Increased risk of death immediately after losing a spouse: Cause-specific mortality following widowhood in Norway.

PubMed

Brenn, Tormod; Ytterstad, Elinor

2016-08-01

This paper examines the short-term risk of cause-specific death following widowhood. We followed all individuals registered as married in Norway in 1975 for marital status and mortality until 2006. Widowed individuals were followed for mortality for 7years following widowhood. Causes of death were categorized into five cause-groups. Life tables were used in survival analyses. Deaths among the widowed were most frequent in the week following widowhood. In this week and compared to married individuals, there were more deaths including those from malignant cancer in men (hazard ratio (HR) of 1.51; 95% CI: 1.12, 1.89), from external causes in men (HR=3.64; 95% CI: 2.01, 5.28), and from respiratory diseases (HR=2.18; 95% CI: 1.52, 2.84 in men and HR=3.18; 95% CI: 2.26, 4.09 in women). A majority of respiratory deaths were from pneumonia. Thereafter excess mortality among the widowed dropped gradually. Although these numbers stabilized, they were still elevated in year 7. Excess mortality was particularly high in the youngest age group considered (55-64years) and decreased with age, though more so in men than in women. Only a few more widowed individuals than expected died of a condition in the same cause-group as their spouses. A novel finding was that excess deaths in the week following widowhood also were from cancer and respiratory diseases. Men in the youngest age group seemed most vulnerable. Prevention should be considered directly after the death of a spouse, and measures should be aimed at virtually all causes of death. Copyright © 2016 Elsevier Inc. All rights reserved.

Widowhood, sex, labor force participation, and the use of physician services by elderly adults.

PubMed

Homan, S M; Haddock, C C; Winner, C A; Coe, R M; Wolinsky, F D

1986-11-01

This paper investigated the relationships of widowhood, sex, and labor force participation with the use of ambulatory physician services by elderly adults. Data on 18,441 individuals aged 55 and over were taken from the 1978 Health Interview Survey. Hierarchical regression results indicated that although these three factors are related to physician utilization at the zero- and first-partial levels, only sex remained significant when their two- and three-way interactions and other variables from the behavioral model (including living arrangements) were introduced. This suggests that the effects of widowhood and labor force participation are spurious. Widows are simply more likely to live alone and are less likely to work than widowers; those who live alone and do not work are more likely to use health services (and more of them) than those who live with others and are gainfully employed.

The Effect of Widowhood on Husbands’ and Wives’ Physical Activity: The Cardiovascular Health Study

PubMed Central

Stahl, Sarah T.; Schulz, Richard

2013-01-01

This prospective study examined the effect of widowhood on physical activity by comparing widowed elders to health status-, age-, and sex-matched married controls. Participants included 396 married controls and 396 widows/widowers age 64 to 91 (M age = 72.7 years) who experienced the death of their spouse while participating in the Cardiovascular Health Study (CHS). Compared to married controls, widowed men, but not women, were more likely to increase their physical activity following the death of their spouse. However, this increased level of activity was not sustained and declines as time since spousal death passes. Moreover, during the year before spousal death, soon-to-be widowed men, but not women, increase their physical activity. Our results suggest that widowed men experience significant changes in physical activity and that the transition to widowhood contribute to these changes. PMID:23975417

[Widows of victims of Nazi concentration camps: their pathology].

PubMed

Ryn, Z J

1992-09-01

The psychosocial situation of widows and orphans of victims of the Nazi concentration camps in Poland are presented. In 1984, 74 widows of victims from the Auschwitz-Birkenau camp were interviewed. This article describes widows' emotional-behavioral reactions when facing the imprisonment and death of their husbands, their difficulties in adapting themselves to widowhood, different adaptative forms of memories of their married life, and consequences relevant to widows' mental health and family, and social consequences of widowhood.

Widowhood and severity of coronary artery disease: a multicenter study.

PubMed

Daoulah, Amin; Alama, Mohamed N; Elkhateeb, Osama E; Al-Murayeh, Mushabab; Al-Kaabi, Salem; Al-Faifi, Salem M; Alosaimi, Hind M; Lotfi, Amir; Asiri, Khalid S; Elimam, Ahmed M; Abougalambo, Ayman S; Murad, Waheed; Haddara, Mamdouh M; Dixon, Ciaran M; Alsheikh-Ali, Alawi A

2017-03-01

The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status. A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the United Arab Emirates were included in the study. CAD was defined as more than 70% lumen stenosis in a major epicardial vessel or more than 50% in the left main coronary artery. Multivessel disease was defined as more than one diseased vessel. Of 1068 patients, 65 (6%) were widowed. Widowed patients were older (65±15 vs. 59±12), more likely to be female (75 vs. 25%), less likely to be smokers (18 vs. 47%), of lower economic and education status, and more likely to have undergone coronary angiography for urgent/emergent indications (75 vs. 61%) (P<0.05 for all). There was a significant association between widowhood and the number of coronary arteries with more than 70% lumen stenosis. Consequently, such a high degree of lumen stenosis in those who were widowed was more likely to require coronary artery bypass graft surgery (38 vs. 16%; P<0.01). After adjusting for baseline differences, widowhood was associated with a significantly higher odds of CAD [adjusted odds ratio (OR) 3.6; 95% confidence interval (CI) 1.2-10.5] and multivessel disease (adjusted OR 4.6; 95% CI 2.2-9.6), but not left main disease (adjusted OR 1.3; 95% CI 0.5-3.1). All associations were consistent in men and women and not modified by age, community setting (urban vs. rural), employment, income, or educational levels (Pinteraction>0.1 for all). Widowhood is associated with the severity and extent of CAD. The association is not modified by sex or socioeconomic status.

