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The long-term impact of multiple sclerosis on the risk of divorce. Mult Scler Relat Disord 2018; 24:145-150. [PMID: 30007180 DOI: 10.1016/j.msard.2018.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/11/2018] [Accepted: 07/01/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Several studies have investigated the impact of multiple sclerosis (MS) on the risk of divorce. However, current evidence is inconclusive and limited by e.g. small sample populations, short follow-up, and/or lack of a control group. The objective of this retrospective, observational study was to estimate the long-term impact of MS on the risk of divorce. METHODS Swedish patients diagnosed with MS between 1975 and 2012 were identified in a nationwide disease-specific register (the Swedish Multiple Sclerosis Registry) and matched with general population controls based on age, sex, region of residency, and marital status. We used survival analysis to estimate the cumulative incidence proportion of divorce after index (i.e. the MS diagnosis date). RESULTS Our final sample comprised 3998 patients and 15,992 general population controls (mean age 44 years; 73% female). Mean follow-up was 10 years (range: 1-37 years). Unadjusted Kaplan-Meier failure functions revealed no significant differences in the cumulative incidence proportion of divorce between patients and controls (log-rank test, p = 0.902), or women with MS and female controls (p = 0.157). In contrast, men with MS were estimated to have a notably higher incidence of divorce compared with male controls (p = 0.040). Cox proportional-hazards model outcomes showed that men with MS had a 21% higher risk (HR: 1.21, p = 0.032) of divorce across follow-up compared with male controls when controlling for age, region of residency, and year of diagnosis. No significant adjusted risk increase was found for women with MS. CONCLUSIONS We show that MS is associated with an increased risk of divorce among men, but not women. Our result should be helpful to inform health policy and clinical interventions, such as relationship counselling programs, and highlight the socio-economic burden of the disease.
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Andersen KK, Olsen TS. Married, unmarried, divorced, and widowed and the risk of stroke. Acta Neurol Scand 2018; 138:41-46. [PMID: 29492956 DOI: 10.1111/ane.12914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Most studies report that marriage carries a lower risk of stroke than single living. Whether the marriage advantage is applicable with respect to all other marital status categories (unmarried, divorced, widow) remains unclear. We studied marital status and its association with incident stroke. MATERIAL AND METHODS We included all patients > 40 years of age admitted to hospital for stroke in Denmark during 2003-2012 and compared marital status to the general Danish population (5.5 millions). Relative risks (RR) for stroke were estimated in log-linear Poisson regression models adjusting for age, sex, calendar year, income, and length of education. RESULTS A total of 58 847 patients with incident stroke were included. Crude incidence rates of stroke (per 1000 per year) among the four marital status categories were as follows: 1.96 (married), 1.52 (unmarried), 2.36 (divorced), and 5.43 (widowed). Compared to married persons, adjusted risk of stroke was significantly increased for divorced (RR 1.23; CI 1.19-1.27) and unmarried men (RR 1.07; CI 1.03-1.11) but not for widowed men (RR 1.02; CI 0.98-1.06); risk was slightly increased for divorced women (RR 1.10; CI 1.06-1.15) while not for widowed (RR 1.0; CI 0.97-1.03) and unmarried women (RR 0.97; CI 0.97-1.03). CONCLUSIONS Divorce was associated with higher risk of stroke, especially in men. Living in marriage or as unmarried or widower had only little or no impact on the risk of stroke.
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Affiliation(s)
- K. K. Andersen
- Danish Cancer Society Research Center; Copenhagen Denmark
| | - T. S. Olsen
- Department of Neurology; Bispebjerg University Hospital; Copenhagen Denmark
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53
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Franke S, Kulu H. Cause-specific mortality by partnership status: simultaneous analysis using longitudinal data from England and Wales. J Epidemiol Community Health 2018; 72:838-844. [DOI: 10.1136/jech-2017-210339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/04/2018] [Accepted: 05/14/2018] [Indexed: 11/04/2022]
Abstract
BackgroundThis paper examines cause-specific mortality by partnership status. Although non-marital cohabitation has spread rapidly in industrialised countries, only a few studies have investigated mortality by partnership status and no recent study has investigated cause-specific mortality by partnership status.MethodsWe use data from the Office for National Statistics Longitudinal Study and apply competing risks survival models.ResultsThe simultaneous analysis shows that married individuals have lower mortality than non-married from circulatory, respiratory, digestive, alcohol and accident related causes of deaths, but not from cancer. The analysis by partnership status reveals that once we distinguish premarital and postmarital cohabitants from other non-married groups, the differences between partnered and non-partnered individuals become even more pronounced for all causes of death; this is largely due to similar cause-specific mortality levels between married and cohabiting individuals.ConclusionsWith declining marriage rates and the spread of cohabitation and separation, a distinction between partnered and non-partnered individuals is critical to understanding whether and how having a partner shapes the individuals’ health behaviour and mortality. The cause-specific analysis supports both the importance of selection into partnership and the protective effect of living with someone together.
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Josefsson K, Elovainio M, Stenholm S, Kawachi I, Kauppi M, Aalto V, Kivimäki M, Vahtera J. Relationship transitions and change in health behavior: A four-phase, twelve-year longitudinal study. Soc Sci Med 2018; 209:152-159. [PMID: 29566960 DOI: 10.1016/j.socscimed.2018.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 02/16/2018] [Accepted: 03/03/2018] [Indexed: 02/08/2023]
Abstract
RATIONALE Extensive scientific evidence shows an association between involvement in social relationships and healthy lifestyle. Prospective studies with many participants and long follow-ups are needed to study the dynamics and change in social factors within individuals over time. OBJECTIVE Our aim was to determine whether a change in relationship status (single, married, divorced, widow, cohabiting) is followed by a change in health behavior (smoking, alcohol consumption, physical activity, and body mass index). METHODS We used data from 81,925 healthy adults participating in the prospective longitudinal Finnish Public Sector Study in the period 2000-2013. We analyzed 327,700 person-observations from four data collection phases. Missing data were multiply imputed. A within-individual methodology was used to minimize the possibility of selection effects affecting the interpretation. RESULTS All four health behaviors showed associations with relationship status. The effects were very similar and in the same direction in women and men, although there were gender differences in the magnitudes of the effects. The end of a relationship was followed by a decrease in body mass index, increased odds of being a smoker, increase in physical activity, and increase in alcohol consumption (widowed men). The effects were reverse when forming a new relationship. CONCLUSION A change in relationship status is associated with a change in health behavior. The association is not explained by socioeconomic status, subjective health status, or anxiety level. People leaving or losing a relationship are at increased risk of unhealthy behavior (smoking and alcohol consumption), but at the same time they have a lower BMI and show higher physical activity compared to the time they were in a relationship. It is not clear if the cumulative health effect of these health behavior changes is positive or negative.
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Affiliation(s)
- Kim Josefsson
- National Institute for Health and Welfare, Helsinki, Finland.
| | - Marko Elovainio
- National Institute for Health and Welfare, Helsinki, Finland; University of Helsinki, Helsinki, Finland
| | | | | | - Maarit Kauppi
- Finnish Institute of Occupational Health, Turku, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Turku, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland; University College London, London, United Kingdom
| | - Jussi Vahtera
- University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland
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The increasing mortality advantage of the married: The role played by education. DEMOGRAPHIC RESEARCH 2018. [DOI: 10.4054/demres.2018.38.20] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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56
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Tseng FM, Petrie D, Wang S, Macduff C, Stephen AI. The impact of spousal bereavement on hospitalisations: Evidence from the Scottish Longitudinal Study. HEALTH ECONOMICS 2018; 27:e120-e138. [PMID: 28833799 DOI: 10.1002/hec.3573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 06/25/2017] [Accepted: 07/06/2017] [Indexed: 06/07/2023]
Abstract
This paper estimates the impact of spousal bereavement on hospital inpatient use for the surviving bereaved by following the experience of 94,272 married Scottish individuals from 1991 until 2009 using a difference-in-difference model. We also consider the sample selection issues related to differences in survival between the bereaved and non-bereaved using a simple Cox Proportional-Hazard model. Before conducting these estimations, propensity score approaches are used to re-weight the non-bereaved to generate a more random-like comparison sample for the bereaved. We find that those bereaved who survive are both more likely to be admitted and to stay longer in hospital than a comparable non-bereaved cohort. Bereavement is estimated to induce on average an extra 0.24 (95% CI [0.15, 0.33]) hospital inpatient days per year. Similar to previous studies, we estimate the bereaved have a 19.2% (95% CI [12.5%, 26.3%]) higher mortality rate than the comparable non-bereaved cohort.
