Do divorce and widowhood increase mortality risk? A 35-year longitudinal cohort study in a Norwegian population: the...

Social relationships are known to influence health outcomes. Getting divorced or widowed may lead to social disconnection, which has been associated with increased mortality.Whether these events independently influence mortality risk-beyond health behaviours, self-rated health and loneliness-remains insufficiently understood. We examined whether divorce or widowhood is associated with increased mortality after accounting for these factors.

We used data from the Trøndelag Health Study (HUNT), a population-based cohort spanning four waves (1984-2019). Three sub-populations were created by identifying participants who reported being married or cohabiting at baseline (T1) in HUNT1, HUNT2 and HUNT3 and who also participated in the subsequent wave (T2: HUNT2, HUNT3, HUNT4), yielding N=28 912, N=22 780 and N=19 864 participants, respectively. At T2, cohabitation status was reclassified as married/cohabiting, divorced/cohabitation breakup or widowed. Mortality data were obtained from the Norwegian Cause of Death Registry through January 2020. Mortality risks were estimated using proportional hazards models adjusted for age, sex, health behaviours, self-rated health and loneliness.

Divorce/cohabitation breakup was consistently associated with higher mortality in the sub-populations from all three periods, with fully adjusted HRs ranging from 1.21 to 1.91. Widowhood was associated with higher mortality only in the first observation period (HR 1.14, 95% CI 1.07 to 1.21). Interaction analyses showed that for the second period, the mortality effect of breakup was higher and statistically significant only in women, while no other sex interactions were statistically significant.

Divorce/breakup and widowhood are associated with increased mortality risk, most consistent for the divorced and independent of other health-related factors. The findings underscore the importance of addressing social disconnection in public health strategies. Interventions aimed at strengthening social bonds may mitigate the adverse health effects of relational loss.