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Journal of Cancer Survivorship :... Apr 2023Promoting positive health behaviors helps improve cancer survivors' health outcomes during survivorship; however, little is known about whether health behaviors differ...
PURPOSE
Promoting positive health behaviors helps improve cancer survivors' health outcomes during survivorship; however, little is known about whether health behaviors differ by marital status. The purpose is to examine whether health behaviors and obesity among cancer survivors vary by marital status and whether the type of cancer and sociodemographic factors influence the relationship.
METHODS
We examined smoking, physical activity, and body mass index (BMI) among 1880 individuals diagnosed with prostate, breast, or colon cancer who were identified from the 2011-2017 Medical Expenditure Panel Survey (MEPS). We used Rao-Scott design-adjusted chi-square tests and weighted multivariable logistic regressions to achieve the research aims.
RESULTS
Current smoking behavior and BMI were significantly related to marital status. Survivors who had never married were the most likely to be current smokers across all cancer types. Married survivors were the most likely to be overweight or obese, while widowed survivors were the most likely to have a normal weight. The relationship between BMI and marital status varied by cancer type. Widowed colon cancer survivors were least likely to be overweight or obese; divorced/separated colon cancer survivors were most likely to be obese or overweight. Health behavior disparities were found among cancer survivors of different age, sex, race, and levels of education and income.
CONCLUSIONS
There were relationships between marital status, health behaviors, and obesity among cancer survivors.
IMPLICATIONS FOR CANCER SURVIVORS
Our results suggested that relationship status and sociodemographic factors need to be considered in tailoring interventions to promote health behaviors among cancer survivors.
Topics: Male; Humans; Cancer Survivors; Overweight; Health Promotion; Marital Status; Health Behavior; Obesity; Neoplasms
PubMed: 36409440
DOI: 10.1007/s11764-022-01269-x -
Social Science & Medicine (1982) Apr 2021Recent studies have found that marital loss through divorce or widowhood is associated with a higher risk of dementia for older adults. However, whether these...
Recent studies have found that marital loss through divorce or widowhood is associated with a higher risk of dementia for older adults. However, whether these associations vary by race and gender is less clear. To address this gap, we drew upon longitudinal data from the Health and Retirement Study (2000-2016) to investigate the association between marital loss and dementia risk, separately for non-Hispanic Whites and non-Hispanic Blacks. We further examined gender variations in the link between marital loss and dementia risk within each racial group. Results from discrete-time event history models suggested that widowhood is significantly associated with a higher risk of dementia for both Whites and Blacks, controlling for basic demographic characteristics. However, while divorce is significantly associated with a higher risk of dementia for Blacks, the association is marginally significant (p < 0.1) for Whites. There are few significant gender variations in these associations except for the effect of divorce among Whites. Even after controlling for economic and health-related factors, we found that divorce is associated with a higher risk of dementia among White men but not among White women. Economic resources explain a significant portion of the association between widowhood and dementia risk, more so for Whites than for Blacks. Our findings call for more research into the pathways through which marital loss shapes the risk of dementia across racial and ethnic groups.
Topics: Aged; Dementia; Divorce; Ethnicity; Female; Humans; Male; Marital Status; Marriage; Retirement; United States
PubMed: 33713925
DOI: 10.1016/j.socscimed.2021.113808 -
Current Oncology (Toronto, Ont.) Dec 2020Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting.
BACKGROUND
Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting.
METHODS
We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct.
RESULTS
We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic ( = 0.58) or autologous ( = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), < 0.001, and chronic gvhd, = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99).
CONCLUSIONS
Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.
Topics: Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Marital Status; Quality of Life
PubMed: 33380875
DOI: 10.3747/co.27.6327 -
Child Abuse & Neglect Oct 2023Marital status is a well-known social determinant of health. Adverse childhood experiences (ACEs) affect attachment, critical to establishing and maintaining intimate...
BACKGROUND
Marital status is a well-known social determinant of health. Adverse childhood experiences (ACEs) affect attachment, critical to establishing and maintaining intimate relationships, such as marital status.
OBJECTIVE
This study examined the association between ACEs and marital status among older Japanese adults.
PARTICIPANTS AND SETTING
This research used data from a nationwide population-based study among functionally independent people aged 65 and above in Japan.
METHODS
ACEs were assessed by self-reported questionnaires on the following experiences before 18 years old: parental death, parental divorce, parental mental disease, exposure to intimate partner violence, physical abuse, psychological neglect, psychological abuse, and poverty. Marital status was asked as currently having a spouse (including common-law marriage), widowed, divorced, or unmarried. Associations between the total number of ACEs and marital status were analyzed by multinomial logistic regression.
RESULTS
Three or more ACEs showed higher risks of being widowed, divorced, or unmarried. Psychological neglect led to higher divorce risks among males (RRR, 95%CI = 1.41, 1.13-1.76) and females (RRR, 95%CI = 1.56, 1.28-1.89). Childhood poverty showed higher risks of unmarried among males (RRR, 95%CI = 1.25, 1.02-1.53) and females (RRR, 95%CI = 1.41, 1.18-1.69). Association between ACEs and divorce risks showed gender differences (RRR, 95%CI of having three or more ACEs in males: 2.19, 1.66-2.90; in females: 3.45, 2.71-4.38; p for interaction = 0.034).