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Affiliation(s)
- Fu-Min Tseng
- Department of Economics, National Chung Cheng University, Chiayi, Taiwan
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia
| | - Shaolin Wang
- Department of Surgery & Cancer, Centre for Health Policy, Imperial College London, London, UK
| | - Colin Macduff
- School of Nursing and Midwifery, Robert Gordon University, Aberdeen, UK
| | - Audrey I Stephen
- School of Nursing and Midwifery, Robert Gordon University, Aberdeen, UK
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Franke S, Kulu H. Mortality Differences by Partnership Status in England and Wales: The Effect of Living Arrangements or Health Selection? EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2018; 34:87-118. [PMID: 30976244 PMCID: PMC6241022 DOI: 10.1007/s10680-017-9423-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/08/2017] [Indexed: 10/19/2022]
Abstract
This article investigates the relationship between partnership status and mortality in England and Wales. Using data from the Office for National Statistics Longitudinal Study for the period between 2001 and 2011, we examine whether married people have lower mortality levels than unmarried individuals; whether individuals who cohabit have mortality levels similar to those of married or single persons; and how much the fact that married couples live with someone rather than alone explains their low mortality. Our analysis shows first that married individuals have lower mortality than unmarried persons. Second, men and women in premarital unions exhibit mortality levels similar to those of married men and women, whereas mortality levels are elevated for post-marital cohabitants. Third, controlling for household size and the presence of children reduces mortality differences between married and unmarried non-partnered individuals, but significant differences persist. The study supports both protection and selection theory. The increase in mortality differences by age between never-married cohabitants and married couples is likely a sign of the long-term accumulation of health and wealth benefits of marriage. Similar mortality levels of cohabiting and married couples at younger ages suggest that healthier individuals are more likely to find a partner.
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Affiliation(s)
- Sebastian Franke
- Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, Roxby Building, Liverpool, L69 7ZT UK
| | - Hill Kulu
- School of Geography and Sustainable Development, University of St Andrews, Irvine Building, North Street, St Andrews, KY16 9AL UK
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Nöhre M, Pollmann I, Mikuteit M, Weissenborn K, Gueler F, de Zwaan M. Partnership Satisfaction in Living Kidney Donors. Front Psychiatry 2018; 9:353. [PMID: 30123146 PMCID: PMC6085414 DOI: 10.3389/fpsyt.2018.00353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022] Open
Abstract
Due to organ shortage, living kidney donation is gaining increasing importance. Medical progress enables a successful transplantation between unrelated individuals, even individuals with AB0-incompatibilities. Spouses are the largest group of living kidney donors. The aim of this study was to assess partnership status and partnership satisfaction in living kidney donors. In the cross-sectional study we investigated 361 living kidney donors. The time since donation ranged between 1 and 38 years. The partnership satisfaction was assessed with the German version of the Quality of Marriage Index. We compared the donor sample with a representative German population sample (n = 1995). In addition, we compared donors who have donated to their partner (spouse donors) to those who have donated to someone else (non-spouse donors). In comparison to the population sample significantly more kidney donors were living in a relationship (82 vs. 60%). Most donors reported an unchanged (76.6%) or improved (20.5%) relationship to the recipient since transplantation. A significantly higher partnership satisfaction could be found in the donor sample compared to the population sample which was mainly due to a higher partnership satisfaction of the spouse donors compared to the non-spouse donors. High partnership satisfaction in living kidney donors might be an indicator for a successful selection process before transplantation. Alternatively, kidney donation might have a stabilizing or even positive impact on the partnership. Due to the design of our study causative interpretations cannot be made. Therefore, prospective studies are required to assess partnership satisfaction before and after living kidney donation.
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Affiliation(s)
- Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Iris Pollmann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Marie Mikuteit
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Department of Neurology, Hannover Medical School, Hannover, Germany.,Department of Nephrology, Hannover Medical School, Hannover, Germany
| | | | - Faikah Gueler
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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Bennett-Britton I, Teyhan A, Macleod J, Sattar N, Davey Smith G, Ben-Shlomo Y. Changes in marital quality over 6 years and its association with cardiovascular disease risk factors in men: findings from the ALSPAC prospective cohort study. J Epidemiol Community Health 2017; 71:1094-1100. [PMID: 28993473 PMCID: PMC5847094 DOI: 10.1136/jech-2017-209178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/30/2017] [Accepted: 08/31/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Marital relationship quality has been suggested to have independent effects on cardiovascular health outcomes. This study investigates the association between changes in marital relationship quality and cardiovascular disease (CVD) risk factors in men. METHODS We used data from The Avon Longitudinal Study of Parents and Children, a prospective birth cohort study (Bristol, UK). Our baseline sample was restricted to married study fathers with baseline relationship and covariate data (n=2496). We restricted final analysis (n=620) to those with complete outcome, exposure and covariate data, who were married and confirmed the study child's father at 6.4 years and 18.8 years after baseline. Relationship quality was measured at baseline and 6.4 years and operationalised as consistently good, improving, deteriorating or consistently poor relationship. We measured CVD risk factors of blood pressure, resting heart rate, body mass index, lipid profile and fasting glucose at 18.8 years after baseline. RESULTS Improving relationships were associated with lower levels of low-density lipoprotein (-0.25 mmol/L, 95% CI -0.46 to -0.03) and relative reduction of body mass index (-1.07 kg/m2, 95% CI -1.73 to -0.42) compared with consistently good relationships, adjusting for confounders. Weaker associations were found between improving relationships and total cholesterol (-0.24 mmol/L, 95% CI -0.48 to 0.00) and diastolic blood pressure (-2.24 mm Hg, 95% CI -4.59 to +0.11). Deteriorating relationships were associated with worsening diastolic blood pressure (+2.74 mm Hg, 95% CI 0.50 to 4.98). CONCLUSIONS Improvement and deterioration of longitudinal relationship quality appears associated with respectively positive and negative associations with a range of CVD risk factors.
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Affiliation(s)
| | - Alison Teyhan
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - John Macleod
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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60
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Du L, Kim JJ, Chen B, Zhu S, Dai N. Marital status is associated with superior survival in patients with esophageal cancer: a Surveillance, Epidemiology, and End Results study. Oncotarget 2017; 8:95965-95972. [PMID: 29221179 PMCID: PMC5707073 DOI: 10.18632/oncotarget.21609] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/23/2017] [Indexed: 02/07/2023] Open
Abstract
The impact of marital status on survival among patients with esophageal cancer has not been evaluated in the U.S. population in depth. The aim of the study was to investigate the impact of marital status on survival among patients diagnosed with esophageal cancer. The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify patients diagnosed with esophageal cancer between 1973 and 2013. Cox regression analysis was performed to evaluate for association between marital status on both cancer-specific and overall survival. Of the 69,139 patients with esophageal cancer, 35,863 (52%) had adenocarcinoma and 21,573 (31%) had distant SEER stage. At the time of diagnosis, 39,805 (57%) patients were married, 10,116 (15%) were single, 8,417 (12%) were divorced or separated, and 10,801 (16%) were widowed. Married patients had superior cancer-specific and overall survival compared to unmarried patients. Multivariate analysis demonstrated that single (adjusted hazard ratio (HR)=1.14, 95%CI 1.11-1.17; P<0.001), divorced or separated (HR=1.16, 95%CI 1.13-1.19; P<0.001), and widowed (HR=1.22, 95%CI 1.19-1.26; P<0.001) compared to married patients had higher risk of death from all causes. In conclusion, marital status was associated with superior survival among U.S. patients with esophageal cancer in a large population-based study.
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Affiliation(s)
- Lijun Du
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - John J Kim
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Binrui Chen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuwen Zhu
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ning Dai
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Zhang J, Gan L, Wu Z, Yan S, Liu X, Guo W. The influence of marital status on the stage at diagnosis, treatment, and survival of adult patients with gastric cancer: a population-based study. Oncotarget 2017; 8:22385-22405. [PMID: 26894860 PMCID: PMC5410231 DOI: 10.18632/oncotarget.7399] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/24/2016] [Indexed: 12/20/2022] Open
Abstract
Background & Aims Marital status was reported as a prognostic factor in many cancers. However, its role in gastric cancer (GC) hasn't been thoroughly explored. In this study, we aimed to investigate the effect of marital status on survival, stage, treatment, and survival in subgroups. Methods We used the Surveillance, Epidemiology and End Results (SEER) database and identified 16910 GC patients. These patients were categorized into married (58.44%) and unmarred (41.56%) groups. Pearson chi-square, Wilcoxon-Mann-Whitney, Log-rank, multivariate Cox regression, univariate and multivariate binomial or multinomial logistic regression analysis were used in our analysis. Subgroup analyses of married versus unmarried patients were summarized in a forest plot. Results Married patients had better 5-year overall survival (OS) (32.09% VS 24.61%, P<0.001) and 5-year cancer-caused special survival (CSS) (37.74% VS 32.79%, P<0.001) than unmarried ones. Then we studied several underlying mechanisms. Firstly, married patients weren't in earlier stage at diagnosis (P=0.159). Secondly, married patients were more likely to receive surgery (P < 0.001) or radiotherapy (P < 0.001) compared with the unmarried. Thirdly, in subgroup analyses, married patients still had survival advantage in subgroups with stage II-IV and no radiotherapy. Conclusions These results showed that marital status was an independently prognostic factor for both OS and CSS in GC patients. Undertreatment and lack of social support in unmarried patients were potential explanations. With the knowledge of heterogeneous effects of marriage in subgroups, we can target unmarried patients with better social support, especially who are diagnosed at late stage and undergo no treatment.
