Spouses doing yoga together

For Better or Worse: Spouses Make or Break Well-Being

Does having a healthy partner increase your odds of being healthy, too? What if your spouse is sedentary, has high blood pressure, and anxiety… does that put you at risk?

The dynamics of health within couples — and how to use it to boost well-being — was addressed in a breakout session at HERO Forum16 in Atlanta by Ashlin Jones, MA, Sr. Informatics Analyst with Healthways, and Andrew Rundle, DrPH, Associate Professor of Epidemiology, Columbia’s Mailman School of Public Health.

Risk and Relationships

According to Jones, couples co-create health through shared environmental factors, lifestyles, social contagion (spreading of information, ideas, behaviors), and other factors. For example, when one has a history of diabetes, the other has a 26% increased risk of developing this condition (1).

A Healthways study of married couples — with 1 partner participating in a year-long disease management program — found spouse well-being is a major predictor of well-being change among participants:

  • For all risk categories, participants were more likely to develop the risk if their spouse had the risk factor.
  • When health risks were shared, participants were more likely to remove the risk if the spouse did, too — except for obesity.
  • When a spouse reported high well-being, the participant had a greater improvement in well-being compared to participants whose spouses reported low well-being.

This isn’t a huge surprise; most married couples already know they influence each other in numerous ways, intentionally and unintentionally. But the findings are especially compelling in the context of workplace wellness — underscoring the vital importance of tapping into the power of family relationships when designing well- being programs and communications.

Heart to Heart

Dr. Rundle shared fascinating observations about spouse influence on cardiovascular health risk factors:

  • Certain measures (systolic and diastolic blood pressure, BMI) tend to converge to the mean over time, even after adjusting for changes in weight. So if a husband’s blood pressure starts out within normal limits and his wife’s readings are high, his will tend to go up and hers will tend to go down.
  • When a partner’s body weight, blood pressure, HDL or LDL cholesterol improve, the other partner’s numbers also improve significantly.
  • This influence isn’t seen when partners’ ages are more than 2 years apart.

Another study by Rundle and colleagues found that higher levels of depression and anxiety predicted shorter sleep duration in the other spouse in 1 year (2).

What to do:

In light of these and similar findings, Jones and Rundle each point to the value of targeting partners as behavior-change units — encouraging shared goal setting and tailoring interventions to the needs of the couple vs. individuals, for example.

This could play out in a number of ways for your well-being program:

  • Gather contact information. At every opportunity (events, registrations, mailed communications), invite spouses to submit preferred contact information for announcements about programs and services.
  • Go the extra mile. Employees don’t always share program information with their families. Create a communication strategy specifically targeting family members… even if they’re not covered by your medical plans. Use social media, regular mail, email, text, and even robo-calls to spread the word.
  • Invite family to events: flu shots, health screenings, lunch-and-learns, weekend 5K races, and company picnics. Use these opportunities to connect with the people who have the most influence over employee health.
  • Meet them where they are. It’s not always practical or convenient for partners to come onsite; work with your EAP provider to offer on-demand webinars on parenting issues, eldercare, personal finance, and more.
  • Ask for couples-oriented services. Your health management vendors work for you, so let them know what you want. Meet with representatives to discuss the value of working with couples together to address risk factors, brainstorm strategies, and create service enhancements.
  • Buddy-up for wellness. Roll out challenges that reinforce the power of social influence on health, and encourage couples to register together to work toward common goals. Provide tips on how to be an effective wellness partner, highlighting specific support strategies. And before launching online programs, test and retest to ensure flawless execution so they can both participate without a hassle.

Capitalize on the most influential people in the lives of workers with services and programs targeting the needs of couples, and you’ll set the stage for a longer, stronger, healthier ever after.



1. Leong A, Rahme E, Dasgupta K, Spousal diabetes as a diabetes risk factor: A systematic review and meta-analysis, BMC Medicine 2014 12:12 DOI: 10.1186/1741-7015-12-12

2. Revenson T, Mari’n-Chollom A, Rundle A, Wisnivesky J, Neugut A, Hey Mr. Sandman: dyadic effects of anxiety, depressive symptoms and sleep among married couples, Journal of Behavioral Medicine 39(2) November 2015 DOI: 10.1007/s10865-015-9693-7


Beth ShepardBeth Shepard
Well-being consultant, educator, writer |National Board Certified Health & Wellness Coach |Certified Lifestyle Medicine Coach|ACSM Certified Clinical Exercise Physiologist |25+ years in wellness |Jazz enthusiast.