causality: Challenges of an Animating Concept for Medical Sociology.” Pp. 67–81 in Handbook of the Sociology of Health, Illness, and Healing, edited by PescosolidoB. A.MartinJ. K.McLeodJ. D.RogersA.New York, NY: Springer New York.
28.
FriedmanEsther M.MareRobert D.2014. “The Schooling of Offspring and the Survival of Parents.”Demography51(4):1271–93.
29.
GelmanAndrewHillJenniferVehtariAki. 2020. Regression and Other Stories. Cambridge, UK: Cambridge University Press.
30.
GrilichesZvi. 1979. “Sibling Models and Data in Economics: Beginnings of a Survey.”Journal of Political Economy87(5, Part 2):S37–S64.
31.
HaasSteven A.2007. “The Long-Term Effects of Poor Childhood Health: An Assessment and Application of Retrospective Reports.”Demography44(1):113–35.
32.
HaasSteven A.BishopNicholas J.2010. “What Do Retrospective Subjective Reports of Childhood Health Capture? Evidence From the Wisconsin Longitudinal Study.”Research on Aging32(6):698–714.
33.
Halpern-MannersAndrewHelgertzJonasWarrenJohn RobertRobertsEvan. 2020. “The Effects of Education on Mortality: Evidence from Linked US Census and Administrative Mortality Data.”Demography57:1513–41.
34.
HauserRobert M.2005. “Survey Response in the Long Run: The Wisconsin Longitudinal Study.”Field Methods17(1):3–29.
35.
HauserRobert M.PalloniAlberto. 2011. “Adolescent IQ and Survival in the Wisconsin Longitudinal Study.”The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences66B:i91–101.
36.
HernandezElaine M.DawJonathanThomeerMieke Beth. 2018. “The Combined Influences of Parental, Spousal, and Individual Education on Current Smoking Behavior.”Department of Sociology, Indiana University, IN. Unpublished manuscript.
37.
HernandezElaine M.PullenErinBrauerJonathan. 2019. “Social Networks and the Emergence of Health Inequalities Following a Medical Advance: Examining Prenatal H1N1 Vaccination Decisions.”Social Networks58(2019):156–67.
38.
HouseJames S.RobbinsCynthaMetznerHelen L.1982. “The Association of Social Relationships and Activities with Mortality: Prospective Evidence from the Tecumseh Community Health Study.”American Journal of Epidemiology116(1):123–40.
39.
HoutMichael. 2012. “Social and Economic Returns to College Education in the United States.”Annual Review of Sociology38:379–400.
40.
HughesMary ElizabethWaiteLinda J.2002. “Health in Household Context: Living Arrangements and Health in Late Middle Age.”Journal of Health and Social Behavior43(1):1–21.
41.
HuijtsTimMondenChristiaan W. S.KraaykampGerbert. 2009. “Education, Educational Heterogamy, and Self-Assessed Health in Europe: A Multilevel Study of Spousal Effects in 29 European Countries.”European Sociological Review26(3):261–76.
42.
HummerRobert A.HernandezElaine M.2013. “The Effect of Educational Attainment on Adult Mortality in the United States.”Population Bulletin68(1):1–16.
43.
HummerRobert A.LariscyJoseph T.2011. “Educational Attainment and Adult Mortality.” Pp. 241–61 in International Handbook of Adult Mortality. Vol 2. edited by RogersR. G.CrimminsE. M.Dordrecht: Springer Netherlands.
44.
IdlerEllen L.RussellLouise B.DavisDiane. 2000. “Survival, Functional Limitations, and Self-Rated Health in the NHANES I Epidemiologic Follow-Up Study, 1992.”American Journal of Epidemiology152(9):874–83.
45.
JacksonMichelleCoxD. R.2013. “The Principles of Experimental Design and Their Application in Sociology.”Annual Review of Sociology39:27–49.
46.
JaffeDena H.EisenbachZviNeumarkYehuda D.ManorOrly. 2006. “Effects of Husbands' and Wives’ Education on Each Other's Mortality.”Social Science & Medicine62(8):2014–23.
47.
JylhäMarja. 2009. “What Is Self-Rated Health and Why Does It Predict Mortality? Towards a Unified Conceptual Model.”Social Science & Medicine69(3):307–16.
48.
