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Choi KH, Vasunilashorn S. Widowhood, age heterogamy, and health: the role of selection, marital quality, and health behaviors. J Gerontol B Psychol Sci Soc Sci 2013; 69:123-34. [PMID: 24128991 DOI: 10.1093/geronb/gbt104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Although the impact of widowhood on the surviving spouse's health has been widely documented, there is little empirical research examining whether certain spousal choice decisions and marital sorting patterns predispose individuals to be more vulnerable to the adverse consequences of widowhood for health. DESIGN AND METHOD We use data from the Wisconsin Longitudinal Study and employ ordinary least squares models to (a) document variations in mental and physical health between married and widowed persons, (b) determine whether widowed persons in age heterogamous unions are especially vulnerable to the adverse consequences of widowhood, and (c) investigate to what extent differential selection, marital quality, and health practices account for health disparities by marital status and the spousal age gap. RESULTS Widowed persons, especially those in age heterogamous unions, have worse mental health than married persons, but they do not seem to be more disadvantaged in terms of physical health. Differential selection, marital quality, and health behaviors partly account for some of the health disparities by marital status and spousal age gap. DISCUSSION Our findings suggest that marrying a spouse who is very dissimilar in age may enhance one's vulnerability to the adverse consequences of widowhood for health.
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Affiliation(s)
- Kate H Choi
- Correspondence should be addressed to Kate H. Choi, Department of Sociology, Social Science Centre Room 5306, University of Western Ontario, London, Ontario N6A5C2, Canada. E-mail:
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Griffin MK, Sobal J. Sustainable Food Activities Among Consumers: A Community Study. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2013. [DOI: 10.1080/19320248.2013.816995] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Barbash IM, Gaglia MA, Torguson R, Minha S, Satler LF, Pichard AD, Waksman R. Effect of marital status on the outcome of patients undergoing elective or urgent coronary revascularization. Am Heart J 2013; 166:729-36. [PMID: 24093854 DOI: 10.1016/j.ahj.2013.07.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Marriage confers various health advantages in the general population. However, the added value of marriage among patients who undergo percutaneous coronary intervention (PCI) beyond the standard cardiovascular risk factors is not clear. This study aimed to assess the effects of marital status on outcomes of patients undergoing elective or urgent PCI. METHODS Clinical observational analysis of consecutive patients undergoing elective or urgent PCI from 1993 to 2011 was performed. Patients were stratified by marital status, comparing married to unmarried patients. Clinical outcome up to 12 months was obtained by telephone contact or office visit. A total of 11,216 patients were included in the present analysis; 55% were married and 45% unmarried. RESULTS Significant differences in baseline characteristics were noted, including a lower prevalence of hypertension (86% vs 88%), diabetes (34% vs 38%), and smoking (19% vs 25%) among married vs unmarried patients, respectively (P < .001). However, married patients had a higher prevalence of hypercholesterolemia and family history of coronary artery disease. Early and late major adverse cardiac event rates were significantly lower for married vs unmarried patients up to 1 year (13.3% vs 8.2%, P < .001). Married status was independently associated with improved outcome in multivariable analysis (hazard ratio 0.7, 95% CI 0.6-0.9). CONCLUSIONS Married patients who undergo urgent or elective PCI have superior short- and long-term outcomes up to 1 year when compared with unmarried patients. These benefits persist after adjustment for multiple traditional cardiovascular risk factors.
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Family Trajectories and Health: A Life Course Perspective. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2013. [DOI: 10.1007/s10680-013-9296-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kent EE, Forsythe LP, Yabroff KR, Weaver KE, de Moor JS, Rodriguez JL, Rowland JH. Are survivors who report cancer-related financial problems more likely to forgo or delay medical care? Cancer 2013; 119:3710-7. [PMID: 23907958 DOI: 10.1002/cncr.28262] [Citation(s) in RCA: 291] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 04/10/2013] [Accepted: 05/10/2013] [Indexed: 01/19/2023]
Abstract
BACKGROUND Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. METHODS The authors identified cancer survivors diagnosed as adults (n=1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. RESULTS Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all P<.05). CONCLUSIONS Cancer-related financial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer.
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Affiliation(s)
- Erin E Kent
- Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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Chereji E, Gatz M, Pedersen NL, Prescott CA. Reexamining the association between fertility and longevity: testing the disposable soma theory in a modern human sample of twins. J Gerontol A Biol Sci Med Sci 2012; 68:499-509. [PMID: 23213027 DOI: 10.1093/gerona/gls218] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The disposable soma theory proposes a trade-off between fertility and longevity but existing findings on this association have been mixed. This study used data from 15,622 twins born between 1901 and 1925 ascertained from the population-based Swedish Twin Registry to test the child-longevity association and whether it is accounted for by individual-level factors or by genetic and environmental factors shared by family members. Based on survival analysis, both women and men with children had significantly longer survival relative to the childless, with a slightly higher relative advantage in men. Adjustments for demographic factors and cotwin fertility did not mediate the parenting-survival association, indicating that this association is attributable to individual-level factors associated with fertility rather than family-level environmental or genetic factors shared by cotwins. These results, derived from a large, population-based sample, are inconsistent with the disposable soma theory as applied to modern human populations.
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Affiliation(s)
- Elizabeth Chereji
- Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
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Fayanju OM, Jeffe DB, Elmore L, Ksiazek DN, Margenthaler JA. Patient and process factors associated with late-stage breast cancer diagnosis in Safety-Net patients: a pilot prospective study. Ann Surg Oncol 2012; 20:723-32. [PMID: 23070783 DOI: 10.1245/s10434-012-2558-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Indexed: 01/07/2023]
Abstract
BACKGROUND Following reforms to our city's Safety-Net (SN) breast cancer referral process, we investigated whether factors often associated with late-stage diagnosis would differ by referral source--SN versus non-Safety-Net (NSN)--or, among SN patients, by stage at diagnosis. METHODS From September 2008 to June 2010, SN patients with any-stage (0-IV) and NSN patients with late-stage (IIB-IV) breast cancer were identified prospectively during initial cancer-center consultations. Data were analyzed using logistic regression, chi-square, and t tests; two-tailed P < 0.05 was considered significant. RESULTS Fifty-seven women completed interviews (33 SN, 24 NSN); 52% of SN-referred patients were diagnosed with late-stage disease. Compared with NSN late-stage patients, SN late-stage patients were more likely to be African-American (83% vs. 21%, P < 0.001), to have an annual household income <$25,000 (89% vs. 38%, P < 0.001), and to report having a health problem in the preceding year but not being able to see a doctor because of cost (67% vs. 25%, P = 0.012); they were less likely to be married/partnered (22% vs. 79%, P < 0.001) and to have post-college education (0% vs. 25%, P < 0.03), any insurance (61% vs. 96%, P < 0.005), and to have sought medical attention within 1 week of realizing they had concerning breast findings (50% vs. 79%, P = 0.047). Married/partnered patients were more likely to delay medical care by >1 week (odds ratio = 9.9, P = 0.038). CONCLUSIONS SN patients presented with higher-than-expected rates of late-stage disease despite improvements in mammography rates and the referral process. Efforts to further facilitate access to care for this vulnerable SN patient population are needed.
