Sean Clouston* PhD Candidate, Department of Sociology, McGill University Amélie Quesnel-Vallée Assistant Professor, Departments of Sociology, Epidemiology, Biostatistics and Occupational Health, McGill University *Corresponding Author. Keywords: Partnership, Health, Life Course, Intersectionality, Risk, Benefit, Gender, Vulnerable Populations, “Paper presented at Conference on Health over the Life Course, University of Western Ontario, London, Ontario, October 2009.”

 Married people live longer than those who remain single both in Canada and the USA, with men showing the most gain from marriage. The benefit to marriage has been exlpicated in four different ways: marital benefits, with protective benefits going mostly to men; negative selection, with sicker individuals seeking healthcare from their spouses in a health-poor policy environment; clean-up for marriage, whereby mostly male risky behaviors are left behind prior to marriage; and positive selection, suggesting instead that the marital selection process is tied to health indicators evident in social circumstances. The importance of social policy to these realms is clear: not only do important healthcare differences define how health is cared for in each country, but maternal and childcare policies differ significantly in the burden placed on the family and thus often the mothers to cope with the double burden of work and childrearing. Using data from the Panel Study of Income Dynamics in the USA, and the Survey of Labour and Income Dynamics in Canada, this paper explicitly tests the relationship between marriage onset, marital selection in the years leading to marriage, and social causation in the years following marriage in a comparative context between Canada and the USA in order to understand the intersection between policy context, and gender relations within the family, and what impact these have on population health. Preliminary findings show that marital selection among men is more imporrtant in the USA than in Canada, and that the period after marriage is often followed by temporary health shocks for women in the USA but not in Canada. Policy implications are considered.

 Married men live 10 years longer than do unmarried men, for women the discrepancy is 4 years  Four hypotheses have arisen to explain this disparity ◦ Partnership as Beneficial to Health ◦ Cleaning Up for Partnership ◦ Negative Health Selection into Partnership ◦ Positive Health Selection of Partners

 These Four Hypotheses can be exhibited graphically: t partner (1) (2) Figure 1 Differing Explanations for Marital Benefits (1) Partnership Benefits – Waite (1995) (2) Cleaning Up for Partnership – Duncan et al. (2006) (3) Positive selection – Waldron et al. (4) Negative selection with benefits – Lillard & Panis (1996) (4) (3) Health of Stable Partnered Health of Stable Single Health

 The Partnership Benefits approach notes that the family often provides for members by acting as a form of insurance  Individuals defer risk by selecting healthy partners  More likely with limited social protections ◦ The family retains control over caretaking and healthcare responsibilities, and the family represents financial risk  Policy may thus change the impact of each of the four prior hypotheses

 Considered by Esping-Anderson as both being liberal welfare states  However, they have a couple of very different key gender and health policies ◦ Universal versus Entrepreneurial Healthcare ◦ Disability and Sickness insurance paid by EI and CPP (80% covered) versus no standard disability insurance (30% covered) ◦ 17 weeks Paid (90% eligible) versus 12 weeks (46% eligible)of unpaid Maternity and Paternity Leave  These may change the relationship between partnership and health

 Use Data from: ◦ Survey of Labour and Income Dynamics (SLID) in Canada ◦ Panel Study of Income Dynamics (PSID) in the USA  Samples include individuals who are followed over time and through their life course transitions  Sample includes individuals age  Multiple Imputation was completed where appropriate  Data is weighted to the population

 We draw non-linear smoothed curves of self- rated health over time  Consider the entrance into partnership  Time is oriented for all individuals around their entrance into partnership: t = 0  Adjustment for important social variables was done prior to drawing curves ◦ Gender; Partnership; Income; HH Income; Age; Age Cohort; Maximum Education; Employment Status; Hours Worked for Pay; Immigrant Status/Race; N Children; √HHSize

 These are the patterns for women entereing into partnership compared to those who were in relationships throughout and those who were single throughout in the USA  After controls: negative selection, no benefits

 Here we see the health curves of women in Canada  Negative Selection  Strong health benefits  Dip before entering partnership?

CanadaUSA MenWomenMenWomen Partnership Benefits YES NO Cleaning Up YESNO YES Positive Selection NO Negative Selection YES NOYES

 It is clear that much of the previous research has created attention around existence of disparity  However, this research suggests that disparity is caused by the interaction of social inequalities and public policy  Public policy creates the atmosphere within which assortative mating and social causation happen

 We see effectively slight but significant differences: More positive selection, less benefits in 0-3 years though similar overall Women Men