Complex marital histories and economic well-being: the continuing legacy of divorce and widowhood as the HRS cohort approaches retirement.

PubMed

Holden, K C; Kuo, H H

1996-06-01

We use data from the first wave of the Health and Retirement Survey (HRS) to examine the marital histories of this cohort of women and men on the verge of retirement. The legacy of past increases in divorce rates is evident in the complex marital histories of HRS households and the relationship between those histories and current economic status. Couples in a first marriage now make up only one-quarter of black households and fewer than half of all white and Hispanic households. In over one-third of all married-couple households, at least one spouse had a previous marriage that ended in divorce or widowhood. These couples have significantly lower incomes and assets than couples in first marriages. Contrary to the popular notion that private and public insurance better provide for the security of widows than divorced persons, currently widowed households and couples in which the prior marriage of one spouse had ended in widowhood are no better off than are their divorced peers. This holds true for both black and white households. From a single cross-section, one cannot tell what caused these differences in income and wealth across marital status groups although it is clear that women and blacks spend a higher percentage of their lifetime outside of marriage than do men and whites. We also speculate from estimates of widowhood expectations for a subset of married respondents that underestimating the chances of widowhood--because both men and women overestimate their chances of joint survival--may be a factor in the relatively low economic status of widows. Because couples in life-long marriages have been the traditional standard upon which marital property reform and the survivorship rules of private and public programs are based, their diminishing importance among all households raises concern about the protection provided by these institutions against the long-term economic consequences of past and future marital dissolution.

In Sickness and in Health? Physical Illness as a Risk Factor for Marital Dissolution in Later Life

PubMed Central

Karraker, Amelia; Latham, Kenzie

2016-01-01

The health consequences of marital dissolution are well-known, but little work has examined the impact of health on the risk of marital dissolution. In this study we use a sample of 2,701 marriages from the Health and Retirement Study (HRS; 1992–2010) to examine the role of serious physical illness onset (i.e., cancer, heart problems, lung disease, and/or stroke) in subsequent marital dissolution due to either divorce or widowhood. We use a series of discrete-time event history models with competing risks to estimate the impact of husband’s and wife’s physical illness onset on risk of divorce and widowhood. We find that only wife’s illness onset is associated with elevated risk of divorce, while either husband’s or wife’s illness onset is associated with elevated risk of widowhood. These findings suggest the importance of health as a determinant of marital dissolution in later life via both biological and gendered social pathways. PMID:26315504

In Sickness and in Health? Physical Illness as a Risk Factor for Marital Dissolution in Later Life.

PubMed

Karraker, Amelia; Latham, Kenzie

2015-09-01

The health consequences of marital dissolution are well known, but little work has examined the impact of health on the risk of marital dissolution. We use a sample of 2,701 marriages from the Health and Retirement Study to examine the role of serious physical illness onset in subsequent marital dissolution via either divorce or widowhood. We use a series of discrete time event history models with competing risks to estimate the impact of husband's and wife's physical illness onset on risk of divorce and widowhood. We find that only measures of wife's illness onset are associated with elevated risk of divorce, while measures of either spouse's illness onset is associated with elevated risk of widowhood. Further, in the case of heart problems, we find that this gender difference is statistically significant. These findings suggest health as a determinant of marital dissolution in later life via both biological and gendered social pathways. © American Sociological Association 2015.

Marital status, family ties, and self-rated health among elders in South India.

PubMed

Sudha, S; Suchindran, Chirayath; Mutran, Elizabeth J; Rajan, S Irudaya; Sarma, P Sankara

2006-01-01

This article examines the impact of familial social support ties (indicated by marital status, kin availability, sources of economic support, and frequency and quality of emotional interaction) on subjective health perception among a sample of elderly men and women aged 60 and older in South India. We used 1993 survey data from three states of South India: Kerala, Tamil Nadu, and Karnataka. We hypothesized that (a) widowhood would be associated with poorer self-rated health, (b) number of kin ties would be positively associated with self-rated health, (c) economic and emotional support from kin would improve outcomes, and (d) these associations would be stronger among women than among men. Results of logistic regression techniques supported the first hypothesis and partially supported the third. With regard to the second hypothesis, the presence of specific kin rather than the number of each type of family member was important. For the fourth hypothesis, results suggest that men and women in this sample have broadly similar associations between widowhood and self-rated health. For women however, controlling for socioeconomic status did not weaken the association between widowhood and self-rated health, suggesting the symbolic/cultural importance of this status. In general, these findings suggest that theories on the importance of marital status and kin ties for older adults' self-rated health, which were developed and tested in Western societies, need to be refined for Asian societies, where the nature of marriage and widowhood are different.

Men's vulnerability--women's resilience: from widowhood to late-life repartnering.