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Kark M, Karnehed N. Weight status at age 18 influences marriage prospects. A population-based study of Swedish men. BMC Public Health 2012; 12:833. [PMID: 23020864 PMCID: PMC3505734 DOI: 10.1186/1471-2458-12-833] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 09/27/2012] [Indexed: 11/28/2022] Open
Abstract
Background In a longitudinal population-based study of the relationship between body mass index (BMI) in early adulthood and marital status at 40 years of age, obese men were half as likely to be married compared with men of normal weight. Significant associations between obesity and marital status among men in a longitudinal setting are novel findings. Methods The study cohort comprised Swedish men born from 1951 to 1961. Height and weight at age 18 was gathered from the Military Service Conscription Register and information on marital status at 40 years of age was obtained from population registers by record-linkage using the unique personal identification number. The odds ratio (OR) for being married was calculated by polytomous logistic regression analysis adjusting for birth year, intellectual performance, education, country of birth, residential area, socioeconomic position in childhood and adulthood, parental education and muscle strength. Results Our study included 486 599 Swedish men. Young men who were obese (BMI≥30.0) at 18 years of age had an OR of 0.49 (95% CI: 0.46–0.52) for being married at 40 years of age compared to normal weight men (BMI: 18.5–24.9). Underweight men (BMI≤18.5) had an OR of 0.84 (0.82–0.86) and overweight men (BMI: 25.0–29.9) had an OR of 0.83 (0.80–0.85) for being married at 40 years of age. Conclusion Underweight, overweight and obese men were less likely to be married than their normal weight counterparts. Obese men had the lowest likelihood of being married. Stigmatization and discrimination may partly explain these findings, but further research is needed before firm conclusions can be drawn.
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Affiliation(s)
- Malin Kark
- Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institutet, Norrbacka, Stockholm 171 76, Sweden.
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Robards J, Evandrou M, Falkingham J, Vlachantoni A. Marital status, health and mortality. Maturitas 2012; 73:295-9. [PMID: 23007006 PMCID: PMC3635122 DOI: 10.1016/j.maturitas.2012.08.007] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 08/13/2012] [Indexed: 11/06/2022]
Abstract
Marital status and living arrangements, along with changes in these in mid-life and older ages, have implications for an individual's health and mortality. Literature on health and mortality by marital status has consistently identified that unmarried individuals generally report poorer health and have a higher mortality risk than their married counterparts, with men being particularly affected in this respect. With evidence of increasing changes in partnership and living arrangements in older ages, with rising divorce amongst younger cohorts offsetting the lower risk of widowhood, it is important to consider the implications of such changes for health in later life. Within research which has examined changes in marital status and living arrangements in later life a key distinction has been between work using cross-sectional data and that which has used longitudinal data. In this context, two key debates have been the focus of research; firstly, research pointing to a possible selection of less healthy individuals into singlehood, separation or divorce, while the second debate relates to the extent to which an individual's transitions earlier in the life course in terms of marital status and living arrangements have a differential impact on their health and mortality compared with transitions over shorter time periods. After reviewing the relevant literature, this paper argues that in order to fully account for changes in living arrangements as a determinant of health and mortality transitions, future research will increasingly need to consider a longer perspective and take into account transitions in living arrangements throughout an individual's life course rather than simply focussing at one stage of the life course.
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Affiliation(s)
- James Robards
- EPSRC Care Life Cycle, Social Sciences, University of Southampton, Southampton, UK.
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For Better and for Worse: The Relationship Between Union Dissolution and Self-Assessed Health in European Panel Data. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2012. [DOI: 10.1007/s10680-012-9269-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Marital status, social capital and health locus of control: a population-based study. Public Health 2012; 126:790-5. [PMID: 22925881 DOI: 10.1016/j.puhe.2012.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 04/05/2012] [Accepted: 06/10/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account. STUDY DESIGN Cross-sectional study. METHODS The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust. RESULTS In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress. CONCLUSIONS Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted.
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Geruso M. Black-white disparities in life expectancy: how much can the standard SES variables explain? Demography 2012; 49:553-74. [PMID: 22287272 DOI: 10.1007/s13524-011-0089-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This article quantifies the extent to which socioeconomic and demographic characteristics can account for black-white disparities in life expectancy in the United States. Although many studies have investigated the linkages between race, socioeconomic status, and mortality, this article is the first to measure how much of the life expectancy gap remains after differences in mortality are purged of the compositional differences in socioeconomic characteristics between blacks and whites. The decomposition is facilitated by a reweighting technique that creates counterfactual estimation samples in which the distribution of income, education, employment and occupation, marital status, and other theoretically relevant variables among blacks is made to match the distribution of these variables among whites. For males, 80% of the black-white gap in life expectancy at age 1 can be accounted for by differences in socioeconomic and demographic characteristics. For females, 70% percent of the gap is accounted for. Labor force participation, occupation, and (among women only) marital status have almost no additional power to explain the black-white disparity in life expectancy after precise measures for income and education are controlled for.
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Affiliation(s)
- Michael Geruso
- Department of Economics, Princeton University, Princeton, NJ 08544, USA.
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Clouston SAP, Quesnel-Vallée A. The role of defamilialization in the relationship between partnership and self-rated health: a cross-national comparison of Canada and the United States. Soc Sci Med 2012; 75:1342-50. [PMID: 22800920 DOI: 10.1016/j.socscimed.2012.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 05/15/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
Abstract
Partnered individuals live longer, healthier lives. In explaining this association, processes involving both social causation (in which partnership provides health benefits to individuals) and health selection (in which those who find partners were healthier than those who do not) have been invoked. Since much of this literature is focused in the U.S., comparative studies of the potential impact of policy on the causation and selection components of this association have been scant. Using comparable data from the U.S. Panel Study of Income Dynamics (N = 25,862, followed from 1984 to 2005) and the Canadian Survey of Labour and Income Dynamics (N = 15,632, followed from 1999 to 2005), we test the selective and causal relationships evident during entrance into partnership. We use fixed change-point analysis with multilevel models to fit trajectories of change in both the U.S. and Canada. In Canada, partnership benefits were evident, while health selection was limited. In contrast, in the U.S., health selection was prominent in both men and women, but partnership benefits were not significant. We argue that the differences in the extent of defamilialization of social policy between the two countries may impact the way and extent to which people choose partners and benefit from those partnerships.
