Subramanian S V, Elwert Felix, Christakis Nicholas
Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge 7th floor, Boston, MA 02115-6096, USA.
Soc Sci Med. 2008 Feb;66(4):873-84. doi: 10.1016/j.socscimed.2007.11.029.
The effect of death of a spouse on the mortality of the survivor (the "widowhood effect") is well-established. We investigated how the effect of widowhood on mortality depends on the neighborhood concentration of widowed individuals in the United States. We developed a large, nationally representative, and longitudinal dataset from Medicare claims and other data sources characterizing 200,000 elderly couples, with nine years of follow-up (1993-2002), and estimated multilevel grouped discrete-time hazard models. In neighborhoods with a low concentration of widowed individuals, widowhood increased the odds of death for men by 22% and for women by 17%, compared to 17% for men, and 15% for women in neighborhoods with a high concentration of widowed individuals. Our findings suggest that neighborhood structural contexts - that provide opportunities for interacting with others and favoring new social engagements - could be potential modifiers of the widowhood effects and as such requires more systematic consideration in future research of widowhood effects on well-being and mortality.
配偶死亡对幸存者死亡率的影响（“寡妇效应”）已得到充分证实。我们研究了寡妇身份对死亡率的影响如何取决于美国丧偶个体的邻里集中度。我们从医疗保险索赔和其他数据源开发了一个大型的、具有全国代表性的纵向数据集，该数据集对20万对老年夫妇进行了特征描述，并进行了九年的随访（1993 - 2002年），并估计了多级分组离散时间风险模型。在丧偶个体集中度较低的社区，与配偶死亡相比，男性死亡几率增加了22%，女性增加了17%；而在丧偶个体集中度较高的社区，男性死亡几率增加了17%，女性增加了15%。我们的研究结果表明，邻里结构环境——为与他人互动和促进新的社交活动提供了机会——可能是寡妇效应的潜在调节因素，因此在未来关于寡妇效应如何影响幸福感和死亡率的研究中需要更系统地加以考虑。
