Research Department, The Social Insurance Institution of Finland, Research department, PO Box 450, 00101 Helsinki, Finland.
J Epidemiol Community Health. 2012 Jan;66(1):30-6. doi: 10.1136/jech.2010.110635. Epub 2010 Oct 5.
Little is known about the effects of long-term marital history on mortality, and the relative importance of using marital history instead of baseline marital status in mortality analyses. No previous comparative studies on the associations of marital history and mortality exist.
Longitudinal data from England & Wales and from Finland were used to assess the effects of marital history, constructed from census records from years 1971, 1981 and 1991, on all-cause mortality in 1991-2004 among men and women aged ≥ 50 years. Data from England & Wales include 57,492 deaths; data from Finland include 424,602 deaths. Poisson regression analysis was applied.
Adding marital history into models including baseline marital status was statistically significant when explaining male mortality, while it was generally not important for female mortality. Adjusted for socio-demographic covariates, those consistently married with no record of marital break-up had the lowest mortality rates among both men and women aged 50-74 in both countries. Those never married, those divorced with a history of divorce and those widowed with a history of widowhood showed the highest mortality risks. Associations between marital history and mortality were weaker among those aged 75+.
Consistent evidence in favour of both protective effects of long-lasting marriage and detrimental effects of marital dissolution were found. Studies would benefit from including marital history in the models instead of baseline marital status whenever possible, especially when studying male mortality.
关于长期婚姻史对死亡率的影响知之甚少,并且在死亡率分析中使用婚姻史而不是基线婚姻状况的相对重要性也知之甚少。以前没有关于婚姻史和死亡率之间关联的比较研究。
使用来自英格兰和威尔士以及芬兰的纵向数据,评估了从 1971 年、1981 年和 1991 年的人口普查记录中构建的婚姻史对 1991-2004 年 50 岁及以上男女全因死亡率的影响。来自英格兰和威尔士的数据包括 57492 例死亡;来自芬兰的数据包括 424602 例死亡。应用泊松回归分析。
在解释男性死亡率时,将婚姻史纳入包括基线婚姻状况的模型中具有统计学意义,而对于女性死亡率通常并不重要。在调整社会人口学协变量后,在两国中,50-74 岁年龄段中一直保持婚姻关系且没有婚姻破裂记录的人死亡率最低。从未结婚、离婚且有离婚史或丧偶且有丧偶史的人死亡率最高。婚姻史与死亡率之间的关联在 75 岁以上的人群中较弱。
有充分的证据表明长期婚姻具有保护作用,而婚姻破裂则具有不利影响。在研究男性死亡率时,只要有可能,研究就应该将婚姻史纳入模型而不是基线婚姻状况,尤其是在研究男性死亡率时。