Mortality and age differences in marriage.

Data from the 1971 census population were used to evaluate the effects of age differences of married partners on mortality rates. Different age groups were isolated to highlight the association between mortality and age of spouse for specific ages of married men and women. Men married to much younger or to older women exhibited a higher mortality rate than men married to women who were only a few years younger than themselves. A similar trend was observed among women married to much younger or much older men compared with those whose spouses were a few years older or of similar ages as themselves. Trends for other age groups (women aged 60-69 years, men below 40, and women below 30) did not exhibit a clear pattern. Although statistical biases within age groups may in part account for the differences in the findings, the trend which emerged from the analysis suggests that lower morbidity is associated with the most common age combinations (husbands same age or slightly older than wives). Other factors could also account for the differences (e.g., selection of healthy partners in 1st marriages, differences in lifestyles between married and single).     

Gender,Ethnicity, Marital Status,and Body Weight in the United States

Married individuals tend to be heavier than those who are unmarried, particularly men, and individuals in different ethnic categories vary in their involvement in marriage and in their body weights. We examined gender and ethnic differences in relationships between marital status and body weight using cross‐sectional data from the 1999–2002 National Health and Nutrition Examination Survey (NHANES) for 3,947 women and 4,019 men. The findings revealed that compared to married men in the same ethnic category, white divorced men, black never‐married men, and all Hispanic men except for widows had lower odds of being overweight. Compared to married women in the same ethnic category, white women's weights did not significantly differ by marital status, black separated women had greater odds of being overweight, and Hispanic never‐married women had lower odds of being overweight. Associations of marriage with body weight appear to be at least partly contingent upon gender and ethnicity, which may reflect larger societal patterns of involvement in marriage, commitment to family, and body‐weight norms and expectations.     

Marital status and mortality among middle age and elderly men and women in urban Shanghai

Background

Previous studies have suggested that marital status is associated with mortality, but few studies have been conducted in China where increasing aging population and divorce rates may have major impact on health and total mortality.

Methods

We examined the association of marital status with mortality using data from the Shanghai Women''s Health Study (1996–2009) and Shanghai Men''s Health Study (2002–2009), two population-based cohort studies of 74,942 women aged 40–70 years and 61,500 men aged 40–74 years at the study enrollment. Deaths were identified by biennial home visits and record linkage with the vital statistics registry. Marital status was categorized as married, never married, divorced, widowed, and all unmarried categories combined. Cox regression models were used to derive hazard ratios (HR) and 95% confidence interval (CI).

Results

Unmarried and widowed women had an increased all-cause HR = 1.11, 95% CI: 1.03, 1.21 and HR = 1.10, 95% CI: 1.02, 1.20 respectively) and cancer (HR = 1.17, 95% CI: 1.04, 1.32 and HR = 1.18, 95% CI: 1.04, 1.34 respectively) mortality. Never married women had excess all-cause mortality (HR = 1.46, 95% CI: 1.03, 2.09). Divorce was associated with elevated cardiovascular disease (CVD) mortality in women (HR = 1.47, 95% CI: 1.01, 2.13) and elevated all-cause mortality (HR = 2.45, 95% CI: 1.55, 3.86) in men. Amongst men, not being married was associated with excess all-cause (HR = 1.45, 95% CI: 1.12, 1.88) and CVD (HR = 1.65, 95% CI: 1.07, 2.54) mortality.

Conclusions

Marriage is associated with decreased all cause mortality and CVD mortality, in particular, among both Chinese men and women.     

Bachelors,Divorcees, and Widowers: Does Marriage Protect Men from Type 2 Diabetes?