PubMed

Koren, Chaya

2016-05-01

The ongoing increase in life expectancy resulting in people living longer after the death of a lifelong spouse along with the stresses of widowhood is likely to increase the phenomenon of repartnering in old age. The aim of this article is to learn about the attributed meanings of late-life repartnering among older repartnered widows and widowers dealing with widowhood. The experiences of 27 couples (54 participants), in which both partners were widowed, were chosen from two larger studies on late-life repartnering: one took a dyadic perspective (interviewing both partners), and the other took an intergenerational approach (interviewing both partners and offspring). Criterion sampling in both studies used the criteria of widowers who repartnered above age 65 and widows above age 60, remarried or not, living separately, or under the same roof, and who had children and grandchildren from a lifelong marriage that had ended with the death of their spouse. All semi-structured interviews were recorded, transcribed verbatim, and analyzed based on grounded theory principles and dyadic analysis adapted to families. Present a grounded model indicating gender differences in dealing with the death of a lifelong spouse. Men tended to experience vulnerability whereas women tended to experience resilience. These findings make an innovative contribution by showing the reversal of gender inequality in old age, and gender differences between widows' and widowers' coping with widowhood, even though both repartnered. They are discussed in light of (critical) feminist gerontology including contribution to theory development and implications for practice.

Interdependence between the Social and Material Convoy: Links between Volunteering, Widowhood, and Housing Transitions

PubMed Central

Shen, Huei-Wern; Perry, Tam

2016-01-01

Relocation in older adulthood may occur due to triggering events, such as widowhood. Guided by Kahn and Antonucci’s convoy model, this study explores the influence of volunteering on decision to relocate following the death of a spouse. Using three waves of data from the Health and Retirement Study (2006, 2008, and 2010), 5,146 community-dwelling married older individuals who were 65 years or older in 2008 were included. Findings from two multinomial logistic regression models showed that widows and widowers who were not volunteering in 2008 were more likely to move out of area in 2010 than their married counterparts, whereas the relationship between widowhood and relocation was not detected among those involved in volunteering. This article emphasizes the interdependency of social relationships and residences, a fundamental of one’s material convoy, for older adults. Volunteering experiences may not only affect instrumental and emotional support after the loss of a key anchor in one’s social convoy, but may also facilitate a widowed older adult to age in place rather than relocate. PMID:27257361

Widowhood in old age: Viewed in a family context☆

PubMed Central

Moss, Miriam S.; Moss, Sidney Z.

2014-01-01

Researchers and clinicians have traditionally explored widowhood as an intrapersonal process. We expand the paradigm of bereavement research to explore the widow's perceptions of her experience within a family context. In a study of family bereavement, 24 widows each participated in 2 separate qualitative interviews, followed by standard qualitative analyses of the transcribed narratives. Three inter-related central topics emerged. (1) Widows stress the importance of their independence vis a vis their family as central to their sense of identity. (2) Widows perceive that they and their adult children avoid expressing their feelings of sadness and loss with each other. (3) Widows believe that their children are unable to understand the meaning of the widows' loss because of differences in generations and life situations. Two inter-woven underlying themes emerged: protection of self and of other, and boundaries between widow and children. Just as protection is rooted in a dynamic of separation between widow and child, boundaries are rooted in their deep bond. When researchers and clinicians recognize the dynamics of these two themes they can potentially increase understanding of widowhood within the context of the family. PMID:24655677

The Effect of Widowhood on Mental Health - an Analysis of Anticipation Patterns Surrounding the Death of a Spouse.

PubMed

Siflinger, Bettina

2017-12-01

This study explores the effects of widowhood on mental health by taking into account the anticipation and adaptation to the partner's death. The empirical analysis uses representative panel data from the USA that are linked to administrative death records of the National Death Index. I estimate static and dynamic specifications of the panel probit model in which unobserved heterogeneity is modeled with correlated random effects. I find strong anticipation effects of the partner's death on the probability of depression, implying that the partner's death event cannot be assumed to be exogenous in econometric models. In the absence of any anticipation effects, the partner's death has long-lasting mental health consequences, leading to a significantly slower adaptation to widowhood. The results suggest that both anticipation effects and adaptation effects can be attributed to a caregiver burden and to the cause of death. The findings of this study have important implications for designing adequate social policies for the elderly US population that alleviate the negative consequences of bereavement. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

New partnerships in widowhood in Spain: Realities and desires.

PubMed

Ayuso, Luis

2018-04-27

Widowhood has traditionally been associated with the end of the family cycle; however, social and generational transformations in Spain are providing a new context for the development of new partnerships in widowhood. This study analyzes widowed persons who have found new partners and those who would be willing to do so, focusing on their characteristics and motives and related sociodemographic factors. Research is based on a sample of 306 widows and widowers in Spain taken from the survey Social Networks and Well-Being. The results reveal the importance of sociodemographic factors for both those who wish to have a partner as well as for those who have one. For the former, elements associated with quality of life are very important, while among those with a new partner, the key is not having an extensive family support network. The principal motives for looking for a new relationship are related to enjoying life more and not feeling alone; while those who reject a new relationship do so because of the belief that their lost partner is irreplaceable.

Daily emotional and physical reactivity to stressors among widowed and married older adults.

PubMed

Hahn, Elizabeth A; Cichy, Kelly E; Small, Brent J; Almeida, David M

2014-01-01

Widowhood may result in declines in health and potentially stressful changes to daily routines. However, little research has examined how daily stressors contribute to physical and emotional well-being in widowhood. The objectives of the current study were to examine daily stressor exposure and reactivity in widowed versus married older adults. Participants included all 100 widowed and 342 married adults aged 65 and older from the National Study of Daily Experiences, a daily diary study from the second wave of the Midlife in the United States. Daily stressors were measured using the Daily Inventory of Stressful Events; multilevel modeling assessed daily reactivity to stressors using daily negative affect (emotional reactivity) and daily physical symptoms (physical reactivity) as outcomes. Married participants reported more stressors in general, and specifically more interpersonal stressors (e.g., arguments). Both married and widowed participants were reactive to daily stressors. Married participants were physically and emotionally reactive to interpersonal stressors. Widowed participants were more physically reactive to home-related stressors. Attention to the types of daily stressors that widowed older adults experience in daily life and the potential physical effects of daily stressors during widowhood may help to alleviate some of the physical distress that widowed older adults may experience.

