TIME Developmental Disorders

Study: 96% of Deceased NFL Players’ Brains Had Degenerative Disease

The seal affixed to the front of the Department of Veterans Affairs building in Washington on June 21, 2013.
The seal affixed to the front of the Department of Veterans Affairs building in Washington on June 21, 2013. Charles Dharapak—AP

The brain bank's research furthers the argument that football is linked brain injury

The brains of 76 out of 79 (96%) of deceased NFL players showed signs of a degenerative brain disease, according to a study released Tuesday by the nation’s largest brain bank.

The Department of Veterans Affairs’ brain repository in Massachusetts, a collaboration between VA and Boston University’s CTE Center, found that the instance of chronic traumatic encephalopathy (CTE), a brain condition that causes dementia and other cognitive problems, was so high that it doubled the number of CTE cases previously reported by the institution, PBS reported.

“Obviously this high percentage of living individuals is not suffering from CTE,” Dr. Ann McKee, the brain bank’s director, told PBS. “Playing football, and the higher the level you play football and the longer you play football, the higher your risk.”

Doctors at the brain repository have previously conducted research on brain tissue samples from professional, semi-professional, college and high-school football players. The rate of CTE, while lower than 96%, still remained high, at 80%.

The studies were made possible by football players who volunteered their brains for scientific research, because CTE can only be diagnosed posthumously, according to PBS. As a result, doctors who conducted the study said their sample may be skewed, as many volunteers donated their brains because when they were alive, they already suspected that they suffered from CTE.

Still, the findings have added fuel to heated discussions that football—both at professional and lower levels—may be linked to degenerative brain diseases like Alzheimer’s, as a recent study showed. The NFL has also come under fire for allegedly covering up the risks of head injuries and concussions, which are linked to individuals who suffer from CTE.

TIME Aging

Norway Is the Best Place to Grow Old

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Westend61—Getty Images/Brand X

But a third of countries are not meeting the needs of their growing aging populations

Growing old is a pleasure—if you’re in Norway, that is. A new report looking at the social and economic wellbeing of older people in 96 countries reveals that Norway is the happiest place to age, followed by Sweden, Switzerland, and Canada.

It’s not as much fun elsewhere. The report, called the Global AgeWatch Index, found that a third of countries are ill equipped to deal with increasingly large aging populations. The report says that in low and middle income countries, only a quarter of people over age 65 receive a pension. Countries on the low-end of the list lacked programs for free health care and chronic disease treatment, community centers and subsidized transport.

The report by HelpAge International and the University of Southampton shows that by 2050, 21% of the global population will be over age 60. While more people are living longer, if people are also living sicker or without support, that takes a serious economic toll. In the U.S. alone, 2012 data noted that Social Security, Medicare and Medicaid eat up about 40% of all federal spending and 10% of the nation’s gross domestic product.

The authors note that Norway claimed the top spot because it has well-developed organizations for the elderly, a long history of state welfare and strong social media campaigns that create public awareness of age-related issues. The worst country for the elderly is Afghanistan, according to the report, and the United States ranked seventh overall.

Here’s the entire Global Age Watch ranking:

