Massive rural-to-urban migration in China has led to spatial separation of millions of married couples. In this article, we examine the question of whether the well-documented health benefits of marriage extend to left-behind individuals in rural China who are spatially separated from their spouses. Using longitudinal data that span 16 years (China Health and Nutrition Survey 1991, 1993, 1997, 2000, 2004, 2006), we compare the self-reported health trajectories of adults across different marital statuses while taking into account the physical location of their spouses. Our results suggest a clear health disadvantage of married individuals whose spouses are absent compared with those whose spouses are living in the same household. Further, longer spousal absence is more harmful to an individual’s health. Finally, spousal absence and longer physical separation from their spouses induce stronger health deficits for married men than for married women, suggesting that a gendered process is at work.

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