Martikainen P, Valkonen T
Department of Sociology, University of Helsinki, Finland.
J Epidemiol Community Health. 1996 Jun;50(3):264-8. doi: 10.1136/jech.50.3.264.
(1) To assess the extent to which death of a spouse causes excess mortality by controlling for the effects of confounding and other sources of bias. Three possible sources of bias are considered: accidents common to spouses, common socioeconomic environment, and common lifestyles. (2) To assess the duration specific effects of death of a spouse on mortality.
Prospective study of mortality in Finland among all 35-84 year old married Finnish men and women (1,580,000 people). Baseline sociodemographic measurement from the 1985 census records. Follow up by computerised record linkage to death certificate registers for the period 1986-91 (about 116,000 deaths, of which almost 10,000 among the bereaved) using personal identification codes.
(1) After controlling for confounding effects, excess mortality was 17% in men and 6% in women. (2) Excess mortality was higher for short durations than long durations of bereavement. (3) Excess mortality after bereavement was higher in men than women.
Controlling for confounding does not seem to have a crucial modifying effect on the relationship between spousal bereavement and mortality. It seems that death of a spouse has a causal effect on mortality. However, although spousal bereavement is a major stressful life event, this causal effect seems to be relatively small and short lived.
（1）通过控制混杂因素及其他偏差来源的影响，评估配偶死亡导致额外死亡率的程度。考虑了三种可能的偏差来源：配偶共有的事故、共同的社会经济环境以及共同的生活方式。（2）评估配偶死亡对死亡率的特定持续时间影响。
对芬兰所有35 - 84岁已婚芬兰男性和女性（158万人）的死亡率进行前瞻性研究。根据1985年人口普查记录进行基线社会人口统计学测量。利用个人识别码，通过计算机化记录链接到1986 - 1991年期间的死亡证明登记册进行随访（约11.6万例死亡，其中近1万例发生在丧偶者中）。
（1）在控制混杂效应后，男性的额外死亡率为17%，女性为6%。（2）丧偶时间短的额外死亡率高于丧偶时间长的。（3）丧偶后男性的额外死亡率高于女性。
控制混杂因素似乎对配偶丧亲与死亡率之间的关系没有关键的修正作用。似乎配偶死亡对死亡率有因果影响。然而，尽管配偶丧亲是一个重大的生活压力事件，但这种因果影响似乎相对较小且持续时间较短。
