The percentage of unmarried individuals in Japan is on the rise. For those who are yet to be married, health is as important as economic stability. Yet, recent studies suggest that many unmarried individuals find it difficult to stay healthy.
Yutaka Honkawa, a social statistician, calculated the mortality rate of the Japanese population, using the data published in the Population Survey Report of 2014. The results showed that the number of unmarried men (including those who got divorced or lost their wives) who died between the age of 45 and 64 was 2.2 times the number of married men in the same age range who died. In the case of women, there was almost no difference in the mortality rate between married and unmarried women.
What could be the cause of the high mortality rate in middle-aged to senior unmarried men? Is it somehow related to their marital status? Or is it because many of the men in these age ranges could not get married in the first place because they had health problems?
A study group led by two public health experts, Associate Professor Ai Ikeda of Juntendo University and Professor Hiroyasu Iso of Osaka University, came to the conclusion that the mortality rate in this age group was indeed related to the marital status of these men.
The research group conducted a follow-up survey of approximately 100,000 men and women in the age range of 40–79 for 10 years (from 1990 to 1999) to find out how many had died during this period, the causes of death, and whether their gender and marital status had any significant relationship with their death.
Poor living habits
At the beginning of the survey, various parameters such as smoking habit, blood pressure, fitness habits, etc., were used to evaluate the initial health status of all the surveyed individuals and correct the data accordingly. A comparative analysis of the corrected data showed that the number of unmarried men who died from myocardial infarction, pulmonary problems, and external causes, including suicide, during the surveyed period was 3.5 times, 2.4 times and 2.2 times, respectively, the number of married men.
“We believe that one of the significant attributes of unmarried men who have a high mortality risk is poor living habits, which include unhealthy eating habits,” says Professor Iso. He pointed out that many unmarried men who passed away during the survey period had a habit of omitting their breakfast. He explained how blood pressure increases sharply if we do not eat in the morning after waking up and how this can increase the risk of cerebral stroke.
Professor Iso also explained why the mortality rate in women is not affected by their marital status: according to Honkawa’s data, in general, women have better self-management skills than men in all aspects of life and their eating habits do not change drastically before and after they get married.
Unhealthy eating habits were cited as a significant causal factor of the high mortality risk, including the frequent intake of nutritionally imbalanced food. According to the results of the National Health and Nutrition Survey conducted by the Ministry of Health, Labour and Welfare (MHLW) in 2008, the amount of ready-made food, such as deli meals and boxed lunches, purchased by single households was double that purchased by households with two or more individuals.
However, MHLW’s survey data do not clarify whether the single households had male or female members. Considering the generally accepted view that more women than men cook their own meals, it would be reasonable to infer that unmarried men tend to purchase prepared food more often than women living alone.
Another statistical finding relevant to this topic was released by a research team at the University of London this spring. It revealed that bachelors consumed more meat and carbohydrates and less vegetables and fruits annually (approximately 7 kg less) than married men.
Mental health is also a familiar issue with unmarried people, compared to married couples and those living with a partner. The statistical data released by the Center for Suicide Prevention showed that the suicide rate among unmarried individuals is, on average, 1.25 times higher than that among those who are married.
What is more frightening is that the suicide rate increases with age. The number of suicides among unmarried middle-aged men (45–55 years old) and seniors (55–64 years old) was 2.1 and 2.4 times, respectively, more than that among married ones in the same age ranges.
According to Dr. Makoto Kitada, head of Shin-Roppongi Clinic, developing a feeling of belonging to a community or a group is the most effective way of preventing suicide: “It can be a workplace, school, or hobby group. It does not matter,” he says.
“The key is to find someone in that community with whom you can share your negative or suicidal feelings when they occur to you. Having that someone on whom you can lean on and get emotional support from when you are down and out will help prevent suicidal thoughts from occurring to you,” says the psychiatrist.
For most people, family members such as their spouse and children are the ones who they feel the closest affinity with; unfortunately, unmarried individuals find it difficult to experience such affinity.
It also seems highly likely that men are more vulnerable to loneliness than women. Compared to unmarried women who are generally more used to socializing and eager to enjoy life by participating in groups that share the same interest in hobbies and what not, many working men who live alone rarely have places to go to or private friends to meet on a regular basis, other than commuting to their offices and hanging out with their colleagues after work.
The likelihood of physical or mental illness leading to death varies largely according to the behavior of the person after he or she finds out about the illness. There are many diseases that will not have fatal results if a person finds out about his or her condition and gets proper medical treatment at an early stage.
“But a lot of unmarried men are very poor with their health management after they get ill,” sighs Professor Iso. Many of them tend to ignore their condition until they get seriously sick. By the time they seek medical help, their disease has worsened, requiring them to spend longer hours and days getting treated. In the worst case, they may even be diagnosed too late.
Difference in the behavior
In February, an international study group formed by members of various institutions, including Shanghai Medical College, released the results of its survey conducted on 17,000 patients diagnosed with gastric cancer. The report indicated that there was a difference in the behavior of married and unmarried patients after they were diagnosed with the disease.
More specifically, the percentage of unmarried patients who underwent surgery or radiation therapy was lower than the percentage of married patients.
“Cancer is a disease that has numerous treatment options now,” says Dr. Sho Okiyama, who runs a medical portal called Medley. “The survival of cancer patients varies considerably according to the option they choose for their treatment. We believe that their choice is largely affected by the degree of their hope and desire to continue living.”
When Okiyama was an emergency physician at the Japanese Red Cross Medical Center, he witnessed many unmarried elderly patients who were carried into the hospital. He still has a vivid memory of the visit he made to a house where an unmarried old man was found dead a few days after he fell unconscious in his home. The poor old man was left unattended until a gardener who was watering the plants in the garden next door requested an emergency unit to check on the neighbor, who had been unusually quiet for several days.
“When someone falls unconscious, his or her probability of survival depends largely on whether there is somebody like a family member who will notice it and call the ambulance immediately or not,” remarked the doctor.
Living with a family may not always have a positive impact on health, whether physical or mental. For example, many married men may be more prone to lifestyle-related diseases because their partners often like to cook and feed them meals that are excessively high in calories or are nutritionally imbalanced.
On another note, the rise of domestic violence is also viewed as a social issue that has a detrimental effect on the physical and mental well-being of family members. Nonetheless, recent statistical data clearly show that the chances of living longer are much higher when you have a lifetime partner rather than when you live in solitude.