CONCLUSIONS
ACEs showed higher risks of being widowed, divorced, and unmarried among older Japanese people. Policy to tackle ACEs and research investigating how ACEs, attachment, and relationship quality influence marital status are required to promote well-being in later life.
Topics: Male; Female; Humans; Aged; Adolescent; Adverse Childhood Experiences; East Asian People; Marital Status; Divorce; Mental Disorders
PubMed: 37467673
DOI: 10.1016/j.chiabu.2023.106340 -
The Journals of Gerontology. Series B,... Sep 2020We provide one of the first population-based studies of variation in dementia by marital status in the United States.
OBJECTIVES
We provide one of the first population-based studies of variation in dementia by marital status in the United States.
METHOD
We analyzed data from the Health and Retirement Study (2000-2014). The sample included 15,379 respondents (6,650 men and 8,729 women) aged 52 years and older in 2000 who showed no evidence of dementia at the baseline survey. Dementia was assessed using either the modified version of the Telephone Interview for Cognitive Status (TICS) or the proxy's assessment. Discrete-time hazard regression models were estimated to predict odds of dementia.
RESULTS
All unmarried groups, including the cohabiting, divorced/separated, widowed, and never married, had significantly higher odds of developing dementia over the study period than their married counterparts; economic resources and, to a lesser degree, health-related factors accounted for only part of the marital status variation in dementia. For divorced/separated and widowed respondents, the differences in the odds of dementia relative to married respondents were greater among men than among women.
DISCUSSION
These findings will be helpful for health policy makers and practitioners who seek to better identify vulnerable subpopulations and to design effective intervention strategies to reduce dementia risk.
Topics: Aged; Aged, 80 and over; Dementia; Female; Health Surveys; Humans; Male; Marital Status; Middle Aged; Prevalence; Retirement; Risk Factors; United States
PubMed: 31251349
DOI: 10.1093/geronb/gbz087 -
The Journals of Gerontology. Series B,... Mar 2022Marital status contributes to differences in social experiences and well-being in late life. Yet, we know little about the role of conversation in these processes....
OBJECTIVES
Marital status contributes to differences in social experiences and well-being in late life. Yet, we know little about the role of conversation in these processes. Drawing on a functionalist perspective and hierarchical compensatory model, this study aimed to understand (a) whether older adults' marital status is associated with conversation frequency throughout the day, (b) whether contacts with nonspousal ties elicit more conversations among unmarried older adults, and (c) whether conversations exert a stronger effect on mood for unmarried older adults than married older adults.
METHOD
Adults aged 65+ (N = 272) provided information about their background characteristics and social partners. Across 5-6 days, they completed ecological momentary assessments reporting their social encounters and mood every 3 hr. Concurrently, electronically activated recorders captured 30 s of sound every 7 min. We compared older adults who were married, widowed, and divorced.
RESULTS
Multilevel models revealed that married older adults engaged in more conversations than divorced older adults throughout the day. Contact with friends elicited more conversations for divorced older adults than married older adults. Furthermore, conversations enhanced mood throughout the day, but this effect was more salient for widowed than married older adults.
DISCUSSION
Findings highlight the role of marital status in older adults' daily conversational experiences and compensatory processes that may occur. Widowed and divorced older adults differed from married older adults in distinct ways. Divorced older adults may compensate for lack of spouse with friends, whereas widowed older adults may benefit emotionally from engaging in conversations.
Topics: Affect; Aged; Divorce; Friends; Humans; Marital Status; Marriage
PubMed: 34159387
DOI: 10.1093/geronb/gbab112 -
BMC Psychiatry Mar 2023Marital status is a robust correlate of disordered gambling, but few studies have examined the direction of this association.
BACKGROUND
Marital status is a robust correlate of disordered gambling, but few studies have examined the direction of this association.
METHODS
The present study used a case-control design by including all adults receiving their first gambling disorder (GD) diagnosis between January 2008 to December 2018 (Norwegian Patient Registry, n = 5,121) and compared them against age and gender matched individuals with other somatic/psychiatric illnesses (Norwegian Patient Registry, n = 27,826) and a random sample from the general population (FD-Trygd database, n = 26,695). The study examined marital status before GD, getting divorced as a risk factor for future GD, and becoming married as a protective factor of future GD.
RESULTS
The findings indicated an 8-9 percentage points higher prevalence of unmarried people and about a 5 percentage points higher prevalence of separation/divorce among those that subsequently experienced GD compared to controls. Logistic regressions showed that transition through divorce was associated with higher odds of future GD compared to illness controls (odds ratio [OR] = 2.45, 95% CI [2.06, 2.92]) and the general population (OR = 2.41 [2.02, 2.87]). Logistic regressions also showed that transition through marriage was associated with lower odds of future GD compared to illness controls (OR = 0.62, CI [0.55, 0.70]) and the general population (OR = 0.57, CI [0.50, 0.64]).
