title: Conjugal bereavement effects on health and mortality at advanced ages.
abstract: Spousal bereavement at old ages may lead to dramatic changes in health. This paper investigates whether spousal bereavement has a causal effect on health and on mortality of the surviving spouse. We advance on the literature in two main ways. First, we model survivals of both spouses and the dynamic evolution of health jointly, allowing for potential endogeneity of timing of bereavement and health in explaining mortality of the surviving spouse. Second, we use a flexible non-parametric data dimensionality reduction method to thoroughly characterize health (using 22 health indicators) by a limited number of latent health indicators. This allows us to investigate the causal effect of spousal bereavement on mortality and on all aspects of health simultaneously. Our analyses are based on an ongoing longitudinal survey that follows a random sample of older individuals from 1992. We find strong instantaneous effects of bereavement on mortality and on certain aspects of health. Individuals lose on average 12% of residual life expectancy after conjugal bereavement. Conjugal bereavement affects the share of healthy years in residual lifetime, primarily because healthy years are replaced by years with chronic diseases. The strong direct effects of bereavement suggest that monitoring and/or interventions just after spousal bereavement are important for the length and quality of life of older bereaved individuals.
authors.affiliation: University of Mannheim, VU University Amsterdam, IFAU-Uppsala, IZA, The Netherlands.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: van den Berg
authors.forename: Maarten
authors.initials: M
authors.lastname: Lindeboom
authors.forename: France
authors.initials: F
authors.lastname: Portrait
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D005260:Female; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands / Q000453:epidemiology; D016019:Survival Analysis; D017805:Widowhood / Q000523:psychology*