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Affiliation(s)
- Jieyun Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Lu Gan
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Zhenhua Wu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Shican Yan
- Department of Surgery, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xiyu Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Weijian Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
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Control Measures and Health Effects of Air Pollution: A Survey among Public Transportation Commuters in Malaysia. SUSTAINABILITY 2017. [DOI: 10.3390/su9091616] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Myroniuk TW. Marital Dissolutions and the Health of Older Individuals in a Rural African Context. J Gerontol B Psychol Sci Soc Sci 2017; 72:656-664. [PMID: 27382043 PMCID: PMC5927165 DOI: 10.1093/geronb/gbw077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 06/13/2016] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Research from high-income countries has often found a negative relationship between marital dissolutions and health. This paper assesses that relationship among older sub-Saharan Africans, on a now-aging continent. Such individuals are likely to be at risk of a dissolution, or have already experienced one, due to high rates of marriage. METHODS Data from over 1,200 rural Malawians, age 45+, are employed from the 2008 and 2010 waves of the Malawi Longitudinal Study of Families and Health. Cross-sectional and lagged dependent variable regressions examine the relationship between marital dissolutions and 4 measures of self-reported health: retrospective health, relative health (compared with others in one's village), and age-standardized SF-12 mental and physical health scales. RESULTS Worse relative, mental, and physical health are associated with being currently divorced/widowed compared with being married. However, worse retrospective health is linked to becoming divorced/widowed between 2008 and 2010. Those divorced/widowed prior to 2008, and who remained so through 2010, are in worse relative and physical health. DISCUSSION The findings question the relative hardship of marital dissolutions for those who have managed to survive into old age, and call for the collection of more detailed longitudinal data on older Africans on this topic.
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Affiliation(s)
- Tyler W Myroniuk
- Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia
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Kim JW, Jung HY, Won DY, Noh JH, Shin YS, Kang TI. Suicide Trends According to Age, Gender, and Marital Status in South Korea. OMEGA-JOURNAL OF DEATH AND DYING 2017. [PMID: 28622733 DOI: 10.1177/0030222817715756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of this study is to examine suicide trends in South Korea, which has one of the highest suicide rates in the world. The results show that the male suicide rate outweighs that of females, the likelihood of committing suicide increases with age, and that, in regard to marital status, nonmarried people are the most at risk. In addition, several methods of reducing suicide rates are identified: the wider use of social networks to reduce social burden, the development of a social atmosphere where aging is accepted as a natural process, and the development of protection factors within families.
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Affiliation(s)
- Jung Woo Kim
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Hee Young Jung
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Do Yeon Won
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Jae Hyun Noh
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Yong Seok Shin
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
| | - Tae In Kang
- 1 Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea.,2 Choong Hyun Community Welfare Center, Seoul, South Korea
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Mukerjee S, Venugopal A. Religiosity and Health Through the Decades: Is There a Gender Difference? Am J Health Promot 2017; 32:1028-1041. [PMID: 28279087 DOI: 10.1177/0890117116687886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE An empirical examination of the long-term association, disaggregated by gender, between religiosity and self-rated health with reference to demographic shifts in labor force participation, education, and income. DESIGN General Social Survey data. SETTING United States, 1974 to 2012. PARTICIPANTS A total of 23 353 respondents. MEASURES Self-assessed health; 2 key religiosity variables: attendance and intensity of belief; income, labor market variables, education, standard demographic variables, household size, region, and time dummies. ANALYSIS Probit estimation conducted for the aggregate sample by gender as well as by decades to examine possible gender differential changes over time. RESULTS Attendance has declined overall with a much greater decline for women. The overall positive association between religiosity and health masks considerable heterogeneity across gender and time; higher and stable for males, there is no longer a significant association for females. Increased education, income, and labor force participation can explain only part of this association. Education is the strongest mediator. CONCLUSION The way women and men benefit from religious attendance has changed, suggesting that some pathways may be working differently for women now, especially those with less education. Moving away from church networks could be due to a perceived lack of support or substitution by other social networks. Ceteris paribus, since religious participation has been shown to weaken preference for risky consumption, declining participation, especially for women, may show up as an increase in risky behavior.
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Affiliation(s)
- Swati Mukerjee
- 1 Economics Department, Bentley University, Waltham, MA, USA
| | - Arun Venugopal
- 1 Economics Department, Bentley University, Waltham, MA, USA
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Gender Differences in Vulnerability to Socioeconomic Status on Self-Rated Health in 15 Countries. WOMEN’S HEALTH BULLETIN 2017. [DOI: 10.5812/whb.45280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gender Differences in Vulnerability to Socioeconomic Status on Self-Rated Health in 15 Countries. WOMEN’S HEALTH BULLETIN 2017. [DOI: 10.5812/whb-45280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lee HY, Short SD. Do Factors Associated Self-rated Good Health and Their Influences Differ between Males and Females across Different Age Groups in Korean and Australia? Osong Public Health Res Perspect 2017; 8:11-25. [PMID: 28443220 PMCID: PMC5402841 DOI: 10.24171/j.phrp.2017.8.1.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This was a comparative study between Australia and Korea that investigated whether and to what extent factors related to self-rated good health (SRGH) differ by gender among age groups. METHODS This study was a secondary analysis of data that were collected in nationally representative, cross-sectional, and population-based surveys. We analyzed Australian and Korean participants > 20 years of age using 2011 data from the Australian National Nutritional Physical Activity Survey (n = 9,276) and the Korean National Health and Nutritional Examination Survey (n = 5,915). Analyses were based on multiple logistic regression after controlling for covariates. RESULTS Factors associated with SRGH and the extent of their influence differed by gender among age groups within each nation. Australian SRGH was associated with more factors than Korean SRGH, except in participants > 65 years old. Many differences among adults aged 20-44 years were observed, particularly with regard to the influence of socioeconomic factors. Living with a spouse only influenced SRGH in men 20-44 years old in both countries, negatively for Korean men and positively for Australian men. In this same age group, SRGH was positively influenced by employment and attainment of a higher education level in Australian men but not among Korean men; among women, income, but not education, affected SRGH in Korea, whereas in Australia, women were more influenced by education than by income. Lack of chronic disease had a strong influence on SRGH in both countries and was influential in all Australians and Koreans except those ≥ 65 years old. CONCLUSION Broad features of society should be considered when discussing health and differences in associated factors and their influences. For focused public health interventions of population groups, it is also necessary to consider gender and age groups within social environments.
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Affiliation(s)
- Hyo Young Lee
- Department of Health Administration, Dongseo University, Busan,
Korea
| | - Stephanie Doris Short
- Discipline of Behavioral & Social Sciences in Health, Faculty of Health Sciences, the University of Sydney, Lidcome, NSW,
Ausrtralia
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Milani SA, Crooke H, Cottler LB, Striley CW. Sex differences in frequent ED use among those with multimorbid chronic diseases. Am J Emerg Med 2016; 34:2127-2131. [PMID: 27592724 DOI: 10.1016/j.ajem.2016.07.059] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The objectives were to examine the association between multimorbid chronic disease and frequency of past 6 months emergency department (ED) visits, by sex, in a community sample of adults from North Florida (N=7143). METHODS Data came from HealthStreet, a community engagement program at the University of Florida which uses the Community Health Worker Model to assess community member health conditions and concerns, and willingness to participate in health research. Using logistic regression, we estimated associations between multimorbid chronic disease and frequent ED use using sex as an effect modifier. RESULTS Multimorbid chronic disease was associated with frequent ED use overall, with a stronger association among men. Of the 7143 respondents, 14.4% were frequent ED users, 58.0% were female, and 61.5% were black non-Hispanic. Major findings included that women with 3+ chronic diseases were 2.49 (95% confidence interval, 1.7-3.6) times as likely as women without chronic diseases to report frequent ED use, compared with men with 3+ chronic diseases, who were 4.98 (95% confidence interval, 2.9-8.6) times as likely as men without chronic disease to report frequent ED use. CONCLUSIONS Multimorbid chronic disease is very strongly associated with frequent ED use among all, but the association is especially strong among men. Future research is needed to further understand this association and its implication for health care.
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Affiliation(s)
- Sadaf A Milani
- University of Florida, College of Public Health and Health Professions & College of Medicine, Department of Epidemiology.
| | - Hannah Crooke
- University of Florida, College of Public Health and Health Professions & College of Medicine, Department of Epidemiology
| | - Linda B Cottler
- University of Florida, College of Public Health and Health Professions & College of Medicine, Department of Epidemiology
| | - Catherine W Striley
- University of Florida, College of Public Health and Health Professions & College of Medicine, Department of Epidemiology
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Seymour-Smith S, Wetherell M. ‘What he hasn’t told you...’: Investigating the Micro-Politics of Gendered Support in Heterosexual Couples’ Co-Constructed Accounts of Illness. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/0959-353506060826] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research has demonstrated that heterosexual men receive enhanced health benefits from their relationships with women. Explanations for this gendered pattern often focus on women’s role as the main caregivers and arrangers of health care. However, what remains unclear is how these benefits are mediated. In this article, we describe the micropolitics evident in negotiations between 12 heterosexual couples as they discuss the serious illness of one of the pair with an interviewer. The interviews were transcribed and subsequently analysed using a synthetic approach to discursive psychology. We argue that in these co-constructed stories, women potentially trouble men’s identity performances. For instance, by interjecting emotional assessments, women supporters allow men the opportunity to discuss aspects of the illness experience that might be otherwise viewed as at odds with hegemonic masculinity. We suggest that women’s positioning of men is a form of complicity with hegemonic masculinity and urge that further research should follow this line of enquiry.