While research has suggested that being married may confer a health advantage, few studies to date have investigated the role of marital status in the development of type 2 diabetes. We examined whether men who are not married have increased risk of incident type 2 diabetes in the Health Professionals Follow-up Study. Men (n = 41,378) who were free of T2D in 1986, were followed for ≤22 years with biennial reports of T2D, marital status and covariates. Cox proportional hazard models were used to compare risk of incident T2D by marital status (married vs unmarried and married vs never married, divorced/separated, or widowed). There were 2,952 cases of incident T2D. Compared to married men, unmarried men had a 16% higher risk of developing T2D (95%CI:1.04,1.30), adjusting for age, family history of diabetes, ethnicity, lifestyle and body mass index (BMI). Relative risks (RR) for developing T2D differed for divorced/separated (1.09 [95%CI: 0.94,1.27]), widowed (1.29 [95%CI:1.06,1.57]), and never married (1.17 [95%CI:0.91,1.52]) after adjusting for age, family history of diabetes and ethnicity. Adjusting for lifestyle and BMI, the RR for T2D associated with widowhood was no longer significant (RR:1.16 [95%CI:0.95,1.41]). When allowing for a 2-year lag period between marital status and disease, RRs of T2D for widowers were augmented and borderline significant (RR:1.24 [95%CI:1.00,1.54]) after full adjustment. In conclusion, not being married, and more specifically, widowhood was more consistently associated with an increased risk of type 2 diabetes in men and this may be mediated, in part, through unfavorable changes in lifestyle, diet and adiposity.     

The effect of marriage on utilization of colorectal endoscopy exam in the United States

Purpose: This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income. Methods: Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50-85 years of age without a personal history of cancer and with complete information on all study variables (n=21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level. Results: Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15-1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons to have undergone a colorectal endoscopy exam. Conclusion: Given that colorectal endoscopy exams are a potentially life-saving procedure, persistently higher uptake of colorectal endoscopy for married persons over time may be an important health promoting benefit of marriage. Therefore, clinicians and policy makers should focus on improving the use of cancer prevention services among unmarried persons.     

Pregnancy outcome is associated with maternal marital status in Austria--even at the beginning of the 21st century

Human reproduction is a biological phenomenon, however, sociocultural factors such as marital status influence pregnancy outcome and reproductive success. In the present study the impact of maternal marital status on pregnancy outcome was tested for all births, which had taken place in Austria between 1999 and 2004, which met the following criteria: single births, nulliparity, mothers older than 19 years (n = 179 830). The rate of preterm delivery (< 37 beginning weeks of gestation) and rate of low birth weight (< 2500 g) among term births were significantly higher among unmarried mothers in comparison to married mothers. Additionally the newborns of unmarried mothers were significantly lighter and shorter than those of married mothers. This was especially true of immigrant mothers. No significant differences between married and unmarried mothers were found regarding mode of delivery. Even at the beginning of the 21st century unmarried status represents an important stress factor for pregnant women.     

Physical attractiveness influences reproductive success of modern men

Theory suggests that reproductive success is positively associated with an individual’s genetic quality. However, the association between physical attractiveness and reproductive success (i.e., number of offspring) in modern humans remains less clear. Here we examined associations between men’s reproductive success and physical attractiveness from retrospective data obtained from married, divorced, and single samples of Slovakian men. As predicted, facially more attractive and taller men were more likely to engage in marriage. In turn, married men had higher reproductive success than single men. Even when men’s marital status was considered, facially more attractive men had higher reproductive success than their less attractive counterparts. This supports the importance of physical attractiveness in sexual selection in modern humans.     

Long-term trends in marital status mortality differences in The Netherlands 1850-1970

This article describes the long-term trends in marital status mortality differences in the Netherlands using a unique dataset relating to the period 1850-1970. Poisson regression analysis was applied to calculate relative mortality risks by marital status. For two periods, cause-of-death by marital status could be used. Clear differences in mortality by marital status were observed, with strongly increasing advantages for married men and women and a relative increase in the mortality of widowed compared with non-married people. Excess mortality among single and formerly married men and women was visible in many cause-of-death categories, and this became more widespread during the last decades of the nineteenth century. Hypotheses are formulated that might explain why married men and women underwent a stronger decrease in mortality up until the end of World War II.     

Marital status and colon cancer outcomes in US Surveillance, Epidemiology and End Results registries: does marriage affect cancer survival by gender and stage?

