Sunday, August 31, 2008

The Ghosts of New Orleans

I remember the first time I saw New Orleans, in June of 2001. I was flying in from California to work at a medical trade show at the Ernest J. Morial convention center. The green, lush, humid city was so different from the brown, parched hills I had left behind that I suddenly became homesick for the humid, overgrown, mosquito-infested summers of the upper Midwest, where I grew up. I didn't realize how much I had missed the general fecundity of life near muddy rivers and lakes.

It was my first real business trip, and I was thrilled to travel on someone else's dime. I had bought a travel guidebook, hoping to haul my co-workers out to eat beignets and crawfish and bread pudding with bourbon sauce in the French Quarter. Could we squeeze in a garden tour or a paddleboat ride up the Mississippi or a jazz club or (one co-worker's favorite) a swamp tour that promised alligator spottings, I wondered? No -- I had to work. We slogged onto the shuttle to the convention center each morning, and took turns running the booth where we were selling patient education brochures.

Clearly, New Orleans was poor. The air-conditioned ride from the hotel next to the French Quarter to the enormous convention center was probably walkable, but I doubt the visitor's bureau wanted conventioneers to look closely at the tiny run-down houses, sketchy-looking bars and restaurants, and broken pavement that reminded me of the south side of Chicago. I knew the crime rate was high, too. Still, I loved New Orleans because it was so different from where I lived: the music, the southern accents, the humidity, the alligators, the fried food for breakfast, lunch, and dinner. When I got back, I told my husband that we needed to take a vacation there some day.

Then Katrina hit. I spent a week glued to the television every night, yelling variations on why the doesn't somebody help these people? I held my own infant daughter as I watched parents pass a baby in diapers onto a bus that they couldn't get on themselves to escape the flooded city. The television showed images of bodies floating face-down in the water, of a young woman going into a diabetic seizure after yelling "I don't want to die!" in the convention center where I had been. Each day that people were still stuck in the city, I became more incredulous and horrified.

The memories return to me, unwanted, with Hurricane Gustav currently headed for New Orleans, even though New Orleans is almost fully evacuated now and far better prepared for a hurricane than it was before Katrina. I told my husband Katrina was the worst thing I ever saw on television. There was nothing to do but watch the misery unfold, and watch the places I had been become utterly unrecognizable.

Thursday, August 28, 2008

Is Marriage Healthy?

Statistically, married men and women enjoy better health than their single, separated, divorced, or widowed counterparts. But the size and scope of this "health benefit" have changed dramatically over the past few decades, with disparities between the experiences of men and women, according to a new analysis in the September issue of the Journal of Health and Social Behavior ("The Times They Are a Changin': Marital Status and Health Differentials from 1972 to 2003" by Hui Liu and Debra J. Umberson).

The authors track the self-reported health status of married and unmarried men and women over three decades. In 1972, women who were married, divorced, widowed, or never married all had about the same rate of excellent/good health (a probability of about .92), while separated women had lower rates of excellent/good health (a probability of about .9). Married men in 1972 were more likely to report excellent/good health (about .92 probability) than those who were widowed, separated, or divorced (about .91 probability). Never-married men were least likely to report good/excellent health (about .89 probability). By 2003, however, the dissolution of a marriage had become a health liability for both genders. Men and women who went through separation, divorce, or the death of a spouse had the worst health, the authors write.

Over the years, unmarried men have become about as healthy as married men, in contrast to the 1972 statistics. The authors attribute this increase to better social support for single men, although they point out that there are many other ways to interpret this data, such as improvements in medical care since the 1970s. Widowed people in 2003, especially women, had far worse health than married men and women. Ultimately, the authors find marriage a risky proposition these days because so many marriages fail. They conclude that "getting married increases one's risk for eventual marital dissolution, and marital dissolution seems to be worse for self-rated health now than at any point in the past three decades."

Why is post-marriage life so dismal for both men and women? Studies have shown that marriage provides economic benefits and social support, both of which can positively impact a person's mental and physical health, the authors write. If a married couple is deeply unhappy, however, separation or divorce seems like a solution that will ultimately make each partner happier and healthier. The authors point out that the couple pays the price, though, in the increased economic strain of maintaining separate households. If a partner has been out of the workforce for a while the economic blow is even worse, and can harm their health even more.