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Affiliation(s)
| | - Margaret Wetherell
- Open University, UK, Economic and Social Research Council (ESRC)
Identities and Social Action Programme,
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71
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Sheffer CE, Cassisi JE, Ferraresi LM, Lofland KR, McCracken LM. Sex Differences in the Presentation of Chronic Low Back Pain. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/1471-6402.00072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sex differences in 351 patients with chronic low back pain were examined. Biological, psychological, and psychosocial factors were considered. Sex differences in adaptive functioning were consistent with traditional gender roles. Significant interactions were found for sex and employment status, and sex and marital status. Retired women reported more pain and less activity than retired men. Retired men reported the least pain of any group. Outdoor work and social activities show opposite within-group patterns for men and women when stratifiedby employment status. Marriage was associated with more household work for women and less for men. The financial and social contexts of employment status and marriage are different for men and women. Results suggest the treatment of women with chronic low back pain requires attention to work in the home and the financial and social context of work outside the home.
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Ahmadipour H, Kiarash G. Promoting Healthy Lifestyles for Women in Kerman, Iran: A Population-Based Study. WOMEN’S HEALTH BULLETIN 2016. [DOI: 10.17795/whb-33612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Vanthomme K, Vandenheede H, Hagedoorn P, Gadeyne S. Socioeconomic disparities in lung cancer mortality in Belgian men and women (2001-2011): does it matter who you live with? BMC Public Health 2016; 16:493. [PMID: 27287541 PMCID: PMC4901481 DOI: 10.1186/s12889-016-3139-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 05/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ample studies have observed an adverse association between individual socioeconomic position (SEP) and lung cancer mortality. Moreover, the presence of a partner has shown to be a crucial determinant of health. Yet, few studies have assessed whether partner's SEP affects health in addition to individual SEP. This paper will study whether own SEP (education), partner's SEP (partner's education) and own and partner's SEP combined (housing conditions), are associated with lung cancer mortality in Belgium. METHODS Data consist of the Belgian 2001 census linked to register data on cause-specific mortality for 2001-2011. The study population includes all married or cohabiting Belgian inhabitants aged 40-84 years. Age-standardized lung cancer mortality rates (direct standardization) and mortality rate ratios (Poisson regression) were computed for the different SEP groups. RESULTS In men, we observed a clear inverse association between all SEP indicators (own and partner's education, and housing conditions) and lung cancer mortality. Men benefit from having a higher educated partner in terms of lower lung cancer mortality rates. These observations hold for both middle-aged and older men. For women, the picture is less uniform. In middle-aged and older women, housing conditions is inversely associated with lung cancer mortality. As for partner's education, for middle-aged women, the association is rather weak whereas for older women, there is no such association. Whereas the educational level of middle-aged women is inversely associated with lung cancer mortality, in older women this association disappears in the fully adjusted model. CONCLUSIONS Both men and women benefit from being in a relationship with a high-educated partner. It seems that for men, the educational level of their partner is of great importance while for women the housing conditions is more substantial. Both research and policy interventions should allow for the family level as well.
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Affiliation(s)
- Katrien Vanthomme
- Interface Demography, Department of Social Research, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
| | - Hadewijch Vandenheede
- Interface Demography, Department of Social Research, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Paulien Hagedoorn
- Interface Demography, Department of Social Research, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Sylvie Gadeyne
- Interface Demography, Department of Social Research, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
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Sharrow DJ, Anderson JJ. A Twin Protection Effect? Explaining Twin Survival Advantages with a Two-Process Mortality Model. PLoS One 2016; 11:e0154774. [PMID: 27192433 PMCID: PMC4871430 DOI: 10.1371/journal.pone.0154774] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 04/19/2016] [Indexed: 12/31/2022] Open
Abstract
Twin studies that focus on the correlation in age-at-death between twin pairs have yielded important insights into the heritability and role of genetic factors in determining lifespan, but less attention is paid to the biological and social role of zygosity itself in determining survival across the entire life course. Using data from the Danish Twin Registry and the Human Mortality Database, we show that monozygotic twins have greater cumulative survival proportions at nearly every age compared to dizygotic twins and the Danish general population. We examine this survival advantage by fitting these data with a two-process mortality model that partitions survivorship patterns into extrinsic and intrinsic mortality processes roughly corresponding to acute, environmental and chronic, biological origins. We find intrinsic processes confer a survival advantage at older ages for males, while at younger ages, all monozygotic twins show a health protection effect against extrinsic death akin to a marriage protection effect. While existing research suggests an increasingly important role for genetic factors at very advanced ages, we conclude that the social closeness of monozygotic twins is a plausible driver of the survival advantage at ages <65.
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Affiliation(s)
- David J. Sharrow
- University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - James J. Anderson
- University of Washington, Seattle, Washington, United States of America
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Honjo K, Iso H, Ikeda A, Inoue M, Sawada N, Tsugane S. Marital Transition and Risk of Stroke. Stroke 2016; 47:991-8. [DOI: 10.1161/strokeaha.115.011926] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/02/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
There have been consistent findings reported that marital transition (ie, change in marital status during a given time period) is associated with risk of cardiovascular disease; however, few studies have been conducted on stroke risk, particularly stroke subtypes. Moreover, no studies have examined the moderating effect of living arrangement and employment status on the association between marital transition and stroke risk.
Methods—
We examined sex-specific associations between marital transition and stroke risk using data from Japan Public Health Center–based Prospective Study. We included 24 162 men and 25 626 women who were married at prebaseline (5 years before baseline). Marital transition was determined by marital status at baseline. Weighted hazard ratios of stroke risk were estimated by Cox proportional regression analysis with inverse probability of weighting using a propensity score.
Results—
An increased risk of stroke, particularly hemorrhagic stroke, was observed among men and women with marital transition (ie, married to unmarried); weighted hazard ratios (95% confidence interval [CI]) for men and women were 1.26 (1.13–1.41) and 1.26 (1.09–1.45), respectively. Participants with marital transition and lived with children had increased stroke risk. Living with parents buffered the increased stroke risk owing to marital transition among men; however, no such effect was identified among women. Elevated stroke risk owing to marital transition was magnified among women if they were unemployed; weighted hazard ratio=2.98 (95% CI, 1.66–5.33).
Conclusions—
Living arrangement and employment status modified the positive associations between marital transition and stroke risk, which differed by sex.
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Affiliation(s)
- Kaori Honjo
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Department of Public Health, Juntendo University, Faculty of Medicine, Tokyo, Japan (A.I.); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (M.I.); and Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Hiroyasu Iso
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Department of Public Health, Juntendo University, Faculty of Medicine, Tokyo, Japan (A.I.); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (M.I.); and Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Ai Ikeda
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Department of Public Health, Juntendo University, Faculty of Medicine, Tokyo, Japan (A.I.); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (M.I.); and Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Manami Inoue
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Department of Public Health, Juntendo University, Faculty of Medicine, Tokyo, Japan (A.I.); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (M.I.); and Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Norie Sawada
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Department of Public Health, Juntendo University, Faculty of Medicine, Tokyo, Japan (A.I.); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (M.I.); and Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Shoichiro Tsugane
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Department of Public Health, Juntendo University, Faculty of Medicine, Tokyo, Japan (A.I.); Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (M.I.); and Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
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Lewis ME, Lin FC, Nanavati P, Mehta N, Mounsey L, Nwosu A, Pursell I, Chung EH, Mounsey JP, Simpson RJ. Estimated incidence and risk factors of sudden unexpected death. Open Heart 2016; 3:e000321. [PMID: 27042316 PMCID: PMC4809187 DOI: 10.1136/openhrt-2015-000321] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 10/06/2015] [Accepted: 12/21/2015] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE In this manuscript, we estimate the incidence and identify risk factors for sudden unexpected death in a socioeconomically and racially diverse population in one county in North Carolina. Estimates of the incidence and risk factors contributing to sudden death vary widely. The Sudden Unexpected Death in North Carolina (SUDDEN) project is a population-based investigation of the incidence and potential causes of sudden death. METHODS From 3 March 2013 to 2 March 2014, all out-of-hospital deaths in Wake County, North Carolina, were screened to identify presumed sudden unexpected death among free-living residents between the ages of 18 and 64 years. Death certificate, public and medical records were reviewed and adjudicated to confirm sudden unexpected death cases. RESULTS Following adjudication, 190 sudden unexpected deaths including 122 men and 68 women were identified. Estimated incidence was 32.1 per 100 000 person-years overall: 42.7 among men and 22.4 among women. The majority of victims were white, unmarried men over age 55 years, with unwitnessed deaths at home. Hypertension and dyslipidaemia were common in men and women. African-American women dying from sudden unexpected death were over-represented. Women who were under age 55 years with coronary disease accounted for over half of female participants with coronary artery disease. CONCLUSIONS The overall estimated incidence of sudden unexpected death may account for approximately 10% of all deaths classified as 'natural'. Women have a lower estimated incidence of sudden unexpected death than men. However, we found no major differences in age or comorbidities between men and women. African-Americans and young women with coronary disease are at risk for sudden unexpected death.
