Changes in depressive symptoms associated with spousal loss in six country context

This exploratory study examines changes in depressive symptoms following spousal loss relative to remaining married across countries, whether these associations vary by national context and gender, and the extent to which selection into widowhood accounts for cross-national differences.

This study uses data from the Health and Retirement Study international family of studies and evaluates change in depressive symptoms across six country contexts: United States, England, Mexico, China, and two combinations of European Union countries categorized by welfare state: Conservative and Social/Democratic. We evaluated change in depressive symptoms among individuals who were married at Wave 1 (2015/2016 depending on country) and at Wave 2 (2018) when some remained married while others reported a spousal loss. The analytic sample included adults aged 60 years and older (Wave 1 mean age = 69.13 years, SD = 6.78).

Using ordinary least squares regression and propensity score methods to account for selection into widowhood, results suggest that the experience of widowhood is generally similar across country contexts, with widows experiencing, on average, about 0.5 SDs increase in depressive symptoms (marginal effect = 0.53, p < .001; propensity adjusted score = 0.56, p < .001), a likely clinically relevant increase, accounting for selection. These effects were roughly the same for men and women in all country contexts.

Future research is needed to identify factors that may buffer the consequences of widowhood and explore cross-national interventions that may help reduce these effects.