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The Journals of Gerontology. Series B,... Jan 2014Becoming widowed is a known risk factor for mortality. This article examines the magnitude of, explanations for, and variation in the association between widowhood and...
OBJECTIVES
Becoming widowed is a known risk factor for mortality. This article examines the magnitude of, explanations for, and variation in the association between widowhood and mortality. Previous research on widowhood mortality has revealed variation by socioeconomic status (SES), in that SES is not protective in widowhood, and by gender, such that men's mortality increases more than women's mortality after the death of spouse.
METHOD
Using data from the Health and Retirement Study, we estimated Cox proportional hazard models to estimate the association between widowhood and mortality.
RESULTS
Becoming widowed is associated with a 48% increase in risk of mortality. Approximately one third of the increase can be attributed to selection, in that those who become widows are socioeconomically disadvantaged. In contrast to previous studies, SES is protective for widows. Widowhood mortality risk increases for men if their wives' deaths were unexpected rather than expected; for women, the extent to which their husbands' death was expected matters less.
DISCUSSION
Widowhood's harmful association with mortality show how strongly social support and individual's health and mortality are related. These findings support the larger literature on the importance of social support for health and longevity.
Topics: Age Factors; Aged; Educational Status; Female; Humans; Male; Middle Aged; Mortality; Proportional Hazards Models; Risk Factors; Social Support; Socioeconomic Factors; United States; Widowhood
PubMed: 24077660
DOI: 10.1093/geronb/gbt079 -
Behavior Therapy May 2022The dual-process model proposes that early and later bereavement involves different types of stressors and adaptation processes (Stroebe & Schut, 1999, 2010). It is thus...
The dual-process model proposes that early and later bereavement involves different types of stressors and adaptation processes (Stroebe & Schut, 1999, 2010). It is thus possible that different factors facilitate adaptation during the early months versus subsequent years following widowhood. Elevated depressive symptoms, though prevalent after widowhood, may indicate problematic adaptation, as they are associated with poor long-term physical and mental health outcomes. We predicted that neutral death acceptance would be associated with less increase in depression during early widowhood (when confronted with loss-oriented stressors), whereas perceived control would predict depressive symptom decline during later widowhood (when adapting to controllable restoration-oriented stressors). Older adults (N = 265) reported on neutral death acceptance, perceived control, and depression before widowhood and on depression 0.5, 1.5, and 4.0 years after the death of their spouse. Bilinear spline growth modeling revealed that, on average, depressive symptoms increased from before to 0.5 years after spouse death and fell from 0.5 to 4.0 years after spouse death. Neutral death acceptance predicted a smaller increase in depression from before to 0.5 years after spouse death, as well as a smaller subsequent decrease in depression from 0.5 to 4.0 years after spouse death. Perceived control predicted a larger decrease in depression from 0.5 to 4.0 years after spouse death. Neutral death acceptance and perceived control had unique associations with resilience and recovery throughout early and later widowhood. These variables may be fruitful targets in interventions for depression throughout the full course of widowhood.
Topics: Aged; Bereavement; Female; Humans; Spouses; Widowhood
PubMed: 35473647
DOI: 10.1016/j.beth.2021.11.002 -
The Journals of Gerontology. Series B,... Nov 2021Widowhood is a stressful life event with one of the most profound negative effects on health and longevity. Immigrant populations are growing and aging throughout...
OBJECTIVES
Widowhood is a stressful life event with one of the most profound negative effects on health and longevity. Immigrant populations are growing and aging throughout Western nations, and marginalization and cultural differences may make some immigrants especially vulnerable to the stressors of widowhood. However, studies have yet to systematically explore whether the widowhood effect differs between immigrant and native-born individuals.
METHODS
Using Danish population register data from 1980 to 2014, this study assesses whether the relationship between widowhood and mortality differs between immigrants from 10 countries and native-born Danes aged 50 and older at 0-2, 3-5, and 6 and more years post-widowhood.
RESULTS
We find that immigrant men are at higher risk of dying in the first 2 years after experiencing widowhood than Danish-born men, but these mortality differences dissipate over longer periods. Immigrant women have a higher risk of having died 3 and more years after a spouse's death than Danish women. Patterns vary further by country of origin.