KalmijnMatthijs. 1998. “Intermarriage and Homogamy: Causes, Patterns, Trends.”Annual Review of Sociology24:395–421.
49.
KilpiFannyMartikainenPekkaKonttinenHannaSilventoinenKarriTorssanderJennyKawachiIchiro. 2018. “The Spillover Influence of Partner's Education on Myocardial Infarction Incidence and Survival.”Epidemiology29(2):237–45.
50.
KimbroRachel TolbertBzostekSharonGoldmanNoreenRodríguezGermán. 2008. “Race, Ethnicity, and the Education Gradient in Health.”Health Affairs27(2):361–72.
51.
LauderdaleDiane S.2001. “Education and Survival: Birth Cohort, Period, And Age Effects.”Demography38:551–61.
52.
LeendersRoger. 1995. Structure and Influence: Statistical Models for the Dynamics of Actor Attributes, Network Structure and Their Interdependence. Amsterdam: Thesis Publishers.
53.
LinNan. 2001. Social Capital: A Theory of Social Structure and Action. New York, NY: Cambridge University Press.
54.
LinkBruce G.NorthridgeMary E.PhelanJo C.GanzMichael L.1998. “Social Epidemiology and the Fundamental Cause Concept: On the Structuring of Effective Cancer Screens by Socioeconomic Status.”The Milbank Quarterly76(3):375–402.
55.
LinkBruce G.PhelanJo. 1995. “Social Conditions as Fundamental Causes of Disease.”Journal of Health and Social Behavior Spec No:80–94.
56.
LynchJamie L.von HippelPaul T.2016. “An Education Gradient in Health, a Health Gradient in Education, or a Confounded Gradient in Both?”Social Science & Medicine154(2016):18–27.
57.
LynchScott M.2003. “Cohort and Life-Course Patterns in the Relationship between Education and Health: A Hierarchical Approach.”Demography40(2):309–31.
58.
MackenbachJohan P.StirbuIrinaRoskamAlbert-Jan R.SchaapMaartje M.MenvielleGwennLeinsaluMallKunstAnton E.2008. “Socioeconomic Inequalities in Health in 22 European Countries.”New England Journal of Medicine358(23):2468–81.
59.
MaralaniVidaPortierCamille. 2021. “The Consolidation of Education and Health in Families.”American Sociological Review86(4):670–99.
60.
MarkeyCharlotte N.MarkeyPatrick M.GrayHeather Fishman. 2007. “Romantic Relationships and Health: An Examination of Individuals’ Perceptions of their Romantic Partners’ Influences on Their Health.”Sex Roles57(5):435–35.
61.
MatthewsKaren A.KelseySheryl F.MeilahnElaine N.MullerLewis H.WingRena R.1989. “Educational Attainment and Behavioral snd Biologic Risk Factors for Coronary Heart Disease in Middle-Aged Women.”American Journal of Epidemiology129(6):1132–44.
62.
MatySiobhan C.Everson-RoseSusan A.HaanMary N.RaghunathanTrivellore E.KaplanGeorge A.2005. “Education, Income, Occupation, and the 34-Year Incidence (1965–99) of Type 2 Diabetes in the Alameda County Study.”International Journal of Epidemiology34(6):1274–81.
63.
MirowskyJohnRossCatherine E.2003. Education, Social Status, and Health. New York, NY: Routledge.
64.
MoenPhyllisHernandezElaine M.2009. “Social Convoys: Studying Linked Lives in Time, Context, and Motion.” Pp. 258–79 in The Craft of Life Course Research, edited by ElderG. H.GieleJ. Z.New York, NY: Guilford Press.
65.
MondenChristiaan W. S.van LentheFrankDe GraafNan DirkKraaykampGerbert. 2003. “Partner’s and Own Education: Does Who You Live with Matter for Self-Assessed Health, Smoking and Excessive Alcohol Consumption?”Social Science & Medicine57(10):1901–12.
66.
MontezJennifer K.ZajacovaAnnaHaywardMark D.WoolfSteven H.ChapmanDerekBeckfieldJason. 2019. “Educational Disparities in Adult Mortality Across U.S. States: How Do They Differ, and Have They Changed Since the Mid-1980s?”Demography56(2):621–44.
67.
MontezJennifer KarasHaywardMark D.2014. “Cumulative Childhood Adversity, Educational Attainment, and Active Life Expectancy among U.S. Adults.”Demography51(2):413–35.
