Trends in total and cause-specific mortality by marital status among elderly Norwegian men and women.
Trends in total and cause-specific mortality by marital status among elderly Norwegian men and women.
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DOI：
10.1186/1471-2458-11-537
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发表时间：
2011-07-06
影响因子：
4.5
通讯作者：
Berntsen, Kjersti Norgard
中科院分区：
文献类型：
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作者：
Berntsen, Kjersti Norgard
背景技术背景：以前的研究表明，在几个国家，婚姻状况导致的死亡率的相对差异很大，而且还在不断增加，但很少有研究考虑到老年人婚姻状况导致的死因特异性死亡率的趋势。作者使用离散-时间风险回归和登记数据，涵盖整个挪威人口，以分析75岁男女的婚姻状况与几种死亡原因之间的关系如何变化，1971年至2007年89。教育程度，居住地区和中心性作为控制变量。有804 243例死亡，在11 102 306人-年的follow-up.RESULTS：相对于已婚人士，那些从未结婚，离婚或丧偶有显着较高的死亡率为大多数死因。离婚者的死亡几率最高，其次是从未结婚和丧偶。此外，未婚者的超额死亡率男性高于女性，至少在这段时间的开始阶段是这样。从1971年至2007年，按婚姻状况分列的死亡率相对差异有所扩大。特别是，未婚妇女的超额死亡率一直在上升，男子的超额死亡率也在上升，但幅度较小。在循环系统疾病、呼吸系统疾病（妇女）、其他疾病和外部死亡（妇女）造成的死亡率方面，婚姻状况差异的扩大最为明显。癌症死亡率的差异，婚姻状况一直是稳定的，随着时间的推移。结论：那些已婚的人可能有较低的死亡率，因为婚姻的保护作用或选择健康的个人进入婚姻，这种机制的重要性可能会随着时间的推移而改变。然而，根据现有数据，不可能确定造成挪威按婚姻状况分列的死亡率相对差异日益增大的机制。
BACKGROUND: Previous research has shown large and increasing relative differences in mortality by marital status in several countries, but few studies have considered trends in cause-specific mortality by marital status among elderly people.METHODS: The author uses discrete-time hazard regression and register data covering the entire Norwegian population to analyze how associations between marital status and several causes of death have changed for men and women of age 75-89 from 1971-2007. Educational level, region of residence and centrality are included as control variables. There are 804 243 deaths during the 11 102 306 person-years of follow-up.RESULTS: Relative to married persons, those who are never married, divorced or widowed have significantly higher mortality for most causes of death. The odds of death are highest for divorcees, followed by never married and widowed. Moreover, the excess mortality among the non-married is higher for men than for women, at least in the beginning of the time period. Relative differences in mortality by marital status have increased from 1971-2007. In particular, the excess mortality of the never married women and, to a lesser extent, men has been rising. The widening of the marital status differentials is most pronounced for mortality resulting from circulatory diseases, respiratory diseases (women), other diseases and external deaths (women). Differences in cancer mortality by marital status have been stable over time.CONCLUSIONS: Those who are married may have lower mortality because of protective effects of marriage or selection of healthy individuals into marriage, and the importance of such mechanisms may have changed over time. However, with the available data it is not possible to identify the mechanisms responsible for the increasing relative differences in mortality by marital status in Norway.