Sex Differences in Medication and Primary Healthcare Use before and after Spousal Bereavement at Older Ages in Denmark: Nationwide Register Study of over 6000 Bereavements

Anna Oksuzyan,Cecilia Tomassini,Rune Jacobsen,James W Vaupel,Karen Glaser,Kaare Christensen

doi:10.4061/2011/678289

Abstract

Background. The study aimed to examine sex differences in healthcare use before and after widowhood to investigate whether reduced healthcare use among widowers compared with widows may partially explain excess mortality and more adverse health outcomes among men than women after spousal loss. Methods. All individuals alive and aged at least 60 years in 1996 and who became widowed in the period from 1996 to 2003 were selected from the 5% sample of the total Danish population and all Danish twins. The healthcare use was assessed as the average daily all-cause and major system-specific medication use and the average annual number of visits to general physicians (GPs). Results. The average daily use of all-cause and major system-specific medications, as well as the number of GP visits increased over the period from 1 year before and up to 5 years after a spouse's death, but there were no sex-specific patterns in the trajectories of medication use and number of GP visits after conjugal loss. Conclusion. We found little support for the hypothesis that reduced healthcare use contributes to the explanation of more adverse health outcomes after conjugal loss in men compared with women in Denmark.

Highlights

There is a mounting research literature showing a mortality and health disadvantage after spousal bereavement [1]
The healthcare use was assessed as the average daily all-cause and major system-specific medication use and the average annual number of visits to general physicians (GPs)
The average daily use of all-cause and major system-specific medications, as well as the number of GP visits increased over the period from 1 year before and up to 5 years after a spouse’s death, but there were no sex-specific patterns in the trajectories of medication use and number of GP visits after conjugal loss

Summary

Introduction

There is a mounting research literature showing a mortality and health disadvantage after spousal bereavement [1]. Elevated risks of death after conjugal loss among middleand old-aged persons were found for all-cause mortality and most major causes of death, such as cancers, cardiovascular diseases (CVD), respiratory diseases, accidents, and violence in Finland, UK, and the US [2,3,4,5] This excess mortality among the bereaved usually occurs within the first six months following the death of a spouse [3, 4]; some studies have suggested that it remains high many years after bereavement [6, 7]. The study aimed to examine sex differences in healthcare use before and after widowhood to investigate whether reduced healthcare use among widowers compared with widows may partially explain excess mortality and more adverse health outcomes among men than women after spousal loss.

Methods

Results

Conclusion