  • Norway (1)
  • Sweden (2)
  • Switzerland (3)
  • Canada (4)
  • Germany (5)
  • Netherlands (6)
  • Iceland (7)
  • United States (8)
  • Japan (9)
  • New Zealand (10)
  • United Kingdom (11)
  • Denmark (12)
  • Australia (13)
  • Austria (14)
  • Finland (15)
  • France (16)
  • Ireland (17)
  • Israel (18)
  • Luxembourg (19)
  • Estonia (20)
  • Spain (21)
  • Chile (22)
  • Uruguay (23)
  • Panama (24)
  • Czech Republic (25)
  • Costa Rica (26)
  • Belgium (27)
  • Georgia (28)
  • Slovenia (29)
  • Mexico (30)
  • Argentina (31)
  • Poland (32)
  • Ecuador (33)
  • Cyprus (34)
  • Latvia (35)
  • Thailand (36)
  • Portugal (37)
  • Mauritius (38)
  • Italy (39)
  • Armenia (40)
  • Romania (41)
  • Peru (42)
  • Sri Lanka (43)
  • Philippines (44)
  • Viet Nam (45)
  • Hungary (46)
  • Slovakia (47)
  • China (48)
  • Kyrgyzstan (49)
  • South Korea (50)
  • Bolivia (51)
  • Columbia (52)
  • Albania (53)
  • Nicaragua (54)
  • Malta (55)
  • Bulgaria (56)
  • El Salvador (57)
  • Brazil (58)
  • Bangladesh (59)
  • Lithuania (60)
  • Tajikistan (61)
  • Dominican Republic (62)
  • Guatemala (63)
  • Belarus (64)
  • Russian (65)
  • Paraguay (66)
  • Croatia (67)
  • Montenegro (68)
  • India (69)
  • Nepal (70)
  • Indonesia (71)
  • Mongolia (72)
  • Greece (73)
  • Moldova (74)
  • Honduras (75)
  • Venezuela (76)
  • Turkey (77)
  • Serbia (78)
  • Cambodia (79)
  • South Africa (80)
  • Ghana (81)
  • Ukraine (82)
  • Morocco (83)
  • Lao PDR (84)
  • Nigeria (85)
  • Rwanda (86)
  • Iraq (87)
  • Zambia (88)
  • Uganda (89)
  • Jordan (90)
  • Pakistan (91)
  • Tanzania (92)
  • Malawi (93)
  • West Bank and Gaza (94)
  • Mozambique (95)
  • Afghanistan (96)
TIME Infectious Disease

CDC Confirms First Case of Ebola Diagnosed in the U.S.

Outbreak has claimed more than 3,000 lives in Africa

Health officials confirmed Tuesday that a patient in Dallas has Ebola, marking the first such diagnosis of the deadly disease ever to occur on U.S. soil.

Until now, the only cases of Ebola in the U.S. have been Americans who were infected abroad and were brought back for treatment. The death toll from the worst Ebola outbreak ever, which has hit several countries in West Africa, surpassed 3,000 last week.

The patient, who has not been identified, had traveled to the U.S. from Liberia, leaving Liberia on Sept. 19 and arriving in the U.S. on Sept. 20. The patient had no symptoms when departing Liberia or when first landing in the U.S., but began developing symptoms for the deadly virus four days after arrival. On Sept. 28, the patient was placed in isolation at Texas Health Presbyterian Hospital in Dallas. The patient’s specimens tested positive for Ebola on Tuesday afternoon.

U.S. Centers for Disease Control and Prevention (CDC) director Dr. Tom Frieden said that the medical team’s priorities are to care for the patient, as well as to track down everyone the patient came in contact with while the patient was infectious. A patient with Ebola is only contagious once an infected person starts presenting symptoms. The CDC and Dallas Health and Human Services will identify all the contacts and monitor them for 21 days, which is the incubation period for the disease. If any of the contacts comes down with a fever, they will be isolated and cared for. The CDC says it has just started the contact tracing.

Frieden acknowledged that it’s possible someone with close contact with the patient could come down with the disease, but is confident the U.S. healthcare system can handle that possibility. “The bottom-line here is I have no doubt that we will control this case of Ebola so that it does not spread widely,” said Frieden during a news conference.

The CDC said that they do not know how the individual was infected, but the patient must have had close contact with someone infected with the disease. The CDC is sending disease specialists to Texas. The CDC has long acknowledged that it’s possible for Ebola to reach the U.S., though concern for widespread infections is low given the quality of U.S. health care. “As long as the outbreak continues in Africa, we need to be on-guard,” Frieden said.