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Affiliation(s)
- Mary Elizabeth Lewis
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Feng-Chang Lin
- NC TraCS, University of North Carolina, North Carolina, USA
| | - Parin Nanavati
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Neil Mehta
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Louisa Mounsey
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Anthony Nwosu
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Irion Pursell
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Eugene H Chung
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - J Paul Mounsey
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
| | - Ross J Simpson
- Department of Medicine, The University of North Carolina, Cardiac Electrophysiology, North Carolina, USA
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Tamborini CR, Reznik GL, Couch KA. Work Disability among Women: The Role of Divorce in a Retrospective Cohort Study. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:98-117. [PMID: 26957137 DOI: 10.1177/0022146515627849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We assess how divorce through midlife affects the subsequent probability of work-limiting health among U.S. women. Using retrospective marital and work disability histories from the Survey of Income and Program Participation matched to Social Security earnings records, we identify women whose first marriage dissolved between 1975 and 1984 (n = 1,214) and women who remain continuously married (n = 3,394). Probit and propensity score matching models examine the cumulative probability of a work disability over a 20-year follow-up period. We find that divorce is associated with a significantly higher cumulative probability of a work disability, controlling for a range of factors. This association is strongest among divorced women who do not remarry. No consistent relationships are observed among divorced women who remarry and remained married. We find that economic hardship, work history, and selection into divorce influence, but do not substantially alter, the lasting impact of divorce on work-limiting health.
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Trevisan C, Veronese N, Maggi S, Baggio G, De Rui M, Bolzetta F, Zambon S, Sartori L, Perissinotto E, Crepaldi G, Manzato E, Sergi G. Marital Status and Frailty in Older People: Gender Differences in the Progetto Veneto Anziani Longitudinal Study. J Womens Health (Larchmt) 2016; 25:630-7. [PMID: 26845424 DOI: 10.1089/jwh.2015.5592] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Marital status has been associated with disability and mortality, but its potential role as a factor influencing frailty has yet to be thoroughly investigated. The analysis of gender-related differences in the relationship between marital status and frailty is another interesting matter that remains to be fully elucidated. The aim of our study was to examine the association between marital status and the incidence of frailty in a cohort of older men and women over a 4.4-year follow-up. MATERIALS AND METHODS A sample of 1887 subjects older than 65 years, enrolled under the Progetto Veneto Anziani (Pro.V.A.) and with no evidence of frailty at baseline, were grouped by marital status. The incidence of frailty after 4.4 years was measured as the presence of at least three of the Fried criteria. RESULTS After the follow-up period, 414 (21.9%) new cases of frailty were identified. Multivariate logistic regression models demonstrated that male gender carried a higher risk of developing frailty among men who had never married (odds ratio [OR] = 3.84, 95% confidence interval [95% CI] = 2.76-5.35; p < 0.0001) and were widowed (OR = 1.43, 95% CI = 1.06-1.95, p = 0.02) than among married participants. For female gender, widows had significantly lower odds of becoming frail than married women (OR = 0.77, 95% CI = 0.66-0.91, p = 0.002). The determinants of frailty more influenced by marital status were unintentional weight loss, low daily energy expenditure, and exhaustion. CONCLUSIONS Marital status seems to significantly influence the onset of frailty, with some gender-specific differences. Unmarried men were at higher risk of frailty, while widowed women carried a lower risk of becoming frail than married women.
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Affiliation(s)
- Caterina Trevisan
- 1 Geriatrics Division, Department of Medicine (DIMED), University of Padova , Padova, Italy
| | - Nicola Veronese
- 1 Geriatrics Division, Department of Medicine (DIMED), University of Padova , Padova, Italy
| | - Stefania Maggi
- 2 National Research Council, Aging Branch, Institute of Neuroscience , Padova, Italy
| | | | - Marina De Rui
- 1 Geriatrics Division, Department of Medicine (DIMED), University of Padova , Padova, Italy
| | - Francesco Bolzetta
- 1 Geriatrics Division, Department of Medicine (DIMED), University of Padova , Padova, Italy
| | - Sabina Zambon
- 2 National Research Council, Aging Branch, Institute of Neuroscience , Padova, Italy .,4 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Padova, Italy
| | - Leonardo Sartori
- 4 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Padova, Italy
| | - Egle Perissinotto
- 5 Department of Cardiac, Thoracic and Vascular Sciences - Biostatistics, Epidemiology and Public Health Unit, University of Padova , Padova, Italy
| | - Gaetano Crepaldi
- 2 National Research Council, Aging Branch, Institute of Neuroscience , Padova, Italy
| | - Enzo Manzato
- 1 Geriatrics Division, Department of Medicine (DIMED), University of Padova , Padova, Italy .,2 National Research Council, Aging Branch, Institute of Neuroscience , Padova, Italy
| | - Giuseppe Sergi
- 1 Geriatrics Division, Department of Medicine (DIMED), University of Padova , Padova, Italy
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Sundström A, Westerlund O, Kotyrlo E. Marital status and risk of dementia: a nationwide population-based prospective study from Sweden. BMJ Open 2016; 6:e008565. [PMID: 26729377 PMCID: PMC4716184 DOI: 10.1136/bmjopen-2015-008565] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine the association between marital status and dementia in a cohort of young-old (50-64) and middle-old (65-74) adults, and also whether this may differ by gender. DESIGN Prospective population-based study with follow-up time of up to 10 years. SETTING Swedish national register-based study. PARTICIPANTS 2,288,489 individuals, aged 50-74 years, without prior dementia diagnosis at baseline. Dementia was identified using the Swedish National Patient Register and the Cause of Death Register. OUTCOME MEASURES The influence of marital status on dementia was analysed using Cox proportional hazards models, adjusted stepwise for multiple covariates (model 1: adjusted for age and gender; and model 2: additionally adjusted for having adult children, education, income and prior cardiovascular disease). RESULTS During follow-up, 31,572 individuals in the study were identified as demented. Cox regression showed each non-married subcategory to be associated with a significantly higher risk of dementia than the married group, with the highest risk observed among people in the young-old age group, especially among those who were divorced or single (HRs 1.79 vs 1.71, fully adjusted model). Analyses stratified by gender showed gender differences in the young-old group, with indications of divorced men having a higher relative risk compared with divorced women (HRs 2.1 vs 1.7, only-age adjusted model). However, in the fully adjusted model, these differences were attenuated and there was no longer any significant difference between male and female participants. CONCLUSIONS Our results suggest that those living alone as non-marrieds may be at risk for early-onset and late-onset dementia. Although more research is needed to understand the underlying mechanism by which marital status is associated with dementia, this suggests that social relationships should be taken seriously as a risk factor for dementia and that social-based interventions may provide an opportunity to reduce the overall dementia risk.
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Affiliation(s)
- Anna Sundström
- Department of Psychology, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - Olle Westerlund
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
- Umeå School of Business and Economics, Umeå University, Umeå, Sweden
| | - Elena Kotyrlo
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
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Turney K, Wildeman C. Self-Reported Health Among Recently Incarcerated Mothers. Am J Public Health 2015; 105:2014-20. [PMID: 26270294 PMCID: PMC4566549 DOI: 10.2105/ajph.2015.302743] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined self-reported health among formerly incarcerated mothers. METHODS We used data from the Fragile Families and Child Wellbeing Study (n = 4096), a longitudinal survey of mostly unmarried parents in urban areas, to estimate the association between recent incarceration (measured as any incarceration in the past 4 years) and 5 self-reported health conditions (depression, illicit drug use, heavy drinking, fair or poor health, and health limitations), net of covariates including health before incarceration. RESULTS In adjusted logistic regression models, recently incarcerated mothers, compared with their counterparts, have an increased likelihood of depression (odds ratio [OR] = 1.60; 95% confidence interval [CI] = 1.18, 2.17), heavy drinking (OR = 1.79; 95% CI = 1.19, 2.68), fair or poor health (OR = 1.49; 95% CI = 1.08, 2.06), and health limitations (OR = 1.78; 95% CI = 1.27, 2.50). This association is similar across racial/ethnic subgroups and is larger among mothers who share children with fathers who have not been recently incarcerated. CONCLUSIONS Recently incarcerated mothers struggle with even more health conditions than expected given the disadvantages they experience before incarceration. Furthermore, because incarceration is concentrated among those who are most disadvantaged, incarceration may increase inequalities in population health.
