title: Changing associations between partnership history and risk of accidents, violence and suicides.
abstract: BACKGROUND
  Lower mortality has been systematically found in married when compared with non-married, especially in men, but little is known about marital status differences in mortality from external causes. Furthermore, the role of cohabitation and partnership history in the formation of these differences and how they have been changed over time are poorly understood.
  
  
  METHODS
  The incidence of fatal and non-fatal cases of accidents, violence and suicides by partnership history was analysed during 1991-1997 and 2001-2007 in a representative sample of the Finnish population aged 26-59 years. HRs were calculated using Cox proportional hazards models.
  
  
  RESULTS
  Incidence rates in accidents, violence and suicides were generally lower in men and women living with a partner than those living alone. Current cohabitation and previous divorce increased the risk of all of these outcomes when compared with married without previous divorce. Higher incidence rates were found in men who had divorced 3 years ago or earlier when compared with those who had divorced later. Generally, these differences were larger in fatal than in non-fatal cases and significantly larger in men. There was little change in these differences between 1991-1997 and 2001-2007. These differences were partly explained by socioeconomic factors but remained statistically significant also after these adjustments.
  
  
  CONCLUSIONS
  Currently living without a partner and cohabitation and previous divorce increased the risk of accidents, violence and suicides. This indicates that also other mechanisms than immediate support from a partner are important in the formation of marital status differences in mortality.
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland. karri.silventoinen@helsinki.fi
authors.forename: Karri
authors.initials: K
authors.lastname: Silventoinen
authors.forename: Heta
authors.initials: H
authors.lastname: Moustgaard
authors.forename: Riina
authors.initials: R
authors.lastname: Peltonen
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
mesh_terms: D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010351:Patient Discharge / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D012306:Risk; D017678:Sex Distribution; D012923:Social Class; D013405:Suicide / Q000706:statistics & numerical data*; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D000092864:Suicide Prevention