Background: Marital status has been associated with outcomes in several cancer sites including breast cancer in the literature, but little is known about colon cancer, the fourth most common cancer in the US. Methods: A total of 127,753 patients with colon cancer were identified who were diagnosed between 1992 and 2006 in the US Surveillance, Epidemiology and End Results (SEER) Program. Marital status consisted of married, single, separated/divorced and widowed. Chi-square tests were used to examine the association between marital status and other variables. The Kaplan–Meier method was used to estimate survival curves. Cox proportional hazards models were fit to estimate the effect of marital status on survival. Results: Married patients were more likely to be diagnosed at an earlier stage (and for men also at an older age) compared with single and separated/divorced patients, and more likely to receive surgical treatment than all other marital groups (all p < 0.0001). The five-year survival rate for the single was six percentage points lower than the married for both men and women. After controlling for age, race, cancer stage and surgery receipt, married patients had a significantly lower risk of death from cancer (for men, HR: 0.86, CI: 0.82–0.90; for women, HR: 0.87, CI: 0.83–0.91) compared with the single. Within the same cancer stage, the survival differences between the single and the married were strongest for localized and regional stages, which had overall middle-range survival rates compared to in situ or distant stage so that support from marriage could make a big difference. Conclusions: Marriage was associated with better outcomes of colon cancer for both men and women, and being single was associated with lower survival rate from colon cancer.     

The impact of co-resident spouses and sons on elderly mortality in rural Bangladesh

This paper uses prospective data from the Matlab surveillance system in rural Bangladesh to demonstrate that initially co-resident spouses and sons have a major impact on the subsequent mortality of old people, with significant differences by the sex of the elderly person, and the age of the son. Spouses significantly reduce mortality by similar magnitudes for both elderly men and women. On the other hand, co-resident adult sons reduce mortality for elderly women much more than for elderly men, with younger sons being more beneficial than older sons. Furthermore, both married and unmarried females appear to benefit equally from co-resident adult sons. Finally, this analysis suggests that the impact of spouses and sons on mortality in old age is not substantially mediated through changes in elderly economic status.     

Studies of the mortality of A-bomb survivors. 8. Cancer mortality, 1950-1982

This study extends an earlier one by 4 years (1979-1982) and includes mortality data on 11,393 additional Nagasaki survivors. Significant dose responses are observed for leukemia, multiple myeloma, and cancers of the lung, female breast, stomach, colon, esophagus, and urinary tract. Due to diagnostic difficulties, results for liver and ovarian cancers, while suggestive of significant dose responses, do not provide convincing evidence for radiogenic effects. No significant dose responses are seen for cancers of the gallbladder, prostate, rectum, pancreas, or uterus, or for lymphoma. For solid tumors, largely due to sex-specific differences in the background rates, the relative risk of radiation-induced mortality is greater for women than for men. For nonleukemic cancers the relative risk seen in those who were young when exposed has decreased with time, while the smaller risks for those who were older at exposure have tended to increase. While the absolute excess risks of radiation-induced mortality due to nonleukemic cancer have increased with time for all age-at-exposure groups, both excess and relative risks of leukemia have generally decreased with time. For leukemia, the rate of decrease in risk and the initial level of risk are inversely related to age at exposure.     

Contraceptive practice of Irish married and single first-time mothers

This study surveys 100 married and 100 unmarried primiparous mothers, attending the National Maternity Hospital, Dublin, with regard to their contraceptive practice, their planning of their pregnancy and the timing of their first antenatal visit. Nineteen per cent of the married women, but 64% of the unmarried women, had never used any contraceptive method. The contraceptive pill was the most popular method for both groups, but while three in five of the married women had at some time used the pill, only a little more than one in five of the unmarried women had ever used it. One quarter of the women who had used contraception reported that their pregnancy was the result of a failure in their contraceptive method. Eighty-nine per cent of the single group and 20% of the married had not planned their pregnancy. None of the married women, but almost a quarter of the single, delayed their first antenatal visit until after they were 20 weeks pregnant.     