DISCUSSION
The results suggest that some immigrants may suffer more from widowhood than native-born individuals, giving insight into how immigration background may influence the health effects of negative life events. They also underscore the potential vulnerabilities of aging immigrant populations to stressors encountered in older age.
Topics: Aged; Cultural Characteristics; Denmark; Emigrants and Immigrants; Female; Humans; Indigenous Peoples; Life Change Events; Male; Middle Aged; Mortality; Sex Factors; Social Marginalization; Stress, Psychological; Vulnerable Populations; Widowhood
PubMed: 34313712
DOI: 10.1093/geronb/gbab090 -
PloS One 2021Individual life expectancies provide information for individuals making retirement decisions and for policy makers. For couples, analogous measures are the expected...
Individual life expectancies provide information for individuals making retirement decisions and for policy makers. For couples, analogous measures are the expected years both spouses will be alive (joint life expectancy) and the expected years the surviving spouse will be a widow or widower (survivor life expectancy). Using individual life expectancies to calculate summary measures for couples is intuitively appealing but yield misleading results, overstating joint life expectancy and dramatically understating survivor life expectancies. This implies that standard "individual life cycle models" are misleading for couples and that "couple life cycle models" must be substantially more complex. Using the CDC life tables for 2010, we construct joint and survivor life expectancy measures for randomly formed couples. The couples we form are defined by age, race and ethnicity, and education. Due to assortative marriage, inequalities in individual life expectancies are compounded into inequalities in joint and survivor life expectancies. We also calculate life expectancy measures for randomly formed couples for the 1930-2010 decennial years. Trends over time show how the relative rate of decrease in the mortality rates of men and women affect joint and survivor life expectancies. Because our couple life expectancy measures are based on randomly formed couples, they do not capture the effects of differences in spouses' premarital characteristics (apart from sex, age, race and ethnicity, and, in some cases, education) or of correlations in spouses' experiences or behaviors during marriage. However, they provide benchmarks which have been sorely lacking in the public discourse.
Topics: Aged; Aged, 80 and over; Databases, Factual; Educational Status; Female; Humans; Life Expectancy; Male; Marriage; Middle Aged; Retirement; Spouses
PubMed: 33989281
DOI: 10.1371/journal.pone.0250564 -
JACC. Clinical Electrophysiology Aug 2022
Topics: Brugada Syndrome; Deep Learning; Female; Humans; Mythology; Wearable Electronic Devices; Widowhood
PubMed: 35981789
DOI: 10.1016/j.jacep.2022.06.017 -
Research on Aging Jan 2022We investigate how preloss marital quality is associated with changes in psychological distress and physical health among older widow(er)s. Using prospective data with a...
We investigate how preloss marital quality is associated with changes in psychological distress and physical health among older widow(er)s. Using prospective data with a 2-year follow-up from the Health and Retirement Study, we selected 546 respondents who transitioned into widowhood. Respondents were classified as supportive, ambivalent, aversive, or neutral groups. The supportive and ambivalent group experienced greater increase in depressive symptoms compared to the aversive group, in widowhood. The aversive group showed greater increase in chronic conditions compared to the supportive group. Findings indicated that spousal loss may result in more psychological distress for those with supportive and ambivalent marital relationship. Yet, those with mostly negative accounts of their marriage may experience worsened physical health, albeit no increase in psychological distress. Understanding different benefits and challenges facing older individuals after a positive or negative marriage may help direct support and interventions efforts toward older couples during marriage and in widowhood.
Topics: Adaptation, Psychological; Female; Humans; Marriage; Prospective Studies; Retirement; Widowhood
PubMed: 33511917
DOI: 10.1177/0164027521989083 -
Journal of the International AIDS... 2014The customs of widow cleansing and widow inheritance are practiced in several communities throughout sub-Saharan Africa. In the Nyanza Province of Kenya, according to...