CONCLUSIONS
Social bonds have previously been shown to impact physical and mental health, and the findings of the study emphasize the importance of considering social network history and previous relationship dissolution among individuals with GD.
Topics: Adult; Humans; Longitudinal Studies; Gambling; Routinely Collected Health Data; Marital Status; Divorce; Marriage
PubMed: 36978051
DOI: 10.1186/s12888-023-04697-w -
International Ophthalmology Dec 2022Marital status influences the presentation and outcome of various cancers. We explored the relationship between marital status and survival of uveal melanoma (UM) and...
BACKGROUND
Marital status influences the presentation and outcome of various cancers. We explored the relationship between marital status and survival of uveal melanoma (UM) and factors influencing this relationship.
METHODS
We conducted a retrospective cohort study on patients diagnosed with UM and registered in the Surveillance Epidemiology and End Results program between 1973 and 2017. Cox regression model was conducted to calculate the hazard ratio of overall and cancer-specific survival rate and delineate the effect of each confounder.
RESULTS
The study involved 10,557 patients with a male-to-female ratio of 1:1.1. Most of the diagnosed patients were aged between 40 and 79 years (81%). Married patients (62%) represented the majority, followed by singles (12%), widowed (11%), and then divorced patients (7%). Single patients were the youngest group (mean age of 59.3 years) while widowed patients were the oldest (mean age of 75.8 years). In the Cox regression model for overall survival, married and single patients exhibited the best overall survival (no significant difference in between them), both surpassing divorced and widowed patients. Married patients were at a significantly lower risk to die from UM than divorced patients. Female patients and younger age groups showed the best overall and cancer-specific survival.
CONCLUSION
Maintained marriages improved the survival of UM patients. Widowed and divorced patients should be included in specially designed support programs during their cancer management.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; SEER Program; Retrospective Studies; Marital Status; Melanoma
PubMed: 35821361
DOI: 10.1007/s10792-022-02406-2 -
International Journal of Environmental... Feb 2022Few studies evaluating the relationship between depression and exercise consider peoples' socio-demographic characteristics. This cross-sectional study investigated the...
Few studies evaluating the relationship between depression and exercise consider peoples' socio-demographic characteristics. This cross-sectional study investigated the interaction between exercise and marital status and depression in Taiwanese adults. Data from the 2-item Patient Health Questionnaire (PHQ-2) was recruited from the Taiwan Biobank. Participants indicated their exercise status, showing 5015 no-exercise cases and 3407 exercise cases. Marital status, including unmarried, divorced or separated, and widowed, were all significant, especially among the no-exercise group. The relationship between exercise/no exercise and marital status was examined; no exercise and unmarried, divorced or separated, and widowed, as well as exercise and married were significant to PHQ-2. Gender was significant in both the married and unmarried groups. The association between exercise, marital status, gender, and education on PHQ-2 score was also significant. Married people, especially men, had lower depression scores. Additionally, exercise had a protective effect against depression for unmarried people, especially women.
Topics: Adult; Biological Specimen Banks; Cross-Sectional Studies; Depression; Female; Humans; Male; Marital Status; Taiwan
PubMed: 35162898
DOI: 10.3390/ijerph19031876 -
Journal of Preventive Medicine and... Nov 2022This study aimed to analyze the associations of income, marital status, and health behaviors with hypertension in male and female over 40 years of age in the Korea.
OBJECTIVES
This study aimed to analyze the associations of income, marital status, and health behaviors with hypertension in male and female over 40 years of age in the Korea.
METHODS
The data were derived from the Korean Genome and Epidemiology Study (KoGES; 4851-302) which included 211 576 participants. To analyze the relationships of income, marital status, and health behaviors with hypertension in male and female over 40 years of age, multiple logistic regression was conducted with adjustments for these variables.
RESULTS
The prevalence of hypertension increased linearly as income decreased. The odds ratio for developing hypertension in people with an income of <0.5 million Korean won (KRW) compared to ≥6.0 million KRW was 1.55 (95% confidence interval [CI], 1.25 to 1.93) in the total population, 1.58 (95% CI, 1.27 to 1.98) in male, and 1.07 (95% CI, 0.35 to 3.28) in female. The combined effect of income level and marital status on hypertension was significant. According to income level and marital status, in male, low income and divorce were most associated with hypertension (1.76 times; 95% CI, 1.01 to 3.08). However, in female, the low-income, married group was most associated with hypertension (1.83 times; 95% CI, 1.71 to 1.97).
CONCLUSIONS
The results of this study show that it is necessary to approach male and female marital status separately according to income in health policies to address inequalities in the prevalence of hypertension.
Topics: Humans; Female; Male; Adult; Middle Aged; Marital Status; Poverty; Marriage; Health Policy; Hypertension
PubMed: 36475316
DOI: 10.3961/jpmph.22.264