EBV seroepidemiology in married and unmarried women and men in Iran

Background:

Among the eight known human herpes viruses, Epstein- Barr virus (EBV) is considered to be sexually transmissible. This study was conducted to evaluate the seroepidemiology of this infection in married and unmarried Iranian couples.

Methods:

In this comparative observational and cross-sectional study, 160 men and women were divided into married and unmarried groups. Serum IgG and IgM antibodies to the EBV viral capsid antigen were analyzed by Enzyme-linked Immunosorbent Assays (ELISAs).

Results:

In this study 78 men and 82 women were enrolled. Ninety percent of the married and 76.2% of the unmarried women were anti-EBV IgG positive (P = 0.08), while 80% of the married and 94% of the unmarried men were antiEBV IgG positive (P = 0.052).

Conclusion:

Seroepidemiology of EBV is not significantly different in married vs. unmarried women and men in Iran; therefore, sexual contact may not be the primary mechanism of EBV transmission in Iran and other developing countries. Attention to other possible routes of transmission is recommended. Key Words: Epstein Barr Virus, Sexual contact, Anti-VCA     

Contribution of deaths related to alcohol use of socioeconomic variation in mortality: register based follow up study.

OBJECTIVE: To estimate the contribution of excessive alcohol use to socioeconomic variation in mortality among men and women in Finland. DESIGN: Register based follow up study. SUBJECTS: The population covered by the 1985 and 1990 censuses, aged > or = 20 in the follow up period 1987-93. MAIN OUTCOME MEASURES: Total mortality and alcohol related mortality from all causes, from diseases, and from accidents and violence according to socioeconomic position. The excess mortality among other classes compared with upper non-manual employees and differences in life expectancy between the classes were used to measure mortality differentials. RESULTS: Alcohol related mortality constituted 11% of all mortality among men aged > or = 20 and 2% among women and was higher among manual workers than among other classes. It accounted for 14% of the excess all cause mortality among manual workers over upper non-manual employees among men and 4% among women and for 24% and 9% of the differences in life expectancy, respectively. Half of the excess mortality from accidents and violence among male manual workers and 38% among female manual workers was accounted for by alcohol related deaths, whereas in diseases the role of alcohol was modest. The contribution of alcohol related deaths to relative mortality differentials weakened with age. CONCLUSIONS: Class differentials in alcohol related mortality are an important factor in the socioeconomic mortality differentials in Finland, especially among men, among younger age groups, and in mortality from accidents and violence.     

Differential indicators of loneliness among elderly. The importance of type of partner relationship, partner history, health, socioeconomic status and social relations

Using data from the 1992 NESTOR-survey 'Living arrangements and social networks of older adults' (N = 4494), the aim of the present study is to identify specific categories of older adults who are most vulnerable to loneliness. By looking at different types of partner relationships (first, second, and third marriages; consensual unions; partners who are not household members) and at partner histories (never married, ever divorced, ever widowed, remarried), this study elaborates on previous research which has tended to look only at the presence versus the absence of partner relationships. Findings indicate that different types of partner relationships provide differential protection against loneliness. There appears to be a 'shadow of the past' of a previous divorce or widowhood in second and third partnerships, which accounts for generally higher levels of loneliness. Single men tend to be more lonely than single women. Moreover, there are no differences in loneliness between men who have always been single and those previously married. Among single women, differences in partner history are relevant: never married single women tend to be least vulnerable to loneliness. The differences in loneliness between older adults with different types of partner relationships and partner histories are only partially attributable to network and social participation differences. The latter independently contribute to the explanation of loneliness. The role of non-social determinants (health and socioeconomic position) is also examined. The results underscore the socially isolating effects of sensory impairments. Older adults with functional limitations, and those with visual or auditory problems tend to be more lonely, findings which are only partially attributable to differences in the number and quality of social relationships. Socioeconomic circumstances primarily have an indirect influence on loneliness. Those with higher levels of educational attainment and higher incomes tend to have more extensive social networks and are therefore less prone to loneliness.     