68.
MontezJennifer KarasZajacovaAnna. 2014. “Why Is Life Expectancy Declining among Low-Educated Women in the United States?”American Journal of Public Health104(10):e5–7.
69.
MurakamiKeikoOhkuboTakayoshiHashimotoHideki. 2017. “Distinct Association between Educational Attainment and Overweight/Obesity in Unmarried and Married Women: Evidence from a Population-Based Study in Japan.”BMC Public Health17(1):1–9.
70.
PaisJeremyCrowderKyleDowneyLiam. 2013. “Unequal Trajectories: Racial and Class Differences in Residential Exposure to Industrial Hazard.”Social Forces92(3):1189–215.
71.
PampelFred C.KruegerPatrick M.DenneyJustin T.2010. “Socioeconomic Disparities in Health Behaviors.”Annual Review of Sociology36:349–70.
72.
PearlJudea. 2009. Causality: Models, Reasoning, and Inference. New York, NY: Cambridge University Press.
73.
PerryBrea L.PescosolidoBernice A.2015. “Social Network Activation: The Role of Health Discussion Partners in Recovery from Mental Illness.”Social Science & Medicine125(2015):116–28.
74.
PescosolidoBernice A.1991. “Illness Careers and Network Ties: A Conceptual Model of Utilization and Compliance.”Advances in Medical Sociology2(16):164–81.
75.
PescosolidoBernice A.2006. “Of Pride and Prejudice: The Role of Sociology and Social Networks in Integrating the Health Sciences.”Journal of Health and Social Behavior47(3):189–208.
76.
PescosolidoBernice A.LevyJudith A.2002. “The Role of Social Networks in Health, Illness, Disease and Healing: The Accepting Present, the Forgotten Past, and the Dangerous Potential for a Complacent Future.” Pp. 3–28 in Social Networks and Health, edited by LevyJ. A.PescosolidoB. A.New York, NY: JAI Press.
77.
PhelanJo C.LinkBruce G.2013. “Fundamental Cause Theory.” Pp. 105–25 in Medical Sociology on the Move, edited by CockerhamW. C.Dordrecht: Springer Netherlands.
78.
PolonijoAndrea N.CarpianoRichard M.2013. “Social Inequalities in Adolescent Human Papillomavirus (HPV) Vaccination: A Test of Fundamental Cause Theory.”Social Science & Medicine82(2013):115–25.
79.
RauscherEmily. 2019. “Why Who Marries Whom Matters: Effects of Educational Assortative Mating on Infant Health in the United States 1969–1994.”Social Forces98(3):1143–73.
80.
RobinsJames M.RotnitzkyAndrea. 1995. “Semiparametric Efficiency in Multivariate Regression Models with Missing Data.”Journal of the American Statistical Association90(429):122–29.
81.
RossCatherine E.MirowskyJohn. 2006. “Sex Differences in the Effect of Education on Depression: Resource Multiplication or Resource Substitution?”Social Science & Medicine63(5):1400–13.
82.
RossCatherine E.WuChia-ling. 1995. “The Links between Education and Health.”American Sociological Review60(5):719–45.
83.
SchaferMarkus H.2013. “Discussion Networks, Physician Visits, and Non-conventional Medicine: Probing the Relational Correlates of Health Care Utilization.”Social Science & Medicine87(2013):176–84.
84.
SchwartzChristine R.2013. “Trends and Variation in Assortative Mating: Causes and Consequences.”Annual Review of Sociology39:451–70.
85.
SchwartzChristine R.MareRobert D.2005. “Trends in Educational Assortative Marriage from 1940 to 2003.”Demography42(4):621–46.
86.
ShaliziCosma RohillaThomasAndrew C.2011. “Homophily and Contagion Are Generically Confounded in Observational Social Network Studies.”Sociological Methods & Research40(2):211–39.
87.
SmithJames P.2009. “The Impact of Childhood Health on Adult Labor Market Outcomes.”The Review of Economics and Statistics91(3):478–89.
88.
SmithKirsten P.ChristakisNicholas A.2008. “Social Networks and Health.”Annual Review of Sociology34:405–29.
89.
SongLijun. 2013. “Social Capital and Health.” Pp. 233–57 in Medical Sociology on the Move, edited by CockerhamW. C.Dordrecht: Springer Netherlands.
