Widowed Persons Research Articles

Widowhood and Depression Among Older Europeans--The Role of Gender, Caregiving, Marital Quality, and Regional Context

This study investigates the role of gender, caregiving, and marital quality in the correlation between widowhood and depression among older people within a European context by applying the theory of Social Production Functions as a theoretical framework. Fixed-effects linear regression models are estimated using the first 2 waves (2004, 2006) of "The Survey of Health, Ageing and Retirement in Europe" (SHARE). A subsample of 7,844 respondents aged 50 and older in 11 countries, who were married at baseline and are either continuously married or widowed at follow-up, is analyzed. Respondents who experienced widowhood between the 2 waves report significantly more depressive symptoms than those continuously married, with respondents living in Denmark and Sweden reporting a lower increase in depressive symptoms than those living in Greece, Spain, or Italy. There is no statistically significant interaction between gender and widowhood. Widowed persons who report higher marital quality at baseline show a larger increase in the number of symptoms of depression than those with low marital quality; widowed persons who report being a caregiver for their partner at baseline report smaller increase in the symptoms of depression compared with widowed noncaregivers. The results support the results of previous studies using longitudinal data. Furthermore, the effect of widowhood varies among the 11 countries in the subsample although only a small amount of the variation in the increase of depressive symptoms after becoming widowed can be explained by such contextual factors.

The Preferred Place of Last Days: Results of a Representative Population-Based Public Survey

The place of death is of considerable interest now, yet few studies have determined public preferences for place of end-of-life (EOL) care or final days of life. A survey was designed to answer three questions: (1) What are public preferences for the place of last days? (2) Is this place preference related to socio-demographic and other background characteristics? and (3) Is this place preference associated with specified previous death and dying experiences, the preparation of a living will or advance directive, or a viewpoint supportive of death hastening? An experienced telephone survey company was commissioned to gain a representative population-based sample and survey participants. In mid-2010, 1203 adults were surveyed in Alberta. Descriptive statistics and multinomial logistic regression were conducted. This survey revealed 70.8% preferred to be at home near death; while 14.7% preferred a hospice/palliative care facility, 7.0% a hospital, and 1.7% a nursing home; 5.7% had no stated preference. Marital status was the only predictor of place preference, with widowed persons more often indicating a preference for a hospital or hospice/palliative care facility. These findings suggest homes are the preferred EOL place now for the majority of Albertans, if not other citizens, while at the same time suggesting that marital and living arrangement realities temper EOL place choices and possibilities, with widows best realizing the need for assistance from others when dying. The widespread preference for home-based EOL care indicates public health interventions are needed to promote good home deaths.

Marital Status, the Economic Benefits of Marriage, and Days of Inactivity due to Poor Health

Purpose. This study explored whether the economic benefits of marriage mediate the association between marriage and health and if that relationship is conditional on the level of shared economic resources. Methods. Pooled, cross-sectional data from NHANES 2001–2006 were analyzed using multivariate zero-inflated negative binomial regression for the number of days of inactivity due to poor physical or mental health. Results. Persons that were divorced/separated reported the highest average number of days of inactivity (mean = 2.5) within a 30 day period, and married persons reported the lowest number of days of inactivity (mean = 1.4). Multivariate results indicated that widowed persons did not report significantly more days of inactivity than married persons. Income to poverty ratio reduced the size and eliminated statistical significance of the difference between divorced/separated and never married marital statuses compared to married persons. The interaction effect for marital status and income to poverty ratio was statistically significant suggesting that the relationship between marital status and inactivity is conditional on shared income. Conclusion. Marriage confers health protective benefits in part through pooled income relative to other marital statuses.

