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Sunday, September 24, 2000

Improve Nation: Boost Marriage

By Joe S. McIlhaney Jr.
Knight Ridder/Tribune News Service

    Imagine if the next president, whether he be George W. Bush or Al Gore, stood up the day after inauguration and said, "My first major policy initiative is guaranteed to improve the health of our nation and improve the sex lives of adults!" That's a pretty good way to increase favorable poll numbers, I should think.
    What is this new and incredible policy initiative? It's neither new nor incredible. It's marriage.
    Promoting marriage, something both Bush and Gore have at least touched upon (Bush a bit more), is the best public health strategy the next administration can unveil. Doing so will help combat the present epidemic of sexually transmitted diseases (STDs), reduce out-of-wedlock births and the long list of related negative economic and social consequences, lower the divorce rate, and, yes, increase the number of adult men and women getting good sex.
    Let's start with the silent epidemic raging in America (yes, I'm going to make you wait for the sex!). STDs are attacking our young people with shocking ferocity. Approximately 15.3 million new cases occur annually in the United States; one in four of the victims are under 20.
    Five of the 11 most common reportable infectious diseases in this country in 1998, the last year for which data are available, were STDs. And that doesn't include the most common STDs, herpes and human papillomavirus (HPV) the Centers for Disease Control and Prevention (CDC) doesn't collect data on these. HPV causes over 90 percent of cancer and pre-cancer of the cervix, which, in turn, is causing the deaths of approximately 5,000 American women yearly.
    The number of lifetime sex partners is highly correlated with the likelihood of contracting an STD. Studies from the CDC clearly show that, on average, the younger a person is when he or she starts to have sex the more partners he or she is likely to have. Hence, delay sexual activity until marriage and avoid STDs. And the likelihood of contracting an STD during marriage is negligible. Thus, more marriage means fewer STDs.
    Promoting marriage means being honest about cohabitation ó the increasingly popular "living together." It doesn't work. Indeed, it may even increase the number of lifetime sexual partners of individuals that cohabit, thus increasing risk for STDs and out-of-wedlock birth. Twenty percent of cohabiting women have a "secondary" sex partner; this compares with only 4 percent of married women.
    And, according to the best study of sexuality yet done in the United States, Sex in America (1994), "since many couples who live together break up within a short time and seek a new partner, the result has been an increasing average number of partners that people have before they marry."
    Half of all cohabiting couples either break up or marry within two years, and after five years, only 10 percent of cohabiting couples are still together. In contrast, 55 percent of first marriages last a lifetime. Plus, the Sex in America study, conducted by University of Chicago researchers and published in a popular book, found that, contrary to public opinion, the "vast majority of married men and women are faithful."
    Yes, this may be an obvious equation, but America needs to re-learn it: Increased marriage equals a decrease in out-of-wedlock births.
    Finally, promoting marriage in America will mean for a lot more happy men and women. Sex in America reported that married sex beats all else. For example: "Married women had much higher rates of usually or always having orgasms 75 percent as compared to women who were never married and not cohabiting, 62 percent." And, the researchers wrote, "those having the most sex and enjoying it the most are the married people."
    Promoting marriage will require a mix of bully pulpit leadership and legislative changes such as ending the marriage tax penalty. But there you have it, Mr. Next President, whomever you shall be ó a prescription for a public health initiative that will be wildly popular.
    Indeed, wouldn't be both ironic and healthy for this country if our next president is remembered as the "marriage president"?
    Joe S. McIlhaney Jr., a physician, is president and founder of The Medical Institute for Sexual Health, a nonprofit medical organization based in Austin, Texas.

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