Batidzirai Jesca M, Manda Samuel O M, Mwambi Henry G, Tanser Frank
School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Biostatistics Unit, South African Medical Research Council, Pretoria, South Africa.
Front Psychol. 2020 Feb 18;11:154. doi: 10.3389/fpsyg.2020.00154. eCollection 2020.
Marriage formation and dissolution are important life-course events which impact psychological well-being and health of adults and children experiencing the events. Family studies have usually concentrated on analyzing single transitions including to and to . This does not allow understanding and interrogation of dynamics of these life changing events and their effects on individuals and their families. The objective of this study was to assess determinants associated with transitions between and within marital states in South Africa. The population-based data available for this study consists of over 55, 000 subjects representing over 340, 000 person-years exposure from the Africa Health Research Institute (AHRI) in rural KwaZulu-Natal, South Africa. It was collected from 1 January 2004 to 31 December 2016. Multilevel multinomial, binary and competing risks regression models were used to model marital state occupation, transitions between marital states as well as investigate determinants of marital dissolution, respectively. Between the years 2006 and 2007, a subject was more likely to be married than never married when compared to years 2004 - 2005. After 2007, subjects were less likely to be married than never married and the trend reduced over the years up to 2016 [with =0.86, =(0.78; 0.94), =0.71, =(0.64; 0.78), =0.60, =(0.54; 0.67), =0.50, =(0.44; 0.56), and = 0.43, = (0.38; 0.48)] for periods 2008 - 2009, 2010 - 2011, 2012 - 2013, 2014 - 2015, and 2016, respectively. In 2008 - 2009, subjects were more likely to experience a marital dissolution than in the period 2004 - 2005 and the trend slightly reduces from 2010 until 2013 [=24.49, =(5.53; 108.37)]. Raising age at first sexual debut was found to be inversely associated with a marital dissolution [ = 0.97; = (0.95; 0.99)]. Highly educated subjects were more likely to stay in one marital state than those who never went to school [=6.43, =(4.89; 8.47), =18.86, =(1.14; 53.31), and OR=2.96, CI=(1.96; 4.46) for being married, separated and widowed, respectively, among subjects with tertiary education]. As the age at first marriage increased, subjects became less likely to experience a marital separation [ = 0.06, = (0.00; 1.11), = 0.05, = (0.00; 0.91), and = 0.04, = (0.00; 0.76) for subjects who entered a first marriage at ages 18 - 22, 23 - 29, and 30 - 40, respectively]. The study found that marrying at later ages is associated with a lower rate of marital dissolution while more educated subjects tend to stay longer in one marital state. Sexual debut at later ages was associated with a lower likelihood of experiencing a marital dissolution. There could, however, be some factors that are not accounted for in the model that may lead to heterogeneity in these dynamics in our model specification which are captured by the random effects in the model. Nonetheless, we may postulate that existing programs that encourage delay in onset of sexual activity for HIV risk reduction for example, may also have a positive impact on lowering rates of marital dissolution, thus ultimately improving psychological and physical health.
婚姻的形成和解体是人生历程中的重要事件，会影响经历这些事件的成年人和儿童的心理健康与身体健康。家庭研究通常集中于分析单一转变，包括结婚和离婚。这无法让人理解和探究这些改变人生的事件的动态变化及其对个人和家庭的影响。本研究的目的是评估与南非婚姻状态之间及内部转变相关的决定因素。本研究可用的基于人群的数据包括来自南非夸祖鲁 - 纳塔尔省农村地区非洲卫生研究所（AHRI）的55000多名受试者，代表超过340000人年的暴露时间。数据收集时间为2004年1月1日至2016年12月31日。多水平多项、二元和竞争风险回归模型分别用于对婚姻状态占据情况、婚姻状态之间的转变以及婚姻解体的决定因素进行建模。在2006年至2007年期间，与2004 - 2005年相比，受试者结婚的可能性高于从未结婚的可能性。2007年之后，受试者结婚的可能性低于从未结婚的可能性，并且这种趋势在2016年之前逐年下降[2008 - 2009年、2010 - 2011年、2012 - 2013年、2014 - 2015年和2016年的比值比分别为0.86，置信区间为(0.78; 0.94)；0.71，置信区间为(0.64; 0.78)；0.60，置信区间为(0.54; 0.67)；0.50，置信区间为(0.44; 0.56)；0.43，置信区间为(0.38; 0.48)]。在2008 - 2009年，受试者经历婚姻解体的可能性高于2004 - 2005年期间，并且从2010年到2013年这种趋势略有下降[比值比 = 24.49，置信区间为(5.53; 108.37)]。首次性行为年龄的提高与婚姻解体呈负相关[比值比 = 0.97；置信区间为(0.95; 0.99)]。受过高等教育的受试者比从未上学的受试者更有可能维持一种婚姻状态[对于受过高等教育的受试者，结婚、分居和丧偶的比值比分别为6.43，置信区间为(4.89; 8.47)；18.86，置信区间为(1.14; 53.31)；2.96，置信区间为(1.96; 4.46)]。随着初婚年龄的增加，受试者经历婚姻分居的可能性降低[对于分别在18 - 22岁、23 - 29岁和30 - 40岁进入初婚的受试者，比值比分别为0.06，置信区间为(0.00; 1.11)；0.05，置信区间为(0.00; 0.91)；0.04，置信区间为(0.00; 0.76)]。研究发现，晚婚与较低的婚姻解体率相关，而受教育程度较高的受试者往往在一种婚姻状态中维持更长时间。较晚的首次性行为年龄与经历婚姻解体的可能性较低相关。然而，模型中可能存在一些未考虑到的因素，这些因素可能导致我们模型设定中的这些动态变化存在异质性，而模型中的随机效应捕捉到了这些异质性。尽管如此，我们可以推测，例如现有的鼓励推迟性活动开始以降低艾滋病毒风险的项目，可能也会对降低婚姻解体率产生积极影响，从而最终改善心理和身体健康。
