Men who are unhappy in their marriages are at higher risk of death, especially from strokes, Tel Aviv University scholars have concluded.

“What we found, which is surprising, is that dissatisfaction among men with their marriage is a risk factor for death, of a similar magnitude to smoking, or men failing to exercise,” Dr. Shahar Lev-Ari, the public health researcher behind the study, told The Times of Israel.

His team insists that the research shows that health authorities should start promoting marriage therapy, in order for people to get sick less frequently and live longer.

“Marital education programs for couples should be implemented as part of health promotion strategies for the general population,” they wrote in a newly published peer-reviewed academic article.

The researchers revived decades of health data on 10,000 Israeli men, from a Tel Aviv University study that started in 1965. As it began, participants were asked to rank their marriage’s success on a scale of one to four.“Revisiting this data, when we are more aware of links between psychological wellbeing and physical health, we found that their marriage satisfaction at the start of the study was actually a predictive factor for death in general and for death by strokes,” Shahar Lev-Ari said.

Men who were dissatisfied with their marriage were 19 percent more likely, on average, to die during the 32-year-long study than others of their age who were satisfied.

Fatal strokes were 69% more common among those who felt they had an unsuccessful marriage compared to those who indicated a very successful marriage.

The paper was published in the Journal of Clinical Medicine.

“The results of our study suggest that marital dissatisfaction may predict an elevated risk of all-cause mortality,” the researchers wrote in the article.

“This research strongly suggests that marital satisfaction and marital resilience is worth investment by public health authorities, just as they invest in preventing smoking and promoting physical exercise,” Lev-Ari said.