Koskinen Seppo, Joutsenniemi Kaisla, Martelin Tuija, Martikainen Pekka
National Public Health Institute, Department of Health and Functional Capacity, Helsinki, Finland.
Int J Epidemiol. 2007 Dec;36(6):1255-64. doi: 10.1093/ije/dym212. Epub 2007 Oct 30.
Research has revealed mortality differences between marital status groups in different societies and different periods of time. Due to the increase in consensual unions, living alone and other changes in living arrangements, it is necessary to apply a more detailed classification of living arrangements that incorporates partnership situation and household composition.
We analyse mortality by cause-of-death in the total Finnish population aged 30 or over in 1996-2000. The linked register dataset includes 15.7 million person-years and 210,139 deaths.
In the working aged population, cohabiters had nearly 70% excess mortality when compared with married people. Among working aged men living with someone other than a partner and among men living alone, mortality was three times higher than among married men. Among women, mortality in these groups was close to that of cohabiters. In the older population, mortality in the other groups was 15-40% higher than among married persons. Adjusting for education, social class and employment status attenuated the mortality differences by 7-31%. Having no children was associated with excess mortality in working aged women and men in each living arrangement group. The relative differences were greatest in deaths from alcohol-related causes, followed by deaths from accidents among men and working aged women and lung cancer in women.
We observed wide mortality differences according to living arrangements, particularly among the working aged. These differences were partly explained by socioeconomic factors. Excessive alcohol use seems to be one major cause of mortality differences.
研究表明，不同社会和不同时期内，婚姻状况群体之间存在死亡率差异。由于自愿结合、独居及其他生活安排变化的增加，有必要采用一种更详细的生活安排分类方法，该方法应纳入伴侣状况和家庭构成。
我们分析了1996 - 2000年芬兰30岁及以上总人口按死因划分的死亡率。关联登记数据集包含1570万人年和210139例死亡。
在劳动年龄人口中，与已婚者相比，同居者的死亡率高出近70%。在与非伴侣的其他人同住的劳动年龄男性和独居男性中，死亡率比已婚男性高出三倍。在女性中，这些群体的死亡率与同居者相近。在老年人口中，其他群体的死亡率比已婚者高出15% - 40%。对教育程度、社会阶层和就业状况进行调整后，死亡率差异降低了7% - 31%。在每个生活安排组中，无子女与劳动年龄女性和男性的高死亡率相关。相对差异在与酒精相关原因导致的死亡中最大，其次是男性和劳动年龄女性因事故导致的死亡以及女性肺癌死亡。
我们观察到，根据生活安排不同，死亡率存在很大差异，尤其是在劳动年龄人群中。这些差异部分由社会经济因素解释。过度饮酒似乎是死亡率差异的一个主要原因。