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Schäfer I, Hansen H, Schön G, Höfels S, Altiner A, Dahlhaus A, Gensichen J, Riedel-Heller S, Weyerer S, Blank WA, König HH, von dem Knesebeck O, Wegscheider K, Scherer M, van den Bussche H, Wiese B. The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. First results from the multicare cohort study. BMC Health Serv Res 2012; 12:89. [PMID: 22471952 PMCID: PMC3348059 DOI: 10.1186/1472-6963-12-89] [Citation(s) in RCA: 209] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 04/03/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multimorbidity is a phenomenon with high burden and high prevalence in the elderly. Our previous research has shown that multimorbidity can be divided into the multimorbidity patterns of 1) anxiety, depression, somatoform disorders (ADS) and pain, and 2) cardiovascular and metabolic disorders. However, it is not yet known, how these patterns are influenced by patient characteristics. The objective of this paper is to analyze the association of socio-demographic variables, and especially socio-economic status with multimorbidity in general and with each multimorbidity pattern. METHODS The MultiCare Cohort Study is a multicentre, prospective, observational cohort study of 3.189 multimorbid patients aged 65+ randomly selected from 158 GP practices. Data were collected in GP interviews and comprehensive patient interviews. Missing values have been imputed by hot deck imputation based on Gower distance in morbidity and other variables. The association of patient characteristics with the number of chronic conditions is analysed by multilevel mixed-effects linear regression analyses. RESULTS Multimorbidity in general is associated with age (+0.07 chronic conditions per year), gender (-0.27 conditions for female), education (-0.26 conditions for medium and -0.29 conditions for high level vs. low level) and income (-0.27 conditions per logarithmic unit). The pattern of cardiovascular and metabolic disorders shows comparable associations with a higher coefficient for gender (-1.29 conditions for female), while multimorbidity within the pattern of ADS and pain correlates with gender (+0.79 conditions for female), but not with age or socioeconomic status. CONCLUSIONS Our study confirms that the morbidity load of multimorbid patients is associated with age, gender and the socioeconomic status of the patients, but there were no effects of living arrangements and marital status. We could also show that the influence of patient characteristics is dependent on the multimorbidity pattern concerned, i.e. there seem to be at least two types of elderly multimorbid patients. First, there are patients with mainly cardiovascular and metabolic disorders, who are more often male, have an older age and a lower socio-economic status. Second, there are patients mainly with ADS and pain-related morbidity, who are more often female and equally distributed across age and socio-economic groups. TRIAL REGISTRATION ISRCTN89818205.
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Affiliation(s)
- Ingmar Schäfer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Germany.
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Pulkki-Råback L, Kivimäki M, Ahola K, Joutsenniemi K, Elovainio M, Rossi H, Puttonen S, Koskinen S, Isometsä E, Lönnqvist J, Virtanen M. Living alone and antidepressant medication use: a prospective study in a working-age population. BMC Public Health 2012; 12:236. [PMID: 22443226 PMCID: PMC3338384 DOI: 10.1186/1471-2458-12-236] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 03/23/2012] [Indexed: 11/11/2022] Open
Abstract
Background An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association. Methods The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.6 years. In the baseline survey in 2000, living arrangements (living alone vs. not) and potential explanatory factors, including psychosocial factors (social support, work climate, hostility), sociodemographic factors (occupational grade, education, income, unemployment, urbanicity, rental living, housing conditions), and health behaviors (smoking, alcohol use, physical activity, obesity), were measured. Antidepressant medication use was followed up from 2000 to 2008 through linkage to national prescription registers. Results Participants living alone had a 1.81-fold (CI = 1.46-2.23) higher purchase rate of antidepressants during the follow-up period than those who did not live alone. Adjustment for sociodemographic factors attenuated this association by 21% (adjusted OR = 1.64, CI = 1.32-2.05). The corresponding attenuation was 12% after adjustment for psychosocial factors (adjusted OR = 1.71, CI = 1.38-2.11) and 9% after adjustment for health behaviors (adjusted OR = 1.74, CI = 1.41-2.14). Gender-stratified analyses showed that in women the greatest attenuation was related to sociodemographic factors and in men to psychosocial factors. Conclusions These data suggest that people living alone may be at increased risk of developing mental health problems. The public health value is in recognizing that people who live alone are more likely to have material and psychosocial problems that may contribute to excess mental health problems in this population group.
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Affiliation(s)
- Laura Pulkki-Råback
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland.
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Lhila A, Long S. What is driving the black-white difference in low birthweight in the US? HEALTH ECONOMICS 2012; 21:301-315. [PMID: 21294220 DOI: 10.1002/hec.1715] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 11/16/2010] [Accepted: 12/16/2010] [Indexed: 05/30/2023]
Abstract
This is a first effort to quantify the contribution of different factors in explaining racial difference in low birthweight rate (LBW). Mother's health, child characteristics, prenatal care, socioeconomic status (SES), and the socioeconomic and healthcare environment of mother's community are important inputs into the birthweight production function, and a vast literature has delved into obtaining causal estimates of their effect on infant health. What is unknown is how much of the racial gap in LBW is explained by all these inputs together. We apply a nonlinear extension of the Oaxaca-Blinder method proposed by Fairlie to decompose this gap into the portion explained by differences in observed characteristics and the portion that remains unexplained. Data are obtained from several sources in order to capture as many observables as possible, although the primary data source is the Natality Detail Files. Results show that of the 6.8 percentage point racial gap in LBW, only 0.9-1.9 points are explained by white-black differences in endowments across those measures, and of those endowments, most of the gap in LBW is explained by the differences in SES. The unexplained difference is attributed to racial differences in the returns to or the marginal product of investments in infant health.
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Affiliation(s)
- Aparna Lhila
- Economics Department, Central Michigan University, Mt Pleasant, MI, USA.
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El-Sayed AM, Tracy M, Galea S. Life course variation in the relation between maternal marital status and preterm birth. Ann Epidemiol 2012; 22:168-74. [PMID: 22285870 DOI: 10.1016/j.annepidem.2012.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 01/06/2012] [Accepted: 01/06/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE Maternal marriage is protective against preterm birth (PTB), whereas advanced maternal age is associated with increased PTB risk. Because relations between social factors and health may vary during the life course, we assessed how the relation between marital status and PTB risk may change with maternal age. METHODS We assessed the interaction between marital status and maternal age as a determinant of PTB among all live singleton births in Michigan between 1995 and 2006. We also fit stratified models by race. We calculated absolute differences in predicted PTB as well as odds ratios of PTB by marital status for each age group. RESULTS In adjusted models, there was a significant interaction (p(interaction)<.001) between marital status and maternal age. The predicted probability of PTB by marital status was marginally different among mothers ages 20-25 years (absolute difference of 1.5%); this difference was substantially greater (3.9% or greater) after 31 years of age. Odds of PTB followed a similar trajectory. Findings were similar among black and white mothers. CONCLUSIONS The relationship between marriage and PTB may vary with maternal age suggesting that the influence of social factors on risk for adverse birth outcomes may differ through the maternal life trajectory. We discuss plausible explanations for these findings.
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Affiliation(s)
- Abdulrahman M El-Sayed
- Department of Epidemiology, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
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Schmeer KK. Union transitions and changes in BMI among adults in Mexico. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2012; 53:263-275. [PMID: 22660828 PMCID: PMC3638789 DOI: 10.1177/0022146512445898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study utilizes nationally representative, longitudinal data from the Mexico Family Life Survey to examine the associations between union transitions and changes in body mass index (BMI) among adults in Mexico. Results from change score regression models (N = 11,339) indicate larger BMI gains for those entering a union than for those remaining single, net of baseline weight status and socioeconomic controls. Further, a significant moderating effect of baseline weight status suggests that overweight individuals entering a union gain almost two BMI points more than overweight single individuals during this three-year period. Individuals experiencing a union dissolution gain less BMI than those entering a union, but are predicted to lose BMI (as found in the United States) only if they are overweight before the transition.
