The effect of widowhood on mortality by the causes of death of both spouses
Open accessAbstract
OBJECTIVES: We investigated the effect of spousal bereavement on mortality to document cause-specific bereavement effects by the causes of death of both the predecedent spouse and the bereaved partner. METHODS: We obtained data from a nationally representative cohort of 373 189 elderly married couples in the United States who were followed from 1993 to 2002. We used competing risk and Cox models in our analyses. RESULTS: For both men and women, the death of a predecedent spouse from almost all causes, including various cancers, infections, and cardiovascular diseases, increased the all-cause mortality of the bereaved partner to varying degrees. Moreover, the death of a predecedent spouse from any cause increased the survivor's cause-specific mortality for almost all causes, including cancers, infections, and cardiovascular diseases, to varying degrees. CONCLUSIONS: The effect of widowhood on mortality varies substantially by the causes of death of both spouses, suggesting that the widowhood effect is not restricted to one aspect of human biology. Future research should examine the specific mechanisms of the widowhood effect and identify opportunities for health interventions.
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The negative effects of caregiving, including a higher mortality rate, are most pronounced in caregivers of patients with advanced cancer, particularly when patients have a protracted disease course and are receiving palliative care.
“Conversely, longer survival comes at a cost for caregivers: the negative effects of caregiving, including a higher mortality rate, are most pronounced in caregivers of patients with advanced cancer [2, 3, 20], particularly when patients have a protracted disease course [25] and are receiving palliative care [4, 21].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [25]
Distress in caregivers contributes to distress in patients, in addition to negatively impacting the health of caregivers themselves, and likely other family members.
“Distress in caregivers contributes to distress in patients [24], in addition to negatively impacting the health of caregivers themselves [2–4, 20, 21, 25], and likely other family members (e.g. many of our participants had young children).”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [25]
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References 42 · Cited by 282
- Authors
- Elwert, F., & Christakis, N. A.
- Affiliations
- University of Wisconsin–Madison (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2008-11
- Volume
- 98
- Issue
- 11
- Pages
- 2092-2098
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC2636447
- OpenAlex
- W2069508713
- Cited by
- 282
- References
- 42
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 18 · 2023: 26 · 2022: 12 · 2021: 23 · 2020: 27 · 2019: 16 · 2018: 13 · 2017: 17 · 2016: 16 · 2015: 10 · 2014: 16 · 2013: 16 · 2012: 19
- FWCI
- 8.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Harvard University
- National Institutes of Health
- Centers for Medicare and Medicaid Services
- National Institute on Aging (R-01AG17548-01, R01AG017548)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Demography › Family Dynamics and Relationships
- Keywords
- widowhood, death of a spouse, mortality, cause-specific mortality, all-cause mortality, married couples, older adults, cancer mortality, cardiovascular mortality, infectious disease mortality, competing risks
- MeSH terms
- Aged, Aged, 80 and over, Bereavement, Cause of Death, Female, Medicare, Humans, Longitudinal Studies, Male, Men, Risk Factors, United States, Women, Proportional Hazards Models, Widowhood, Spouses, Risk Assessment, Censuses
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