title: Marital history and survival after a heart attack.
abstract: Heart disease is the leading cause of death in the United States and nearly one million Americans will have a heart attack this year. Although the risks associated with a heart attack are well established, we know surprisingly little about how marital factors contribute to survival in adults afflicted with heart disease. This study uses a life course perspective and longitudinal data from the Health and Retirement Study to examine how various dimensions of marital life influence survival in U.S. older adults who suffered a heart attack (n = 2197). We found that adults who were never married (odds ratio [OR] = 1.73), currently divorced (OR = 1.70), or widowed (OR = 1.34) were at significantly greater risk of dying after a heart attack than adults who were continuously married; and the risks were not uniform over time. We also found that the risk of dying increased by 12% for every additional marital loss and decreased by 7% for every one-tenth increase in the proportion of years married. After accounting for more than a dozen socioeconomic, psychosocial, behavioral, and physiological factors, we found that current marital status remained the most robust indicator of survival following a heart attack. The implications of the findings are discussed in the context of life course inequalities in chronic disease and directions for future research.
authors: Department of Sociology, Duke University, Durham, NC, USA; Department of Community and Family Medicine, Duke University, Durham, NC, USA; Duke Clinical Research Institute, Duke University, Durham, NC, USA. Electronic address: matthew.dupre@duke.edu.
authors: Matthew E
authors: ME
authors: Dupre
authors: Department of Community and Family Medicine, Duke University, Durham, NC, USA.
authors: Alicia
authors: A
authors: Nelson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004243:Divorce / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000401:mortality* / Q000523:psychology*; D011446:Prospective Studies; D012189:Retrospective Studies; D012847:Single Person / Q000523:psychology / Q000706:statistics & numerical data; D018454:Spouses / Q000523:psychology / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States; D017805:Widowhood / Q000523:psychology / Q000706:statistics & numerical data
keywords: Aging; Heart attack; Marital status; Survival