INTRODUCTION
The customs of widow cleansing and widow inheritance are practiced in several communities throughout sub-Saharan Africa. In the Nyanza Province of Kenya, according to tradition, Luo widows are expected to engage in sexual intercourse with a "cleanser," without the use of a condom, in order to remove the impurity ascribed to her after her husband's death. Luo couples, including widows, are also expected to engage in sex preceding specific agricultural activities, building homes, funerals, weddings, and other significant cultural and social events. Widows who are inherited for the purpose of fulfilling cultural obligation have a higher prevalence of HIV than those who remain un-inherited or are inherited for the purpose of companionship.
METHODS
As part of a larger descriptive qualitative study to inform study procedures for FEM-PrEP, an HIV prevention pre-exposure prophylaxis clinical trial, we conducted 15 semi-structured interviews (SSIs) with widows, 15 SSIs with inheritors, and four focus group discussions with widows in the Bondo and Rarieda districts in Nyanza Province to explore the HIV risk context within widow cleansing and inheritance practices. Thematic qualitative analysis was used to analyze the data.
RESULTS
The majority of widows reported in the demographic questionnaire being inherited, and most widows in the SSIs described participating in the cleansing ritual. We identified two main themes related to HIV prevention within the context of widow cleansing and inheritance: 1) widows must balance limiting their risk for HIV infection with meeting cultural expectations and ensuring that their livelihood needs are met, and 2) sexual abstinence undermines cultural expectations in widowhood while the use of condoms is deemed inappropriate in fulfilling culturally prescribed sexual rituals, and is often beyond the widow's ability to negotiate.
CONCLUSIONS
Women-controlled HIV prevention methods such as antiretroviral-based oral pre-exposure prophylaxis, vaginal gels, and vaginal rings are needed for HIV-negative widows who engage in sexual rituals related to widowhood.
Topics: Adolescent; Adult; Culture; Ethnicity; Female; Focus Groups; HIV Infections; Health Services Needs and Demand; Humans; Interviews as Topic; Kenya; Qualitative Research; Widowhood; Women's Health Services; Young Adult
PubMed: 24973041
DOI: 10.7448/IAS.17.1.19010 -
Health Literacy Research and Practice Oct 2021To date, there has been a dearth of research on health literacy in the Eastern Mediterranean Region and in particular Lebanon.
BACKGROUND
To date, there has been a dearth of research on health literacy in the Eastern Mediterranean Region and in particular Lebanon.
OBJECTIVES
This cross-sectional study assessed the levels and correlates of health literacy in Lebanese adults.
METHODS
A total of 587 participants (54.5% women) were recruited from the outpatient clinics of five health facilities in Beirut. The questionnaire consisted of the Arabic version of the Functional Health literacy Scale, the Arabic short version of the European Health Literacy Survey, and questions on sociodemographic and health-related factors. Descriptive and inferential statistics were performed to assess the association of these factors with functional health literacy (FHL) and comprehensive health literacy (CHL) levels.
KEY RESULTS
About 65.8% had inadequate or problematic FHL and 43.8% had inadequate or problematic CHL. Although FHL was negatively correlated with long-term illness, it was positively correlated with ability to pay and health status. CHL was positively correlated with education, income, ability to pay for treatment, health status, and FHL level, whereas it was negatively correlated with long-term illness. Binary logistic regression showed that low education, low socioeconomic status, and being a widow were predictive of inadequate FHL. Moreover, having inadequate FHL and low income increased the likelihood of having inadequate CHL.
CONCLUSION
This study has identified those with risk factors for inadequate health literacy and unfavorable health outcomes. A national action plan can guide the promotion of health literacy and its embeddedness in society to instill competencies and the environment that would eliminate health inequities and sustain health in Lebanon. Plain Language Summary: This study examined health literacy levels and correlates in 587 Lebanese adults using two recognized screening tools. The first tool measured functional health literacy (FHL), which represents the ability of a person to acquire information on health through reading or writing. The second tool assessed comprehensive health literacy (CHL), which encompasses the ability of a person to use their social skills to acquire health information from different media and make appropriate health decisions based on this information. Close to two-thirds of the participants had inadequate or problematic FHL. More specifically, low education, low socioeconomic status, and widowhood were predictive of inadequate FHL. Nearly one-half of the participants had inadequate or problematic CHL with an increased likelihood of inadequate levels in people with low FHL and low income.
