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Marital status, labour force activity and mortality: a study in the USA and six European countries.

ABSTRACT: Labour force activity and marriage share some pathways through which they potentially influence health. In this paper, we examine whether marriage and labour force participation interact in the way they influence mortality in the USA and six European countries.We used data from the US National Health Interview Survey linked to the National Death Index, and national mortality registry data for Austria, England/Wales, Finland, Hungary, Norway and Spain (specifically, the Basque country) during 1999-2007, for men and women aged 30-59 years at baseline. We used Poisson regression to estimate both the additive (relative excess risk due to interaction) and multiplicative interactions between marriage and labour force activity on mortality.Labour force inactivity was associated with higher mortality, but this association was stronger for unmarried, rather than married, individuals. Likewise, being unmarried was associated with higher mortality, but this association was stronger for inactive than for active individuals. To illustrate, among US women out of the labour force, being unmarried was associated with a 3.98 times (95%CI 3.28-4.82) higher risk of dying than being married; whereas the relative risk (RR) was 2.49 (95%CI 2.10-2.94), for women who were active in the labour market. Although this interaction between marriage and labour force activity was only significant for women on a multiplicative scale, there was a significant additive interaction for both men and women. The pattern was similar across all countries.Marriage attenuated the increased mortality risk associated with labour force inactivity; while labour force activity attenuated the mortality risk associated with being unmarried. Our study emphasizes the importance of public health and social policies that improve the health and well-being of unmarried and inactive men and women.

SUBMITTER: Van Hedel K

PROVIDER: S-EPMC4673396 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Marital status, labour force activity and mortality: a study in the USA and six European countries.

Van Hedel Karen K Van Lenthe Frank J FJ Avendano Mauricio M Bopp Matthias M Esnaola Santiago S Kovács Katalin K Martikainen Pekka P Regidor Enrique E Mackenbach Johan P JP

Scandinavian journal of public health 20150413 5

<h4>Aims</h4>Labour force activity and marriage share some pathways through which they potentially influence health. In this paper, we examine whether marriage and labour force participation interact in the way they influence mortality in the USA and six European countries.<h4>Methods</h4>We used data from the US National Health Interview Survey linked to the National Death Index, and national mortality registry data for Austria, England/Wales, Finland, Hungary, Norway and Spain (specifically, t ...[more]

PMID: 25868643

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Project description:ImportanceMarital status has been shown to be associated with mortality, but evidence in Asian populations is limited.ObjectiveTo examine the association of marital status with total and cause-specific mortality.Design, setting, and participantsThis 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.ExposuresMarital status.Main outcomes and measuresAll-cause and cause-specific mortality.ResultsOf 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 relevanceThis 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.

Project description:ObjectivesWe analysed the information on current national physical activity recommendations in all EU Member States provided by governments in a joint EU/WHO survey on the implementation status of the EU Council Recommendation on Health-Enhancing Physical Activity across Sectors.DesignCross-sectional survey.ParticipantsThe representatives of the 28 EU Member State governments to the EU Physical Activity Focal Point Network.Outcome measuresNational recommendations on: (A) minimum frequency, duration, intensity and lengths of bouts of physical activity, (B) preventing inactivity or sedentary behaviour and (C) further recommendations for additional health benefits, obesity prevention and specific types of activity.ResultsAn official document could be located for 23 of the 28 EU Member States, while four are currently developing recommendations. For children and adolescents, most countries follow the 2010 WHO Global Recommendations for Physical Activity, but there are notable differences in the delimitation of age groups. 14 countries also followed WHO in their recommendations for adults, and 11 countries have additional advice on avoiding inactivity and sitting among adults. 18 Member States have recommendations for older adults, 12 of which follow WHO. Thirteen countries also address at least one special population (eg, pregnant women, people with disabilities and people with chronic diseases), but the level of detail varies substantially between countries.ConclusionsThe large majority of EU Member States either has physical activity recommendations in place or is in the process of developing them. There is a general tendency to use the WHO Global Recommendations as a basis, with the greatest variation observable for children and adolescents. Comparing results with a previous round of data collection shows that the number of EU countries with physical activity recommendations is increasing and that both special groups and sedentary behaviour have become more important in recent years.

Dataset Information

Marital status, labour force activity and mortality: a study in the USA and six European countries.

Publications

Marital status, labour force activity and mortality: a study in the USA and six European countries.

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