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Affiliation(s)
- Kristin Turney
- Kristin Turney is with the Department of Sociology, University of California, Irvine. Christopher Wildeman is with the Department of Policy Analysis and Management, Cornell University, Ithaca, NY
| | - Christopher Wildeman
- Kristin Turney is with the Department of Sociology, University of California, Irvine. Christopher Wildeman is with the Department of Policy Analysis and Management, Cornell University, Ithaca, NY
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81
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Assari S, Lankarani MM. Does Multi-morbidity Mediate the Effect of Socioeconomics on Self-rated Health? Cross-country Differences. Int J Prev Med 2015; 6:85. [PMID: 26445632 PMCID: PMC4587073 DOI: 10.4103/2008-7802.164413] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 01/03/2015] [Indexed: 11/04/2022] Open
Abstract
Background: This study explored cross-country differences in how multi-morbidity explains the effects of socioeconomic characteristics on self-rated health. Methods: The study borrowed data from the Research on Early Life and Aging Trends and Effects. Participants were 44,530 individuals (age > 65 years) who were sampled from 15 countries (i.e. United States, China, India, Russia, Costa Rica, Puerto Rico, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, Ghana and South Africa). Multi-morbidity was measured as number of chronic medical conditions. In Model I, main effects of socioeconomic factors on self-rated health were calculated using country-specific logistic regressions. In Model II, number of chronic conditions were also added to the models to find changes in coefficients for demographic and socioeconomic factors. Results: In the United States, number of chronic medical conditions explained the effect of income on subjective health. In Puerto Rico, number of chronic medical conditions explained the effect of marital status on subjective health. In Costa Rica, Argentina, Barbados, Cuba, and Uruguay, number of chronic medical conditions explained gender disparities in subjective health. In China, Mexico, Brazil, Russia, Chile, India, Ghana and South Africa, number of chronic medical conditions did not explain the effect of demographic or socioeconomic factors on subjective health. Conclusions: Multi-morbidity explains the effect of demographic and socioeconomic factors on subjective health in some but not other countries. Further research is needed.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Michigan, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Michigan, USA
| | - Maryam Moghani Lankarani
- Department of Psychiatry, School of Medicine, University of Michigan, Michigan, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Michigan, USA
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82
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Chung W, Kim R. Are Married Men Healthier than Single Women? A Gender Comparison of the Health Effects of Marriage and Marital Satisfaction in East Asia. PLoS One 2015; 10:e0134260. [PMID: 26230841 PMCID: PMC4521890 DOI: 10.1371/journal.pone.0134260] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 07/01/2015] [Indexed: 12/03/2022] Open
Abstract
Background Although Asian societies are remarkably different from Western societies in terms of sociocultural characteristics, little is known about the gender differences in the health effects of marriage and marital satisfaction in Asian countries. Methodology/Principal Findings Using a randomly sampled dataset from the 2006 East Asian Social Survey comprising 8528 individuals from China, Japan, Taiwan, and South Korea, this study performs analyses using a multivariate logistic regression model to predict the probability for a man or a woman to report poor health. Our results differ quite significantly from those of most studies focusing on Western countries. Considering marital satisfaction, there may be no health benefits from marriage for a specific gender in a given country, because the health loss associated with a dissatisfied marriage usually supersedes the health benefits from marriage. Moreover, women may reap greater health benefits from marriage than men. Additionally, those most likely to report poor health are found to be married and dissatisfied men or women, rather than never-married individuals. Conclusion/Significance The present study argues the need to design and carry out a gender- and country-specific social health policy approach to target individuals suffering from poor health, thereby reducing the gender differences in health status.
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Affiliation(s)
- Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Roeul Kim
- National Tobacco Control Center, Korea Health Promotion Foundation, Seoul, Korea
- * E-mail:
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83
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Ploubidis GB, Silverwood RJ, DeStavola B, Grundy E. Life-Course Partnership Status and Biomarkers in Midlife: Evidence From the 1958 British Birth Cohort. Am J Public Health 2015; 105:1596-603. [PMID: 26066911 DOI: 10.2105/ajph.2015.302644] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between trajectories of partnership status over the life course and objectively measured health indicators in midlife. METHODS We used data from 4 waves (1981, 1991, 2000, and 2002-2004) of the British National Child Development Study (NCDS), a prospective cohort study that includes all people born in Britain during 1 week in March 1958 (n = 18 558). RESULTS After controlling for selection attributable to early-life and early-adulthood characteristics, we found that life-course trajectories of partnership status were associated with hemostatic and inflammatory markers, the prevalence of metabolic syndrome and respiratory function in midlife. Never marrying or cohabiting was negatively associated with health in midlife for both genders, but the effect was more pronounced in men. Women who had married in their late 20s or early 30s and remained married had the best health in midlife. Men and women in cohabiting unions had midlife health outcomes similar to those in formal marriages. CONCLUSIONS Partnership status over the life course has a cumulative effect on a wide range of objectively measured health indicators in midlife.
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Affiliation(s)
- George B Ploubidis
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
| | - Richard J Silverwood
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
| | - Bianca DeStavola
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
| | - Emily Grundy
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
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84
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McShall JR, Johnson MD. The Association Between Relationship Quality and Physical Health Across Racial and Ethnic Groups. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2015. [DOI: 10.1177/0022022115587026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The association between relationship quality and physical health is well established. We examined whether this association was similar across different races and ethnicities. Relationship quality and health were assessed in three national samples from the United States: the National Survey of American Life, the National Latino and Asian American Study, and the National Comorbidity Survey Replication ( N = 9,020). Relationship quality was positively correlated with overall health across races and ethnicities; however, the association between relationship quality and specific health problems was inconsistent. Finally, there were no reliable differences between racial or ethnic groups in the magnitude of the relationship quality and physical health association.
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85
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Bazzi AR, Rangel G, Martinez G, Ulibarri MD, Syvertsen JL, Bazzi SA, Roesch S, Pines HA, Strathdee SA. Incidence and Predictors of HIV and Sexually Transmitted Infections Among Female Sex Workers and Their Intimate Male Partners in Northern Mexico: A Longitudinal, Multilevel Study. Am J Epidemiol 2015; 181:723-31. [PMID: 25769307 PMCID: PMC4408950 DOI: 10.1093/aje/kwu340] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/05/2014] [Indexed: 11/12/2022] Open
Abstract
Preventing human immunodeficiency virus (HIV) infection and other sexually transmitted infections (STIs) requires an understanding of sexual relationship factors beyond the individual level. We estimated HIV/STI incidence and identified time-varying predictors of STI acquisition in a prospective cohort study of female sex workers and their intimate (noncommercial) male partners in northern Mexico. From 2010 to 2013, couples underwent behavioral and biological assessments biannually for 24 months. Among 413 initially HIV-uninfected participants, 8 seroconverted during follow-up. Incidence of HIV (1.12 cases/100 person-years (PY)), chlamydia (9.47 cases/100 PY), active syphilis (4.01 cases/100 PY), and gonorrhea (1.78 cases/100 PY) was higher among women than among men (HIV: P = 0.069; all STIs combined: P < 0.001). In multivariable conditional logistic regression with individual fixed effects and correlated error terms within couples, risk of STI acquisition was significantly higher among women who had recently used cocaine, crack, or methamphetamine (adjusted odds ratio (OR) = 2.13, 95% confidence interval (CI): 1.07, 4.28). STI risk was lower among women who reported physically assaulting their male partners (adjusted OR = 0.44, 95% CI: 0.22, 0.86) and among men whose female partners had regular sex-work clients (adjusted OR = 0.38, 95% CI: 0.14, 1.03). Improving vulnerable couples' sexual health will require addressing the contexts in which drug use, interpersonal conflict, and economic vulnerability converge.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Steffanie A. Strathdee
- Correspondence to Dr. Steffanie A. Strathdee, Division of Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0507 (e-mail: )
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86
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Living arrangements as determinants of myocardial infarction incidence and survival: A prospective register study of over 300,000 Finnish men and women. Soc Sci Med 2015; 133:93-100. [DOI: 10.1016/j.socscimed.2015.03.054] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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87
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Van Hedel K, Van Lenthe FJ, Avendano M, Bopp M, Esnaola S, Kovács K, Martikainen P, Regidor E, Mackenbach JP. Marital status, labour force activity and mortality: a study in the USA and six European countries. Scand J Public Health 2015; 43:469-80. [PMID: 25868643 DOI: 10.1177/1403494815578947] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/15/2022]
Abstract
AIMS Labour force activity and marriage share some pathways through which they potentially influence health. In this paper, we examine whether marriage and labour force participation interact in the way they influence mortality in the USA and six European countries. METHODS We used data from the US National Health Interview Survey linked to the National Death Index, and national mortality registry data for Austria, England/Wales, Finland, Hungary, Norway and Spain (specifically, the Basque country) during 1999-2007, for men and women aged 30-59 years at baseline. We used Poisson regression to estimate both the additive (relative excess risk due to interaction) and multiplicative interactions between marriage and labour force activity on mortality. RESULTS Labour force inactivity was associated with higher mortality, but this association was stronger for unmarried, rather than married, individuals. Likewise, being unmarried was associated with higher mortality, but this association was stronger for inactive than for active individuals. To illustrate, among US women out of the labour force, being unmarried was associated with a 3.98 times (95%CI 3.28-4.82) higher risk of dying than being married; whereas the relative risk (RR) was 2.49 (95%CI 2.10-2.94), for women who were active in the labour market. Although this interaction between marriage and labour force activity was only significant for women on a multiplicative scale, there was a significant additive interaction for both men and women. The pattern was similar across all countries. CONCLUSIONS Marriage attenuated the increased mortality risk associated with labour force inactivity; while labour force activity attenuated the mortality risk associated with being unmarried. Our study emphasizes the importance of public health and social policies that improve the health and well-being of unmarried and inactive men and women.