TIME Developmental Disorders

How to Improve a Baby’s Language Skills Before They Start to Talk

Researchers say playing a series of sounds when infants are four months old could speed up the way babies process language and make them linguistic stars when they’re older. How babies respond to the sounds can also predict which infants will have trouble with language as well

The first few months of a baby’s life come with a flurry of challenges on a still-developing brain. Sights, sounds, smells and touches as well as other emotional experiences flood in, waiting to be processed and filed away as the foundation for everything from language to emotions and how to socialize with others. What happens if things are not finding their right place in the brain during these critical months? Some research suggests it results in developmental delays later on—and that’s just what neuroscientist April Benasich and her colleagues from Rutgers University found in a new study, published in the Journal of Neuroscience.

Previous studies done by both Benasich and others show that the brains of children who learn to speak later or who develop reading disorders like dyslexia showed differences in detecting small differences in speech, such as the difference between da and ba, when they were infants. Other research has come to similar conclusions.

Genetic factors certainly play a role, but up to 10% of the babies Benasich has studied had no family history of developmental problems, yet still showed language trouble when they started talking. That’s why she turned to studying the brain maps of healthy babies before they learned to speak. These routes show how infants detect and respond to sounds in their environment—from words spoken to them to the humming of a dishwasher. In these early months, their brains are primed to sort out this cacophony of auditory stimuli and start making more refined distinctions between them. Doing so requires distinguishing between tiny differences, both in the sounds themselves as well as in frequencies. “Babies do this naturally; this is their job, since they want to be able to pick sounds out quickly and figure out whether they need to pay attention to them,” says Benasich.

For the babies in this study, she adorned them with skull caps studded with electronic sensors that would draw a map of their EEGs as they were presented with different, non-linguistic tones. Some of the babies were played sounds that changed ever so slightly, such as in their tone or frequency, and whenever there was a change, a small video in the corner of a screen they were looking at popped up. The babies naturally turned to watch the video, so the scientists used these eye turns as a signal that the babies had heard and recognized the transition in sounds, and were expecting to see the video. Another group of babies were played the same sounds but without the video training, and a control group didn’t hear the sounds at all.

MORE: Want to Learn a Language? Don’t Try So Hard

It wasn’t the sounds themselves that were important, but the changes in them that were key to priming the babies’ brains. Those who were trained to pay attention to the changes in the sounds, for example, showed more robust mapping of language sounds later on when they started to babble; by 18 months, these infants showed brain mapping patterns similar to those in two year olds. They were faster at discriminating different sounds, and quicker to pay attention to even tiny differences in inflection or frequency compared to babies who weren’t given the sounds. The babies who only listened to the sounds without the training fell somewhere between these two groups when it came to their language mapping networks.

Benasich says that the training lays the foundation in babies’ brains to become more efficient in processing language sounds, including very tiny variations among them. Their brains are setting up different neural routes for each sound, like a well-organized airport with separate runways designated for northbound and southbound flights. Other babies were less adept at this, essentially routing every sound through the same neural network, akin to sending every plane off the same runway, leading to delays as some have to bank and redirect in the opposite direction. In similar ways, says Benasich, in language, this cruder processing of sounds could result in delays in reading or speaking or language acquisition, and toddlers end up having to “manually” process the sounds in a more tedious and less automatic process. “Instead of automatically discriminating sounds without pausing, they have to stop and think and what that sound might be, and that leads them to hesitate a little,” she says. “That small hesitation makes a huge difference in how well they learn and process language.”

The training, she says, was minimal – the babies’ parents brought them in for six to eight minute sessions once a week for about six weeks. Yet she was “surprised by how robust the effects are for the babies.”

The study involved healthy babies who did not have risk factors for language disorders, so the training only helped them to enhance their later language learning. But the team is currently studying a group of babies at higher risk of having language deficits, either because of genetic risk factors or by having siblings affected by such disorders. If these babies show different brain patterns compared to those not at risk, then it’s possible that EEG patterns in response to sounds could predict which infants are at risk of developing language problems even before they start to talk.

