Partnership and mortality in mid and late life: Protection or selection?

Requena, Miguel; Reher, David

doi:10.1016/j.socscimed.2021.113971

Cited by 6 publications

(5 citation statements)

References 66 publications

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“…This finding consists of a former census data study that found protective effects from the partnership were strong during mature adult life and the early stages of old age but tended to decline among the very old. 28 The exact reasons will need to be explored further, but it could probably reflect that for old patients, social support from their children, friends, or the community may play a more critical role in their recovery from AMI than their younger counterparts.…”

Section: Discussionmentioning

confidence: 99%

Impact of Marital Status on Management and Outcomes of Patients With Acute Myocardial Infarction: Insights From the China Acute Myocardial Infarction Registry

Wei

Yang

Hua

et al. 2022

JAHA

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Background Acute myocardial infarction (AMI) is one of the leading causes of mortality worldwide, whereas social support is a known predictor of the prognosis after AMI. As a common factor influencing social support, the impact of marital status on care quality, in‐hospital mortality, and long‐term prognosis of patients with AMI remains largely unknown. Methods and Results The present study analyzed data from the CAMI (China Acute Myocardial Infarction) registry involving 19 912 patients with AMI admitted at 108 hospitals in China between January 2013 and September 2014 and aimed to evaluate marital status–based differences in acute management, medical therapies, and short‐term and long‐term outcomes. The primary end point was 2‐year all‐cause death. The secondary end points included in‐hospital death and 2‐year major adverse cardiac and cerebrovascular events (a composite of all‐cause death, myocardial infarction, or stroke). After multivariable adjustment, 1210 (6.1%) unmarried patients received less reperfusion treatment in patients with both ST‐segment–elevation myocardial infarction and non–ST‐segment–elevation myocardial infarction (adjusted odds ratio [OR], 0.520 [95% CI, 0.437–0.618]; P <0.0001; adjusted OR, 0.489 [95% CI, 0.364–0.656]; P <0.0001). Being unmarried was not associated with poorer in‐hospital outcome but with long‐term all‐cause mortality and major adverse cardiac and cerebrovascular events in both ST‐segment–elevation myocardial infarction (adjusted hazard ratio [HR], 1.225 [95% CI, 1.031–1.456]; P =0.0209; adjusted HR, 1.277 [95% CI, 1.089–1.498]; P =0.0027) and non–ST‐segment–elevation myocardial infarction (adjusted HR, 1.302 [95% CI, 1.036–1.638]; P =0.0239; adjusted HR, 1.368 [95% CI, 1.105–1.694]; P =0.0040) populations. Conclusions The present study suggests that being unmarried is independently related to less reperfusion received, but could not explain the higher in‐hospital mortality rate after covariate adjustment. Being unmarried is associated with a substantially increased risk of adverse events over at least the first 24 months after AMI. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01874691.

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Section: Discussionmentioning

confidence: 99%

Impact of Marital Status on Management and Outcomes of Patients With Acute Myocardial Infarction: Insights From the China Acute Myocardial Infarction Registry

Wei

Yang

Hua

et al. 2022

JAHA

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“…The second points out that individuals who get married and/or live with someone are probably different from individuals who do not. These differences can be tied to physical health, socioeconomic status (SES), or even personality traits (Requena and Reher 2021). From the moment these traits influence positively both entry into marriage or partnership and survival, they could explain the mortality differentials between various groups.…”

Section: Relationship Statusmentioning

confidence: 99%

“…From the moment these traits influence positively both entry into marriage or partnership and survival, they could explain the mortality differentials between various groups. Recent studies find that these two mechanisms coexist, although selection effects may be particularly important at younger ages, while protection effects play a greater role later in life (Franke and Kulu 2018;Requena and Reher 2021).…”

Section: Relationship Statusmentioning

confidence: 99%

“…We also do not include any information on health. While health characteristics are thought to influence the probability of entering a partnership (Requena and Reher 2021), stratifying by both education and health would have risked excessively fragmenting the population. Already stratifying by education only, some groups (especially complex households, the smallest sub-population) showed substantial year-to-year variations.…”

Section: Limitationsmentioning

confidence: 99%

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Differences in mortality before retirement: The role of living arrangements and marital status in Denmark

Vigezzi,

Strozza

2024

DemRes

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BACKGROUNDTo make the pension system robust to population ageing, Denmark will increase the statutory retirement age in tandem with national life expectancy. By universally increasing this age, this pension indexation policy might amplify known inequalities in mortality, such as those between people in different living arrangements. OBJECTIVEWe aim to quantify inequalities in mortality before retirement age by living arrangement over time and to estimate whether an increase in the retirement age could disproportionately affect disadvantaged groups. METHODSWe estimate the probability of dying between ages 50 and 65/67/70 for several cohorts of Danes living in different household types, stratifying by socioeconomic status. To give a more complete picture, we also calculate equivalent age for each sub-group. RESULTSIn Denmark considerable mortality inequalities exist depending on living arrangements, and they are becoming larger. Across all the dimensions of mortality we examine, single individuals cumulate a clear disadvantage. An increased retirement age would increase absolute and (for single individuals) relative differences in pre-retirement survival, adding to the widening trends across cohorts. CONCLUSIONSRelying on the national average to set the statutory retirement age risks maintaining these subpopulations' disadvantage. While early retirement schemes exist in Denmark, they mostly impact people based on their occupation. We highlight that other characteristics are strongly tied to mortality and should also be considered.

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“…As the literature suggests that there may be sex interactions in the association of partnership status and health ( Wang et al, 2020 ), we explore interactions with sex. Further, as partnership status may have different saliency in younger and older age groups ( Requena & Reher, 2021 ), we explore interactions with age group. In addition to age and sex, a number of factors are associated with partnership and dissolution that could play a role in the association between partnership status and biological age.…”

Section: Introductionmentioning

confidence: 99%

Partnership status and positive DNA methylation age acceleration across the adult lifespan in the UK

Wang,

Dearman,

Bao

et al. 2023

SSM - Population Health

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Partnership and mortality in mid and late life: Protection or selection?

Cited by 6 publications

References 66 publications

Impact of Marital Status on Management and Outcomes of Patients With Acute Myocardial Infarction: Insights From the China Acute Myocardial Infarction Registry

Impact of Marital Status on Management and Outcomes of Patients With Acute Myocardial Infarction: Insights From the China Acute Myocardial Infarction Registry

Differences in mortality before retirement: The role of living arrangements and marital status in Denmark

Partnership status and positive DNA methylation age acceleration across the adult lifespan in the UK

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