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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 -
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 -
PloS One 2023Stay-at-home strategies taken during the COVID-19 pandemic changed our lifestyle drastically. Although marital status and household size are important social...
Stay-at-home strategies taken during the COVID-19 pandemic changed our lifestyle drastically. Although marital status and household size are important social determinants of health that affect lifestyle, their impacts on lifestyle during the pandemic are still unclear. We aimed to evaluate the association between marital status, household size, and lifestyle changes during the first pandemic in Japan. Questionnaire surveys on lifestyle changes from before to during the first COVID-19 pandemic were conducted on October 2020 in Japan. Classified into age groups, multivariable logistic regression analysis was performed to examine the combined association of marital status and household size on lifestyle, adjusted for potential confounders including socioeconomic factors. In our prospective cohort study, 1928 participants were included. Among older participants, the singles living alone were likely to perceive more unhealthy lifestyle changes (45.8%), compared with the married (33.2%), and significantly associated with at least one unhealthy change [adjusted odds ratio (OR): 1.81, 95% confidence interval (CI): 1,18-2.78], mainly due to decreased physical activity and increased alcohol consumption. Meanwhile, the younger participants showed no significant association between marital status, household size, and unhealthy changes, while those living alone had 2.87 times higher odds of weight gain (≥ 3 kg) than the married (adjusted OR: 2.87, 95% CI: 0.96-8.54) during the pandemic. Our findings suggest that older singles living alone are potentially vulnerable subgroups to drastic social changes which warrant special attention to prevent adverse health outcomes and additional burden on health systems in the following future.
Topics: Humans; Pandemics; COVID-19; Prospective Studies; Life Style; Marital Status
PubMed: 36972241
DOI: 10.1371/journal.pone.0283430 -
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 Geriatrics Apr 2023Living with a partner and separation is becoming more common among older people. Mortality disparities associated with marital status are significant in increasingly...
BACKGROUND
Living with a partner and separation is becoming more common among older people. Mortality disparities associated with marital status are significant in increasingly diverse aging populations. The link between marital status and all-cause mortality risk in older adults remains uncertain.
METHODS
This prospective cohort study included data from the US National Health and Nutrition Examination Survey (NHANES). We included NHANES participants ≥ 60 years of age (data from 1999 to 2014). Data for mortality follow-up beginning from the commencement date of survey participation to the last day of December 2015. Univariate- and multivariate-adjusted Cox proportional hazard models for marital status were estimated, and the findings were presented as regression coefficients and 95% confidence intervals (CI). Kaplan-Meier curves were reported.
RESULTS
Compared to never married individuals, the risk of all-cause mortality was 0.77 (0.50-1.18), 0.72 (0.56-0.93), 0.56 (0.36-0.88), and 0.84 (0.67-1.07) in those people living with a partner, married, separated, and divorced, respectively, after adjusting for demographics, socioeconomics, behavior, anthropometric variables, and medical history. The risk of all-cause mortality was 1.24 (0.97-1.59) in widowed participants.
CONCLUSION
This population-based cohort study included a large sample size followed by long-term follow-up. The association between marriage, health, and reduced mortality in older individuals has been illustrated in this study. Being married or separated was associated with a lower risk of mortality.
Topics: Humans; Aged; Nutrition Surveys; Cohort Studies; Prospective Studies; Marital Status; Marriage; Mortality
PubMed: 37016371
DOI: 10.1186/s12877-023-03880-8 -
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 -
International Journal of Environmental... Mar 2023We evaluated whether the maternal marital status and father acknowledgement (proxy for paternal presence) affect birth weight, and if so, whether the maternal...
We evaluated whether the maternal marital status and father acknowledgement (proxy for paternal presence) affect birth weight, and if so, whether the maternal educational attainment modifies this effect. The growing tendency of alternative forms of family structure affects maternal well-being and pregnancy outcome. However, it is not known whether poorer birth outcomes of out-of-wedlock childbearing can be overcome or compensated by maternal education. Using birth registry data, we assessed the impact of maternal civil status and child recognition by the father on birth-weight-for-gestational age (BWGA) z-scores, with respect to maternal education, among Polish mothers (N = 53,528). After standardization, the effect of being unmarried with father acknowledgement (UM-F) vs. married with father acknowledgement (M-F) reduced the BWGA z-score of 0.05 ( < 0.001), irrespective of educational attainment ( for interaction = 0.79). However, education differentiated the effect of father acknowledgement across unmarried mothers. BWGA z-scores were significantly lower among the low-educated unmarried group without father acknowledgment (UM-NF) as compared to UM-F (equaled -0.11, = 0.01). The same effect among the higher-educated group was non-significant ( = 0.72). Higher maternal education can compensate for the negative effect of a lack of father acknowledgement, but it does not help to overcome the effect of out-of-wedlock stress exposure.
