Till Death Do Us Part, or maybe not. The classic marriage vow is to stay together “in sickness and in health” bounds couples to support each other no matter what. However, new research shows that when illness strikes, this promise isn’t always kept, especially if it is the wife who becomes ill.A major new study published in February 2025 in the Journal of Marriage and Family found that marriages are about seven times more likely to end when the wife becomes seriously ill compared to when the husband does. While most marriages survive a health crisis, this gender gap raises difficult questions about caregiving, emotional support, and the psychological toll of illness on relationships.The Study: Tracking Couples Across EuropeResearchers Daniele Vignoli, Giammarco Alderotti, and Cecilia Tomassini followed more than 25,000 heterosexual couples aged 50 and above, across 27 European countries, over an 18-year period. Couples were surveyed repeatedly about their physical health, mental health, daily functioning, and relationship status.The study focused on two groups: couples aged 50 to 64 and those aged 65 and older, to understand how age and life stage may influence relationship stability when illness strikes.Younger Couples: When Wives Get Sick, Divorces RiseThe most striking findings came from couples between 50 and 64. When wives reported poor health but husbands remained well, the marriage was significantly more likely to end compared to couples in which both partners were healthy.The same was true for limitations in daily life. If the wife struggled with everyday tasks but the husband did not, the couple’s risk of divorce increased. Interestingly, the reverse pattern, a sick or limited husband with a healthy wife, did not significantly increase the likelihood of divorce.Mental health also played a role. Wives experiencing depression were more likely to face separation, whereas husbands’ depression did not have the same effect.Older Couples: Depression Matters MostAmong couples in which at least one partner was 65 or older, physical illness was less strongly associated with divorce. Instead, depression became the main predictor of marital breakdown, but again, only when it was the wife who was depressed. If husbands were depressed but wives were not, the marriage was just as likely to continue as if neither partner had depression.The Psychological Angle: Caregiver Stress and Gender RolesWhy are marriages more likely to end when the wife gets sick? The researchers did not test specific explanations but suggested that caregiving roles may play a central part. In most heterosexual marriages, wives traditionally take on the bulk of caregiving tasks. When they become unable to fulfill that role, couples may experience more stress, both practically and emotionally.Psychologists suggest that men may enter marriage with an implicit expectation of being cared for. When illness requires them to become the primary caregiver, some may find the role emotionally overwhelming or inconsistent with their expectations, leading to marital breakdown.Financial dynamics may also matter. Women in this age group are often more economically vulnerable and may face barriers to leaving a stressful marriage even when they want to. This means that when divorces do happen, they may be driven by the healthier spouse, in this case, the husband.Previous Research Paints a Similar PictureThis is not the first study to highlight this troubling trend. Earlier research on couples in which one partner was diagnosed with a brain tumor or multiple sclerosis found that 21% of marriages ended when the wife was the patient, compared to just 3% when the husband was the one who was ill.That sevenfold difference reinforces the idea that illness affects women’s marriages more than men’s — a finding that has serious psychological implications for women facing chronic disease.Life After Divorce: The Resilience of SinglesInterestingly, research also shows that people who have always been single, sometimes referred to as “single at heart”, often cope better with illness or life transitions than those who divorce later in life. Lifelong singles typically maintain strong friendships, community ties, and the skills needed to navigate daily life on their own.This raises an important point: the fear that single people will have “no one” to care for them may be misplaced. Marital status does not guarantee emotional or physical support, and as this study shows, women may actually face a higher risk of abandonment when ill.A Call to Rethink Support SystemsThe findings carry significant implications for public health and mental health services. If women are more vulnerable to relationship breakdown during illness, they may need additional psychological, social, and financial support.Experts suggest normalizing conversations about caregiving roles early in marriage, encouraging men to participate more equally in domestic and emotional labor, and providing counseling for couples navigating health crises. Strengthening social safety nets and peer support networks could also help buffer the psychological stress of both illness and divorce.
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