The Costly Consequences of Divorce

Assessing the Clinical, Economic, and Public Health Impact of Marital Disruption in the United States.

A Research-Based Seminar

by
David B. Larson, M.D., M.S.P.H.
James P. Swyers, M.A.
Susan S. Larson, M.A.T.
National Institute for Healthcare Research
Rockville, Maryland

Table of Contents

Acknowledgments

Introduction

Purpose and Intended Audience for This Seminar

Structure of the Seminar

Module 1: Is Marriage An Endangered Institution?

You will become familiar with recent trends in marriage, divorce, and remarriage statistics and the accompanying changes in Americans' attitudes about marriage and family life that have helped to shape these trends. You will also become familiar with how these trends have substantially altered family life in this country. You will then be able to begin to examine how this knowledge may be relevant to family and marital problems and begin to formulate potential approaches for dealing with these difficulties.

• 1.1 Introduction
• 1.2 What Are Trends in Marriage, Cohabitation, Divorce, and Remarriage in Recent Decades?
• 1.2.1 Marriage
• 1.2.2 Cohabitation
• 1.2.3 Divorce
• 1.2.4 Remarriage
• 1.3 How Have Americans' Views and Attitudes About Marriage, Divorce, Being Single, and Parenthood Changed in Recent Decades?
• 1.3.1 Trends in Attitutes About Marriage
• 1.3.2 Trends in Attitudes About Divorce
• 1.3.3 Trends in Attitudes About Remaining Single
• 1.3.4 Trends in Attitudes About Parenting and Childlessness
• 1.3.5 Trends in Attitudes About Cohabitation
• 1.4 How Have Recent Changes in Marriage Behavior and Attitudes About Marriage Altered Family Life in the United States?
• 1.5 Conclusion

Module 2: What Are The Clinical And Economic Consequences Of Marital Disruption For Spouses?

You will become familiar with the economic and clinical consequences of divorce for adults and also be able to discuss the issues such consequences raise for potential marital and family counseling, treatment, and intervention.

• 2.1 Introduction
• 2.2 What Are the Mortality and Morbidity Consequences of Marital Disruption?
• 2.2.1 Mortality
• 2.2.2 Morbidity
• 2.3 What Are the Psychological Consequences of Marital Disruption for Spouses?
• 2.3.1 Psychiatric Disease
• 2.4 What Are the Economic Well-Being and Social Adjustment Consequences of Marital Disruption for Spouses?
• 2.5 Economic Well-Being
• 2.5.1 Social Adjustment
• 2.5.2 Research Linking Economic Hardship and Social Adjustment Problems with Psychological Stress
• 2.6 Conclusion

Module 3: What Are The Clinical And Economic Consequences Of Marital Disruption For Children, Adolescents, And Young Adults?

You will become familiar with the major potential consequences of divorce and separation for children, adolescents, and young adults. This includes a variety of effects that either independently or in combination with other predictive factors can significantly affect the ability of many individuals who have experienced divorce as a child to adjust to everyday life strains and adversity. You will then be able to use this information to form an overall picture of post-divorce family dynamics, both short-term and long-term.

• 3.1 Introduction
• 3.2 How Does Marital Disruption Affect Parent-Child Relationships?
• 3.3 What Are the Consequences of Marital Disruption on Child Self-Esteem?
• 3.4 How Does Marital Disruption Affect Child-Peer Relationships?
• 3.5 How Does Marital Disruption Affect the Academic Success of Children?
• 3.6 How Does Marital Disruption Affect the Short and Long-Term Behavioral Adjustment of Children, Adolescents, and Young Adults?
• 3.6.1 Delinquent and Antisocial Behavior
• 3.6.2 Alcohol and Other Drug Abuse
• 3.6.3 Behavioral and Emotional Problems
• 3.6.4 Suicide and Depression
• 3.6.5 Early Sexuality
• 3.7 How Does Marital Disruption Affect the Physical Health of Children, Adolescents, and Young Adults?
• 3.8 How Does Marital Disruption Affect the Economic Well-Being of Children, Adolescents, and Young Adults?
• 3.9 Conclusion

Module 4: Does Remarriage Lessen Negative Consequences Of Marital Disruption?

