It appears the quality of your relationships with your extended family — mom, dad, siblings, aunts, uncles, grandparents and more — could make a real difference in your health as you age, maybe even more than your special love.

A new study finds people who feel they aren’t supported by their extended family are more likely to suffer chronic illness than those who aren’t happy with their spouse or partner.

Who appreciates you?

The study, published Thursday in the Journal of Family Psychology, looked at data collected on nearly 3,000 people between 1995 and 2014. The average age of people was about 45 years old during the first round of data collection.

At three points during those 19 years, people were asked to rate the quality of their family and partner interactions, which was then compared to their total number of chronic conditions, ranging from stroke to headaches.

To test their intimate partnership, subjects answered questions such as: “How often does your spouse or partner argue with you? How much does your spouse or partner appreciate you?”

To discover the quality of their familial associations, they answered questions like: “Not including your spouse or partner, how often do members of your family criticize you? How much can you rely on your family for help if you have a serious problem?”

The study found strained extended family relations to be highly associated with a greater number of chronic conditions and poor health.

Oddly, the study found no such health association due to troubled relationships with spouses.

“A lot of research emphasizes the importance of the spousal relationship, but this study is unique in looking at the impact of spousal and other family relationships, net of the other,” said Purdue University sociologist Patricia Thomas, who was not involved in the study.

“And here it seems that family relationships had a more important direct impact on chronic conditions and how people subjectively rate their health,” Thomas wrote in an email.

Family is forever

For lead author Sarah Woods, assistant professor of family and community medicine at UT Southwestern Medical Center, the results were surprising.

She and her colleagues had expected to find health impacts from both family and intimate dysfunction. One reason they may not, she said, is due to the changing nature of marriage, especially the role of divorce.

“Adults are waiting longer to marry, if they marry at all ,” Woods said. “And they may be less likely to be married to that same person for the rest of their lifespan. But you have your family for all of your life.”

In fact, Woods said, the majority of the people in the study had living parents or siblings. If the dynamics of the interactions are negative, then family-based stress could continue to impact a person as they age.

“Family relationships are long and emotionally intense,” Woods said. “These are people you are connected to forever. If you are sensitive to emotional stress, then being bathed in that stress would over time wear and tear on your body.”

While intimate partner relationships weren’t found to have as much of an impact on a person’s health, they are likely to reflect the suffering happening in other areas, Thomas pointed out.

“The strain in intimate partner relationships was related to greater strain in family relationships, which speaks to how intimate relationships are embedded in and affect one’s other social relationships, ” Thomas said.

While more research is needed to tease out the dynamics of the interactions, the study’s results should be a wakeup call for dysfuntional families and health care practitioners, Woods said.

“It’s our takeaway that if your family or relationship are conflictual or unhealthy in adulthood, it could be very important to work to improve them, perhaps by therapy,” Woods said. “Until now that’s not something we would typically consider for somebody in the middle of their life.”