Mortality by marital status in a rapidly changing society: Evidence from the Czech Republic

Abstract

AbstractBACKGROUNDMarried people tend to live longer than their unmarried counterparts, and the advantage in life expectancy enjoyed by married people relative to other groups has been increasing over time. The question of whether the benefits of marriage result from selection or protection continues to be debated. But even as this advantage has been increasing, the share of married people in the population has been declining.OBJECTIVEWe explore the dynamics of marital status mortality differentials in the Czech Republic since 1961. We are interested in the selection environment before and after the abrupt political shift in 1989, which led to a great deal of social change.METHODSUnlinked all-cause death counts were combined with the census population by marital status. Changes in overall life expectancy at age 30 were decomposed into those associated with mortality change within marital statuses, and those attributable to changes in the marital status composition of the population.RESULTSMortality differences by marital status increased mainly between 1961 and 1991, and were largely due to the failure of unmarried adults to catch up with the (modest) mortality improvements seen among married adults. Since 1991, the differentials have risen only slightly. Never-married people have lagged the most, with a life expectancy in 2010 that was 9.6 years lower among men and 7.7 years among women than among their married counterparts. The decrease in marriage prevalence reduced the improvement in overall male life expectancy by 0.9 years.CONCLUSIONSWhile there has been an absolute improvement in mortality among unmarried men since 1991, the life expectancy gap between married and unmarried men has increased. A plausible explanation for this gap is that the benefits of marriage are now available to a more (positively) selected population. Further research is needed to confirm these findings.1. IntroductionThere is extensive evidence that married people live longer than people who are unmarried (Ben-Shlomo et al. 1993; Burgoa et al. 1998; Hu and Goldman 1990; Lillard and Panis 1996; Martikainen et al. 2005; Vallin, Mesle, and Valkonen 2001; van Poppel and Joung 2001), and that mortality differentials by marital status tend to increase with time (Hu and Goldman 1990; Murphy, Grundy, and Kalogirou 2007; Valkonen, Martikainen, and Blomgren 2004). The majority of the previous research has focused on Western Europe and North America. At present, however, the European countries in which the relationship between mortality and marital status is changing most rapidly are those of the former Eastern Bloc. Studies of differential mortality in some former Soviet Republics have found extreme variability by marital status (Jasilionis et al. 2007; Kalediene, Petrauskiene, and Starkuviene 2007), and have demonstrated that the abandonment of marriage is an important obstacle to health improvement (Jasilionis et al. 2012).Our paper focuses on marital status mortality differentials in the Czech Republic between 1961 and 2010. These five decades cover three types of marital regimes: 1) pre-war, which was characterized by quasi-universal marriage and persists in older cohorts; 2) socialist, which was typified by high marriage and high divorce rates following the liberalization of divorce legislation in the 1960s; and 3) modern, which has been part of the on-going second demographic transition, and has been in place since the 1990s (Sobotka et al. 2008). In the modern regime, marriage is postponed and is no longer universal, cohabitation is prevalent, and divorce rates are still high. During the period studied, adult mortality stagnated for long stretches, but was improving rapidly by the end of the 1980s, mainly due to advances in health care (Rychta?ikova 2004). Despite these social and demographic changes in marriage patterns, little attention has been paid to mortality differentials by marital status in the Czech Republic. …