Urban/rural variation in the influence of widowhood on mortality risk: A cohort study of almost 300, 000 couples. (July 2015)

• Record Type: Journal Article
• Authors: Wright, David M.; Rosato, Michael; O'Reilly, Dermot
• Is Part Of: Health & place. Volume 34(2015:Jul.)
• Page Start: 67
• Page End: 73
• Publication Date: 2015-07
• Subjects: Widowhood -- Bereavement -- Mortality rates -- Urban/rural; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2015.04.003
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect). We investigated whether the effect magnitude varied between urban, rural and intermediate areas, assembling death records (2001–2009) for a prospective cohort of 296, 125 married couples in Northern Ireland. The effect was greatest during the first six months of widowhood in all areas and for both sexes. Subsequently, the effect was attenuated among men in rural and intermediate areas but persisted in urban areas (HRs and 95% CIs: rural 1.09 [0.99, 1.21]; urban 1.35 [1.26, 1.44]). Among women the effect was attenuated in all areas (rural 1.06 [0.96, 1.17]; urban 1.09 [1.01, 1.17]). The impacts of spousal bereavement varied between urban and more rural areas, possibly due to variation in social support provided by the wider community. We identify men in urban areas as being in greatest need of such support and a possible target for health interventions. Highlights: Mortality risk increases with death of a spouse (the widowhood effect). The association between area of residence and the widowhood effect was assessed. A total of 296, 125 married couples were included in the analysis. The widowhood effect was attenuated over time for both sexes in rural areas. Men in urban areas remained at increased mortality risk but women did not.