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Affiliation(s)
- Kammi K Schmeer
- Department of Sociology,The Ohio State University, 1885 Neil Ave. Mall, Columbus, OH 43210, USA.
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El-Sayed AM, Galea S. Changes in the relationship between marriage and preterm birth, 1989-2006. Public Health Rep 2011; 126:717-25. [PMID: 21886332 DOI: 10.1177/003335491112600514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Maternal marriage has historically been protective against preterm birth (PTB); however, social norms and behaviors surrounding marriage have changed over time in the United States. We analyzed secular trends in the relationship between marriage and PTB. METHODS We collected data about all births in Michigan between 1989 and 2006 to assess (1) the relationship between marital status and PTB and moderately PTB risk by year, and (2) the relationship between married and unmarried status and PTB and moderately PTB by year relative to similar marital status in 1989. RESULTS Among nearly 2.4 million births between 1989 and 2006, PTB risk among married mothers increased while risk among unmarried mothers decreased. In adjusted models, married status became less protective against PTB relative to unmarried status over time by year, and was associated with higher risk of PTB over time. Moderately PTB risk increased among both married and unmarried groups, but more so among married mothers. CONCLUSION Our findings suggest that marriage is becoming less protective against PTB over time. The influence of social factors on risk for adverse birth outcomes is likely dynamic, suggesting that ongoing revisions to our understanding are in order.
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Affiliation(s)
- Abdulrahman M El-Sayed
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, USA.
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120
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Roelfs DJ, Shor E, Kalish R, Yogev T. The rising relative risk of mortality for singles: meta-analysis and meta-regression. Am J Epidemiol 2011; 174:379-89. [PMID: 21715646 DOI: 10.1093/aje/kwr111] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Never-married persons (singles) constitute a growing demographic group; yet, the magnitude of the all-cause relative mortality risk for nonelderly singles is not known and important moderating factors have not been explored. The authors used meta-analysis to examine 641 risk estimates from 95 publications that provided data on more than 500 million persons. The comparison group consisted of currently married individuals. The mean hazard ratio for mortality was 1.24 (95% confidence interval: 1.19, 1.30) among multivariate-adjusted hazard ratios with a high subjective quality rating. Meta-regressions showed that hazard ratios have been modestly increasing over time for both genders, but have done so somewhat more rapidly for women. The results also showed that the hazard ratio decreased with age and that study quality has an important relation to hazard ratio magnitude.
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Affiliation(s)
- David J Roelfs
- Department of Sociology, Stony Brook University, New York, USA.
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121
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The Influence of Men's Income and Employment on Marriage and Cohabitation: Testing Oppenheimer's Theory in Europe. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2011; 27:269-293. [PMID: 21957323 PMCID: PMC3163818 DOI: 10.1007/s10680-011-9238-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 05/13/2011] [Indexed: 11/02/2022]
Abstract
This article discusses Oppenheimer's theory on marriage timing, reviews the way this theory was received in European demography and family sociology, and develops a new test of the theory using annual panel data from 13 European countries for the period 1994-2001. Several indicators of men's economic status are used, including school enrollment, employment, type of labor contract, work experience, income, and education. Effects of these indicators are estimated for the transition to marriage and cohabitation, as well as for the transition from cohabitation to marriage. Country differences in these effects are examined as well. The evidence provides strong support for the male breadwinner hypothesis on the one hand, and for Oppenheimer's career uncertainty hypothesis on the other. However, the relevance of these hypotheses also depends on the national context, and especially on the way gender roles are divided in a society.
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Abdollah F, Sun M, Thuret R, Abdo A, Morgan M, Jeldres C, Shariat SF, Perrotte P, Montorsi F, Karakiewicz PI. The effect of marital status on stage and survival of prostate cancer patients treated with radical prostatectomy: a population-based study. Cancer Causes Control 2011; 22:1085-95. [DOI: 10.1007/s10552-011-9784-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 05/23/2011] [Indexed: 10/18/2022]
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123
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Differences in suicide risk according to living arrangements in Japanese men and women--the Japan Public Health Center-based (JPHC) prospective study. J Affect Disord 2011; 131:113-9. [PMID: 21168916 DOI: 10.1016/j.jad.2010.11.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 10/27/2010] [Accepted: 11/24/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND Living alone has been suggested as a risk factor for suicide. However, the effect on suicide risk of living together with spouse, child(ren) and parent(s) is unclear. This study aims to examine the association between living arrangements with spouse, child(ren), and parent(s) and suicide in a Japanese men and women. METHODS Altogether 104, 528 participants aged 40-69 years, who completed baseline questionnaire (1990-1994), were followed for death through December 2005. We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for suicide according to living arrangements. RESULTS During an average 13.2-year follow up, 406 suicidal deaths were recorded. Men living without a spouse and women living with a parent(s) only were at increased risk of suicide than those living with a spouse only. The multivariate HR (95% CI) in men were as follows: "living with a parent(s) only", 1.86 (1.03-3.36); "living with a child(ren) only", 2.20 (1.32-3.66); "living with a parent(s) and child(ren)", 1.95 (1.02-3.72); and "living alone", 1.80 (0.99-3.25); and in women was as follow "living with a parent(s) only", 3.80 (1.90-7.61). Suicide risk was significantly decreased among women living with a spouse and child(ren) as compared with women living with a spouse only (HR 0.58, 95%CI 0.34 to 0.98). CONCLUSIONS Men living without a spouse and women living with a parent(s) only were at increased risk of suicide. Women living together with a spouse and child(ren) were at decreased risk of suicide.
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In the Company of Men: Quality of Life and Social Support Among the Ariaal of Northern Kenya. J Cross Cult Gerontol 2011; 26:221-37. [DOI: 10.1007/s10823-011-9146-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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125
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Bourne PA, Charles CA, McGrowder DA. Ill-males in an English-speaking Caribbean society. JOURNAL OF MEN'S HEALTH 2011. [DOI: 10.1016/j.jomh.2010.09.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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126
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Artazcoz L, Cortès I, Borrell C, Escribà-Agüir V, Cascant L. Social inequalities in the association between partner/marital status and health among workers in Spain. Soc Sci Med 2011; 72:600-7. [DOI: 10.1016/j.socscimed.2010.11.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 10/14/2010] [Accepted: 11/29/2010] [Indexed: 10/18/2022]
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127
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Khattak MW, Sandhu GS, Woodward R, Stoff JS, Goldfarb-Rumyantzev AS. Association of marital status with access to renal transplantation. Am J Transplant 2010; 10:2624-31. [PMID: 21070605 DOI: 10.1111/j.1600-6143.2010.03318.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In this report we evaluated the association of marital status with access to renal transplantation. We analyzed data from the USRDS. In patients with ESRD aged ≥ 27 (mean age of first marriage in the US), we analyzed the association of marital status with two outcomes: (1) likelihood of being placed on the waiting list for renal transplantation or first transplant, (2) likelihood of receiving kidney transplant in patients already listed. We analyzed marital status as a categorical variable: (1) not married (including never been married and widowed); (2) divorced or separated; and (3) currently married. Subgroups based on age, race, sex, donor type and diabetic status were also analyzed. After adjustments for the included independent variables and compared to individuals never married or widowed, those who were divorced/separated (HR 1.55, p < 0.001) and currently married (HR 1.54, p < 0.001) had a higher likelihood of being placed on the transplant waiting list. Once listed, married individuals had higher chances of getting transplanted as well (HR 1.28, p = 0.033). This trend was consistent in most of the subgroups studied. We demonstrated that being married is associated with better access to renal transplantation compared to those who were never married/widowed.
