Marital status and mortality in the elderly: A systematic review and meta-analysis
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.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 64 (2007)
Issue (Month): 1 (January)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Yuanreng Hu & Noreen Goldman, 1990. "Mortality Differentials by Marital Status: An International Comparison," Demography, Springer;Population Association of America (PAA), vol. 27(2), pages 233-250, May.
- Henrard, J. C., 1996. "Cultural problems of ageing especially regarding gender and intergenerational equity," Social Science & Medicine, Elsevier, vol. 43(5), pages 667-680, September.
- Jersey Liang & John F. McCarthy & Arvind Jain & Neal Krause & Joan M. Bennett & Shengzu Gu, 2000. "Socioeconomic Gradient in Old Age Mortality in Wuhan, China," Journals of Gerontology: Series B, Gerontological Society of America, vol. 55(4), pages 222-233.
- Helweg-Larsen, Marie & Kjøller, Mette & Thoning, Henrik, 2003. "Do age and social relations moderate the relationship between self-rated health and mortality among adult Danes?," Social Science & Medicine, Elsevier, vol. 57(7), pages 1237-1247, October.
- Walter-Ginzburg, Adrian & Shmotkin, Dov & Blumstein, Tzvia & Shorek, Aviva, 2005. "A gender-based dynamic multidimensional longitudinal analysis of resilience and mortality in the old-old in Israel: the cross-sectional and longitudinal aging study (CALAS)," Social Science & Medicine, Elsevier, vol. 60(8), pages 1705-1715, April.
- Jaffe, Dena H. & Eisenbach, Zvi & Neumark, Yehuda D. & Manor, Orly, 2005. "Individual, household and neighborhood socioeconomic status and mortality: a study of absolute and relative deprivation," Social Science & Medicine, Elsevier, vol. 60(5), pages 989-997, March.
- Waldron, Ingrid & Weiss, Christopher C. & Hughes, Mary Elizabeth, 1997. "Marital status effects on health: Are there differences between never married women and divorced and separated women?," Social Science & Medicine, Elsevier, vol. 45(9), pages 1387-1397, November.
- Shye, Diana & Mullooly, John P. & Freeborn, Donald K. & Pope, Clyde R., 1995. "Gender differences in the relationship between social network support and mortality: A longitudinal study of an elderly cohort," Social Science & Medicine, Elsevier, vol. 41(7), pages 935-947, October.
- Lund, Rikke & Due, Pernille & Modvig, Jens & Holstein, Bjørn Evald & Damsgaard, Mogens Trab & Andersen, Per Kragh, 2002. "Cohabitation and marital status as predictors of mortality--an eight year follow-up study," Social Science & Medicine, Elsevier, vol. 55(4), pages 673-679, August.
- Manor, Orly & Eisenbach, Zvi & Israeli, Avi & Friedlander, Yechiel, 2000. "Mortality differentials among women: the Israel Longitudinal Mortality Study," Social Science & Medicine, Elsevier, vol. 51(8), pages 1175-1188, October.
- Baron-Epel, Orna & Shemy, Galia & Carmel, Sara, 2004. "Prediction of survival: a comparison between two subjective health measures in an elderly population," Social Science & Medicine, Elsevier, vol. 58(10), pages 2035-2043, May.
- Goldman, Noreen & Korenman, Sanders & Weinstein, Rachel, 1995. "Marital status and health among the elderly," Social Science & Medicine, Elsevier, vol. 40(12), pages 1717-1730, June.
- Bowling, Ann, 1987. "Mortality after bereavement: A review of the literature on survival periods and factors affecting survival," Social Science & Medicine, Elsevier, vol. 24(2), pages 117-124, January.
- Stuck, Andreas E. & Walthert, Jutta M. & Nikolaus, Thorsten & Büla, Christophe J. & Hohmann, Christoph & Beck, John C., 1999. "Risk factors for functional status decline in community-living elderly people: a systematic literature review," Social Science & Medicine, Elsevier, vol. 48(4), pages 445-469, February.
- Mostafa, Golam & van Ginneken, Jeroen K., 2000. "Trends in and determinants of mortality in the elderly population of Matlab, Bangladesh," Social Science & Medicine, Elsevier, vol. 50(6), pages 763-771, March.
- Joung, Inez M. A. & van de Mheen, H. Dike & Stronks, Karien & van Poppel, Frans W. A. & Mackenbach, Johan P., 1998. "A longitudinal study of health selection in marital transitions," Social Science & Medicine, Elsevier, vol. 46(3), pages 425-435, February.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:64:y:2007:i:1:p:77-94. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.