Benasich is also working on developing her test into a parent-friendly toy that parents can buy and use with their babies; if their babies are developing normally, then the training can only accelerate and enhance their language skills later on, while for those who are struggling, the training could help them to avoid learning disabilities when they start school. It’s not possible to screen every baby, but if parents and doctors are able to take advantage of such a tool, then she hopes that more language-based disorders might be avoided. “Babies naturally do this, but for those who are having trouble, we are guiding them to pay more attention to things that are important in their environment, such as language-based sounds,“ she says. “We think we could make a huge difference in the number of kids who end up with learning problems.”

TIME Infectious Disease

Ebola Outbreak Contained in Nigeria, Officials Say

After a total of 19 cases and seven deaths

The Ebola outbreak in Nigeria appears to be contained, health officials said Tuesday.

The U.S. Centers for Disease Control and Prevention (CDC) said that due to a very rapid local and international response, the country may have fully contained its Ebola outbreak. The 21-day incubation period for the disease has passed.

Nigeria saw its first confirmed case of Ebola on July 17 when a Liberian-American man collapsed at a Nigerian airport after traveling from Liberia. The man infected the health workers who treated him, and the country experienced a total of 19 cases and seven deaths. Unlike in other countries like Guinea, Sierra Leone and Liberia, where it took months for Ebola to be recognized, the Nigerian government quickly declared a public health emergency when it discovered the traveler may have come in contact with 72 people at the airport and hospital.

The Nigerian government coordinated the outbreak response with state and national networks and rolled out a massive public education initiative, with trained “social mobilizers” who were deployed to do house to house visits in areas where an Ebola contact resided. Nigeria also recently worked to eradicate polio, and the country tapped into those strategies as part of their response.

Still, if there’s a lesson to be learned from Ebola thus far, it’s not to overestimate containment. As TIME reported last week, there was a period in April when it appeared Guinea’s outbreak had subsided. In actuality, there were several unreported and hidden cases that re-ignited the outbreak with an even greater wave of infections.

TIME drinking

Science Explains Why Men Get Wasted Together

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Marcus Richardson—Getty Images/Flickr Select

A new study may shed light on why men seem to like getting drunk together more than women do

Male bonding over booze is a ritual as old as booze but modern science may have finally shed some light on why getting sloshed with your mates can seem like a particularly male pursuit.

Smiles are contagious in a group of men sitting around drinking alcohol, according to a study announced Tuesday in the journal Clinical Psychological Science. This suggests that booze serves as a social lubricant for men, making them more sensitive to social behaviors, like smiling, and freeing them to connect with one another in a way that a soda can’t.

Lest that strike you as laughably obvious, consider this: the effect does not hold if there are any women in the group, according to the study authors.

Researchers divided 720 “healthy social drinkers” — half men, half women, all ages 21 to 28 — into three groups. Each group received either an alcoholic drink (vodka cranberry, regrettably for any lab rats with refined taste, but so it goes), a placebo or a non-alcoholic drink. They found that, among men, smiles — and associated increases in positive mood and social bonding — tend to catch on, leaping from face to face, as it were, but only in exclusively male groups.

“Many men report that the majority of their social support and social bonding time occurs within the context of alcohol consumption,” said lead researcher Catharine Fairbairn. “We wanted to explore the possibility that social alcohol consumption was more rewarding to men than to women — the idea that alcohol might actually ‘lubricate’ social interaction to a greater extent among men.”

More importantly — get ready to never hear the end of this one, boyfriends and husbands of the world — researchers note that genuine smiles are perfectly contagious among sober women, just not sober men. A cold one merely evens the score for men, allowing them to catch smiles from each other, so long as there are no women present.

The authors don’t posit a guess as to why the presence of a woman keeps drunk men from catching smiles from one another, except to say that booze seems to disrupt “processes that would normally prevent them from responding to another person’s smile.”