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Affiliation(s)
- M W Khattak
- Division of Nephrology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
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128
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Lurie S, Zalmanovitch A, Golan A, Sadan O. The effect of marital status on pregnancy outcome in Israel: a retrospective case-control study. J Obstet Gynaecol Res 2010; 36:1161-4. [PMID: 21083838 DOI: 10.1111/j.1447-0756.2010.01312.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Previous studies have observed an association between unmarried status of the mother and adverse perinatal outcome such as increased rate of preterm deliveries, low birthweight and small-for-gestational-age infants. In Israel, attendance of prenatal care is imposed by the state and is not related to socioeconomic status; therefore, unmarried women are expected to have a similar prenatal care as married women. The objective of this study is to test the hypothesis that unmarried and married pregnant women have a similar perinatal outcome. MATERIAL & METHODS In a retrospective case-control study, analysis of the records of women who gave birth at the delivery ward of Edith Wolfson Medical Center (a tertiary health care center) over a one-year period (2005) with respect to marital status was performed. The cases group included 304 unmarried women who were matched with 1:1 ratio for maternal age, parity, and number of fetuses in the current pregnancy. RESULTS Unmarried women (n = 304) were more likely to smoke during pregnancy (35.2% vs 15.2%, P < 0.001), had a longer second stage (44.4 ± 9.8 min vs 54.4 ± 4.4 min, P < 0.05) and a shorter first stage (484.0 ± 34.8 min vs 421.0 ± 25.3 min P < 0.05) of labor. The unmarried women had similar length of gestation, preterm delivery rate, mode of delivery, low birthweight rates, low Apgar scores or meconium passage during labor as married women. CONCLUSION In Israel, unmarried and married pregnant women may have almost similar pregnancy outcomes on length of gestation, mode of delivery and Apgar score.
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Affiliation(s)
- Samuel Lurie
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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129
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Harris KM, Lee H, DeLeone FY. Marriage and Health in the Transition to Adulthood: Evidence for African Americans in Add Health. JOURNAL OF FAMILY ISSUES 2010; 31:1106-1143. [PMID: 21833154 PMCID: PMC3151642 DOI: 10.1177/0192513x10365823] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This paper examines the relationship between early marriage (before age 26), cohabitation, and health for African Americans and whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). We examine three categories of health outcomes relevant to young adulthood: physical health, mental health, and health risk behaviors. Lagged dependent variable models are used to examine the health effects of early marriage and cohabitation accounting for potential health selection into unions. Our results indicate that early marriage by young adults does not have protective effects for African Americans, and finds more negative effects for African American men than women. There are mixed results for whites with some protective effects of marriage for binge drinking. Early marriage for both African Americans and whites is associated with increased Body Mass Index (BMI). Cohabitation is uniformly associated with negative health outcomes for all race and sex groups.
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Affiliation(s)
- Kathleen Mullan Harris
- Carolina Population Center and Department of Sociology University of North Carolina at Chapel Hill 505 University Square East 123 W. Franklin Street Chapel Hill, North Carolina 27516 Phone: 919-966-5560 or 919-962-1388 Fax: 919-966-6638
| | - Hedwig Lee
- School of Public Health and Department of Epidemiology University of Michigan 1415 Washington Heights Ann Arbor, MI 48109 Phone: 734-615-9215 Fax: 734-763-5706
| | - Felicia Yang DeLeone
- Carolina Population Center University of North Carolina at Chapel Hill 302-E University Square East 123 W. Franklin Street Chapel Hill, North Carolina 27516 Phone: 919-843-5548 Fax: 919-962-7217
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130
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Decreased risk of squamous cell carcinoma of the head and neck in users of nonsteroidal anti-inflammatory drugs. Int J Otolaryngol 2010; 2010:424161. [PMID: 20628564 PMCID: PMC2902018 DOI: 10.1155/2010/424161] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 03/17/2010] [Accepted: 03/27/2010] [Indexed: 11/18/2022] Open
Abstract
We evaluated the chemopreventive effect of nonsteroidal anti-inflammatory drug (NSAID) use in head and neck squamous cell carcinomas (HNSCC) by conducting a case-control study based on the administration of a standardized questionnaire to 71 incident HNSCC cases and same number of healthy controls. NSAID use was associated with a 75% reduction in risk of developing HNSCC. A significant risk reduction was noted in association with frequency of NSAID use. Restricting the analysis to aspirin users revealed a significant 90% reduction in risk of developing HNSCC. This study provides evidence for a significant reduction in the risk of developing HNSCC in users of NSAIDs, and specifically aspirin users.
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131
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Manning WD, Trella D, Lyons H, Toit NCD. Marriageable Women: A Focus on Participants in a Community Healthy Marriage Program. FAMILY RELATIONS 2010; 59:87-102. [PMID: 23258947 PMCID: PMC3524582 DOI: 10.1111/j.1741-3729.2009.00588.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although disadvantaged women are the targets of marriage programs, little attention has been paid to women's marriage constraints and their views of marriage. Drawing on an exchange framework and using qualitative data collected from single women participating in a marriage initiative, we introduce the concept of marriageable women-the notion that certain limitations may make women poor marriage partners. Like their male counterparts, we find women also possess qualities that are not considered assets in the marriage market, such as economic constraints, mental and physical health issues, substance use, multiple partner fertility, and gender distrust. We also consider how women participating in a marriage program frame their marriage options, whereas a few opt out of the marriage market altogether.
