title: Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses.
abstract: BACKGROUND
  Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this 'widowhood effect' persists over time.
  
  
  METHODS
  Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.
  
  
  RESULTS
  Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio (OR) for men = 1.87, 95% CI: 1.27, 2.75; OR for women = 1.47, 95% CI: 0.96, 2.24) in models adjusted for age, gender, race and baseline SES (education, household wealth and household income), behavioral risk factors and co-morbidities. Twelve months following bereavement, men experienced borderline elevated mortality (OR = 1.16, 95% CI: 1.00, 1.35), whereas women did not (OR = 1.07, 95% CI: 0.90, 1.28), though the gender difference was non-significant.
  
  
  CONCLUSIONS
  The 'widowhood effect' was not fully explained by adjusting for pre-widowhood SES and particularly elevated within the first few months after widowhood. These associations did not differ by sex.
authors.affiliation: Office of the Mayor, New York City, NY, USA.
authors.forename: J Robin
authors.initials: JR
authors.lastname: Moon
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, 7th Floor, Boston, MA 02115, USA.
authors.forename: M Maria
authors.initials: MM
authors.lastname: Glymour
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, 7th Floor, Boston, MA 02115, USA.
authors.forename: Anusha M
authors.initials: AM
authors.lastname: Vable
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, 7th Floor, Boston, MA 02115, USA.
authors.forename: Sze Y
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, 7th Floor, Boston, MA 02115, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
mesh_terms: D001601:Bereavement; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D017805:Widowhood / Q000706:statistics & numerical data*
keywords: longitudinal studies; mortality; socioeconomic status; spousal loss; widowhood