Abstract
BackgroundSeveral studies have indicated a significant association between marital status and mortality risks. However, most of these studies have compared married and unmarried people without differentiating among single, divorced and widowed status. Moreover, gender differences in mortality rates associated with marital status have not been sufficiently clarified. With significant increases in the percentages of divorced and widowed people and a corresponding drop in the marriage rate in Japan during the past two or three decades, it can be expected that these changes will have a significant impact on mortality rates.MethodsThis investigation used a prospective study of a total of 94,062 Japanese men and women aged 40–79 who completed self-administered questionnaires at baseline and during a followed-up of 9.9-years.ResultsCompared with married men, never-married men showed higher risks of mortality from cardiovascular disease [relative risk (RR) = 3.05, 95% confidence interval (CI) 2.03–4.60], respiratory disease (RR = 2.43, 95%CI 1.27–4.63), external causes (RR = 2.18, 95%CI 1.05–4.54) and all causes (RR = 1.91, 95%CI 1.51–2.42) after adjustment for potentially confounding variables. For never-married women, there was a smaller but significantly higher risk of mortality from all causes (RR = 1.46, 95%CI 1.15–1.84). Divorced and widowed men showed moderately higher risks of mortality from cardiovascular disease, external causes and all causes compared with married men, but such a trend was not observed in women.ConclusionSingle status was associated with a higher risk of mortality than was married status for both men and women. Divorce and widowhood were associated with elevated risk for men, but not for women. These findings suggest single, divorce and widowhood status constitute potentially adverse health effects.
Highlights
Several studies have indicated a significant association between marital status and mortality risks
Widowed men had approximately 1.3 to 1.7-fold higher risks of mortality from stroke, coronary heart disease, cardiovascular disease, cancer, and external causes and all causes compared with married men
Divorced men had 1.6 to 2.5-fold higher risks of mortality from cardiovascular disease, respiratory disease, external causes and all causes compared with married men
Summary
Several studies have indicated a significant association between marital status and mortality risks Most of these studies have compared married and unmarried people without differentiating among single, divorced and widowed status. Marital status has been identified as an important social factor associated with mortality Studies of this association conducted in the United States [1,2], European countries [3] and Japan [4,5] have shown that the risk of mortality for widowed, divorced, or single persons is 1.2 to 2.5-fold higher than for married persons. In the 1970s, an exceptionally high annual mortality rate was reported among Japanese singles (65 per 1000) compared to other countries (15–35 per 1000), possibly due to the high prevalence of tuberculosis [6,7]. A recent 7-year prospective study of 11,565 Japanese aged 40–69 found a risk of all-cause mortality among single men and women that was twice as high as that among their married counterparts, but the effects of divorce or widowhood on mortality were not be thoroughly examined in that study due to the limited number of deaths [9]
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