University of Mannheim, VU University Amsterdam, IFAU-Uppsala, IZA, The Netherlands.
J Health Econ. 2011 Jul;30(4):774-94. doi: 10.1016/j.jhealeco.2011.05.011. Epub 2011 May 31.
Spousal bereavement at old ages may lead to dramatic changes in health. This paper investigates whether spousal bereavement has a causal effect on health and on mortality of the surviving spouse. We advance on the literature in two main ways. First, we model survivals of both spouses and the dynamic evolution of health jointly, allowing for potential endogeneity of timing of bereavement and health in explaining mortality of the surviving spouse. Second, we use a flexible non-parametric data dimensionality reduction method to thoroughly characterize health (using 22 health indicators) by a limited number of latent health indicators. This allows us to investigate the causal effect of spousal bereavement on mortality and on all aspects of health simultaneously. Our analyses are based on an ongoing longitudinal survey that follows a random sample of older individuals from 1992. We find strong instantaneous effects of bereavement on mortality and on certain aspects of health. Individuals lose on average 12% of residual life expectancy after conjugal bereavement. Conjugal bereavement affects the share of healthy years in residual lifetime, primarily because healthy years are replaced by years with chronic diseases. The strong direct effects of bereavement suggest that monitoring and/or interventions just after spousal bereavement are important for the length and quality of life of older bereaved individuals.
老年丧偶可能导致健康状况的急剧变化。本文研究了丧偶对健在配偶健康和死亡率是否有因果影响。我们在两个主要方面对文献进行了拓展。首先，我们联合建模了双方配偶的生存状况和健康状况的动态演变，允许丧偶和健康在解释健在配偶的死亡率方面存在潜在的内生性。其次，我们使用一种灵活的非参数数据降维方法，通过有限数量的潜在健康指标来彻底描述健康（使用 22 个健康指标）。这使我们能够同时研究丧偶对死亡率和健康各个方面的因果影响。我们的分析基于一项正在进行的纵向调查，该调查跟踪了 1992 年以来的一组随机老年个体。我们发现丧偶对死亡率和某些健康方面有强烈的即时影响。个体在配偶去世后平均失去 12%的剩余预期寿命。丧偶会影响剩余寿命中健康年份的比例，主要是因为健康年份被慢性病年份所取代。丧偶的直接强烈影响表明，在配偶去世后立即进行监测和/或干预对于丧偶的老年个体的寿命和生活质量非常重要。