This module will review many of the challenges and stressors faced by stepfamilies when compared to nuclear families and how these additional stresses can affect both the adults and children involved. You will also become familiar with some explanatory models that have been developed to help explain why stepfamilies face additional complicating stressful factors as well as research providing support for these models. In essence, this module attempts to provide a more complete picture of the different types and sequences of events that are likely to occur as the result of the breakup of a first marriage when it is followed by a remarriage.

• 4.1 Introduction
• 4.2 Why Are Remarriages Less Stable Than First-Time Marriages?
• 4.3 How Well Are People Prepared for the Rigors of Stepfamily Life?
• 4.4 How Well Do Stepfamilies Bond?
• 4.5 What Are the Physical and Psychological Consequences for Stepfamily Members When Adequate Cohesion Fails to Occur?
• 4.5.1 What Are the Physical and Psychological Well-Being Consequences for Stepchildren?
• 4.5.2 What Are the Physical and Psychological Health Consequences for Stepparents?
• 4.5.3 Conclusion

Module 5: What Are Public Health And Public Policy Issues Associated With Marital Disruption?

This Module reviews the research concerning several major potential public health and public policy issues associated with marital disruption. One issue concerns the increased utilization of health care services and social welfare programs by those who have experienced a marital disruption. In addition, public health consequences such as increased costs to society of undereducation of individuals who have experienced a marital disruption as a child as well as their increased potential for becoming involved in juvenile delinquency and adult crime are discussed. Finally, possible public health and policy responses to these continuing problems are reviewed.

• 5.1 Introduction
• 5.2 How Does Marital Disruption Contribute to Health Care Costs?
• 5.2.1 Utilization of Mental Health Services
• 5.2.2 Utilization of Outpatient and Inpatient Health Care
• 5.2.3 Use of Medicaid
• 5.3 How Does Marital Disruption Contribute to Child Poverty and Welfare Dependency?
• 5.4 How Does Marital Disruption Contribute to Diminished Economic and Occupational Achievement for Adults Who Experienced Divorce as a Child?
• 5.5 How Does Marital Disruption Contribute to Juvenile Delinquency and Crime?
• 5.6 Conclusion

Module 6: What Are The Determinants Of Marital Instability And Marital Satisfaction?

This module reviews several important factors that research shows can contribute to marital instability and divorce. The module also reviews factors that the research shows can contribute to higher levels of marital satisfaction, in turn increasing marital stability. This information may be useful in saving and improving troubled marriages.

• 6.1 Introduction
• 6.2 Who Is Most Likely to Divorce and Why?
• 6.2.1 How Does Exposure to Divorce as a Child Affect Later Marital Instability?
• 6.2.2 Does Having Premarital Sex Affect Marital Instability?
• 6.2.3 How Does Age at First Marriage Affect Marital Instability?
• 6.2.4 How Does Length of Courtship Affect Marital Instability?
• 6.2.5 How Does Premarital Cohabitation Contribute to Marital Instability?
• 6.2.6 Is There a Relationship Between Racial Characteristics and Marital Instability?
• 6.2.7 How Does Socioeconomic Status Contribute to Marital Instability?
• 6.2.8 How Do Economic Cycles Contribute to Marital Instability?
• 6.2.9 Personal Accounts of Divorce
• 6.3 Determinants of Marital Stability and Satisfaction
• 6.3.1 How Can Effective Communication and Conflict Resolution Protect Marriages?
• 6.3.2 How Does Wife-Husband Division of Household Labor and Childrearing Responsibilities Contribute to Marital Satisfaction and Stability?
• 6.3.3 Does Childbearing Contribute to Marital Stability?
• 6.3.4 How Does Religious Commitment Affect Marital Stability?
• 6.3.5 Personal Accounts of Enduring Marriages
• 6.4 Conclusion

References