Does the positive relationship between health and marriage reflect protection or selection? Evidence from middle-aged and elderly Japanese

This study investigates the marriage protection and selection effects among middle-aged and elderly Japanese. Using 9 years of a longitudinal data set from a nationally representative survey in Japan from 2005 to 2013, we extract 15,242 respondents aged 50–59 years in the baseline year. We utilize positive self-rated health to present subjective health status and lifestyle diseases to present objective health status. Using dynamic panel data approach to control for endogeneity issue, we find that being married does protect respondents’ subjective health, in terms of a higher probability of self-ratings of “very good” or “good” health statuses. Nonetheless, we find that marriage deteriorated their objective health in terms of a higher probability of having lifestyle diseases. Regarding the selection effect, better subjective health is found to select middle-aged and elderly Japanese into marriage, but such influence is fairly modest. Although objective health status also selects respondents into marriage, it positively affects women but adversely affects men. The findings provide a more comprehensive understanding of the relationship between marriage and health, which may have substantial implications for health-related public policies for middle-aged and elderly people in Japan.