Nice work, dudes. There’s nothing a girl likes more than an unsmiling humorless dolt.

TIME Heart Disease

People Without Friends Have Worse Outcomes After Heart Attack

holding hands
Getty Images

The importance of friends for heart health

Without the support of friends and family, you’re less likely to emerge from a heart attack healthy.

A study in the Journal of the American Heart Association analyzed the responses of 3,432 heart attack patients on their levels of social support one month and then a year after a heart attack. One-fifth of them had low social support—meaning they felt that they didn’t have friends or family they could confide in or lean on for emotional or financial support—and during their recovery this group showed lower mental functioning, worse quality of life and more depressive symptoms. The effect affected men and women equally.

MORE: A Happy, Optimistic Outlook May Protect Your Heart

Encouraging social support isn’t usually seen as a top priority for heart attack recovery, but this is just one more piece of evidence that it should be: one study showed that within six months of having a heart attack, depression increased the risk of death from 3% to 17%.

MORE: A Link Between Anxiety and Heart Attacks

“We shouldn’t just be concerning ourselves with pills and procedures,” said Harlan Krumholz, MD, the study’s senior author and director of the Center of Outcomes Research and Evaluation at Yale-New Haven Hospital, in a statement. “We have to pay attention to things like love and friendship and the context of people’s lives. It may be that these efforts to help people connect better with others, particularly after an illness, may have very powerful effects on their recovery and the quality of their lives afterwards.”

TIME neuroscience

How A Girl’s Brain Changes After a Traumatic Brain Injury

Close up of teenage girls eyelashes
Getty Images

Concussions may influence girls differently than boys

Girls who suffer traumatic brain injuries (TBIs) may be more susceptible to behavioral problems like psychological distress and smoking compared to boys, according to a new study.

Each year, TBIs cause 2.5 million emergency room visits, and so far research has consistently shown that they’re more common among boys than girls. Girls still get them, though, and often in sports like soccer, basketball and cheerleading. A new study published in the journal PLOS ONE that surveyed 9,288 Ontario students in grades 7 through 12 reports that girls who suffered brain injuries—in sports, most commonly—were more likely to report having contemplated suicide, experienced psychological distress, been the target of bullying and having smoked cigarettes.

Overall, the new study reports that one in five adolescents had sustained a TBI that resulted in their loss of consciousness for at least five minutes or hospitalization at some point in their lifetime. Boys experienced them 6% more than girls. These young people who had experienced a lifetime TBI also reported behaviors in the last year like daily smoking, binge drinking, using marijuana, cyberbullying and poor grades.

MORE: The Tragic Risks of American Football

Since the results were self-reported, the researchers could not determine causation, nor could they provide a definitive explanation for the gender differences. In the study, they speculate that it could have to do with a variety of factors that include hormonal differences, treatment differences, differences in cognitive abilities or some combination.

Dr. Geoffrey Manley, vice chairman of neurological surgery at the University of California, San Francisco, was not involved in the study but has another theory. According to his own research, women tend to be more forthcoming about their concussion symptoms than men. “Currently, we don’t have a clear idea of what exactly a concussion is,” he says. “We are really limited to self-reporting, and women are more honest about their symptoms than boys.”

Girls get TBIs most often playing soccer and basketball, but other sports—cheerleading, in particular—have very high risk for injuries. The American Academy of Pediatrics has called for more safety regulations for the cheerleading, even though it tends to not be included in national high school sports injury research.

There’s still a lot we don’t know about TBIs and concussions, including the best way to diagnose them. So far there is not a reliable imaging or biomarker test. But understanding who is at a risk, and for which reasons, helps bolster the collective knowledge of the issue. “No matter how you slice this, a subset of these folks are going to go on and have long-term disability,” says Manley. “We can try to predict who these people are going to be, and gender may be part of this.”