Marriage systems and remarriage in 19th century Hungary: a comparative study

The paper tries to examine the intensity and possible influencing factors of remarriages in two distant communities of historic Hungary during the 19th century. It uses longitudinal data gained from parish registers and family reconstitution method and event history models for the analysis of remarriage. Having only incomplete information on the social status of widowed persons, we used sex, age at widowhood, period, duration of widowhood and family composition as independent variables in the models. The analysis could prove that there were considerable differences within the ‘Eastern marriage pattern’: the analysed Transylvanian community showed a higher propensity to remarry than the West Hungarian one. This result fits well into the differing demographic patterns of the two communities. The most probable causes of these differences were better mortality and differing social composition in the Hungarian village. High propensity to remarry and the high proportion of widower/widow marriages stress the unique character of the Transylvanian community. Otherwise the role of sex was decisive in remarriage, that of age and duration of widowhood were also considerable, while period effect could not be observed. The presence of working-age sons decreased the relative risk of remarriage significantly. In this respect there were no considerable differences between the studied communities, and the results are similar to those of other research.

Impact of Widowhood on Parent–Child Relations: Does Parents' Personality Matter?

The authors evaluated the extent to which the short‐term effect of late life widowhood on parent–child relationships is moderated by 5 personality traits—Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Openness to Experience—and how these interactive effects differ by gender. Data were from the Changing Lives of Older Couples Study (N = 1,532). The results indicated that the effects of widowhood on positive and negative interactions with children were significantly moderated by Agreeableness, Extraversion, and Openness to Experience. An agreeable personality helped widowed persons receive more positive interactions, whereas Openness to Experience reduced negative interactions. Widowed persons with higher Extraversion reported more negative interactions. Furthermore, moderating effects of Extraversion and Openness to Experience differed by gender; specifically, higher Extraversion scores predicted increased positive interactions with children for widowed women but decreased positive interactions for widowed men. The significant association between Openness to Experience and decreased negative interactions with children was more apparent among men than among women.

Adherence to a Mediterranean diet in Morocco and its correlates: cross-sectional analysis of a sample of the adult Moroccan population.

BackgroundDietary habits in Morocco are changing and the causes are not well understood. This study aimed to analyse socio-demographic factors associated with adherence to the Mediterranean diet (MeDi) in a national random sample of the adult Moroccan population.MethodsThe data collected in this cross-sectional survey included socio-demographic factors and a food frequency questionnaire. MeDi adherence was assessed in 2214 individuals with complete dietary data. MeDi adherence was measured according to a simplified MeDi score based on the weekly frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and olive oil) with the use of the sex specific medians of the sample as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Logistic regression was used to estimate the association between MeDi adherence (low score 1-4 vs. high 5-8) and other factors.ResultsMean age of the sample was 41.4 (standard deviation 15.3) years, 45.4% were men and 29.9% had a low MeDi adherence. Married subjects (adjusted odds ratio ORa=0.68, 95% CI 0.55-0.84) were less likely to have a low MeDi adherence compared to single, divorced or widowed persons. Persons from rural areas (ORa=1.46, 95% CI: 1.02-2.08), were more often low MeDi adherents compared to those from urban areas. Obese persons (ORa=1.56, 95% CI: 1.16-2.11) were more prone to low MeDi adherence than normal weight individuals.ConclusionMeDi is far from being a universal pattern in the Moroccan population. Intervention strategies should be implemented in target groups to maintain the traditional MeDi pattern considered as the original diet in Morocco.

Wearing the Garment of Widowhood: Variations in Time Since Spousal Loss Among Community-Dwelling Older Adults

We examine how the passage of time since spousal loss varies by social and demographic characteristics, using data from the University of Alabama at Birmingham Study of Aging. In multivariate analyses, African American race, female sex, lower income, and higher risk of social isolation had significant and independent associations with variation in time since spousal loss. African American women were at highest risk for long-term widowhood. Accurate characterizations of widowhood among community-dwelling older adults must consider variation in the length of time individuals are living as widowed persons and socioeconomic concomitants of long-term widowhood.

International Real Estate Review

The number of single person households has dramatically increased in Taiwan in the past several decades as it has elsewhere in the world, but this phenomenon has been largely neglected in the literature. This research explores the factors that affect the formation of single person households and their housing decisions. Taiwan¡¦s population census data for 1980, 1990 and 2000 are used. Some interesting trends can be found. First of all, people who are married or cohabiting have exhibited an increasing tendency to live alone census by census. This shows the increasing need in a modern society for the husband and wife to live separately due to employment or other reasons. Secondly, unmarried and widowed elderly persons have had an increasing probability of living alone over the decades. Thirdly, the number of female single person households has been increasing rapidly, and there is a higher probability that they are homeowners and also occupying a larger living space than their male counterparts. To sum up, the results of this study show that the demand for housing among single person households will continue to increase as their numbers increase. Their demand for homeownership and living space are also increasing.

