Magnitude and causes of mortality differences between married and unmarried men.

Abstract

Study objective-To determine the effect of marital status on mortality for men. In particular, to examine whether subgroups of unmarried men (widowed, single, and divorced/separated men) have a similar mortality to married men. Design-Cohort study Setting-Whitehall civil on relatively small cohorts and are therefore unable to examine cause-specific mortality in any detail.7-9 " Attention has mainly been paid to mortality in widowers compared with married men10 13 14 or has focused on the mortality of married versus unmarried men.7-9 1 l This assumes that widowed, separated/divorced, and never married men will experience similar mortality, obscuring possible differences in these groups.In disease aetiology, marriage may be both an acute stressor (for example the emotional trauma of widowhood or divorce) and a protector (for example, the social support provided by a spouse). 5 Changes in neural, hormonal, and immunological control sytems in unmarried men have been postulated to result in a broad array of diseases.4 1617 This has led to the idea that unmarried men are more susceptible to ill health. '6 18 This is a large cohort study ofmiddle aged men, followed up for 18 years. It has collected data on marital status at baseline and on several important risk factors that may act as possible confounders or intermediaries in the relationship between marital status and mortality. It is therefore suitable for exploring whether a generalised increase in mortality for different causes is seen for all unmarried men, as predicted by the general susceptibility theory, and whether the increased risk seen in unmarried men is related to differences in established risk factors. MethodsIn the Whitehall study 18

Obesity and overweight in relation to organ-specific cancer mortality in London (UK): findings from the original Whitehall study

“…This involved the completion of a study questionnaire and participation in a medical examination, both of which have been described in detail elsewhere. 8 In brief, the questionnaire included enquiries regarding civil service employment grade (an indicator of socio-economic position), 12 smoking habits, 13 intermittent claudication, 14 angina, 15,16 chronic bronchitis, 17 marital status, 18 physical activity, 19 unexplained weight loss in the preceding year and the use of drug therapy for heart problem or high blood pressure. 8 Forced expiratory volume in one second (FEV 1 ) adjusted for height, 20 ischaemia, 21 fasting plasma cholesterol, 22 postchallenge 2-h blood glucose, 23 blood pressure, 24 and triceps skinfold thickness 8 were determined using standardised protocols.…”

Gender disparity in the rate of partner abandonment in patients with serious medical illness

“…13,14 Although many community resources and family members can serve important caregiving roles, the presence of a dedicated spouse may be the most important component of strong social support. Not surprisingly, therefore, most studies have supported the hypothesis that all-cause mortality, cancer-specific mortality, and quality of life are better in married than unmarried cancer patients across many different tumor types, [15][16][17][18][19][20][21][22][23] including primary brain tumors. [24][25][26] This information is important for counseling patients, marshalling resources, and designing clinical trials.…”

Marital Status and Cardiovascular Risk Factors among Middle‐aged Japanese Male Workers: The High‐risk and Population Strategy for Occupational Health Promotion (HIPOP‐OHP) Study

“…Gliksman et al showed that Australian men aged ≥65 yr who had never married had low average HDL-cholesterol, and that those living alone had high average SBP 6) . However, Kumlin et al 8) and Ben-Shlomo et al 11) in a study of French, Swedish and English workplaces found that CVD risk factors did not differ between married men and those who had never married. We found here, that Japanese married men had fewer CVD risk factors and less clustering of multiple risk factors than those who had never married.…”