Associations Between Divorce and Onset of Drug Abuse in a Swedish National Sample.

PubMed

Edwards, Alexis C; Larsson Lönn, Sara; Sundquist, Jan; Kendler, Kenneth S; Sundquist, Kristina

2018-05-01

Rates of drug abuse are higher among divorced individuals than among those who are married, but it is not clear whether divorce itself is a risk factor for drug abuse or whether the observed association is confounded by other factors. We examined the association between divorce and onset of drug abuse in a population-based Swedish cohort born during 1965-1975 (n = 651,092) using Cox proportional hazards methods, with marital status as a time-varying covariate. Potential confounders (e.g., demographics, adolescent deviance, and family history of drug abuse) were included as covariates. Parallel analyses were conducted for widowhood and drug-abuse onset. In models with adjustments, divorce was associated with a substantial increase in risk of drug-abuse onset in both sexes (hazard ratios > 5). Co-relative analyses (among biological relatives) were consistent with a partially causal role of divorce on drug-abuse onset. Widowhood also increased risk of drug-abuse onset, although to a lesser extent. Divorce is a potent risk factor for onset of drug abuse, even after adjusting for deviant behavior in adolescence and family history of drug abuse. The somewhat less-pronounced association with widowhood, particularly among men, suggests that the magnitude of association between divorce and drug abuse may not be generalizable to the end of a relationship.

Daily Emotional and Physical Reactivity to Stressors Among Widowed and Married Older Adults

PubMed Central

2014-01-01

Objectives. Widowhood may result in declines in health and potentially stressful changes to daily routines. However, little research has examined how daily stressors contribute to physical and emotional well-being in widowhood. The objectives of the current study were to examine daily stressor exposure and reactivity in widowed versus married older adults. Method. Participants included all 100 widowed and 342 married adults aged 65 and older from the National Study of Daily Experiences, a daily diary study from the second wave of the Midlife in the United States. Daily stressors were measured using the Daily Inventory of Stressful Events; multilevel modeling assessed daily reactivity to stressors using daily negative affect (emotional reactivity) and daily physical symptoms (physical reactivity) as outcomes. Results. Married participants reported more stressors in general, and specifically more interpersonal stressors (e.g., arguments). Both married and widowed participants were reactive to daily stressors. Married participants were physically and emotionally reactive to interpersonal stressors. Widowed participants were more physically reactive to home-related stressors. Discussion. Attention to the types of daily stressors that widowed older adults experience in daily life and the potential physical effects of daily stressors during widowhood may help to alleviate some of the physical distress that widowed older adults may experience. PMID:23685921

Reduction in leisure activity and well-being during the transition to widowhood.

PubMed

Janke, Megan C; Nimrod, Galit; Kleiber, Douglas A

2008-01-01

There is relatively little evidence available about how leisure involvement changes with the death of a spouse and even less about how leisure activity is associated with the health and well-being of widows during this transition. Using data from the Americans Changing Lives (ACL) dataset, this study of 154 widows investigated change in leisure involvement during the transition to widowhood and examined the relationship between leisure activity reduction and widows' well-being. Results indicated a majority of widows reduced their involvement in leisure activity. Path models revealed that depressive symptoms and recovery from spousal loss were predictors of activity reduction, providing more support for the causal relationship of well-being influencing activity involvement than for activity influencing well-being.

A comparison of widowhood and well-being among older Greek and British-Australian migrant women.

PubMed

Panagiotopoulos, Georgia; Walker, Ruth; Luszcz, Mary

2013-12-01

The impact of widowhood on well-being has been well-documented, but to date has not focused extensively on the experience of older migrants who have aged in a foreign land. This study aimed to examine the well-being of older migrant widows from two groups in South Australia: British-born (n=61) and Greek-born (n=60) Australian migrants, who had been widowed, on average, 13 years. All participants completed a self-report questionnaire in their preferred language. Three indicators of current well-being (self-rated health, depression and loneliness) as well as variables expected to differ cross-culturally, and potentially influence well-being (mourning rituals; continuing bonds to one's spouse; religiosity; social support) were measured. Greek-born widows displayed higher levels of mourning rituals, continuing bonds and religiosity than the British. Both groups perceived similarly high levels of familial social support. Greek widows also reported worse self-rated health, and increased symptoms of depression and loneliness compared to the British. This paper suggests that the detrimental impact of widowhood on well-being may be greater for non-English speaking migrants who are ageing outside of their country of origin, and who, despite residing in an English-speaking host country for several decades, have retained the linguistic, cultural and religious practices and traditions of their home country. © 2013.

Does widowhood affect memory performance of older persons?

