AI Article Synopsis

  • The study investigates how marital status affects overall and specific types of mortality rates in Asian populations by analyzing data from 16 studies in the Asia Cohort Consortium from 1963 to 2015.
  • The findings indicate that unmarried individuals have a higher risk of death compared to married individuals, with significant hazards for total mortality and specific causes like cardiovascular diseases and cancer.
  • Results show that being single, separated, divorced, or widowed is linked to an increased mortality risk, particularly among men and younger individuals under 65.

Article Abstract

Importance: Marital status has been shown to be associated with mortality, but evidence in Asian populations is limited.

Objective: To examine the association of marital status with total and cause-specific mortality.

Design, Setting, And Participants: This cohort study included individual participant data from 16 prospective studies in the Asia Cohort Consortium conducted between 1963 and 2015. Asian participants with complete information on marital and vital status were included. Study-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards model and then pooled using a random-effects meta-analysis. The analysis began in February 2021 and ended in August 2021.

Exposures: Marital status.

Main Outcomes And Measures: All-cause and cause-specific mortality.

Results: Of 623 140 participants (326 397 women [52.4%] and 296 743 men [47.6%]; mean [SD] age, 53.7 [10.2] years; mean [SD] follow-up time, 15.5 [6.1] years), 123 264 deaths were ascertained. Compared with married individuals, those who were unmarried had pooled HRs of 1.15 (95% CI, 1.07-1.24) for total mortality, 1.12 (95% CI, 1.03-1.22) for cerebrovascular disease mortality, 1.20 (95% CI, 1.09-1.31) for coronary heart disease mortality, 1.17 (95% CI, 1.07-1.28) for circulatory system diseases mortality, 1.06 (95% CI, 1.01-1.11) for cancer mortality, 1.14 (95% CI, 1.05-1.23) for respiratory diseases mortality, and 1.19 (95% CI, 1.05-1.34) for external causes of death. Positive associations with total mortality were also observed for those who were single (HR, 1.62; 95% CI, 1.41-1.86), separated (HR, 1.35; 95% CI, 1.13-1.61), divorced (HR, 1.38; 95% CI, 1.13-1.69), and widowed (HR, 1.09; 95% CI, 1.04-1.13). In subgroup analyses, the positive association persisted across baseline health conditions, and the risk of death was more pronounced among men or people younger than 65 years.

Conclusions And Relevance: This large pooled cohort study of individual participant data provides strong evidence that being unmarried, as well as belonging to the unmarried subcategories, was positively associated with total and cause-specific mortality. Investment of targeted social support services might need to be considered in light of the mortality differences between married and unmarried individuals.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157263PMC
http://dx.doi.org/10.1001/jamanetworkopen.2022.14181DOI Listing

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