Perils of single life and benefits of marriage

Abstract

It has long been observed that married persons experience more favorable mortality than unmarried persons. Hypotheses about possible explanations for mortality differentials by marital status fall into three general categories: (1) hypotheses regarding errors in the data, (2) hypotheses related to the selection of persons into and out of marital states, and (3) hypotheses regarding environmental and behavioral factors associated with various marital states. In this paper the authors investigate the extent to which mortality differences by marital status are similar across populations and assess the importance of selection factors in producing the excess mortality of the single populations.     

Marriage and fatherhood are associated with lower testosterone in males

In order to study the hormonal correlates of the tradeoff between mating and parenting effort in human males, we examined the salivary testosterone (T) levels of 58 Boston-area men who were either unmarried (n=29), married without children (n=14), or married with children (n=15). Additionally, we asked participants to complete a questionnaire that surveyed their demographic, marital, and parenting backgrounds. We tested the hypotheses that (1) T levels will be lower in married than in unmarried men and (2) married men with children will have lower T levels than unmarried men and married men without children. We also tested a series of hypotheses relating variation in parenting and spousal relationships to T. We found that married men with and without children had significantly lower evening T than unmarried men. No significant differences in T were found among the groups in morning samples. Among married men without children, higher scores on a “spousal investment” measure and more hours spent with a man's wife on his last day off work were both associated with lower T levels. We suggest that lower T levels during the day among fathers may facilitate paternal care in humans by decreasing the likelihood that a father will engage in competitive and/or mating behavior.     

Pet companionship and depression: Results from a United States Internet sample

Abstract

Using Internet survey data from 2,291 respondents from the United States, we examined socio-demographic predictors of living with a cat or dog. Logistic regressions showed that, for men, being married, living with children, being Midwestern and non-urban increased odds of living with a pet. For women, being White, having a high income, living with children, and living in a rural setting increased odds for pet ownership. Multivariate analyses examining influences of gender, marital status, and pet ownership on depression (CES-D) scores, adjusting for potential confounders, revealed that unmarried women who live with a pet have the fewest depressive symptoms, and unmarried men who live with a pet have the most. These findings suggest that single women benefit from pet companionship, whereas single men may be burdened by it.     

Therapeutic abortion and its psychological implications: the Canadian experience.

Approximately 9 months after a legal therapeutic abortion, 188 Canadian women were interviewed. One half were single and the rest were married, separated or divorced. They were matched closely for a number of demographic variables with control women who had not had abortions. Neurotic disturbance in several areas of personality functioning was assessed from questionnaire responses. Out of 27 psychological scales, differences between the abortion and control groups were found on only 3: in general, women who had had abortions were more rebellious than control women, abortion tended to be associated with somewhat greater depression in married women, and single women who had had abortions scored higher on the shallow-affect scale. However, all the personality scores were well within the normal range. Perceived social support was strongly associated with favourable psychological reactions after abortion. Use of contraceptives improved greatly after the abortion, when over 90% of women reported using contraceptives regularly.     

Marital state,alcohol consumption,and liability to myocardial infarction,stroke, diabetes mellitus,or hypertension in men from Gothenburg.

Data from the Swedish personal number system were used to examine rates of admissions to hospital, particularly with myocardial infarction, stroke, diabetes mellitus, or hypertension, in relation to marital state and histories of admission with alcoholism in 77843 men from Gothenburg born in 1911-40. The number of admissions to hospital with the four diseases varied with marital state and history of admission with alcoholism, but by considering each subset from the total group it was possible to show that among alcoholic men no material variation in the number of admissions was evident. By contrast, among the non-alcoholic men those who were married were particularly prone to myocardial infarction but less likely to be admitted with stroke or diabetes mellitus than the unmarried or divorced men. The data show the value of common personal and health statistical numbering systems in generating epidemiological information beyond that obtainable from aggregated data without a record linkage technique.