Marital status, marital transition and health behaviour and mental health outcomes among middle-aged and older adults in Thailand: A national longitudinal study

Objectives: The aim of this study was to assess the longitudinal association between marital status, marital transition, mental ill-health, and health risk behaviours among middle-aged and older adults in Thailand. Methods: We analyzed prospective cohort data of participants 45 years and older from three consecutive waves in 2015, 2017, and in 2020 (analytic sample, n = 2863) of the Health, Aging and Retirement in Thailand (HART) study. Sociodemographic and health variables were assessed by self-report. Results: Being single was positively associated with current smoking among men and transitioning to widowed or divorced was associated with incident current smoking among women. Divorced or separated was positively associated with current alcohol use among men and transitioning to marriage was associated with incident alcohol use among women. Being single or widowed was positively associated with underweight and negatively associated with obesity among women. Men who were divorced, single, or widowed had higher odds of having depressive symptoms and among women, transitioning to being widowed or divorced or separated was associated with incident depressive symptoms. Among both men and women, being divorced, single or widowed were positively associated with poor quality of life/happiness, and among men being divorced, single or widowed was positively associated with loneliness, and among women, being single or widowed was positively associated with loneliness. Among men, being single was positively associated with having an emotional or psychiatric disorder. Conclusion: We found among men and/or women that being unmarried was associated with several health risk behaviours and mental-ill health indicators.