Abstract
BackgroundPrevious research has shown large and increasing relative differences in mortality by marital status in several countries, but few studies have considered trends in cause-specific mortality by marital status among elderly people.MethodsThe author uses discrete-time hazard regression and register data covering the entire Norwegian population to analyze how associations between marital status and several causes of death have changed for men and women of age 75-89 from 1971-2007. Educational level, region of residence and centrality are included as control variables. There are 804 243 deaths during the 11 102 306 person-years of follow-up.ResultsRelative to married persons, those who are never married, divorced or widowed have significantly higher mortality for most causes of death. The odds of death are highest for divorcees, followed by never married and widowed. Moreover, the excess mortality among the non-married is higher for men than for women, at least in the beginning of the time period. Relative differences in mortality by marital status have increased from 1971-2007. In particular, the excess mortality of the never married women and, to a lesser extent, men has been rising. The widening of the marital status differentials is most pronounced for mortality resulting from circulatory diseases, respiratory diseases (women), other diseases and external deaths (women). Differences in cancer mortality by marital status have been stable over time.ConclusionsThose who are married may have lower mortality because of protective effects of marriage or selection of healthy individuals into marriage, and the importance of such mechanisms may have changed over time. However, with the available data it is not possible to identify the mechanisms responsible for the increasing relative differences in mortality by marital status in Norway.
Highlights
Previous research has shown large and increasing relative differences in mortality by marital status in several countries, but few studies have considered trends in cause-specific mortality by marital status among elderly people
Differences in mortality by marital status The results are similar to those reported in several other studies, which have concluded that elderly non-married persons have an excess mortality from all-cause mortality [1,2,3,4,5,6,13,14], cancers [2,14], cardiovascular mortality [2,6,14], respiratory diseases [6] and external deaths [6]
This study, which is based on large data of high quality, confirms that differences in mortality by marital status are present among elderly Norwegian males and females, and for most causes of death
Summary
Previous research has shown large and increasing relative differences in mortality by marital status in several countries, but few studies have considered trends in cause-specific mortality by marital status among elderly people. The few studies investigating how the marital status differentials in old-age mortality have changed over time suggest that excess mortality among the non-married has increased. Murphy et al [4] report increasing relative differences in mortality by marital status among elderly people aged 60-89 in seven European countries during the 1990s. Because studies of trends in the relationship between marital status and mortality among elderly people are sparse, and only a small number of them analyze data on cause-specific mortality, the objective of the present study is to investigate how the associations between marital status and several causes of death have changed for Norwegian males and females of age 75-89 from 1971-2007. Data for the entire Norwegian population will be used, and I will control for the marital status differentials in education and place of residence
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