{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T21:26:09Z","timestamp":1787088369922,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007154","name":"Wake Forest University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007154","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social determinants of health influence healthcare access and engagement. Marital and partnership relationships may shape care-seeking through household organization, care-related labor, and social support. Less is known about how marital status relates to mental health\u2013related access barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between marital status and discordant care among US adults and assess whether associations differ by sex and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional analysis of 2024 Behavioral Risk Factor Surveillance System (BRFSS) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The analytic sample included 346,330 respondents, representing 192.7 million noninstitutionalized US adults after application of survey weights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>Discordant care was defined as frequent mental distress, measured as 14 or more poor mental health days in the past 30\u00a0days, combined with two or more access barriers: no routine checkup in the past year, no personal doctor, no current health insurance, or inability to see a doctor because of cost. Marital status was categorized as partnered, previously partnered, or never partnered. Survey-weighted logistic regression models adjusted for age, sex, income, education, race and ethnicity, and the marital status by sex interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      The weighted prevalence of discordant care was 3.43% (95% CI, 3.29\u20133.58). In sex-specific contrasts from the race- and ethnicity-adjusted interaction model, previously partnered men had higher odds of discordant care than partnered men (aOR, 2.53; 95% CI, 2.09\u20133.05;\n                      <jats:italic>P\u2009<\/jats:italic>\n                      &lt;\u2009.001). Previously partnered women had higher odds, though the association was smaller (aOR, 1.40; 95% CI, 1.18\u20131.65;\n                      <jats:italic>P\u2009<\/jats:italic>\n                      &lt;\u2009.001). Never partnered status was not significantly associated with discordant care among men or women after adjustment. Older age, higher income, and education were associated with lower odds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Previously partnered adults, especially men, had higher adjusted odds of discordant care. Marital status may mark care-access vulnerability but should not be interpreted as a measure of relationship quality, caregiving labor, or social support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10697-9","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T21:03:08Z","timestamp":1787086988000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Marital Disruption and Mental Health\u2013Related Care Access Barriers Among US Adults"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2170-3181","authenticated-orcid":false,"given":"David J.","family":"Johnson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"10697_CR1","doi-asserted-by":"publisher","unstructured":"DiMatteo MR. 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Artificial intelligence tools were used for limited editorial assistance during manuscript preparation. No AI tools were used in study design, data analysis, interpretation of results, or generation of scientific conclusions.","order":1,"name":"Ethics","label":"Human Ethics and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The author declares no conflicts of interest.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Clinical Trial Number","group":{"name":"EthicsHeading","label":"Declarations"}}]}}