P2-S7.04 Maximising the impact of positive prevention practices in people living with HIV: learning's from Karnataka, South India

BackgroundWe tried to understand the positive prevention practices in people living with HIV in Karnataka with specific focus on behaviours related to seeking treatment for sexually transmitted diseases and condom...

P1-S5.19 Marriage dissolution and HIV prevalence in rural Zimbabwe 2003-2008

<h3>Background</h3> Over the past decade, HIV prevalence in Zimbabwe has significantly declined, with recent research attributing this decline to wide-spread behaviour change such as reductions in extramarital sexual partnerships. Despite these reductions in risky sexual Behaviours, infections could still be transmitted from one marital union to another as divorced or widowed HIV-positive persons remarry. <h3>Methods</h3> Using information collected through face-to-face interviews in 2003–2005 AND 2006–2008, we compared HIV prevalence and basic demographics among women and their spouses (married, or in a long-term or cohabiting relationship for &gt;12 months) in Manicaland, Zimbabwe. We used logistic regression to assess differences in marital history and basic demographics between HIV seronegative concordant couples, HIV serodiscordant couples and HIV seropositive concordant couples. <h3>Results</h3> In nearly one-third of the 2836 (27.8%) of marital unions interviewed, at least one member was infected with HIV (n=787); both members were HIV positive in 372 couples (13%). Of the 415 serodiscordant couples, 157 (5.5%) were serodiscordant female positive. Overall, compared to those in seronegative concordant (NC) partnerships, women in female-positive discordant (FP) or seropositive concordant (PC) partnerships were older (25–34 years vs 15–24; OR 1.7, 95% CI 1.17 to 2.47; OR 3.35, 2.52 to 4.45, respectively), more likely to been divorced (FP OR 4.19, 2.83 to 6.20; PC OR 4.12, 3.10 to 5.48), and more likely to have been widowed (FP OR 7.83, 3.65 to 16.76; PC OR 7.86, 4.30 to 14.36). Similar but weaker trends in divorce/widowhood were observed among men in male-positive discordant relationships compared to men in SN relationships. Women in FP and PC partnerships both were nearly three times as likely to report &gt;1 lifetime sex partners than women in SN partnerships (FP OR 2.82, 2.02 to 3.92; PC OR 2.86, 2.27 to 3.59); mean lifetime sex partners reported by women in FP and PC partnerships was similar (FP: 2.11 lifetime partners; PC 2.06). <h3>Conclusions</h3> HIV prevalence is high among persons in long-term, stable partnerships, and strongly associated with one or both partners reporting a history of divorce or being widowed. In particular, widowed and divorced women may play an important role in ongoing HIV transmission dynamics. VCT services and other interventions that target couples should be promoted among divorced and widowed individuals.

Moderators in the relationship between social contact and psychological distress among widowed adults

Objectives: This study examines: (1) the effect of widowed persons’ frequency of contact with friends and relatives on their depressive and grief symptoms six months following spousal loss and (2) the extent to which the effects of social contact are contingent upon the degree of emotional support received from these relationships and the congruence between widowed persons’ preferred and actual levels of social contact. Method: Analyses are based on the Changing Lives of Older Couples (CLOC) study, a prospective study of a two-stage area probability sample of 1532 married men and women aged 65 or older. Depressive and grief symptoms, six months after spousal loss, were regressed on social contact, support, and congruence between preferred and actual social contact. Results: Frequency of contact did not have a significant influence on psychological distress when contextual factors are controlled. Social support and the incongruence between preferred and actual social contact were significantly associated with decreased psychological distress for several outcomes. As for the moderating effects of social support and incongruence on the link between social contact and distress, those who had high social contact and high social support experienced less anger and fewer intrusive thoughts than their counterparts; and those who had low social contact but preferred high social contact experienced greater anger. Conclusion: The findings highlight the importance of understanding the quality of widowed persons’ relationships as well as the congruence between their preferred and actual social contact.

