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

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.

Fig. 1

Conceptual framework.

Fig. 2

Distribution of women by child marriage and widowed/divorced/separated groups across age group, residence, and wealth index quintiles Note: Estimates were obtained using complex survey weights.

Fig. 3

Hypertension prevalence across socioeconomic groups by marital age and marital status groups – by younger (18–34) and older (35–49) age groups Note: Estimates were obtained using complex survey weights. The orange-colored cross shows the average prevalence of the respective socioeconomic groups. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

Fig. 4

Hypertension prevalence across socioeconomic groups by marital age and marital status groups – by urban and rural areas Note: Estimates were obtained using complex survey weights. The orange-colored cross shows the average prevalence of the respective socioeconomic groups. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)