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Marital status and mortality in the elderly: A systematic review and meta-analysis

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  • Manzoli, Lamberto
  • Villari, Paolo
  • M Pirone, Giovanni
  • Boccia, Antonio
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    Abstract

    Although a relationship between marital status and mortality has long been recognized, no summary estimates of the strength of the association are available. A meta-analysis of cohort studies was conducted to produce an overall estimate of the excess mortality associated with being unmarried in aged individuals as well as to evaluate whether and to what degree the effect of marriage differs with respect to gender, geographical/cultural context, type of non-married condition and study methodological quality. All included studies were published after the year 1994, used multivariate analyses and were written in English. Pooling 53 independent comparisons, consisting of more than 250,000 elderly subjects, the overall relative risk (RR) for married versus non-married individuals (including widowed, divorced/separated and never married) was 0.88 (95% Confidence Interval: 0.85-0.91). This estimate did not vary by gender, study quality, or between Europe and North America. Compared to married individuals, the widowed had a RR of death of 1.11 (1.08-1.14), divorced/separated 1.16 (1.09-1.23), never married 1.11 (1.07-1.15). Although some evidence of publication bias was found, the overall estimate of the effect of marriage was robust to several statistical approaches and sensitivity analyses. When the overall meta-analysis was repeated with an extremely conservative approach and including eight non-significant comparisons, which were initially excluded because of data unavailable, the marriage protective influence remained significant, although the effect size was reduced (RR=0.94; 0.92-0.95). Despite some methodological and conceptual limitations, these findings might be important to support health care providers in identifying individuals "at risk" and could be integrated into the current programs of mortality risk estimation for the elderly.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 64 (2007)
    Issue (Month): 1 (January)
    Pages: 77-94

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    Handle: RePEc:eee:socmed:v:64:y:2007:i:1:p:77-94

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    Related research

    Keywords: Mortality Elderly Marital status Widowhood Social network Meta-analysis;

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    Cited by:
    1. Porter, Jeremy R. & Purser, Christopher W., 2010. "Social disorganization, marriage, and reported crime: A spatial econometrics examination of family formation and criminal offending," Journal of Criminal Justice, Elsevier, vol. 38(5), pages 942-950, September.
    2. Fisher, Hayley, 2012. "Just a piece of paper? The effect of marriage on health," Working Papers 2012-17, University of Sydney, School of Economics.
    3. Berntsen, Kjersti Norgård & Kravdal, Øystein, 2012. "The relationship between mortality and time since divorce, widowhood or remarriage in Norway," Social Science & Medicine, Elsevier, vol. 75(12), pages 2267-2274.
    4. Wilson, Sven E., 2012. "Marriage, gender and obesity in later life," Economics & Human Biology, Elsevier, vol. 10(4), pages 431-453.
    5. Jeremy Porter, 2012. "A Simplified Indicator of Social Well-Being in the United States: Examining the Ecological Impact of Family Formation within a County Level Framework," Social Indicators Research, Springer, vol. 108(3), pages 421-440, September.
    6. Hilke Brockmann, 2012. "Ungesunde Verhältnisse?: Eine Längsschnittanalyse zur Gesundheit von Kindern in zusammen- und getrenntlebenden Familien," SOEPpapers on Multidisciplinary Panel Data Research 503, DIW Berlin, The German Socio-Economic Panel (SOEP).
    7. Arber, Sara & Fenn, Kirsty & Meadows, Robert, 2014. "Subjective financial well-being, income and health inequalities in mid and later life in Britain," Social Science & Medicine, Elsevier, vol. 100(C), pages 12-20.
    8. Shor, Eran & Roelfs, David J. & Bugyi, Paul & Schwartz, Joseph E., 2012. "Meta-analysis of marital dissolution and mortality: Reevaluating the intersection of gender and age," Social Science & Medicine, Elsevier, vol. 75(1), pages 46-59.
    9. Inés Berniell & Dolores de la Mata & Matilde P. Machado, 2013. "The impact of a permanent Income shock on the situation of women in the household: the case of a pension reform in Argentina," DOCUMENTOS DE TRABAJO 011037, UNIVERSIDAD DEL ROSARIO.

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