Marital history, health and mortality among older men and women in England and Wales

Marital status and marital history are associated with health. Marital history can be represented by the marital trajectory components of timing, transitions, sequence, and duration. We examined whether marital trajectory components add insights beyond marital status in predicting body weight in a retrospective analysis of 3,011 adults. Marital status findings revealed that married men were heavier than separated/divorced men, and never married women were heavier and more often obese than married women. Marital history findings showed that after adjusting for marital status, trajectory measures of age at first marriage, second marriage or second divorce, experiencing widowhood, and duration of separation/divorce were not clearly associated with body weight or obesity. Body weight and obesity appear to be associated with current marital status but not marital history.

Most research on marriage and well-being only looks at current marital status, which fails to address the impact of the timing and sequence of marital events on well-being. To fill in this gap, we use data from the Health and Retirement Study (HRS) and China Health and Retirement Longitudinal Study (CHARLS) to investigate the relationship between marital histories over the life course and loneliness and social participation in late life among older adults aged 65 and over across the US and China, and the gender differences therein. We show that marital histories are associated with loneliness and social participation differently across countries. Off-time marital transition is associated with worse socio-emotional well-being than on-time transition, represented by the higher likelihood of loneliness among Chinese widowed prematurely. On-time transition, featured by mid-life divorce in the US, is otherwise linked to less loneliness. We find weak evidence of gendered differences in the US, such that premature widowhood is linked to higher participation in leisure activities than friend visits for US women but not men. Lifelong singlehood, otherwise, is associated with lower odds of attending leisure activities than friend visits for US men but not women. Our findings reveal the associations between marital histories, including the states and transitions, and the socio-emotional well-being of older adults from three interconnected theories: the life course paradigm, the normative transition theory and the 'gender-as-relational' theory. We also highlight the importance of studying holistic marital histories (rather than current marital status) and their socio-psychological consequences over the life course, with particular attention to non-normative marital transitions that standardised measures of marital status tend to overlook.

Book Reviews

In this autoethnography I discuss some of the impacts of a chronic and long -term illness on my professional identity of a professor. I examine issues of lack of control throughout the discussion. I also discuss the contribution of phenomenological accounts in the form of autoethnography in serving to challenge society’s view of disability. I suggest the individual intersection of disability and identity demand that the scholarly community listen more to the stories of people who have actual experience of long-term chronic illness. In doing this, we may develop nuanced understandings of the impact of chronic long - term illness on the development on professional identity.

Marital history and home ownership: Evidence from Australia

This study investigates the relationship between health and marital status, focusing particularly on older persons, using data on reported long-term illness rates from the Samples of Anonymised Records (SARs) drawn from the British Census. Until about age 70, long-term illness rates are generally lowest for those in first marriage, followed by the remarried, with intermediate values for the widowed and divorced, and highest for the single. Beyond age 75 for both sexes, single people in the private household population report the lowest illness rates, but when the institutionalized population is included single people at older ages no longer appear to be the healthiest group. This is because at older ages increasingly high proportions of those with long-term illness are in institutions, disproportionately so for single people, explaining why such cross-overs have been found in analyses of private household populations. The health status of co-habiters is generally closer to the married than to other groups for both sexes.

Obesity continues to be an important public health problem worldwide. The objective of this study was to determine the association of body mass index and abdominal obesity with current marital status among the adult population of Iran. A nation-wide cross-sectional survey was conducted from December 2004 through February 2005.The subjects were selected by stratified probability cluster sampling through household family members in Iran. Weight, height, waist circumference, and marital status of 89,404 men and women aged 15 - 65 (mean: 39.2) years were recorded. Four classes of body mass index, i.e., <18.5, 18.5 - 24.9, 25 - 29.9, and > or =30 kg/cm2, and three marital status, i.e., currently-, formerly-, and never-married were used. Abdominal obesity was defined as waist circumference > or =102 cm in men and > or =88 cm in women. The prevalence of overweight was twofold higher in married men (OR: 2.24; 95% CI: 2.08 - 2.41) and women (OR: 2.36; 95% CI: 2.20 - 2.53) than never-married men and women, even when age, educational level, leisure time physical activity, smoking habits, and place of residence were controlled. The multivariate OR of obesity was increased about threefold in married men (2.82; 95% CI: 2.51 - 3.18) and women (3.64; 95% CI: 3.31 - 3.99). The prevalence of abdominal obesity was twofold higher among married men (2.02; 95% CI: 1.79 - 2.29) and about threefold higher among married women (2.87; 95% CI: 2.69 - 3.06). The marital status appears to influence the likelihood of developing overweight, obesity, and abdominal obesity in both men and women in Iran.

Background and ObjectivesAlthough marital status influences cognitive health, limited research has examined the effects of diverse marital histories, particularly regarding remarriage. This study investigates the relationship between remarriage, marital histories, and cognitive impairment with a focus on gender differences. Building on the stress and marital resource models, we examine whether this relationship operates through economic and health-related factors.Research Design and MethodsUsing the Health and Retirement Study (2004–2020; N = 11,406), we constructed 8 mutually exclusive categories based on current marital status and previous transitions, including divorce, widowhood, and multiple disruptions. We fit discrete-time hazard models to assess cognitive impairment risk across these marital trajectories. The bootstrap resampling method was used to conduct a formal mediation test.ResultsRemarriage was associated with higher risks of cognitive impairment for women, but not for men, even after controlling for economic and health-related factors. Specifically, remarried women following widowhood or multiple disruptions had 39% and 32% higher risks of cognitive impairment, respectively, compared to continuously married women. The formal mediation test revealed that remarriage after multiple disruptions has adverse impacts on cognitive impairment, in part, through unhealthy behaviors and poor health status. However, when comparing remarried and unmarried groups, remarriage was associated with lower risks of cognitive impairment for men, whereas remarried women continued to show higher risks of cognitive impairment compared to their unmarried counterparts.Discussion and ImplicationsThis study is among the first to examine gender differences in how lifetime marital histories affect cognitive impairment risk. Remarriage, particularly following widowhood or multiple disruptions may put women at higher risks of cognitive impairment compared to those in their first marriage or those who remain single. These findings underscore the importance of considering detailed marital histories, beyond simple married/unmarried classification, when evaluating the role of social conditions in shaping cognitive impairment risk in practice settings.