PubMed

Aartsen, Marja J; Van Tilburg, Theo; Smits, Carolien H M; Comijs, Hannie C; Knipscheer, Kees C P M

2005-02-01

The loss of a spouse has been found to have a negative effect on physical and mental health and leads to increased mortality. Whether conjugal bereavement also affects memory functioning has largely been unexamined. The present study investigates the effect of widowhood on memory functioning in older persons. The sample consisted of 474 married women and 690 married men aged 60-85 years in 1992, followed up in 1995 and 1998. During the study 135 (28%) of the women and 69 (10%) of the men lost their spouse. Linear regression analysis was used to examine whether widowed men and women differed from those who had not been widowed in rate of memory change over 6 years. Cross-domain latent-change models were subsequently used to evaluate the extent to which changes in memory are related to changes in other domains of functioning that may be affected by widowhood. Older adults who lost a spouse during follow-up showed a greater decline in memory over 6 years than those who remained married. A higher level of depressive symptoms at baseline was related to lower levels of memory functioning and a greater decline. Memory decline was unrelated to changes in depressive symptoms and physical health. Loss of the spouse is related to a greater decline in memory in older adults. The absence of an association with physical functioning and the weak association with mental functioning suggest that losing a spouse has an independent effect on memory functioning.

Ethno-cultural diversity in the experience of widowhood in later life: Chinese widows in Canada.

PubMed

Martin-Matthews, Anne; Tong, Catherine E; Rosenthal, Carolyn J; McDonald, Lynn

2013-12-01

This paper utilizes Helena Znaniecka Lopata's concept of life frameworks as a lens through which to understand the experience of widowhood amongst elderly Chinese immigrant women living in Toronto, Canada. While Lopata defined life frameworks as including social supports, social relations and social roles, for these widows, personal resources (framed in Chinese cultural context) were also important aspects of life frameworks. In-depth interviews with 20 widows contacted through a Chinese community center were conducted in Mandarin and Cantonese and then transcribed and interpreted through team-based qualitative analyses. These women ranged in age from 69 to 93 years and had been in Canada an average of 17 years, with over half of them widowed following immigration. Our analysis framed the widows' narratives in terms of four types of supports defined by Lopata: social, service, financial and emotional supports. They had fairly extensive social and service supports focused primarily around family and the Chinese community. Although norms of filial piety traditionally dictate sons as primary supports, daughters predominated as providers of supports to these widows. Interpreted from a life course perspective, financial supports were deemed sufficient, despite overall limited financial means. Emotional support was more nuanced and complex for these widows. Loneliness and feelings of social isolation were prevalent. Nevertheless, themes of acceptance and satisfaction dominated our findings, as did reciprocity and exchange. The narrative accounts of these widows depict a complexity of experience rooted in their biographies as Chinese women and as immigrants, rather than primarily in widowhood itself. © 2013.

Who needs a friend? Marital status transitions and physical health outcomes in later life.

PubMed

Bookwala, Jamila; Marshall, Kirsten I; Manning, Suzanne W

2014-06-01

This study assessed the moderating role of 2 types of confidante relationships in mitigating the negative health impact of transitions involving spousal loss in late life (widowhood and divorce/separation). The sample included 707 respondents who participated in the 1992 and 2004 waves of the Wisconsin Longitudinal Study (WLS, 2007) all of whom were married at Time 1 and by Time 2 experienced either an end of the marriage resulting from widowhood or divorce/separation or remained continuously married to the same spouse. The majority of the sample was female (n = 457) and 64.3 years old on average. Three indicators of physical health were examined, including somatic depressive symptomatology, self-rated health, and number of sick days in the preceding year. Moderated regression analyses showed that the availability of a friend as confidante at Time 2 played a significant moderating role in the link between marital transitions and health outcomes, buffering the health impact of widowhood. Specifically, among those who became widowed between the 2 waves, those who had available a friend as confidante at Time 2 reported significantly lower somatic depressive symptoms, better self-rated health, and fewer sick days in bed during the preceding year than those who reported not having a friend as confidante. No support was obtained for the moderating role of having a family member as confidante at Time 2 in the link from marital transitions to health. These results highlight the need to develop means to maintain and enhance confiding friendships among widowed older adults. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Physical activity to overcome the adversity of widowhood: Benefits beyond physical health.

PubMed

Li, Chu-Shiu; Lee, June Han; Chang, Ly-Yun; Liu, Chwen-Chi; Chan, Yan-Lan; Wen, Christopher; Chiu, Mu-Lin; Tsai, Min Kuang; Tsai, Shan Pou; Wai, Jackson Pui Man; Tsao, Chwen Keng; Wu, Xifeng; Wen, Chi Pang

2016-08-01

Widowhood has been increasingly encountered because of increasing longevity of women, often characterized by social stigmatization and poor physical and mental health. However, applied research to overcome its adversity has been quite limited. The goal of this study is to explore the role of physical activity in improving the health of widows.A cohort of 446,582 adults in Taiwan who successively participated in a comprehensive medical screening program starting in 1994, including 232,788 women, was followed up for mortality until 2008. Each individual provided detailed health history, and extensive lab tests results.The number of widows increased with time trend. Every other woman above age 65 was a widow (44%). Widows were less active, more obese, and smoked and drank more, had sleep problems, were more depressed with taking sedatives or psychoactive drugs, leading to more suicides. In the global development of health policies by World Health Organization (WHO), physical activity is one of the main factors to reverse poor health. The poor health of inactive widow was mitigated when becoming fully active in this study. Exercise not only reduced the observed 18% increase in all-cause mortality, but also gained 4 years and as much as 14% mortality advantage over the married but inactive. More importantly, becoming physically active energized their mental status, improved sleep quality and quantity, reduced depressions and the need for psychoactive drugs, and increased socialization circles.Widows, a rapidly growing and socially stigmatized group, suffered from social and financial inequality and tended to develop poorer health. Sustained physical activity could be one of the ways for them to overcome and reverse some of the physical and mental adversities of widowhood, and improve their quality and quantity of life.