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132
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Sprehn GC, Chambers JE, Saykin AJ, Konski A, Johnstone PAS. Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology? Cancer 2009; 115:5108-16. [PMID: 19705348 DOI: 10.1002/cncr.24547] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND : It long has been recognized that married patients have improved cancer survival when compared with unmarried patients. This has been postulated as being due to increased support, potentially leading to better compliance with therapy. Conversely, some data exist pointing to a relationship between marital discord and decreased immunity. We examined whether unmarried patients have a different prognosis by whether they are 1) never married, 2) divorced, 3) widowed, or 4) separated at time of diagnosis. METHODS : The public access data of the Surveillance, Epidemiology and End Results (SEER) registry were queried for cancer survival across all 17 registries between 1973 and 2004. SEER last updated data in April 2007. Records of 3.79 million patients were included in the analysis. We specifically analyzed 5-year and 10-year relative survival (RS; 5yRS, 10yRS), defined as observed survival divided by observed survival of an age-matched, race-matched, and gender-matched population without disease, for all cancer patients by marital status, with specific subset analyses as indicated. RESULTS : Among unmarried patients, those separated at time of diagnosis had the lowest survival, followed by widowed, divorced, and never married patients. 5-year and 10-year RS of separated patients was 72% and 64% than that of married patients, respectively. This relationship persists when data are analyzed by gender. CONCLUSIONS : Separated marital status is associated with a significant decrement in cancer survival, even in comparison with other unmarried groups. While other socioeconomic variables could contribute to this phenomenon, further research into the immunologic correlates of the acutely stressful condition of marital separation should be conducted. Cancer 2009. (c) 2009 American Cancer Society.
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Affiliation(s)
- Gwen C Sprehn
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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133
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Baquero B, Ayala GX, Arredondo EM, Campbell NR, Slymen DJ, Gallo L, Elder JP. Secretos de la Buena Vida: processes of dietary change via a tailored nutrition communication intervention for Latinas. HEALTH EDUCATION RESEARCH 2009; 24:855-66. [PMID: 19339374 PMCID: PMC2738959 DOI: 10.1093/her/cyp022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 02/27/2009] [Indexed: 05/10/2023]
Abstract
Secretos de la Buena Vida was a successful tailored nutrition communication intervention delivered to Latinas living along the US-Mexico border in California. The intervention was delivered over a 14-week period and consisted of three intervention conditions: weekly home visits with promotoras + weekly tailored mailed newsletters in the first condition, weekly tailored mailed newsletters in the second condition and targeted materials in the attention control condition. The current study examined what elements of the promotora + tailored newsletter and tailored newsletter-only conditions were most effective for behavioral adoption and maintenance in a sample of 238 Latina women. Process evaluation measures assessed the implementation, fidelity and dose of these two intervention conditions. Results indicate that there was high fidelity to program implementation and delivery. Perceived effort, perceived support and intervention length predicted adoption of a lower fat diet at the 15-month follow-up. In the promotora + tailored newsletter condition, married women were four times more likely to be adopters of dietary fat changes than single women. These findings highlight the importance of process evaluation measures and help us understand the mechanism by which tailored print materials and interpersonal health communication via promotoras can facilitate health behavior change.
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Affiliation(s)
- Barbara Baquero
- Graduate School of Public Health, San Diego State University, San Diego, CA 92115, USA.
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134
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Cyr-Villeneuve C, Cyr F. En quoi et pourquoi les hommes et les femmes sont-ils affectés différemment par la séparation conjugale ? PSYCHOLOGIE FRANCAISE 2009. [DOI: 10.1016/j.psfr.2009.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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135
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Bowling A. Predictors of mortality among a national sample of elderly widowed people: analysis of 28-year mortality rates. Age Ageing 2009; 38:527-30. [PMID: 19608548 DOI: 10.1093/ageing/afp108] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE to identify predictors of mortality among a national sample of elderly widowed people 28 years post-baseline interview. DESIGN AND SETTING face to face home interview survey across England. MEASURES physical, psychological, social, and socio-economic status and circumstances. RESULTS excess risk of mortality, which had been noted up to six months post bereavement among males aged 75+, had disappeared. In contrast to findings up to 13 years post-bereavement, neither psycho-social factors, social circumstances nor social class independently predicted differentials in mortality when analysed up to 28 years post-bereavement. The most significant, independent predictors, up to the 28-year term, were, as would be expected, male sex, older age, poorer physical functioning, and expressed 'relief at the death of the spouse'. When the sample was split by duration of widow(er)hood male sex and older age retained significance. CONCLUSION the increasing frailty of the sample overall, and reduced statistical power in split-sample analyses, may explain the loss of significance of physical functioning and 'expressed relief at the death' in the split-sample results. The psycho-social risk factors for mortality after bereavement reduce over time, although further examination of expressed relief would be worthwhile.
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Affiliation(s)
- Ann Bowling
- Department of Primary Care and Population Health, University College London, Royal Free Campus, London NW3 2PF, UK.
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136
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Lindström M. Marital status, social capital, material conditions and self-rated health: a population-based study. Health Policy 2009; 93:172-9. [PMID: 19692141 DOI: 10.1016/j.healthpol.2009.05.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 05/07/2009] [Accepted: 05/13/2009] [Indexed: 11/29/2022]
Abstract
AIMS Associations between marital status and self-rated health were investigated, adjusting for material conditions and trust (social capital). METHODS The 2004 public-health survey in Skåne is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate associations between marital status and self-rated health, adjusting for economic problems and trust. RESULTS The prevalence of poor self-rated health was 28.7% among men and 33.2% among women. Older respondents, respondents born abroad, with medium/low education, low emotional support, low instrumental support, economic problems, low trust, never married and divorced had significantly higher odds ratios of poor self-rated health than their respective reference group. Low trust was significantly higher among the divorced and unmarried compared to the married/cohabitating. Adjustment for economic problems but not for trust reduced the odds ratios of poor self-rated health among the divorced, which became not significant among men. CONCLUSIONS Never married and the divorced have significantly higher age-adjusted odds ratios of poor self-rated health than the married/cohabitating group. Economic problems but not trust seem to affect the association between marital status and poor self-rated health.
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Affiliation(s)
- Martin Lindström
- Department of Clinical Sciences, Malmö University Hospital, Lund University, 205 02 Malmö, Sweden.
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137
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Meadows SO. Family structure and fathers' well-being: trajectories of mental health and self-rated health. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2009; 50:115-31. [PMID: 19537455 PMCID: PMC3580197 DOI: 10.1177/002214650905000201] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The association between marital status and health among men has been well documented, but few studies track health trajectories following family structure transitions among unmarried fathers. Using the Fragile Families and Child Wellbeing Study this article examines trajectories of paternal mental health and self-rated health, focusing on transitions into and out of residential relationships with the child's biological mother or a new partner during a five-year post-birth period (N = 4,331). Continuously married fathers report higher time-specific self-rated health and fewer mental health problems than continuously single fathers, controlling for underlying health trajectories. The disparity, however does not increase over time, providing little support for the marital resource model during these years. Static group differences suggest that resources fathers carry with them into unions may buffer them from the negative effects of union dissolution. The implications of these findings for cohabitation, as well as selection and causation arguments, are also discussed.
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Affiliation(s)
- Sarah O Meadows
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138, USA.
