Effects of marital status on the risk of mortality in poor and non-poor neighborhoods.

PURPOSE

The purpose of this paper is to consider whether the mortality risks associated with marital status are conditioned by the socioeconomic quality of neighborhoods.

METHODS

The analysis is based on the first National Health and Nutrition Examination Survey 1971-1974 (NHANES I), and the 1987 NHANES I Epidemiologic Followup Survey (NHEFS). Cox proportional hazards regressions were used to assess whether the effect of marital status on the risk of all-cause and cause-specific mortality is altered by local area poverty. Analyses are stratified by age, sex, and urbanicity.

RESULTS

The interaction between neighborhood poverty and marital status is suggested for non-elderly men, particularly for cancer mortality and for men in urban areas. Interaction effects are evident among older women residing in urban areas.

CONCLUSIONS

The absence of a spouse elevates the risk of mortality but this risk is moderately higher in impoverished neighborhoods, notably in urbanized areas, for non-elderly men and elderly women. Future studies with larger samples of non-married persons where marital status changes are incorporated are needed to improve our understanding of the joint mortality effects of local area poverty and marital status.