Divorce and the Onset of Alcohol Use Disorders: A Swedish Population-Based Longitudinal Cohort and Co-Relative Study

PubMed Central

Kendler, Kenneth S.; Larsson Lönn, Sara; Salvatore, Jessica; Sundquist, Jan; Sundquist, Kristina

2017-01-01

Objective To clarify the magnitude and nature of the relationship between divorce and risk for alcohol use disorder (AUD). Method In a population-based Swedish sample of married individuals (n=942,366), we examined the association between divorce or widowhood and risk for first registration for AUD. AUD was assessed using medical, criminal and pharmacy registries. Results Divorce was strongly associated with risk for first AUD onset in both men (HR=5.98, 95% CI, 5.65–6.33) and women (HR=7.29, 6.72–7.91). We estimated the HR for AUD onset given divorce in discordant monozygotic twins to equal 3.45 and 3.62 in men and women, respectively. Divorce was also associated with an AUD recurrence in those with AUD registrations before marriage. Furthermore, widowhood increased risk for AUD in men (HR=3.85, 2.81–5.28) and women (HR=4.10, 2.98–5.64). Among divorced individuals, remarriage was associated with a large decline in AUD in both sexes: males 0.56, 0.62–0.64 and females 0.61, 0.55–0.69. Divorce produced a greater increase in first AUD onset in those with a family history of AUD or with prior externalizing behaviors. Conclusions Spousal loss through divorce or bereavement is associated with a large enduring increased AUD risk. This association likely reflects both causal and non-causal processes. That the AUD status of the spouse alters this association highlights the importance of spouse characteristics for the behavioral health consequences of spousal loss. The pronounced elevation in AUD risk following divorce or widowhood, and the protective effect of remarriage against subsequent AUD, speaks to the profound impact of marriage on problematic alcohol use. PMID:28103713

Physical activity to overcome the adversity of widowhood

PubMed Central

Li, Chu-Shiu; Lee, June Han; Chang, Ly-yun; Liu, Chwen-Chi; Chan, Yan-Lan; Wen, Christopher; Chiu, Mu-Lin; Tsai, Min Kuang; Tsai, Shan Pou; Wai, Jackson Pui Man; Tsao, Chwen Keng; Wu, Xifeng; Wen, Chi Pang

2016-01-01

Abstract Widowhood has been increasingly encountered because of increasing longevity of women, often characterized by social stigmatization and poor physical and mental health. However, applied research to overcome its adversity has been quite limited. The goal of this study is to explore the role of physical activity in improving the health of widows. A cohort of 446,582 adults in Taiwan who successively participated in a comprehensive medical screening program starting in 1994, including 232,788 women, was followed up for mortality until 2008. Each individual provided detailed health history, and extensive lab tests results. The number of widows increased with time trend. Every other woman above age 65 was a widow (44%). Widows were less active, more obese, and smoked and drank more, had sleep problems, were more depressed with taking sedatives or psychoactive drugs, leading to more suicides. In the global development of health policies by World Health Organization (WHO), physical activity is one of the main factors to reverse poor health. The poor health of inactive widow was mitigated when becoming fully active in this study. Exercise not only reduced the observed 18% increase in all-cause mortality, but also gained 4 years and as much as 14% mortality advantage over the married but inactive. More importantly, becoming physically active energized their mental status, improved sleep quality and quantity, reduced depressions and the need for psychoactive drugs, and increased socialization circles. Widows, a rapidly growing and socially stigmatized group, suffered from social and financial inequality and tended to develop poorer health. Sustained physical activity could be one of the ways for them to overcome and reverse some of the physical and mental adversities of widowhood, and improve their quality and quantity of life. PMID:27512856

The Impact of Religious Orientation in Conjugal Bereavement among Older Adults.

ERIC Educational Resources Information Center

Rosik, Christopher H.

1989-01-01

Explored relationship between religious commitment and adaptation to widowhood among 159 widowed elderly involved in southern Californian support groups. Grief, depression, and intrinsic-extrinsic religiousness were assessed and then analyzed via hierarchical multiple regression procedures. Higher extrinsicness (religion as a means to…

Loneliness among Elderly Widowers.

ERIC Educational Resources Information Center

Vinick, Barbara H.

The fact that few researchers have studied loneliness in widowhood may be related to the concept itself which spans intellectual perspectives, incorporating elements of affect, cognition, and social structure. To examine loneliness among elderly widowers, 24 adult males (participants in a more comprehensive study of widowed men, aged 63 to 93…

The Legal Status of Homemakers in Wisconsin.

ERIC Educational Resources Information Center

Melli, Marygold Shire

This report focuses on laws in the state of Wisconsin as they relate to homemakers. Four areas are discussed, each in separate sections: marriage, widowhood, divorce, and wife abuse. The section on marriage includes information on property rights, disability and death of homemaker, federal Equal Credit Opportunity Act, domicile, interspousal…

The Fifty-Year-Old Woman and Midlife Stress.