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138
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Montez JK, Angel JL, Angel RJ. Employment, marriage, and inequality in health insurance for Mexican-origin women. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2009; 50:132-48. [PMID: 19537456 PMCID: PMC2700956 DOI: 10.1177/002214650905000202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
In the United States, a woman health insurance coverage is largely determined by her employment and marital roles. This research evaluates competing hypotheses regarding how the combination of employment and marital roles shapes insurance coverage among Mexican-origin, non-Hispanic white, and African American women. We use data from the 2004 and 2006 March Supplements to the Current Population Surveys. Results show that these roles largely substitute for each other among non-Hispanic white and African American women, although marriage generally increases the odds of coverage slightly more than employment among non-Hispanic white women. In contrast, these roles cumulatively increase those odds among Mexican-origin women. Yet neither employment, nor marriage, nor their combination assures their coverage. Married Mexican-origin women are particularly disadvantaged. As women increasingly spend a smaller fraction of their lives in marriage, and as relatively few women are in benefits-rich occupations, stable and equitable coverage may require a universal health insurance system.
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Affiliation(s)
- Jennifer Karas Montez
- University of Texas at Austin, Population Research Center, 1 University Station, Austin, TX 78712, USA.
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139
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Syse A, Aas GB. Marriage after cancer in older adulthood. J Cancer Surviv 2009; 3:66-71. [DOI: 10.1007/s11764-008-0078-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Accepted: 12/27/2008] [Indexed: 11/29/2022]
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140
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Abstract
Socioeconomic status differentials in health are well documented. Less is known about the socioeconomic variation in health in older people, and in older women in particular. The aim of the study was to examine the association between socioeconomic status and health in older women in relation to two indicators of socioeconomic status and three measures of health, and further, to investigate whether socioeconomic differences in health increase or decrease with advancing age. Data from a cross-sectional population based health survey inviting all women ≥70 years were analysed; 6,380 women aged 70-103 years participated. Logistic regression was applied to analyse variation in health by socioeconomic status. Disadvantaged socioeconomic status (i.e. lower educational levels and previous manual or never been in paid work) was significantly associated with poorer health outcomes, whether measured as self-assessed health or depression. Limiting long-standing illness was significantly associated with never been in paid work. The associations were not attenuated by simultaneous adjustments for health behavioural factors, social support, and marital status. Additional adjustments for medical conditions did only alter the significant association between employment status and limiting long-standing illness. The analyses revealed that educational inequalities did not decrease with advancing age, whereas the results for employment varied across age groups. Our findings suggest an enduring relation between socioeconomic status and health in later life. The study adds to the understanding of the consistent associations between poorer health and social disadvantages at older age. We are not aware of any previous study showing the persistence of social inequalities in health upon adjustments for medical conditions.
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Affiliation(s)
- Berit Rostad
- Department of Public Health and General Practice, Faculty of Medicine, MTFS, Norwegian University of Science and Technology, NTNU, 7489 Trondheim, Norway
| | - Dorly J H Deeg
- VU University Medical Centre, LASA, Amsterdam, The Netherlands
| | - Berit Schei
- Department of Public Health and General Practice, Faculty of Medicine, MTFS, Norwegian University of Science and Technology, NTNU, 7489 Trondheim, Norway
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Cho SJ, Jang SN, Cho SI. [Multiple roles and health among Korean women]. J Prev Med Public Health 2008; 41:355-63. [PMID: 18827504 DOI: 10.3961/jpmph.2008.41.5.355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Most studies about multiple roles and women's health suggested that combining with paid job, being married and having children was more likely to improve health status than in case of single or traditional roles. We investigated whether there was better health outcome in multiple roles among Korean women coinciding with previous studies of other nations. METHODS Data were from the 2005 Korea National Health & Nutritional Examination Survey, a subsample of women aged 25-59 years (N=2,943). Health status was assessed for self-rated poor health, perceived stress and depression, respectively based on one questionnaire item. The age-standardized prevalence of all health outcomes were calculated by role categories and socioeconomic status. Multiple logistic regression was used to assess the association of self rated health, perceived stress, and depression with multiple roles adjusted for age, education, household income, number of children and age of children. RESULTS Having multiple roles with working role was not associated with better health and psychological wellbeing. Compared to those with traditional roles, employed women more frequently experienced perceived stress, with marital and/or parental roles. Non-working single mothers suffered depression more often than women with traditional roles or other role occupancy. Socioeconomic status indicators were potent independent correlates of self-rated health and perceived stress. CONCLUSIONS Employment of women with other roles did not confer additional health benefit to traditional family responsibility. Juggling of work and family responsibility appeared more stressful than traditional unemployed parental and marital role in Korean women.
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Affiliation(s)
- Su-Jin Cho
- Health Insurance Review & Assessment Service, Institute of Health and Environment, Seoul National University, Korea
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142
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Averett SL, Sikora A, Argys LM. For better or worse: relationship status and body mass index. ECONOMICS AND HUMAN BIOLOGY 2008; 6:330-349. [PMID: 18753018 DOI: 10.1016/j.ehb.2008.07.003] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2008] [Accepted: 07/06/2008] [Indexed: 05/26/2023]
Abstract
Recent increases in the incidence of obesity and declines in marriage have prompted policymakers to implement policies to mitigate these trends. This paper examines the link between these two outcomes. There are four hypotheses (selection, protection, social obligation and marriage market) that might explain the relationship between marital status transitions and changes in Body Mass Index (BMI). The selection hypothesis suggests that those with a lower BMI are more likely to be selected into marriage. The protection hypothesis states that married adults will have better physical health as a result of the increased social support and reduced incidence of risky behavior among married individuals. The social obligation hypothesis states that those in relationships may eat more regular meals and/or richer and denser foods due to social obligations which may arise because of marriage. Finally, the marriage market hypothesis indicates that when adults are no longer in the marriage market they may not maintain a healthy BMI because doing so is costly and they are in a stable union-or on the other hand, adults may enhance their prospects in the marriage market by losing weight. Taking advantage of longitudinal data and complete marriage histories in the National Longitudinal Survey of Youth 1979, we estimate individual fixed effects models to examine associations between the change in log BMI and the incidence of overweight and obesity, and changes in relationship status controlling for the effects of aging and other respondent characteristics. We find no support for the marriage protection hypothesis. Rather we find evidence supporting the social obligation and marriage market hypotheses-BMI increases for both men and women during marriage and in the course of a cohabiting relationship. Separate analyses by race and ethnicity reveal substantial differences in the response of BMI to relationship status across these groups.
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Affiliation(s)
- Susan L Averett
- Department of Economics and Business, Lafayette College, Easton, PA 18042, USA.
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143
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Scafato E, Galluzzo L, Gandin C, Ghirini S, Baldereschi M, Capurso A, Maggi S, Farchi G, for the ILSA Working Group. Marital and cohabitation status as predictors of mortality: A 10-year follow-up of an Italian elderly cohort. Soc Sci Med 2008; 67:1456-64. [DOI: 10.1016/j.socscimed.2008.06.026] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Indexed: 10/21/2022]
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144
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Abstract
In a setting where the transmission of HIV occurs primarily through heterosexual contact and where no cure or vaccine is available, behavioral change is imperative for containing the epidemic. Abstinence, faithfulness, and condom use most often receive attention in this regard. In contrast, this article treats marriage as a resource for HIV risk management via mechanisms of positive selection (partner choice) and negative selection (divorce of an adulterous spouse). Retrospective marriage histories and panel data provide the evidence for this study and results indicate that men and women in Malawi increasingly turned to union-based risk-avoidance strategies during the period that the threat of HIV/AIDS materialized. Although both sexes strategize in a similar fashion, men are better equipped than women to deploy these strategies to their advantage. The article concludes with reflections on the long-term and population-level implications of these coping mechanisms.
