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The protective effect of marriage on mortality in a dynamic society
Dena H Jaffe1, Orly Manor, Zvi Eisenbach
1Braun School of Public Health and Community Medicine, Hebrew University - Hadassah, Jerusalem, Israel. denaj@ekmd.huji.ac.il
Purpose:
We sought to assess whether the protective effect of marriage on overall and cause-specific mortality has changed over time in a dynamic society.
Methods:
Data from the census-based Israel Longitudinal Studies (ILMS) I (1983-1992) and II (1995-2004) were analyzed. Cox proportional hazard modeling adjusting for sociodemographic factors was applied to 152,150 and 209,125 individuals, ages 45-89 years from the ILMS I and II, respectively. During each study period 31,749 (ILMS I) and 37,656 (ILMS II) deaths were reported.
Results:
Mortality inequalities by marital status remained significant and widened over time for middle-aged and elderly men and women. Changes in cause-specific mortality indicated a widening of cardiovascular disease mortality inequalities by marital status. An increasing trend was also noted for deaths from cancer (+25%) and other causes (+38%, p < 0.05) in middle-aged men, but not women (cancer = 0%; other causes = -3%).
Conclusions:
The stronger beneficial effect of marriage over time may reflect societal changes that have differentially affected men and women.
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