The health benefits of marriage and the adverse effects of family breakdown, both for individuals and society at large, are well documented in the medical literature, and yet the message that marriage is good for us is not getting out to our non-Christian colleagues.

In a recent morning surgery family breakdown was a significant factor in five of six depressed patients, one of six with physical problems, one of two for medication review and two DNAs. How different the morning could have been had relationships been intact, and how many more quality points I might have been able to earn! Studies back this up. Mental health improves after marriage and deteriorates after divorce or separation.(1) Even taking demographic factors into account children from single parent households are twice as likely to be unhappy, have low self-esteem, or mental health problems.(2) Single mothers have poorer health than their married counterparts.(3)

Throughout the Bible marriage and family are constantly affirmed. Christ himself was born into a family and knew what this involved. We are also encouraged to welcome strangers and the lonely into the Christian family. Family is the building block of society throughout the world and yet it is crumbling around us.

The message that marriage is good for us is not getting through to our non-Christian colleagues; and there are also many Christian doctors who don't know about the statistics surrounding family breakdown in Britain today. Although divorce rates have increased, once a couple have married they are far more likely to stay together than if they co-habit or if they marry prior to having children.(4) The health benefits of marriage, and the adverse affects of family breakdown are well documented (see box).

Family breakdown has huge financial implications too. In 2000 the direct cost to the UK government of family breakdown was estimated to be at least £15 billion per year (£11 per week for every taxpayer).(5) An accountant friend worked out that a doctor who earns £70,000 a year will contribute at least £35 a week to sorting out the problems of family breakdown, the major components being for social benefits and welfare, the criminal justice system, extra costs of education, free prescriptions and lost productivity.

As Christians we have a responsibility to be aware of the problems in our society. It is not our place to judge those who are in difficulty but to approach their problems as Christ would have done. As Christian doctors we are not immune from relationship problems ourselves and perhaps even more prone as we take on others burdens.

As Christians in the UK have begun to pray about the dire situation within families things have started to happen. Some towns and cities have set up Community Family Trusts, charitable organisations that work with registrars, religious organisations, health services, education authorities and debt services in order to provide simple relationship education.(6) Communication in relationships is vital as communication problems invariably lie at the heart of most of society's difficulties.

Community Family Trusts are in their infancy in the UK but already there are glimmers of hope. Marriage preparation classes are being set up and relationship education is starting to be seen in our schools. Trusts are bringing Christians together from different denominations, and hence churches are coming together as they look to ways of promoting marriage in their communities. The benefit is not just for Christians; non-Christians are being drawn in too. Hopefully as they see marriage working they will start to see something of Christ himself. It is a small step forward to solving a huge problem but there is hope of seeing a positive change in our society.

Health benefits of marriage

• 52% of co-habiting parents have split by the time their children are five, but 92% of married parents are still together.(7)
• 70% of children born to married parents expect to spend their entire childhood with both natural parents, but only 36% of children born to cohabiting parents do.(8)
• Divorced or co-habiting men aged 20-60 have 70%-100% higher mortality rates than married men. For women the figures are 35%-58%.(9) (10)
• Sudden Infant Death Syndrome (SIDS) is three times more common in cohabiting mothers than in married mothers, and seven times more common in single mothers than married mothers.(11)
• Child abuse is six times more common in stepfamilies, 33 times if mother has a live-in boyfriend, and 20 times when both biological parents cohabit.(12)
• Divorced fathers misuse more drugs and have more unsafe sex.(13)
• Divorced young people are twice as likely to drink more alcohol.(14)
• Married men earn 30-40% more than divorced men over a lifetime.(15)
• 69% of single mothers live in the bottom 40% of household income, compared with only 34% of married couples with children.(16)
• Single parents are eight times more likely to be out of work and twelve times more likely to receive benefits than married parents.(17) (18)
• Children from broken homes are nine times more likely to become young offenders - and make up 70% of all young offenders.(19)

References

• Marks N, Lambert J. Marital status continuity and change among young and midlife adults: longitudinal effects on psychological well-being. Journal of Family Issues,1998;19:652-86
• Cockett M, Tripp, J. The Exeter Family Study: Family Breakdown and its Impact on Children. Exeter: University of Exeter Press, 1994
• Benzeval M. The self-reported health status of lone parents. Social Science & Medicine 1998;46:1337-1353
• Boheim R, Ermisch J. Breaking up - financial surprises and partnership dissolution. Paper presented at the Royal Economic Society Conference, Nottingham, 1999
• Family Matters Institute. The cost of family breakdown. A report for the Lords and Commons Family and Child Protection Group 2000
• www.foccusinc.com;
• Kiernan K. Childbearing outside marriage in Western Europe. Population Trends, 1999;98:11-20
• Ermisch J, Francesconi M. Patterns of household & family formation. In Berthoud R, Gershuny J (eds). Seven Years in the Lives of British Families. Bristol: The Policy Press, 2000
• Office of National Statistics. Mortality Statistics: General Review of the Registrar General on Deaths in England and Wales, 1999. Series DH1 32. London: HMSO, 2001
• Lillard LA, Waite LJ. Till Death Do Us Part: Marital Disruption and Mortality. American Journal of Sociology 1995;100:1131-1156
• Office of National Statistics. Mortality Statistics: Childhood, Infant & Perinatal Review of the Registrar General on Deaths in England and Wales. Series DH3 33. London: HMSO, 2002
• Whelan R. Broken homes and battered children; a study of the relationship between child abuse and family type. Oxford: Family Education Trust, 1994
• Umberson D. Family status & health behaviours: Social control as a dimension of social integration. Journal of Health & Social Behavior 1987;28:306-319
• Power C et al. Heavy alcohol consumption and marital status: Disentangling the relationship in a national study of young adults. Addiction, 1999;94:1477-1487
• Schoeni R. Marital status and earnings in developed countries. Journal of population economics 1995;8:351-9
• Department for Work & Pensions. Households below average income 1994/95 to 2000/01. London: HMSO, 2002
• Office of National Statistics. Work & worklessness among households. London: HMSO, 2001
• Office of National Statistics. Family resources survey, Great Britain, 2000-01. London: HMSO, 2002
• Youth Justice Board. Review 2001/02: Building on success. London: HMSO, 2002