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Affiliation(s)
- Georges Reniers
- Institute of Behavioral Science, Population Program, University of Colorado-Boulder, 484 UCB, Boulder, CO 80309, USA.
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145
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Mofidi N, Ghazinour M, Araste M, Jacobsson L, Richter J. General mental health, quality of life and suicide-related attitudes among Kurdish people in Iran. Int J Soc Psychiatry 2008; 54:457-68. [PMID: 18786907 DOI: 10.1177/0020764008091663] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To investigate (1) general mental health, (2) quality of life and (3) suicide-related attitudes in Kurds living in Iranian Kurdistan. METHODS Cross-sectional investigation; cluster random sampling procedure; 1,000 Kurds were randomly selected from 1,000 of 68,000 households in Sannandaj City, Iran; General Health Questionnaire (GHQ-12); Questionnaire on Attitudes Towards Suicide (ATTS). RESULTS About 27% of the subjects had to be regarded as probably suffering from a psychological disturbance. There was no gender difference regarding the number of ;cases'. These possible ;cases' were younger than ;non-cases'. The most ;cases' occurred among the unemployed. An increasing number of experiences related to suicide and the increasing emotional closeness of those experiences was found to be related to an increased probability that the individual would be classified as a ;case' according to the GHQ-12 total score. Unmarried individuals more often evaluated their overall quality of life as ;moderate' or ;bad' compared to married individuals. Unemployed people, self-employed people and housewives formed the groups who most often reported a ;very bad' or ;bad' quality of life. CONCLUSIONS Kurdish people in Iran are in need of facilities and interventional programmes aiming to improve general mental health.
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Affiliation(s)
- N Mofidi
- Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden
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146
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Espinosa J, Evans WN. Heightened mortality after the death of a spouse: marriage protection or marriage selection? JOURNAL OF HEALTH ECONOMICS 2008; 27:1326-1342. [PMID: 18513810 DOI: 10.1016/j.jhealeco.2008.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 03/27/2008] [Accepted: 04/03/2008] [Indexed: 05/26/2023]
Abstract
We test whether the heightened mortality after the death of a spouse represents correlation or causation by examining the heterogeneity in the bereavement effect based on the spouse's cause of death. Some causes of death are correlated with socioeconomic characteristics while others are not. Equality in the bereavement effect across these two types of death would signal a causal relationship while no bereavement effect for uncorrelated causes of death would indicate an omitted variables bias. Results indicate that the observed effect for women is subject to an omitted variables bias but the estimates for men indicate a causal relationship.
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Affiliation(s)
- Javier Espinosa
- Department of Economics, Rochester Institute of Technology, Rochester, NY 14623, USA.
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147
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Abstract
INTRODUCTION Finding a life partner is of great importance for persons' life satisfaction, but cancer's potential impact on family life is not well described. Cancer's impact on marriage formation rates was therefore explored. METHOD Data on the entire unmarried Norwegian population aged 17-44 in 1974-2001 (N = 2.2 million) come from the Cancer Registry and the Central Population Register. Marriage rates for 12,100 persons diagnosed with cancer were compared to marriage rates for otherwise similar persons using discrete-time hazard regression models. RESULTS Men with cancer had a marriage probability that was five percent higher (OR 1.05, CI 1.01-1.11) than cancer-free men. No cancer forms reduced men's marriage rates, and significantly elevated rates were seen after skin and testicular cancer (OR 1.16 and 1.11). Cancer did not impact significantly on women's overall marriage rate (OR 0.95, CI 0.90-1.00), but pronounced deficiencies were seen after brain and breast cancer (OR 0.62 and 0.74). Skin cancer elevated women's marriage rate (OR 1.27). Male cancer survivors with children were more likely to marry than their female counterparts. Significant increases in cancer survivors' marriage rates were observed over time. CONCLUSION Marrying after cancer is more common today than previously, and only slight overall differences were observed in cancer survivors' marriage rates relative to those of the cancer-free population. However, while brain and breast cancer in women is associated with reduced marriage rates, testicular cancer is associated with increased rates. The differences observed between common cancer forms in young adults deserve further exploration. IMPLICATIONS FOR CANCER SURVIVORS In general, marriage rates in survivors of most types of cancer are very similar to those in the population as a whole. Women with brain and breast cancer have lower marriage rates than their cancer-free counterparts. While it is necessary to identify exactly why this was observed, the information can alert those with these cancers to the potential impact on marriage and thus work to reduce the possible effect, if desired.
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Affiliation(s)
- Astri Syse
- Cancer Registry of Norway, Oslo, Norway.
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148
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HARTL HK, REITTER S, EIDHER U, RAMSCHAK H, AY C, PABINGER I. The impact of severe haemophilia on the social status and quality of life among Austrian haemophiliacs. Haemophilia 2008; 14:703-8. [DOI: 10.1111/j.1365-2516.2008.01684.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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149
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Yannakoulia M, Panagiotakos D, Pitsavos C, Skoumas Y, Stafanadis C. Eating patterns may mediate the association between marital status, body mass index, and blood cholesterol levels in apparently healthy men and women from the ATTICA study. Soc Sci Med 2008; 66:2230-9. [DOI: 10.1016/j.socscimed.2008.01.051] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Indexed: 10/22/2022]
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150
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Wong PWC, Chan WSC, Chen EYH, Chan SSM, Law YW, Yip PSF. Suicide among adults aged 30-49: a psychological autopsy study in Hong Kong. BMC Public Health 2008; 8:147. [PMID: 18447958 PMCID: PMC2412876 DOI: 10.1186/1471-2458-8-147] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 05/01/2008] [Indexed: 12/19/2022] Open
Abstract
Background A surge in suicide rates in middle age people in Hong Kong and many Asian countries was recently observed. However, there is a paucity of suicide research on this subgroup of people in Asia. Methods The next-of-kin of 85 suicide cases and 85 community subjects aged 30–49 years were interviewed by a psychological autopsy approach. Information was triangulated by interview notes, coroner's court files, and police investigation reports. Results A multiple logistic regression analysis identified the following risk factors for suicide among the middle age people in Hong Kong: the presence of at least one psychiatric disorder (OR = 37.5, 95% CI 11.5–121.9, p < 0.001), indebtedness (OR = 9.4, 95% CI 2.2–40.8, p < 0.01), unemployment (OR = 4.8, 95% CI 1.3–17.5, p < 0.05), never married (OR = 4.2, 95% CI 1.1–16.3, p < 0.05), and lived alone (OR = 3.9, 95% CI 1.2–13.4, p < 0.05). Conclusion The data show that socio-economical factors had a strong impact on suicide in the target group. Further research is needed to explore any positive qualities that protect the middle-aged from suicide. The prevention of suicide in the middle-aged requires multiple strategies.
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Affiliation(s)
- Paul W C Wong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong SAR, PR China.
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