TIME Heart Disease

Olive Oil Repairs Failing Hearts, Study Finds

Olive oil.
Josa Manuel Ferra—Getty Images

Yup, the Mediterranean diet seriously starts today

For broken rat hearts, nothing beats a healthy glug of olive oil.

That’s what new research published in the journal Circulation found when it looked at beating rat hearts riddled with heart failure, a condition that manifests itself in humans over time when chronic high blood pressure makes it harder for the heart to pump blood, making the heart grow bigger, thicker, and less effective. The heart becomes unable to metabolize and store the fat it needs to keep pumping—like an engine out of fuel, the study author says—and the fat it does manage to metabolize breaks down into toxic by-products that exacerbate heart disease.

MORE: Ending the War on Fat

It’s a complicated problem without an obvious quick fix, which is why researchers were surprised by what came next. To see exactly how fat moves around in the cells of these impaired hearts, they removed hearts from rats, kept them beating normally and put them in a strong magnetic field through a process called nuclear magnetic resonance spectroscopy. They delivered two types of fat directly to the hearts—either oleate, the kind of fat found in olive oil and canola oil, or palmitate, which is in dairy products, palm oil and animal fat. When the scientists followed the fat around, they found drastic differences in how the hearts reacted to the two fats.

MORE: The Worst Times to Be Treated for a Heart Condition

“If we gave hearts that were failing palmitate, they basically looked like failing hearts,” says E. Douglas Lewandowski, study author and director of the University of Illinois at Chicago Center for Cardiovascular Research. Their fat metabolism and storage remained depressed and the hearts weren’t producing enzymes that would help metabolize fat. But when they gave the hearts oleate, they vastly improved. The presence of oleate completely restored the fat content in the cell back to normal, Lewandowski says, and the hearts contracted better and showed normalized genes that help in fat metabolism.

“We didn’t think it would have such profound effects,” Lewandowski says. “When we think about normalizing the metabolism, it’s so far upstream of so many disease processes that it’s very exciting.” In just half an hour, the fat induced all of these positive changes.

MORE: Can Olive Oil Help Prevent Stroke?

More research—especially on humans—is needed before imagining that oleate could help the failing hearts of people, but Lewandowski admits his study shows the potential for actual dietary therapeutic regimens. And the results might help partly explain why the Mediterranean diet is so heart-healthy. People who follow it have long shown lower rates of heart disease death and heart problems, and the good monounsaturated fats, like the kind in oleate, raises the good kind of cholesterol and lowers the less desirable kind. We’ll have to wait for the olive oil heart infusions, but in the meantime, here’s your latest excuse for heavy-handed drizzling.

TIME

7 Ways Being Single Affects Your Health

woman standing alone
Getty Images

The link between relationship status and well-being is a complicated one. Despite plenty of sensational headlines—”Get married and get fat!” “Stay single and die young!”—it’s hard to say definitively whether being a spouse or a singleton (or something in between, as many Americans are today) is healthier overall.

That’s because every relationship and every person is different, says Bella DePaulo, Ph.D., a visiting researcher at the University of California Santa Barbara and author of Singled Out: How Singles Are Stereotyped, Stigmatized, and Ignored, and Still Live Happily Ever After. And because scientists can’t randomly assign study participants to either get married or stay single, it’s impossible to rule out other factors that could be at play.

HEALTH.COM: 13 Reasons to Have More Sex

Still, trends do seem to exist among people in different types of relationships, with potential lessons that all adults—regardless of their marital status—can use to better their quality of life. Here are seven ways flying solo may affect your health, for better or worse.

You’re less likely to gain weight

A 2013 study in the journal Health Psychology shows that happily married couples tend to gain weight in the four years after getting hitched. Without the pressure to attract a new mate, the authors say, newlyweds can get complacent about their appearance.

A recent Australian study in the journal Body Image showed that women who feel pressured to slim down before their wedding gained more weight within the following 6 months. Married men were more likely to be overweight or obese compared to their peers who were single, in relationships, or engaged, according to a 2014 University of Minnesota study of young adults.

