Ikeda Ai, Iso Hiroyasu, Toyoshima Hideaki, Fujino Yoshihisa, Mizoue Tetsuya, Yoshimura Takesumi, Inaba Yutaka, Tamakoshi Akiko
Department of Public Health Medicine, Doctoral Program in Social and Environmental Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennoudai, Tsukuba-shi, Ibaraki, Japan.
BMC Public Health. 2007 May 7;7:73. doi: 10.1186/1471-2458-7-73.
Several studies have indicated a significant association between marital status and mortality risks. However, most of these studies have compared married and unmarried people without differentiating among single, divorced and widowed status. Moreover, gender differences in mortality rates associated with marital status have not been sufficiently clarified. With significant increases in the percentages of divorced and widowed people and a corresponding drop in the marriage rate in Japan during the past two or three decades, it can be expected that these changes will have a significant impact on mortality rates.
This investigation used a prospective study of a total of 94,062 Japanese men and women aged 40-79 who completed self-administered questionnaires at baseline and during a followed-up of 9.9-years.
Compared with married men, never-married men showed higher risks of mortality from cardiovascular disease [relative risk (RR) = 3.05, 95% confidence interval (CI) 2.03-4.60], respiratory disease (RR = 2.43, 95%CI 1.27-4.63), external causes (RR = 2.18, 95%CI 1.05-4.54) and all causes (RR = 1.91, 95%CI 1.51-2.42) after adjustment for potentially confounding variables. For never-married women, there was a smaller but significantly higher risk of mortality from all causes (RR = 1.46, 95%CI 1.15-1.84). Divorced and widowed men showed moderately higher risks of mortality from cardiovascular disease, external causes and all causes compared with married men, but such a trend was not observed in women.
Single status was associated with a higher risk of mortality than was married status for both men and women. Divorce and widowhood were associated with elevated risk for men, but not for women. These findings suggest single, divorce and widowhood status constitute potentially adverse health effects.
多项研究表明婚姻状况与死亡风险之间存在显著关联。然而，这些研究大多比较的是已婚者和未婚者，并未区分单身、离异和丧偶状态。此外，与婚姻状况相关的死亡率性别差异尚未得到充分阐明。在过去二三十年里，日本离异和丧偶人群的比例显著增加，结婚率相应下降，预计这些变化将对死亡率产生重大影响。
本调查采用前瞻性研究，共纳入94062名年龄在40 - 79岁的日本男性和女性，他们在基线时及9.9年的随访期间完成了自我管理问卷。
与已婚男性相比，从未结婚的男性在调整潜在混杂变量后，患心血管疾病死亡的风险更高[相对风险（RR）= 3.05，95%置信区间（CI）2.03 - 4.60]、呼吸系统疾病（RR = 2.43，95%CI 1.27 - 4.63）、外部原因导致的死亡（RR = 2.18，95%CI 1.05 - 4.54）以及全因死亡（RR = 1.91，95%CI 1.51 - 2.42）。对于从未结婚的女性，全因死亡风险虽较小但显著更高（RR = 1.46，95%CI 1.15 - 1.84）。与已婚男性相比，离异和丧偶男性患心血管疾病、外部原因导致的死亡以及全因死亡的风险略高，但在女性中未观察到这种趋势。
单身状态与已婚状态相比，男性和女性的死亡风险均更高。离异和丧偶与男性风险升高相关，但与女性无关。这些发现表明单身、离异和丧偶状态可能对健康产生不利影响。