90.
SongLijunChangTian-Yun. 2012. “Do Resources of Network Members Help in Help Seeking? Social Capital and Health Information Search.”Social Networks34(4):658–69.
91.
SongLijunFrazierCleothia G.PettisPhilip J.2018. “Do Network Members’ Resources Generate Health Inequality? Social Capital Theory and beyond.” Pp. 233–56 in Elgar Companion to Social Capital and Health, edited by S. F.NauenbergE.London: Edward Elgar Publishing Limited.
92.
SweeneyMegan M.2002. “Two Decades of Family Change: The Shifting Economic Foundations of Marriage.”American Sociological Review67(1):132–47.
93.
SyseAstriLyngstadTorkild Hovde. 2017. “In Sickness and in Health: The Role of Marital Partners in Cancer Survival.”SSM - Population Health3(2017):99–110.
94.
TorssanderJ.EriksonR.2009. “Marital Partner and Mortality: The Effects of the Social Positions of Both Spouses.”Journal of Epidemiology & Community Health63(12):992–98.
95.
TorssanderJennyMoustgaardHetaPeltonenRiinaKilpiFannyMartikainenPekka. 2018. “Partner Resources and Incidence and Survival in Two Major Causes of Death.”SSM - Population Health4(2018):271–79.
96.
UmbersonDebra. 1987. “Family Status and Health Behaviors: Social Control as a Dimension of Social Integration.”Journal of Health and Social Behavior28(3):306–19.
97.
UmbersonDebraMontezJennifer Karas. 2010. “Social Relationships and Health: A Flashpoint for Health Policy.”Journal of Health and Social Behavior51(Suppl. 1):S54–66.
98.
UmbersonDebraPudrovskaTetyanaReczekCorinne. 2010. “Parenthood, Childlessness, and Well-Being: A Life Course Perspective.”Journal of Marriage and Family72(3):612–29.
99.
ValenteThomas W.2010. Social Networks and Health: Models, Methods, and Applications. Oxford, UK: Oxford University Press, Inc.
100.
VanderWeeleTyler J.ChristakisNicholas A.2019. “Network Multipliers and Public Health.”International Journal of Epidemiology48(4):1032–37.
101.
VanthommeKatrienVandenheedeHadewijchHagedoornPaulienGadeyneSylvie. 2016. “Socioeconomic Disparities in Lung Cancer Mortality in Belgian Men and Women (2001–2011): Does It Matter Who You Live with?”BMC Public Health16:1–10.
102.
von HippelPaul T.2016. “New Confidence Intervals and Bias Comparisons Show That Maximum Likelihood Can Beat Multiple Imputation in Small Samples.”Structural Equation Modeling: A Multidisciplinary Journal23(3):422–37.
103.
WaiteLinda J.GallagherMaggie. 2001. The Case for Marriage: Why Married People Are Happier, Healthier, and Better Off Financially. New York, NY: Doubleday.
104.
WarrenJohn RobertSheridanJennifer T.HauserRobert M.2002. “Occupational Stratification across the Life Course: Evidence from the Wisconsin Longitudinal Study.”American Sociological Review67(3):432–55.
105.
WilliamsDavid R.SternthalMichelle. 2010. “Understanding Racial-Ethnic Disparities in Health: Sociological Contributions.”Journal of Health and Social Behavior51(1):S15–27.
106.
WinklebyMarilyn A.JatulisDarius E.FrankEricaFortmannStephen P.1992. “Socioeconomic Status and Health: How Education, Income, and Occupation Contribute to Risk Factors for Cardiovascular Disease.”American Journal of Public Health82(6):816–20.
107.
WolfeJoseph D.BauldryShawnHardyMelissa A.PavalkoEliza K.2018. “Multigenerational Attainments, Race, and Mortality Risk among Silent Generation Women.”Journal of Health and Social Behavior59(3):335–51.
108.
WooldridgeJeffrey M.2007. “Inverse Probability Weighted Estimation for General Missing Data Problems.”Journal of Econometrics141(2):1281–301.
109.
XuMinle. 2019. “Spousal Education and Cognitive Functioning in Later Life.”The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences75(7):e141–50.
110.
ZhangJingwenCentolaDamon. 2019. “Social Networks and Health: New Developments in Diffusion, Online and Offline.”Annual Review of Sociology45:91–109.
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