The role of child marriage and marital disruptions on hypertension in women - A nationally representative study from India

Ashwini Tiwari; Biplab Kumar Datta; Mohammad Rifat Haider; Murshed Jahan

doi:10.1016/j.ssmph.2023.101409

The role of child marriage and marital disruptions on hypertension in women - A nationally representative study from India

SSM Popul Health. 2023 Apr 17:22:101409. doi: 10.1016/j.ssmph.2023.101409. eCollection 2023 Jun.

Authors

Ashwini Tiwari¹, Biplab Kumar Datta¹, Mohammad Rifat Haider², Murshed Jahan³

Affiliations

¹ Institute of Public and Preventive Health, Augusta University, 1120 15th Street, CJ 2300, Augusta, GA, 30912, USA.
² Department of Health Policy and Management, College of Public Health, University of Georgia, Wright Hall 301B 100 Foster Rd, Athens, GA, 30602, USA.
³ Langdale College of Business Administration, Valdosta State University, 1500 N. Patterson St, Valdosta, GA, 31698, USA.

Abstract

Child marriage is associated with negative health trajectories among women in low- and middle-income countries (LMICs). Marital disruptions in LMICs are also associated with adverse socioeconomic and health outcomes in women. Yet, little is known about the compounded health effects of experiencing both child marriage and marital disruptions. Using nationally representative data from India among women aged 18-49 years, we examined the effects of marital age (i.e., marriage before or after 18 years) and martial disruptions (i.e., widowed/divorced/separated) on the odds of having hypertension. Findings suggest that together, marital disruptions and child marriage increase the risk of hypertension. Specifically, women married as children and who experienced marital disruptions were 1.2 (95% CI: 1.2-1.3) times more likely to have hypertension compared to women who married as adults and currently in marriage. Additionally, among women married as children, those who experienced martial disruptions had a higher risk (AOR = 1.1, 95% CI: 1.0-1.2) of hypertension compared to their currently married peers. These results suggest public health strategies must consider contextual effects of being widowed/divorced/separated among women who were married as children. Simultaneously, prevention initiatives should be strengthened to reduce the incidence of child marriage in LMICs and associated downstream health consequences.

Keywords: Child marriage; Hypertension; Marital disruptions.