Stearns Stephen A, Farid Alexander R, Jena Anupam B
Harvard Medical School, Boston, MA.
Massachusetts General Hospital, Boston, MA.
Ann Surg. 2025 Jan 1;281(1):110-115. doi: 10.1097/SLA.0000000000006531. Epub 2024 Sep 11.
To compare divorce prevalence among surgeons with that of nonsurgeon physicians.
The demanding nature of a career in surgery uniquely challenges the social well-being of a surgeon; however, its impact on marital health has not yet been well described.
A cross-sectional study was conducted using publicly available US Census data from 2017 to 2021 to investigate the prevalence of divorce across different occupations. Survey respondents were divided into 2 groups, surgeons and nonsurgeon physicians, with the remaining Census participants as a control. All participants under the age of 18 were excluded to focus on the US adult population. The lifetime prevalence of divorce was measured across occupations, and multivariable logistic regression analyses were performed to identify factors that were independently associated with divorce. Secondarily, the occurrence of more than one marriage was used to supplement the understanding of marital health.
A total of 3171 surgeons and 51,660 nonsurgeon physicians were identified, with both groups similarly aged (51.6 and 50.2 y, respectively) and predominately male (82.9% and 61.9%, respectively). In unadjusted analysis, 21.3% (676/3,171) of surgeons had undergone a divorce compared with only 17.9% (9252/51,660) of nonsurgeon physicians, a 19% increase in risk of divorce [risk ratio (RR)=1.19; 95% CI, 1.11-1.28]. Both surgeons and nonsurgeon physicians were significantly less likely to report being divorced compared with the general population. The increased divorce prevalence among surgeons persisted in multivariable analysis that adjusted for age, age at the time of marriage, sex, race, income, hours worked per week, and the number of children in the household, with surgeons experiencing a 22% increased prevalence of divorce over nonsurgical physicians [adjusted divorce prevalence of 21.8% vs 18.7%, respectively; odds ratio (OR)=1.22; 95% CI, 1.09-1.35]. In subgroup analysis, the finding of higher divorce prevalence for surgeons over nonsurgeon physicians was concentrated among men (adjusted divorce prevalence: 22.6% of male surgeons vs 18.9% of male nonsurgeon physicians; adjusted OR 1.26, 95% CI, 1.11-1.42), White (adjusted divorce prevalence: 22.4% of white surgeons vs 19.1% of White nonsurgeons; adjusted OR 1.22, 95% CI, 1.09-1.38) and Asian surgeons (adjusted divorce prevalence: 12.0% of Asian surgeons vs 8.1% of Asian nonsurgeons; adjusted OR 1.55, 95% CI, 1.06-2.26), with the effect not present in other measured subgroups.
Both surgeons and physicians have lower divorce prevalence than the general population. Surgeons exhibit higher prevalence of divorce compared with nonsurgeon physicians, with measured demographic and work characteristics insufficient to explain this difference.
比较外科医生与非外科医生的离婚率。
外科职业生涯的高要求性质对外科医生的社会幸福感构成独特挑战；然而，其对婚姻健康的影响尚未得到充分描述。
利用2017年至2021年公开的美国人口普查数据进行横断面研究，以调查不同职业的离婚率。调查对象分为两组，外科医生和非外科医生，其余人口普查参与者作为对照组。排除所有18岁以下的参与者，以聚焦美国成年人口。测量各职业的终身离婚率，并进行多变量逻辑回归分析，以确定与离婚独立相关的因素。其次，用多次结婚的情况来补充对婚姻健康的理解。
共识别出3171名外科医生和51660名非外科医生，两组年龄相近（分别为51.6岁和50.2岁），且男性占主导（分别为82.9%和61.9%）。在未调整分析中，21.3%（676/3171）的外科医生经历过离婚，而非外科医生中只有17.9%（9252/51660），离婚风险增加了19%[风险比（RR）=1.19；95%置信区间，1.11-1.28]。与普通人群相比，外科医生和非外科医生报告离婚的可能性均显著降低。在对年龄、结婚时年龄、性别、种族、收入、每周工作时长和家庭子女数量进行调整的多变量分析中，外科医生的离婚率仍然较高，与非外科医生相比，外科医生的离婚率增加了22%[调整后的离婚率分别为21.8%和18.7%；优势比（OR）=1.22；95%置信区间，1.09-1.35]。在亚组分析中，外科医生离婚率高于非外科医生的发现集中在男性（调整后的离婚率：男性外科医生为22.6%，男性非外科医生为18.9%；调整后的OR为1.26，95%置信区间，1.11-1.42）、白人（调整后的离婚率：白人外科医生为22.4%，白人非外科医生为19.1%；调整后的OR为1.22，95%置信区间，1.09-1.38）和亚洲外科医生（调整后的离婚率：亚洲外科医生为12.0%，亚洲非外科医生为8.1%；调整后的OR为1.55，95%置信区间，1.06-2.26）中，在其他测量的亚组中未发现此效应。
外科医生和内科医生的离婚率均低于普通人群。与非外科医生相比，外科医生的离婚率更高，所测量的人口统计学和工作特征不足以解释这种差异。