This study investigated the impact of union history and marital transitions on wealth inequality between older Black and White women (N = 7,026). Cohort data from the Health and Retirement Study show large and increasing Black – White differences in wealth. Marital and relationship histories are associated with the wealth accumulation process among older women. Women who married and stay married accumulated levels of wealth that exceeded those of other women with disrupted family lives. The marriage – wealth nexus is sensitive to a woman's position in the wealth distribution. Quantile regression results revealed that racial differences in total wealth holdings between Black and White women exist throughout the wealth distribution, whereas the relationship between current union history and wealth differentials is significant at the lower tail and middle of the distribution. Decomposition analyses highlighted the nontrivial role of racial disparities in marital histories in accounting for the racial wealth gap. As members of the baby boom generation enter their retirement years, it will be more important than ever to monitor the wealth accumulation process among older single and racial/ethnic minority women.

Only a minority of older people in England and Wales live in institutional care, but among the older of the old, this minority is large. Disability is the major driver of admissions, but socio-demographic factors are also relevant. Understanding more about the influence of these is important for planning by long-term care. To investigate effects of socio-demographic factors, including housing tenure, household type, marital status, and number of children, on the proportions of elderly people who made a transition from living in the community in 1991 to living in institutional care in 2001. Nationally representative record linkage study including 36,650 people aged 65 years and over, living in the community in England and Wales in 1991, who were still alive in 2001. Nineteen thousand women aged 75-89 years in 2001 were included in additional analyses of effects of parity (number of children borne). Bi-variate and multivariate analyses of variations in sample proportions, who by 2001 were resident in institutional care. 4.3% of men and 9.3% of women in the surviving sample then aged 75 years and over, were in institutional care in 2001. Older age, living in rented accommodation, living alone in 1991 and being unmarried in 2001, as well as long-term illness, were associated with higher proportions making this transition. Women had higher risks than men. Childless women aged 64-79 years in 1991 had a 25% higher risk than women with children of being in institutional care in 2001. Socio-demographic factors continue to influence risks of entry to institutional care in England and Wales.

Gender, union formation, and assortative mating among older women

Since the 1970s greater numbers of people are now living with several serious long term illnesses. These include rarer genetic conditions and ‘lifestyle conditions’ as well as those of an idiopathic nature. This article examines the growing need for new terms and concepts that reflect the changes in the lives of people living with long-term serious illnesses.

BackgroundStroke is among the leading causes of disability and death in the United States, and nearly 7 million adults are currently alive after experiencing a stroke. Although the risks associated with having a stroke are well established, we know surprisingly little about how marital status influences survival in adults with this condition. This study is the first prospective investigation of how marital history is related to survival after stroke in the United States.Methods and ResultsData from a nationally representative sample of older adults who experienced a stroke (n=2351) were used to examine whether and to what extent current marital status and past marital losses were associated with risks of dying after the onset of disease. Results showed that the risks of dying following a stroke were significantly higher among the never married (hazard ratio [HR], 1.55; 95% CI, 1.15–2.08), remarried (HR, 1.22; 95% CI, 1.05–1.43), divorced (HR, 1.22; 95% CI, 1.01–1.50), and widowed (HR, 1.32; 95% CI, 1.16–1.51) relative to those who remained continuously married. We also found that having multiple marital losses was especially detrimental to survival—regardless of current marital status and accounting for multiple socioeconomic, psychosocial, behavioral, and physiological risk factors.ConclusionsMarital history is significantly associated with survival after stroke. Additional studies are needed to further examine the mechanisms contributing to the associations and to better understand how this information can be used to personalize care and aggressively treat vulnerable segments of the population.

Age at marriage is rising throughout sub-Saharan Africa. The singulate mean age at marriage is now greater than 18 in the vast majority of countries in the region and in all of the countries included in our analysis (United Nations Department of Economic and Social Affairs Population Division 2015). Even so sub-Saharan Africa has the highest rates of child marriage in the world and previous studies have estimated that more than half of girls marry before age 18 in many countries in the region (Singh and Samara 1996; Mensch Singh and Casterline 2006). Measuring trends in the prevalence of child marriage over time is important for understanding where the practice is most common and for evaluating the effectiveness of efforts to eliminate it. However measuring age at marriage in sub-Saharan Africa is difficult. Unlike Western marriages which are often unambiguously dated by a ceremony the signing of legal documents and civil registration marriage in sub-Saharan Africa is often described as a process consisting of multiple stages including legitimized sexual relations cohabitation and ceremonies. The process can be lengthy and the various stages occur in different sequences across ethnic and social groups (van de Walle and Meekers 1994; Locoh 1994; Arnaldo 2004). If several events are required to solidify a union it may be unclear when the union was formalized. (excerpt)

A Randomized Controlled Trial of a Supported Employment Program for Persons With Long-Term Mental Illness in Hong Kong