ERIC Educational Resources Information Center

Campbell, Shirley

1984-01-01

Suggests that women in their fifties are susceptible to many stresses. The possibilities of widowhood, divorce, or poverty, combined with intra- and interpersonal strains, make this a time of insecurity about aging for many women. Some suggestions as to why women nonetheless cope successfully with aging are considered. (Author/JAC)

Grief, Depressive Symptoms, and Physical Health among Recently Bereaved Spouses

ERIC Educational Resources Information Center

Utz, Rebecca L.; Caserta, Michael; Lund, Dale

2012-01-01

Purpose: Widowhood is among the most distressing of all life events, resulting in both mental and physical health declines. This paper explores the dynamic relationship between physical health and psychological well-being among recently bereaved spouses. Design and Methods: Using a sample of 328 bereaved persons who participated in the "Living…

American Women: Three Decades of Change. Special Demographic Analyses, CDS-80-8.

ERIC Educational Resources Information Center

Bianchi, Suzanne M.; Spain, Daphne

One of a series of reports which use Census Bureau data to provide perspective on important demographic and socioeconomic trends and patterns, this analysis describes changes that have affected women's roles in the last 30 years. Topics discussed are: marriage, divorce, widowhood, childbearing, household and family living arrangements, education,…

A Research-Based Community Theater Performance to Promote Ageing: Is It More than Just a Show?

ERIC Educational Resources Information Center

Feldman, Susan; Radermacher, Harriet; Lorains, Felicity; Haines, Terence

2011-01-01

Research-based community theater can address important life issues in a safe and entertaining environment. This study investigated using a theater performance about widowhood as a medium for facilitating older people's engagement with key life events and countering negative stereotypes. Quantitative questions incorporating semistructured…

Real Women, Real Lives. Marriage, Divorce, Widowhood.

ERIC Educational Resources Information Center

Governor's Commission on the Status of Women, Madison, WI.

The booklet describes economic handicaps faced by women who become divorced or widowed. The purpose of the document is to increase the general public's understanding of how customs, old laws, and government policies support the framework of the family when things go wrong. The document is presented in four major sections. Section I focuses on…

Older Women: A Population at Risk for Mental Health Problems.

ERIC Educational Resources Information Center

Wisniewski, Wendy; Cohen, Donna

The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future. Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…

The One-Parent Family: Perspectives and Annotated Bibliography. Fourth Edition.

ERIC Educational Resources Information Center

Schlesinger, Benjamin

This source-book on the one parent family contains two sections. The first section includes six papers dealing with motherless families, fatherless separated families, divorce and children, the crisis of widowhood in the family cycle, the unmarried mother who keeps her child, and single parent adoptions. Section II includes 750 annotations of…

School Participation of Children from Single-Mother Families in Malaysia.

ERIC Educational Resources Information Center

Pong, Suet-Ling

1996-01-01

Uses data from the Second Malaysian Family Life Survey to examine effects of mother's divorce/separation or widowhood on Malaysian adolescents' school participation. Children (ages 15-19) of divorced or separated (but not widowed) mothers were at greater risk of leaving school than those in other family situations, regardless of individual…

Institutionalization of Older Adults After the Death of a Spouse

PubMed Central

Nihtilä, Elina; Martikainen, Pekka

2008-01-01

Objectives. We investigated the risk of entering long-term institutional care after the death of a spouse in relation to the duration of widowhood among older Finnish men and women. We also examined whether high levels of education or household income buffered the effects of bereavement on institutionalization. Methods. We used linked register-based data on Finnish adults 65 years or older who were living with a spouse at the beginning of the study period (n=140902) and were followed from January 1998 to December 2002. Results. The excess risk of institutionalization was highest during the first month following a spouse’s death compared with still living with a spouse (adjusted hazard ratio=3.31 for men, 3.62 for women). This risk decreased over time among both men and women. The relative effect of the duration of widowhood on institutionalization did not significantly vary according to the level of education or income. Conclusions. Risk of institutionalization is particularly high immediately after the death of a spouse, demonstrating the importance of loss of social and instrumental support. PMID:18511726

Widowhood and divorce in relation to overall survival among middle-aged Norwegian women with cancer.

PubMed Central

Kvikstad, A.; Vatten, L. J.; Tretli, S.

1995-01-01

The aim of the study was to examine the relations between widowhood and divorce and overall survival among women with cancer. All Norwegian women born between 1935 and 1954, and diagnosed with cancer between 1966 and 1990, were followed up until 1991. In all, 14,231 cases were followed up for a median length of approximately 4.5 years (mean = 6 years), and 4311 women died during follow-up. In addition to overall cancer, separate analyses have been made for cancer at specific sites. Widows had a risk of dying which was nearly identical to that of married women for all sites except colorectal cancer, for which widows had a 2-fold increased death rate compared with married women. Divorced women had an overall increased hazard ratio of 1.17 (95% CI 1.07-1.27), which was confined to cancer of the breast, lung and cervix. With few clear exceptions women with children had a better survival than nulliparous women (overall hazard ratio = 0.80, 95% CI 0.74-0.87). PMID:7779736

Divorce and the Onset of Alcohol Use Disorder: A Swedish Population-Based Longitudinal Cohort and Co-Relative Study.

