The landscape of union formation has been shifting; Americans are now marrying at the highest ages on record and the majority of young adults have cohabited. Yet little attention has been paid to the timing of cohabitation relative to marriage. Using the National Survey of Families and Households and 4 cycles of the National Survey of Family Growth, the authors examined the timing of marriage, cohabitation, and unions over 20 years. As the median age at first marriage has climbed, the age at cohabitation has remained stable for men and women. The changes in the timing of union formation have been similar according to race/ethnicity. The marked delay in marriage among women and men with low educational attainment has resulted in a near-convergence in the age at first marriage according to education. The authors conclude that the rise in cohabitation has offset changes in the levels and timing of marriage.

Using data from the nationally representative 2010 Married and Cohabiting Couples (MCC) survey of different-sex cohabiting and married couples, we compared the relationship quality of today’s cohabitors and marrieds. Consistent with diffusion theory and recent conceptual work on the deinstitutionalization of marriage, we found that the relationship between union type and relationship quality is now bifurcated with direct marrieds reporting the highest relationship quality and cohabitors without marriage plans reporting the lowest marital quality. In the middle were the two largest groups: marrieds who premaritally cohabited and cohabitors with plans to marry. These two groups did not differ in terms of relationship quality. This study adds to the growing literature indicating that the role of cohabitation in the family life course is changing in the contemporary context.

The incidence of reported pertussis has increased during the past decade and poses a growing health and economic burden in developed countries, despite high rates of primary vaccination. Administration of a booster dose of acellular pertussis vaccine to adolescents may help reduce this burden, not only by reducing infections in vaccinated individuals but also by reducing transmission of Bordetella pertussis to other individuals, particularly infants. An epidemiologic model was created to assess the health and economic impact of implementing a program of routine acellular pertussis immunization in adolescents 11-18 years of age in the United States, considering both the reduction in cases in those vaccinated and among the unvaccinated population (due to herd immunity). Inputs for the base case were defined according to information derived from published literature and were supplemented by estimates provided by members of the Global Pertussis Initiative. Both direct and indirect costs were included (in 2002 US dollars) using U.S. data. Outcomes were evaluated over the lifetime of a cohort of potential adolescent vaccine candidates. Because of uncertainty in many of the inputs, extensive sensitivity analyses were conducted. With 80% vaccination coverage of adolescents and a 20% reduction of other cases because of herd immunity, >68,000 cases and 41 pertussis-related deaths would be avoided in the subsequent 10 years by routine administration of acellular pertussis boosters to a single cohort of adolescents in the United States. This strategy would be cost-effective, incurring from 6000 US dollars to 22,000 US dollars per life-year gained. The level of herd immunity attained and the true incidence of pertussis are critical determinants of cost effectiveness, as is the duration of immunity resulting from immunization. The cost of immunization and the discount rate also play a role. Although there is considerable uncertainty surrounding key inputs, the results indicate that the conditions required for adolescent immunization to be economically warranted are realistic.

The decline in marriage and divorce was evident prior to the coronavirus disease 2019 pandemic, but it remains unknown whether these patterns have persisted during the pandemic. The authors compared monthly marriage and divorce counts for two years prior to the pandemic (2018 and 2019) and during the pandemic for the five states that published monthly vital statistics data for 2020 (Arizona, Florida, Missouri, New Hampshire, and Oregon). All five states witnessed initial declines in marriage. Counts of marriages in Arizona and New Hampshire rebounded. In contrast, marriage shortfalls occurred in Florida, Missouri, and Oregon. In the early pandemic months, divorces initially declined in all five states and rebounded in Arizona. In the remaining four states, divorce shortfalls have occurred. As more data become available, it will be important to acknowledge these state variations in response to the pandemic.

The median age at first marriage in the United States has increased steadily since the mid-20th century. In the mid1950s, the median age was at a record low of just over 20 for women and 22 for men, but by 2018, the median age was almost 28 for women and nearing 30 for men (see Figure 1). This trend is partially due to a declining share of women ever married. In 2016, 31% of women aged 18 and older were never married compared to a low of 17% in 1960 (FP-18-17). The median age at first marriage has increased similarly for both men and women. Consequently, the gender gap in the median age at first marriage for men and women has persisted, fluctuating between 1.6 and 2.7 years. This profile uses data from the 2017 American Community Survey (ACS), 1-year estimates to track the trend in men's and women's median ages at first marriage. The ACS is ideal because it provides the best annual data on marital status and demographic characteristics allowing for direct estimation of the median age at first marriage (Simmons & Dye, 2004). This is an update to our previous profiles on the topic for the years 2014 (FP-16-07), 2013 (FP-15-05), 2010 (FP-12-07), and 2008 (FP-09-03).