Does marriage matter? Racial differences in allostatic load among women

Prior research suggests that there are health benefits associated with marriage, although the physiological implications of marital status for women's health is less clear. Given that recent trends indicate that Black women are less likely to marry than White women, the goal of this study was to evaluate whether marital status accounts for racial differences in women's physical health. Using data from the Nashville Stress and Health Study (2011-2014), we estimated the probability of high allostatic load (AL), a biological indicator of physiological dysregulation, among women aged 18-69. We examined AL scores by race and marital status, evaluated the extent to which Black-White differences persisted after accounting for marital status, and assessed whether the racial disparity in AL varied across marital status groups. Results indicated that Black women had higher AL than White women, although racial differences in AL were not explained by marital status. In addition, marital status was a significant predictor of AL among Black, but not White women. Moreover, the racial disparity in AL was smallest among never married women and largest among currently and formally married women. Taken together, these findings suggest that Black-White inequalities in women's physical health are not explained by racial differences in marital status, despite the widening racial gap in marriage. Nevertheless, marital status may be an influential factor in shaping outcomes among Black women.