You’re more likely to exercise regularly

“Many single women and men care about their health and their well-being,” says DePaulo. “They exercise, eat right, and live overall healthy lifestyles.” In a 2004 study from the University of Maryland, for example, unmarried adults exercised more than married ones, including those without kids.

A British survey conducted in 2011 echoed these results, finding that 76% of married men and 63% of married women failed to meet the recommended 150 minutes of physical activity a week. Only 24 and 33% of single men and women, respectively, missed the mark.

HEALTH.COM: 20 Ways to Make Exercise a Habit

You may have more close friends

And you may be a better one, at that: A 2006 University of Massachusetts at Amherst study found that single people were better at maintaining relationships with friends, neighbors, and extended family than those who had tied the knot—both with and without kids.

Other studies have also found that single adults tend to do more volunteer work and keep in close contact with their siblings, says DePaulo. “Single people—especially single women—often have networks of people who are important to them,” she says. “They have ‘the ones’ rather than ‘the one.’”

You stress less about chores and money

One stereotype of single people is that they’re constantly worried about finding a mate—but that’s certainly not true for everyone. And in fact, there are plenty of areas where single people stress less than those in relationships. According to a 2005 University of Michigan study, for example, they do less housework than married people.

HEALTH.COM: 12 Signs You May Have an Anxiety Disorder

Money woes may weigh less on single people as well. In a 2014 survey of more than 2,000 adults in relationships, one in three admitted to “financial infidelity,” or lying to a partner about money issues. Married people are also more likely to have credit card debt—not exactly a health issue in itself, but something that has been shown to detract from both emotional and physical wellbeing.

You may be stigmatized—but maybe not for long

Single people are often viewed as lonely and unhappy, says DePaulo, which can in turn have a negative effect on their overall health. But that may be changing: the Bureau of Labor Statistics recently reported that, for the first time, the majority of adults in the United States are unmarried, with singles clocking in at 50.2%.

“I do think that as the number of single people continues to grow—to well over 100 million adults just in the U.S.—it will be increasingly difficult to maintain the stereotypes and caricatures of single people,” says DePaulo. “There are just too many single people who are happy and healthy and love their single lives, and too many people who know single people who are thriving, for the misperceptions to endure.”

In the meantime, DePaulo’s advice is simple. “Living your single life fully, joyfully, and unapologetically—even as other people are insisting, without any good scientific basis, that you must be less healthy than your married counterparts—is a good way to maintain your good health.”

HEALTH.COM: 12 Ways Your Relationship Can Hurt Your Health

Surgery may be more dangerous

Going under the knife carries risks no matter your relationship status, but a 2012 Emory University study found that single people were three times more likely to die in the three months following heart surgery (and 71% more likely to die over the next five years) than married study participants. Married people tended to be more optimistic about their recovery going into surgery, but they also had lower smoking rates than single people—an important factor in their higher five-year survival rates.

But even these findings aren’t definitive, says DePaulo. She points to a 2011 RAND Corporation survey on alumni of the Wounded Warrior Project, which found that veterans who had never been married reported higher levels of resiliency—the ability to bounce back after injury, illness, or hardships—than those who were married, divorced, or separated.

Your heart health may be at risk

Single adults are 5% more likely to develop heart disease than their married peers, according to a 2014 study of more than 3.5 million people presented at the American College of Cardiology’s 63rd Annual Scientific Session. (Divorced and widowed people in the study also had a higher risk.) “Not all marriages are created equal, but we would expect the size of this study population to account for variations in good and bad marriages,” said the study authors in a press release.

But other research hasn’t found that being married is any better for your heart. In a 2006 study from the University of Texas at Austin of more than 9,000 people there was no statistically significant difference in cardiovascular disease risk between those who were currently married or had never gotten hitched.

This article originally appeared on Health.com.

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