Topics: Adult; Ambulatory Care Facilities; Cross-Sectional Studies; Female; Health Literacy; Health Status; Health Surveys; Humans; Male
PubMed: 34756119
DOI: 10.3928/24748307-20211012-02 -
Journal of Preventive Medicine and... Dec 2019Today mental disorders are important concerns of health care system in all countries. Among different mental disorders; depression, anxiety, and somatization are more...
INTRODUCTION
Today mental disorders are important concerns of health care system in all countries. Among different mental disorders; depression, anxiety, and somatization are more frequent. This manuscript was conducted to evaluate the frequency of somatization symptoms, its related factors and the correlation between somatization symptoms and anxiety and depression disorders in Iranian population.
METHODS
The cross-sectional study was conducted in Kerman, Iran, 2017. Participants were selected from patients who referred to the Clinics of Educational Hospitals using convenience sampling method. The PHQ-15 and HADS questionnaire were used to assess the somatization and depression and anxiety, respectively. The univariate and multivariate logistic regression was used to determine the predictive factors of somatization symptoms. The correlations between each PHQ-15 item score and anxiety and depression score were expressed.
RESULTS
The frequency of mild, moderate and severe levels of somatization was 66.3%, 20.5% and 13.1%, respectively. Considering multivariate logistic regression analysis; age was associated with somatic symptoms, significantly. The risk of somatic symptoms was 3.4 times more in Divorced/Widowed participants than single ones (p-value: 0.035). There were significant positive correlations between anxiety and depression scores. Each additional score of anxiety and depression were associated with 1.14 times more likely (p-value: < 0.001) and 1.11 times less likely (p-value: 0.003) of having somatic symptoms, respectively.
CONCLUSION
The burden of somatization, depression and anxiety is high in Iranian population. Psychologists and policy-makers should consider these predictive factors for primary prevention of somatization at the personal and community level, respectively.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anxiety; Child; Cross-Sectional Studies; Depression; Divorce; Female; Humans; Iran; Logistic Models; Male; Marital Status; Middle Aged; Multivariate Analysis; Patient Health Questionnaire; Prevalence; Risk Factors; Somatoform Disorders; Widowhood; Young Adult
PubMed: 31967099
DOI: 10.15167/2421-4248/jpmh2019.60.4.1006 -
European Journal of Psychotraumatology 2019: Narratives play a central role in the recovery process following death, and linguistic properties of grief narratives can serve as indicators of adjustment to loss....
: Narratives play a central role in the recovery process following death, and linguistic properties of grief narratives can serve as indicators of adjustment to loss. The present study examined whether bereaved men and women differ in how they discuss their loss, and how linguistic markers relate to psychological functioning. Positive associations were hypothesized between first-person singular pronoun use and psychological distress. Gender differences were expected for different emotion and social process words, and overall word use. Exploratory analyses were conducted to assess the relationship between linguistic markers and psychosocial outcomes for men and women separately. : 50 bereaved widow(er)s and parents (29 women, 21 men; = 71.16 years, = 9.95) completed psychosocial self-report questionnaires and individual in-depth interviews. Grief narratives were analysed using Linguistic Inquiry and Word Count (LIWC), a software program that quantifies words into linguistic and psychological categories. : Contrary to our hypothesis, first-person pronoun use was not related to psychological distress. Although gender differences emerged in self-reported psychosocial outcomes, we failed to find the predicted gender differences in linguistic markers (emotion and social process words, overall word count). Exploratory analyses revealed additional associations between linguistic markers and psychosocial outcomes, and gender differences in these relationships. Notably, first-person pronoun use was related to heightened grief avoidance. Furthermore, various linguistic markers were associated with increased depression levels in females, but not males. In contrast, nonfluencies were positively associated with indicators of psychological distress in men only. : In line with the gender similarities hypothesis, analyses suggest similarities between men and women's discussion of their grief experience. Associations between linguistic markers and psychological adjustment indicate that grief narratives contain meaningful indices of underlying health.
PubMed: 31807234
DOI: 10.1080/20008198.2019.1688130