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Affiliation(s)
- Karen Van Hedel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J Van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mauricio Avendano
- LSE Health and Social Care, London School of Economics and Political Science, London, UK Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Matthias Bopp
- Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland
| | | | - Katalin Kovács
- Demographic Research Institute of the Central Statistical Office, Budapest, Hungary
| | - Pekka Martikainen
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Madrid, Spain
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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Teixeira MFN, Martins AB, Celeste RK, Hugo FN, Hilgert JB. Associação entre resiliência e qualidade de vida relacionada à saúde bucal em idosos. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18:220-33. [DOI: 10.1590/1980-5497201500010017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 05/30/2014] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a associação entre resiliência e qualidade de vida relacionada à saúde bucal, por meio de uma abordagem hierárquica baseada em um modelo teórico conceitual em uma coorte de idosos do Rio Grande do Sul. MÉTODOS: Foi conduzido um estudo transversal aninhado a um estudo de coorte, em 2008. Foram avaliados 498 idosos de Carlos Barbosa, Rio Grande do Sul. As medidas avaliadas foram sociodemográficas, comportamentos de saúde, qualidade de vida relacionada à saúde bucal, medida pelo Oral Health Impact Profile (OHIP-14), Escala de Resiliência e CPOD. A associação entre o potencial de resiliência e os impactos na percepção de saúde bucal relacionados à qualidade de vida foi verificada por meio de regressão binomial negativa. Razões das médias (RM) são apresentadas com seus intervalos de confiança de 95% (IC95%). RESULTADOS: Maiores médias do OHIP foram encontradas entre mulheres (6,7 ± 6,3; p = 0,011), moradores da zona rural (7,3 ± 6,7; p = 0,004) e solteiros (8,0 ± 6,3; p = 0,032). O modelo final da análise multivariada mostrou que ser morador da zona rural (RM = 1,32; IC95% 1,06 - 1,65) e casado (RM = 1,36; IC95% 1,07 - 1,72) foram variáveis independentemente associadas à qualidade de vida relacionada à saúde bucal. Não houve associação entre resiliência e qualidade de vida relacionada à saúde bucal. CONCLUSÃO: Os resultados sugerem que variáveis sociodemográficas estão associados à qualidade de vida relacionada à saúde bucal. A hipótese de que a resiliência pudesse exercer um papel importante no desfecho não foi confirmada.
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Affiliation(s)
| | | | | | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
| | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
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89
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Soulsby LK, Bennett KM. Marriage and Psychological Wellbeing: The Role of Social Support. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/psych.2015.611132] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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90
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Morton H, Gorzalka BB. Role of Partner Novelty in Sexual Functioning: A Review. JOURNAL OF SEX & MARITAL THERAPY 2014; 41:593-609. [PMID: 25222339 DOI: 10.1080/0092623x.2014.958788] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This review investigates whether sexual desire and arousal decline in response to partner familiarity, increase in response to partner novelty, and show differential responding in men and women. These questions were considered through the perspective of two leading evolutionary theories regarding human mating strategies: sexual strategies theory and attachment fertility theory. The hypotheses emerging from these theories were evaluated through a critical analysis of several areas of research including habituation of arousal to erotic stimuli, preferences regarding number of sexual partners, the effect of long-term monogamous relationships on sexual arousal and desire, and prevalence and risk factors associated with extradyadic behavior. The current literature best supports the predictions made by sexual strategies theory in that sexual functioning has evolved to promote short-term mating. Sexual arousal and desire appear to decrease in response to partner familiarity and increase in response to partner novelty in men and women. Evidence to date suggests this effect may be greater in men.
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Affiliation(s)
- Heather Morton
- a Department of Psychology , University of British Columbia , Vancouver , British Columbia , Canada
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92
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Archie EA, Tung J, Clark M, Altmann J, Alberts SC. Social affiliation matters: both same-sex and opposite-sex relationships predict survival in wild female baboons. Proc Biol Sci 2014; 281:20141261. [PMID: 25209936 PMCID: PMC4173677 DOI: 10.1098/rspb.2014.1261] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 08/13/2014] [Indexed: 12/31/2022] Open
Abstract
Social integration and support can have profound effects on human survival. The extent of this phenomenon in non-human animals is largely unknown, but such knowledge is important to understanding the evolution of both lifespan and sociality. Here, we report evidence that levels of affiliative social behaviour (i.e. 'social connectedness') with both same-sex and opposite-sex conspecifics predict adult survival in wild female baboons. In the Amboseli ecosystem in Kenya, adult female baboons that were socially connected to either adult males or adult females lived longer than females who were socially isolated from both sexes--females with strong connectedness to individuals of both sexes lived the longest. Female social connectedness to males was predicted by high dominance rank, indicating that males are a limited resource for females, and females compete for access to male social partners. To date, only a handful of animal studies have found that social relationships may affect survival. This study extends those findings by examining relationships to both sexes in by far the largest dataset yet examined for any animal. Our results support the idea that social effects on survival are evolutionarily conserved in social mammals.
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Affiliation(s)
- Elizabeth A Archie
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, USA Institute of Primate Research, National Museums of Kenya, Nairobi, Kenya
| | - Jenny Tung
- Institute of Primate Research, National Museums of Kenya, Nairobi, Kenya Department of Evolutionary Anthropology, Duke University, Durham, NC, USA Duke Population Research Institute, Duke University, Durham, NC, USA Department of Biology, Duke University, Durham, NC, USA
| | - Michael Clark
- Center for Social Research, University of Notre Dame, Notre Dame, IN, USA
| | - Jeanne Altmann
- Institute of Primate Research, National Museums of Kenya, Nairobi, Kenya Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Susan C Alberts
- Institute of Primate Research, National Museums of Kenya, Nairobi, Kenya Duke Population Research Institute, Duke University, Durham, NC, USA
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Gant Z, Gant L, Song R, Willis L, Johnson AS. A census tract-level examination of social determinants of health among black/African American men with diagnosed HIV infection, 2005-2009--17 US areas. PLoS One 2014; 9:e107701. [PMID: 25268831 PMCID: PMC4182518 DOI: 10.1371/journal.pone.0107701] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/20/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND HIV disproportionately affects black men in the United States: most diagnoses are for black gay, bisexual, and other men who have sex with men (collectively referred to as MSM). A better understanding of the social conditions in which black men live and work may better explain why HIV incidence and diagnosis rates are higher than expected in this population. METHODS Using data from the National HIV Surveillance System and the US Census Bureau's American Community Survey, we examined the relationships of HIV diagnosis rates and 5 census tract-level social determinants of health variables for 21,948 black MSM and non-MSM aged ≥ 15 years residing in 17 areas in the United States. We examined federal poverty status, marital status, education level, employment status, and vacancy status and computed rate ratios (RRs) and prevalence odds ratios (PORs), using logistic regression with zero-inflated negative binomial modeling. RESULTS Among black MSM, HIV diagnosis rates decreased as poverty increased (RR: 0.54). At the time of HIV diagnosis, black MSM were less likely than black non-MSM to live in census tracts with a higher proportion below the poverty level (POR: 0.81) and with a higher proportion of vacant houses (POR: 0.86). In comparison, housing vacancy was positively associated with HIV diagnosis rates among black non-MSM (RR: 1.65). HIV diagnosis rates were higher for black MSM (RR: 2.75) and non-MSM (RR: 4.90) whose educational level was low. Rates were significantly lower for black MSM (RR: 0.06) and non-MSM (RR: 0.26) as the proportion unemployed and the proportion married increased. CONCLUSIONS This exploratory study found differences in the patterns of HIV diagnosis rates for black MSM and non-MSM and provides insight into the transmission of HIV infection in areas that reflect substantial disadvantage in education, housing, employment, and income.
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Affiliation(s)
- Zanetta Gant
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia, United States of America
| | - Larry Gant
- School of Social Work, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ruiguang Song
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia, United States of America
| | - Leigh Willis
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia, United States of America
| | - Anna Satcher Johnson
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia, United States of America
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Newton NJ, Ryan LH, King RT, Smith J. Cohort differences in the marriage-health relationship for midlife women. Soc Sci Med 2014; 116:64-72. [PMID: 24983699 PMCID: PMC4625785 DOI: 10.1016/j.socscimed.2014.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 05/14/2014] [Accepted: 06/23/2014] [Indexed: 12/19/2022]
Abstract
The present study aimed to identify potential cohort differences in midlife women's self-reported functional limitations and chronic diseases. Additionally, we examined the relationship between marital status and health, comparing the health of divorced, widowed, and never married women with married women, and how this relationship differs by cohort. Using data from the Health and Retirement Study (HRS), we examined potential differences in the level of functional limitations and six chronic diseases in two age-matched cohorts of midlife women in the United States: Pre-Baby Boomers, born 1933-1942, N = 4574; and Early Baby Boomers, born 1947-1956, N = 2098. Linear and logistic regressions tested the marital status/health relationship, as well as cohort differences in this relationship, controlling for age, education, race, number of marriages, length of time in marital status, physical activity, and smoking status. We found that Early Baby Boom women had fewer functional limitations but higher risk of chronic disease diagnosis compared to Pre-Baby Boom women. In both cohorts, marriage was associated with lower disease risk and fewer functional limitations; however, never-married Early Baby Boom women had more functional limitations, as well as greater likelihood of lung disease than their Pre-Baby Boom counterparts (OR = 0.28). Results are discussed in terms of the stress model of marriage, and the association between historical context and cohort health (e.g., the influence of economic hardship vs. economic prosperity). Additionally, we discuss cohort differences in selection into marital status, particularly as they pertain to never-married women, and the relative impact of marital dissolution on physical health for the two cohorts of women.