Perceived Self-Competency Among the Recently Bereaved

In this study, the authors identified personal resources, features of the marital relationship, and death circumstances that affected perceived self-competency among recently bereaved older adults. Data came from 328 widowed persons who participated in the “Living After Loss” project. Results suggested that those who had more personal resources—namely, income and good health—were the most competent in daily life tasks. Surprisingly, neither death forewarning nor marital quality improved competency after widowhood. Higher competency was associated with more positive mental health outcomes, suggesting that grief is complicated by the need to enhance and/or restore daily life activities as well as the need to deal with the sadness associated with the loss.

Gender and Widowhood: Disparity in Health Status and Health Care Utilization Among the Aged in India

Despite an increasing feminization of India's older population marked by a high incidence of widowhood among aged women, women's health in later life and the health consequences of widowhood has received little attention in the existing gender and gerontological scholarship in India. Based on data of a nationally representative survey by the National Sample Survey Organization (N = 34,831, ages 60 and over), this study analyzed marital status, gender, health and health care utilization, and examined the gendered nature of aging and widowhood in India. Significant differences were found in health status and utilization of health care services by gender and marital status. Widowed persons of either gender were found to be the most vulnerable and, overall, widows emerge as the most disadvantaged group.

Direct and indirect medical costs of functional constipation: a population-based study

Constipation causes a large number of medical visits each year and imposes significant financial toll on healthcare systems worldwide. So the present community-based study was conducted in order to estimate attributable direct and indirect costs to functional constipation (FC) and to provide an overview of related physician visits in general population of Iran. From May 2006 to December 2007, a total of 19,200 adult persons (aged 16 and above) were drawn randomly in Tehran province, Iran (response rate 94%). Participants who reported any gastrointestinal symptoms (2,790 persons) were referred to assigned physicians to be questioned about symptoms of functional bowel disorders according to the Rome III criteria. Direct and indirect costs to FC were calculated. Attributable costs were reported as purchasing power parity dollars (PPP$). Of the total 18,180 consenting participants in this study, 435 (2.4%) had FC according to Rome III criteria. Mean total cost of constipation per person was 146.84 PPP$, of which 128.68 PPP$ was related to direct costs and 18.16 PPP$ to indirect costs. Higher educated persons (189.75 PPP$), those above 64years of age (373.42 PPP$), subjects with BMI of less than 18.5kg/m(2) (510.84 PPP$), and widowed persons (258.50 PPP$) had the highest costs. This study determined that although the economic burden of FC does not seem to be substantial in comparison to other major health problems, it still exacts a substantial toll on the health system for two reasons: chronicity and ambiguity of symptoms.

Do Personality Traits Moderate the Effect of Late-Life Spousal Loss on Psychological Distress?

We use data from the Changing Lives of Older Couples (CLOC) study to investigate the extent to which: (1) five personality traits (agreeableness, conscientiousness, emotional stability/neuroticism, extraversion, and openness) moderate the effect of late-life spousal loss on depressive symptoms; (2) these patterns vary based on the expectedness of the death; and (3) the patterns documented in (1) and (2) are explained by secondary stressors and social support. Widowed persons report significantly more depressive symptoms than married persons, yet the deleterious effects of loss are significantly smaller for highly extraverted and conscientious individuals. The protective effects of personality traits, however, vary based on the expectedness of the death. Extraversion is protective against depression only for persons who had forewarning of the death. Extraverts may be particularly good at marshalling social support during prolonged periods of spousal illness. We discuss the ways that extraversion and conscientiousness may buffer against bereavement-related stressors.

Prospective predictors of positive emotions following spousal loss.

Whereas theoreticians are interested in modeling how bereavement contributes to health, the bulk of research on spousal bereavement is conducted after a loss has occurred. Using prospective longitudinal data, this study examined the extent to which positive emotion following spousal loss varies on the basis of preloss characteristics of the bereaved spouse and the marital relationship prior to loss. Analyses are based on the National Survey of Midlife Development (MIDUS), a 2-wave panel survey of adults in the contiguous United States. Results indicate that compared with continuously married controls, widowed participants experienced a significant decline in positive emotion within 3 years following loss. Conversely, no significant declines in positive emotion were evident among widowed persons with greater preloss trait resilience or greater marital strain. Results provide support for the notion that adjustment to loss may be linked to factors that precede actual loss.

