title: Marital status, intergenerational co-residence and cardiovascular and all-cause mortality among middle-aged and older men and women during wartime in Beirut: gains and liabilities.
abstract: Studies from the West have shown an increased risk of mortality with various indicators of social isolation. In this study, we examine associations of marital status and intergenerational co-residence with mortality in Lebanon, a country that suffered wars and atrocities for almost 16 years. Using data from a retrospective 10-year follow-up study (1984-1994) among 1567 adults aged 50 years and older in Beirut, cardiovascular disease and all-cause mortality rates (per 1000 person-years) were computed for men and women separately. Age-adjusted Mantel-Haenszel rate ratios (RR) and their 95% confidence intervals (CI) were estimated, and associations were examined using multivariate Poisson regression analysis. Most men (91.3%) were married at baseline, in contrast to only 55.4% of women. Compared to men, women were more likely to be living in one- and three-generation households and with a married child at baseline. While widowhood was associated with an increased risk of all-cause mortality among men only, being never married was associated with a higher CVD mortality risk among men and women. The presence of an adult married child was associated with a significantly higher mortality risk for men and women, even after adjusting for household socioeconomic indicators, marital status, lifestyle variables or pre-existing health-related conditions (hypertension, cholesterol, and diabetes) at baseline. The popular belief that co-residence with adult children reflects greater support networks and an avenue for old age security may not be a valid presumption in the Lebanese context during times of war.
authors.affiliation: Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon. ansibai@aub.edu.lb
authors.forename: Abla M
authors.initials: AM
authors.lastname: Sibai
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Yount
authors.forename: Astrid
authors.initials: A
authors.lastname: Fletcher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016901:Intergenerational Relations; D007407:Interviews as Topic; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D012944:Social Support; D014857:Warfare