Compulsory coupledom: in sickness and in health?

Recent research has suggested that people who live together, including cohabiting unmarried and married couples, report better health than individuals who have never engaged in such relationships. Perhaps not surprising when we think about the poor health outcomes that can be associated with loneliness, and the endless pressure on single people to meet ‘the one’, settle down and buy a houseplant. Or whatever the presumed ‘next step’ is. However, there are obvious gaps in data of this kind, as society prioritises coupledom; there is just that one comparison point. Less traditional romantic/sexual relationships are largely perceived to be either patriarchal setups of one man and his many wives, or a practice of wannabe radicals engaging in polyamory in one of a collection of configurations. Other important and intimate relationships are also often dismissed, undermined or ridiculed, particularly friendships between women; ‘sisters before misters’ has not quite reached the pervasive use of ‘bros before hoes’.

If we extend this critical focus to consider the role of illness and relationships, then we find that there is evidence that people in long-term relationships with cancer experience better outcomes than those on their own. Largely this is attributed to having someone who is aware of any health issues experienced by their partner, putting pressure on them to seek help and caring for them in the event of illness. What does this actually tell us though? Essentially, it seems that people who have someone in their life who is invested in their well-being do better. This isn’t surprising. It is therefore not an extreme leap of logic to think that someone with a collection of invested caring people in their life, who live with or near them might experience similar benefits. Perhaps we might extend this, and consider also that the individuals providing care might experience some benefit. Care work is exhausting, and extensive evidence shows the poor mental and physical health outcomes associated with so-called ‘informal’ care. A wider distribution of care, across a wider network of people, would likely alleviate this. Carer’s allowance, however, is paid to one person, and though it is not explicitly aimed at partners, the implicit assumption is there; in sickness and in health, where illness is framed as a domestic management issue for the couple.

Looking further across the life course to explore the commonly identified health issue for older people of loneliness, monogamy can be seen as a contributor to (rather than an inhibitor of) loneliness. If most of our social needs are met by one person, and they leave or die, loneliness is likely to set in – especially if in the preceding years and months the surviving partner was singularly responsible for household care. In fact, the focus on coupledom can be seen to actively police each partner’s access to other intimate relationships, leaving them more vulnerable to loneliness in the event of becoming single. The current ‘slash-and-burn’ approach to the provision of welfare to disabled people and their carers means that in addition to increased risk of loneliness, financial hardship is also a feature of bereavement. The immediate suspension of welfare payments in the event of death, and continued cruelty of the ‘bedroom tax’, exacerbate grief with stress and anxiety.

In 2013 Priyamvada Gopal wrote an excellent opinion piece in the Guardian discussing the political and social consequences of prioritising coupledom within society. Beyond our own personal domestic arrangements, economic and social policy, marketing and popular media organises around the orthodoxy of the couple, whether aspirational or material. Priyamvada points to the problems this raises for a number of people in society. At the time she was responding to the introduction of gay marriage, which was building on hard-fought moves for civil partnerships, or as some would understand it, legislative assimilation. This move extends ‘coupledom’, and can be thought of as a step further away from the communal living and loving arrangements trail blazed in particular by lesbian separatist communities – which were in part a reaction against the orthodoxy of coupledom. Socio-economic status and class are also important to consider when reflecting on the social script of coupledom. There is improved, and state-supported, financial security in coupledom for those on low incomes, which can be contrasted with the relative liberation for some digression from social norms for those with particular social and cultural capital.

Medical sociologists have done little to interrogate alternative relationship types, especially in relation to health and austerity, and when we do they tend to sit within a hierarchy in which heterosexual, or at least heteronormative, relationships sit at the top. There is some exploration of whether this particular dominant mode of household organisation creates or triggers poor health: there are some (contested) statistics that suggest that single women have longer life expectancies than married women, whereas the opposite is true for men. In our patriarchal society, this would be expected. As the number of women participating in the labour market has increased, there has been a proliferation of research and theorising over the ‘double shift’, whereby women go out to paid work, and then return home and do the majority of domestic labour and/or caring duties. Overwork and exhaustion equals lower life expectancy. Similarly, the positive health outcomes associated with long-term relationships refer to happy long-term relationships. Other research has revealed that individuals in conflict-ridden relationships have higher levels of cardiac health risk factors, which is associated with many age-related diseases, weaker responses to flu vaccination and slower wound healing rates, compared with happy couples. A recent decision at the supreme court has left a woman who is desperate for a divorce unable to leave her husband, for at least five years as she could not evidence unreasonable behaviour on his part. Furthermore, with the gendered nature of domestic violence, home can be a dangerous place for women.

If society wasn’t so centred on coupledom, we would be able to collect meaningful data on the potential health outcomes of being single by choice or in a non-traditional relationship. This blog isn’t necessarily advocating that people do not follow a traditional framework for their relationship, but to question the dichotomy of single Vs partnered, in a world increasingly defined by fluidity. For good health, what do humans need from each other? If there is a requisite amount of love, friendship, support, desire, respect, care, choice and control – why would it be necessary, or even sensible to try and access all these requisites from one person? As argued by Dr Gopal, “scare stories about single people dying earlier or loneliness becoming a pandemic must be seen in the larger context of a social order that is hostile to non-couples and an economic order to which the collective good seems to be anathema”. Perhaps it is through a sociological lens that we can challenge this social order more widely. Imaginably, to sustain a pushback against the seemingly unstoppable tide of hyper-individualism, we could get our own houses in disorder and move toward a modern, multi-faceted collectivism.