Prevalence and Patterns of Earned Income: Tax Credit use among Eligible Tax-Filing Families: A Panel Study, 1999-2005

This study expands our understanding of participation in the Earned Income Tax Credit (EITC) program among prime working-age individuals from EITC-eligible families between 1999 and 2005. It identifies gaps in program use over time such that outreach efforts might better target low-income working families to increase EITC take-up rates. Relying on National Longitudinal Survey data, findings indicate that more than one third (37.8%) of the population sample was EITC-eligible at least 1 year (3,034 of 8,033 individuals). Less than 20% of EITC-eligible families filed for the credit, and about half of these filed more than 1 year. Robust correlates of EITC use included lower income; larger families; separated, divorced, or widowed persons; and women versus their respective counterparts. Strategies to increase the EITC take-up rates are discussed.

The Effects of Positive and Negative Support From Children on Widowed Older Adults' Psychological Adjustment: A Longitudinal Analysis

This article examines the extent to which positive and negative support from children prior to and after spousal loss and changes in support from pre- to post-loss affect widowed older adults' depressive symptoms, anxiety, and anger 18 months following widowhood. Analyses are based on the Changing Lives of Older Couples, a prospective study of 1,532 married individuals aged 65 years and older. The analytic sample includes 148 widowed persons who have at least one living child and participated in the baseline and two follow-up interviews conducted 6 and 18 months following widowhood. The analyses revealed that higher levels of positive support from children 6 months following widowhood were associated with fewer depressive symptoms at the 18-month follow-up, whereas higher levels of negative support 18 months after loss and a decrease in positive support following loss were associated with more depressive symptoms. Greater negative support both prior to and after loss was associated with greater anxiety, whereas greater negative support 6 months after loss and an increase in negative support following loss were related to greater anger. Given their differential impact on widowed persons' psychological adjustment, both positive and negative aspects of social support as well as its changing nature should be considered in working with bereaved older adults.

Effects of marital closeness on the transition from caregiving to widowhood

Objective: To examine the effects of marital closeness on indicators of well-being (depressive symptoms, grief, and relief) as spouses transition from the role of caregiver to that of widowed person. Methods: 118 spouses of persons with end stage renal disease were interviewed prior to and after the death of the patient. Spouses reported on marital closeness, multiple indicators of pre-death strain as reflected by subjective health, depressive symptoms, caregiving burden, and caregiving satisfaction, as well as post-loss feelings of grief, depression, and relief. Results: Hierarchical regressions indicated that post-loss grief was predicted by gender (b = 0.32, p < 0.001), self-reported health (b = −0.28, p < 0.01), marital closeness (0.22, p < 0.05), and pre-loss depressive symptoms (b = 0.19, p < 0.10). Caregiver burden (b = 0.28, p < 0.05) and marital closeness (b = −0.41, p < 0.001) before the death, predicted relief from the caregiver role post-loss. Subjective health (b = −0.21, p < 0.05) and pre-loss depressive symptoms (b = 0.47, p < 0.001) predicted change in depressive symptoms over time. Conclusion: These data highlight differences in the experiences of grief, relief, and depressive symptoms and suggest that marital closeness plays a central role. Results are interpreted in terms of theory regarding marital quality. Implications for interventions to improve the lives of caregivers and newly widowed spouses are discussed.

The impact of widowhood on Irish mortality due to suicide and accidents

The impact of widowhood on suicide and accident mortality in Ireland was investigated using Poisson regression analysis applied to routine data relating to all 10 561 suicidal and accidental deaths of married or widowed persons aged at least 35 years in Ireland during 1986-2005. Mortality rates were almost always higher among the widowed and often by a 2-fold, statistically significant difference. The excess mortality was equivalent to 2083 or 57.6% of all suicidal or accidental deaths of widowed persons in 1986-2005. Routine contact with recently widowed persons by public health professionals may be warranted with a view to reducing their excess mortality.