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Affiliation(s)
- Nicky J Newton
- Foley Center for the Study of Lives, School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Room 216, Evanston, IL 60208, USA.
| | - Lindsay H Ryan
- Institute for Social Research, University of Michigan, Michigan Square Building, 330E. Liberty St Room 4035, Ann Arbor, MI 48104, USA.
| | - Rachel T King
- Department of Psychology, Bowling Green State University, Bowling Green, OH 43403-0232, USA.
| | - Jacqui Smith
- Institute for Social Research, University of Michigan, 426 Thompson Street, MISQ 4010, Ann Arbor, MI 48106-1248, USA.
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Chung W, Kim R. Does marriage really matter to health? Intra- and inter-country evidence from China, Japan, Taiwan, and the Republic of Korea. PLoS One 2014; 9:e104868. [PMID: 25118189 PMCID: PMC4130618 DOI: 10.1371/journal.pone.0104868] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 07/17/2014] [Indexed: 11/18/2022] Open
Abstract
Background The health benefits of marriage have been demonstrated mainly by studies on Western populations. This study aims to test whether the benefits are also valid in East Asian populations. Methodology/Principal Findings Individuals (n = 8,538) from China, Japan, Taiwan, and the Republic of Korea were sampled from the 2006 East Asian Social Survey. The association between self-rated health status and two marriage-related independent variables was analyzed using multivariate logistic regression models. In a two-level analysis for individuals from all countries, married individuals were more likely to report very good or good health compared to their never-married counterparts [odds ratio (OR) 1.56; 95% confidence interval (95% CI) 1.16−2.10]. However, the addition of marital satisfaction disintegrated the significant association of marriage with self-rated health. Married individuals in satisfying marriages were more likely to report very good or good health compared with never-married individuals (OR 1.85; 95% CI 1.37−2.50). In contrast, married individuals in dissatisfying marriages were as likely to report very good or good health as never-married individuals (OR 0.78; 95% CI 0.50−1.24). In a one-level analysis for each country, the importance of marital satisfaction varied greatly across countries. Unlike in other countries, in Japan, married individuals in dissatisfying marriages were about half as likely to report very good or good health as never-married individuals (OR 0.51, 95% CI 0.31−0.83), thereby showing no significant benefits from marriage with regard to self-rated health. Conclusion/Significance The present study of East Asian countries suggests that marital satisfaction is of greater importance in determining self-rated health than marriage itself, and that the importance of marital satisfaction varies across countries. Further research is required to better understand the relationship between marital satisfaction and self-rated health in different socio-cultural settings, and to establish effective social policies aiming at improving public health.
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Affiliation(s)
- Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Roeul Kim
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
- * E-mail:
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96
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Lipowicz A. Some evidence for health-related marriage selection. Am J Hum Biol 2014; 26:747-52. [PMID: 25065487 DOI: 10.1002/ajhb.22588] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/25/2014] [Accepted: 07/05/2014] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Married people live longer and are healthier than unmarried people. This can be explained in terms of marriage protection and marriage selection. The aim of the present study was to examine the direct effect of marriage selection on health status. METHODS Data were collected from the archives of the Lower Silesian Medical Center (DOLMED) in Wrocław, Poland. The sample consisted of 2,265 adult (never married or currently married) men. Subjects were assigned to categories for selected variables, including age, level of education, military category upon conscription, height, hearing acuity, and visual acuity. Military category, objective data gathered upon military conscription at age 18, was used to assess initial health status. To identify any relationships between marital status and health status, generalized linear models with binomially distributed dependent variable were used. RESULTS The never-married subjects were more likely to have been assigned to lower military categories, which indicates that their health status at age 18 was inferior to those conscripts who would later marry. Hearing acuity and visual acuity were generally worse in never-married subjects than in married subjects. Never-married subjects were also more likely to be short and less likely to be tall. CONCLUSIONS The results provide evidence for direct health-related marriage selection in men between 25 and 60 years of age. Poor health status reduces the likelihood of marriage.
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Affiliation(s)
- Anna Lipowicz
- Polish Academy of Sciences, Unit of Anthropology, Ul. Podwale 75, 50-449, Wroclaw, Poland
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97
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Williams ME, Fredriksen-Goldsen KI. SAME-SEX PARTNERSHIPS AND THE HEALTH OF OLDER ADULTS. JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 42:558-570. [PMID: 25948876 PMCID: PMC4418547 DOI: 10.1002/jcop.21637] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
While extensive research has examined associations between marriage, cohabitation, and the health of heterosexual adults, it remains unclear whether similar patterns of health are associated with same-sex partnerships for lesbian, gay, and bisexual (LGB) older adults. This article examines whether having a same-sex partner is associated with general self-reported health and depressive symptoms for LGB older adults. Based on survey data collected from LGB adults 50 years of age and older, having a same-sex partner was associated with better self-reported health and fewer depressive symptoms when compared with single LGB older adults, controlling for gender, age, education, income, sexuality, and relationship duration. Relationship duration did not significantly impact the association between partnership status and health. In light of recent public debates and changes in policies regarding same-sex partnerships, more socially integrated relationship statuses appear to play a role in better health for LGB older adults.
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98
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Su D, Stimpson JP, Wilson FA. Racial Disparities in Mortality Among Middle-Aged and Older Men: Does Marriage Matter? Am J Mens Health 2014; 9:289-300. [PMID: 24963098 DOI: 10.1177/1557988314540199] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Based on longitudinal data from the Health and Retirement Study, this study assesses the importance of marital status in explaining racial disparities in all-cause mortality during an 18-year follow-up among White and African American men aged 51 to 61 years in 1992. Being married was associated with significant advantages in household income, health behaviors, and self-rated health. These advantages associated with marriage at baseline also got translated into better survival chance for married men during the 1992-2010 follow-up. Both marital selection and marital protection were relevant in explaining the mortality advantages associated with marriage. After adjusting for the effect of selected variables on premarital socioeconomic status and health, about 28% of the mortality gap between White and African American men in the Health and Retirement Study can be explained by the relatively low rates of marriage among African American men. Addressing the historically low rates of marriage among African Americans and their contributing factors becomes important for reducing racial disparities in men's mortality.
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Affiliation(s)
- Dejun Su
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jim P Stimpson
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Fernando A Wilson
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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99
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Moorman SM, Carr D, Boerner K. The Role of Relationship Biography in Advance Care Planning. J Aging Health 2014; 26:969-92. [DOI: 10.1177/0898264314534895] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objective: We examine the ways that romantic relationship biographies are related to whether, how, and with whom individuals complete advance care planning (ACP), preparations for end-of-life medical care. Method: Data are from an Internet survey of 2,144 adults aged 18 to 64, all of whom were either married to or cohabiting with an opposite-sex partner. Results: Cohabitors were less likely than married people to complete ACP. Relationship quality was an important influence on ACP, but did not account for the differences between married and cohabiting persons. Differences were largely explained by the age composition of the groups. Discussion: Couples who foresee a long and stable future together are those most likely to engage in end-of-life planning, a preventative health behavior with long-term consequences for well-being.
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Affiliation(s)
| | | | - Kathrin Boerner
- Jewish Home Lifecare, New York, NY, USA
- Icahn School of Medicine at Mount Sinai School, New York, NY, USA
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100
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Spousal social support and strain: impacts on health in older couples. J Behav Med 2014; 37:1108-17. [PMID: 24622976 DOI: 10.1007/s10865-014-9561-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 03/02/2014] [Indexed: 10/25/2022]
Abstract
Using a nationally representative sample of couples aged 51+ in the United States (N = 1,923 couples), the current study investigated whether both partners' perceptions of relationship support and strain are associated with an individual's self-rated health and functional limitations. The sample had an average age of 67.17 years (SD = 9.0; range 50-97). Actor-Partner Interdependence Models adjusting for couple interdependencies were applied using multilevel models. After accounting for age, education, gender, race, and couple differences in length of marriage, results indicate that individual perceptions of support were significantly associated with higher self-rated health and fewer functional limitations. These individual-level benefits increased if the spouse also perceived positive support and low strain. Finally, the negative association of an individual's perceived support on functional limitations was greater in those with a spouse reporting low levels of perceived strain. Findings are discussed relative to theory on behavioral and psychological pathways between partners' perceptions of support and health.
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