Topics: Female; Humans; Male; Pregnancy; Educational Status; Fathers; Marital Status; Mothers; Parturition; Infant, Newborn
PubMed: 36981777
DOI: 10.3390/ijerph20064868 -
Medicine Apr 2018Previous studies have shown that marital status is an independent prognostic factor for survival in several types of cancer. In this study, we investigated the effects...
Previous studies have shown that marital status is an independent prognostic factor for survival in several types of cancer. In this study, we investigated the effects of marital status on survival outcomes among renal cell carcinoma (RCC) patients.We identified patients diagnosed with RCC between 1973 and 2013 from the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier analysis and Cox regression were used to identify the effects of marital status on overall survival (OS) and cancer-specific survival (CSS).We enrolled 97,662 eligible RCC patients, including 64,884 married patients, and 32,778 unmarried (9831 divorced/separated, 9692 widowed, and 13,255 single) patients at diagnosis. The 5-year OS and CSS rates of the married, separated/divorced, widowed, and single patients were 73.7%, 69.5%, 58.3%, and 73.2% (OS), and 82.2%, 80.7%, 75.7%, and 83.3% (CSS), respectively. Multivariate Cox regression showed that, compared with married patients, widowed individuals showed poorer OS (hazard ratio, 1.419; 95% confidence interval, 1.370-1.469) and CSS (hazard ratio, 1.210; 95% confidence interval, 1.144-1.279). Stratified analyses and multivariate Cox regression showed that, in the insured and uninsured groups, married patients had better survival outcomes while widowed patients suffered worse OS outcomes; however, this trend was not significant for CSS.In RCC patients, married patients had better survival outcomes while widowed patients tended to suffer worse survival outcomes in terms of both OS and CSS.
Topics: Age Factors; Aged; Carcinoma, Renal Cell; Female; Humans; Kaplan-Meier Estimate; Male; Marital Status; Middle Aged; Proportional Hazards Models; Protective Factors; Risk Factors; SEER Program; Sex Factors; United States; Widowhood
PubMed: 29668592
DOI: 10.1097/MD.0000000000010385 -
American Journal of Men's Health 2019Racial disparities in obesity among men are accompanied by positive associations between income and obesity among Black men only. Race also moderates the positive...
Racial disparities in obesity among men are accompanied by positive associations between income and obesity among Black men only. Race also moderates the positive association between marital status and obesity. This study sought to determine how race, income, and marital status interact on obesity among men. Using data from the 2007 to 2014 National Health and Nutrition Examination Survey, obesity was measured as body mass index ≥30 kg/m among 6,145 Black and White men. Income was measured by percentage of the federal poverty line and marital status was categorized as currently, formerly, or never married. Using logistic regression and interaction terms, the associations between income and obesity were assessed by race and marital status categories adjusted for covariates. Black compared to White (OR = 1.19, 95% CI [1.03, 1.38]), currently married compared to never married (OR = 1.45, 95% CI [1.24, 1.69]), and high-income men compared to low income men (OR = 1.26, 95% CI [1.06, 1.50]) had higher odds of obesity. A three-way interaction was significant and analyses identified that income was positively associated with obesity among currently married Black men and never married White men with the highest and lowest probabilities of obesity, respectively. High-income, currently married Black men had higher obesity rates and may be at increased risk for obesity-related morbidities.
Topics: Adult; Black or African American; Humans; Income; Male; Marital Status; Middle Aged; Nutrition Surveys; Obesity; White People
PubMed: 30767595
DOI: 10.1177/1557988319829952 -
Demography Feb 2018Assumptions that single mothers are "time poor" compared with married mothers are ubiquitous. We tested theorized associations derived from the time poverty thesis and...
Assumptions that single mothers are "time poor" compared with married mothers are ubiquitous. We tested theorized associations derived from the time poverty thesis and the gender perspective using the 2003-2012 American Time Use Surveys (ATUS). We found marital status differentiated housework, leisure, and sleep time, but did not influence the amount of time that mothers provided childcare. Net of the number of employment hours, married mothers did more housework and slept less than never-married and divorced mothers, counter to expectations of the time poverty thesis. Never-married and cohabiting mothers reported more total and more sedentary leisure time than married mothers. We assessed the influence of demographic differences among mothers to account for variation in their time use by marital status. Compositional differences explained more than two-thirds of the variance in sedentary leisure time between married and never-married mothers, but only one-third of the variance between married and cohabiting mothers. The larger unexplained gap in leisure quality between cohabiting and married mothers is consistent with the gender perspective.
Topics: Adolescent; Adult; Age Factors; Child; Child Care; Child, Preschool; Divorce; Female; Gender Identity; Household Work; Humans; Infant; Infant, Newborn; Leisure Activities; Marital Status; Middle Aged; Mothers; Single Parent; Sleep; Socioeconomic Factors; United States; Young Adult
PubMed: 29423629
DOI: 10.1007/s13524-018-0647-x