Widowhood and Mortality: A Meta-Analysis and Meta-Regression

Abstract

The study of spousal bereavement and mortality has long been a major topic of interest for social scientists, but much remains unknown with respect to important moderating factors such as age, follow-up duration, and geographic region. The present study examines these factors using meta-analysis. Keyword searches were conducted in multiple electronic databases, supplemented by extensive iterative hand searches. We extracted 1381 mortality risk estimates from 124 publications, providing data on more than 500 million persons. Compared to married people, widowers had a mean hazard ratio (HR) of 1.23 (95% confidence interval [CI], 1.19–1.28) among HRs adjusted for age and additional covariates and a high subjective quality score. The mean HR was higher for men (HR, 1.27; 95% CI, 1.19–1.35) than for women (HR, 1.15; 95% CI: 1.08–1.22). A significant interaction effect was found between gender and mean age, with HRs decreasing more rapidly for men than for women as age increased. Other significant predictors of HR magnitude included sample size, geographic region, level of statistical adjustment, and study quality.

Increased risk of death immediately after losing a spouse: Cause-specific mortality following widowhood in Norway

“…A large number of publications have dealt with the "widowhood effect", i.e., high mortality after the loss of a spouse (Manzoli et al, 2007;Moon et al, 2011;Shor et al, 2012) and reported a mortality risk that is elevated by up to 30%. This risk is higher just after widowhood, but remains elevated even after several years.…”

Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study

“…We reasoned that the high level of social support in the Amish population might mitigate the bereavement effect. Previous studies used covariates such as education (homogeneous in the Amish),12 health habits, remarriage, church visits, neighbourhood interaction and household size to study the relationship between bereavement and social support 4 8 13…”

Gender differences in the use of anti-infective medications before and after widowhood: a register-based study

“…2 It has been suggested that widowhood affects the mortality and the health of the surviving spouse. Adverse effects of spousal loss have been found for mortality, 3–7 for physical disabilities and mental health, 8 and for the risk of institutionalisation. 9 …”