PubMed

Kendler, Kenneth S; Lönn, Sara Larsson; Salvatore, Jessica; Sundquist, Jan; Sundquist, Kristina

2017-05-01

The purpose of this study was to clarify the magnitude and nature of the relationship between divorce and risk for alcohol use disorder (AUD). In a population-based Swedish sample of married individuals (N=942,366), the authors examined the association between divorce or widowhood and risk for first registration for AUD. AUD was assessed using medical, criminal, and pharmacy registries. Divorce was strongly associated with risk for first AUD onset in both men (hazard ratio=5.98, 95% CI=5.65-6.33) and women (hazard ratio=7.29, 95% CI=6.72-7.91). The hazard ratio was estimated for AUD onset given divorce among discordant monozygotic twins to equal 3.45 and 3.62 in men and women, respectively. Divorce was also associated with an AUD recurrence in those with AUD registrations before marriage. Furthermore, widowhood increased risk for AUD in men (hazard ratio=3.85, 95% CI=2.81-5.28) and women (hazard ratio=4.10, 95% CI=2.98-5.64). Among divorced individuals, remarriage was associated with a large decline in AUD in both sexes (men: hazard ratio=0.56, 95% CI=0.52-0.64; women: hazard ratio=0.61, 95% CI=0.55-0.69). Divorce produced a greater increase in first AUD onset in those with a family history of AUD or with prior externalizing behaviors. Spousal loss through divorce or bereavement is associated with a large enduring increased AUD risk. This association likely reflects both causal and noncausal processes. That the AUD status of the spouse alters this association highlights the importance of spouse characteristics for the behavioral health consequences of spousal loss. The pronounced elevation in AUD risk following divorce or widowhood, and the protective effect of remarriage against subsequent AUD, speaks to the profound impact of marriage on problematic alcohol use.

Stressful Events and Depressive Symptoms among Old Women and Men: A Longitudinal Study.

ERIC Educational Resources Information Center

Chou, Kee-Lee; Chi, Iris

2000-01-01

Examines the impact of a series of common stressful life events (SLEs) on changes in depressive symptoms among older adults (N=260) aged 70 or older. Results show that of eight SLEs only widowhood was associated with depression symptoms three years later. SLEs influenced the depression of men and women differently. (Author/MKA)

Do Spousal Discrepancies in Marital Quality Assessments Affect Psychological Adjustment to Widowhood?

ERIC Educational Resources Information Center

Carr, Deborah; Boerner, Kathrin

2009-01-01

We use prospective couple-level data from the Changing Lives of Older Couples to assess the extent to which spouses concur in their assessments of marital quality (N = 844) and whether discrepancies in spouses' marital assessments affect the bereaved spouse's psychological adjustment 6 months after loss (n = 105). Spouses' assessments of marital…

Aging Widows and Widowers: Does the Impact of Bereavement Differ?

ERIC Educational Resources Information Center

Feinson, Marjorie Chary

Though many theories of the greater impact of a spouse's death on men than on women derive some support from role theory, little empirical data exist to support the hypotheses. Behavioral studies of widowhood have focused on social participation as a determinant in coping, without studying the survivor's degree of social involvement before the…

From Widowhood to Wickedness: The Politics of Class and Gender in New York City Private Charity, 1799-1860.

ERIC Educational Resources Information Center

Gilman, Amy

1984-01-01

Vast changes took place in urban benevolence toward poor females in the first half of the nineteenth century. Agencies started by upper-class women as private organizations to support needy women became agencies run by salaried, professional, male charity workers whose job it was to train and discipline poor females. (RM)

The fifty-year-old woman and midlife stress.

PubMed

Campbell, S

It has been assumed that the fifties are a relatively stable decade; however, women in their fifties are susceptible to many stresses, internal and external. The possibilities of widowhood, divorce, or poverty, combined with intra- and interpersonal strains, make this a time of insecurity about aging for many women. Some suggestions as to why women nonetheless cope successfully with aging are considered.

Widowhood: An End and a New Beginning. Lifecycle Learning Sheet.

ERIC Educational Resources Information Center

Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.

According to statistics, 69% of women who marry will outlive their husbands, women are widowed at an average age of 56, and women often experience a loss of half their income with the death of their spouse. Women who become widowed must deal with a number of financial concerns, including the following: obtaining a death certificate and presenting…

Economic Well-Being Following Marital Termination: A Comparison of Widowed and Divorced Women.

ERIC Educational Resources Information Center

Morgan, Leslie A.

1989-01-01

Used data from National Longitudinal Surveys cohort of mature women to examine probability of becoming poor after widowhood or divorce among midlife women, and factors that seem to influence economic well-being. Found that 40 percent of widows and over 25 percent of divorced women fell into poverty for some time during first five years after…

Translating research findings into community based theatre: More than a dead man's wife.

PubMed

Feldman, Susan; Hopgood, Alan; Dickins, Marissa

2013-12-01

Increasingly, qualitative scholars in health and social sciences are turning to innovative strategies as a way of translating research findings into informative, accessible and enjoyable forms for the community. The aim of this article is to describe how the research findings of a doctoral thesis - a narrative study about 58 older women's experiences of widowhood - were translated into a unique and professionally developed script to form the basis for a successful theatrical production that has travelled extensively within Australia. This article reports on the process of collaboration between a researcher, a highly regarded Australian actor/script writer and an ensemble of well-known and experienced professional actors. Together the collaborating partners translated the research data and findings about growing older and 'widowhood' into a high quality theatre production. In particular, we argue in this paper that research-based theatre is an appropriate medium for communicating research findings about important life issues of concern to older people in a safe, affirming and entertaining manner. By outlining the process of translating research findings into theatre we hope to show that there is a real value in this translation approach for both researcher and audience alike. © 2013.

The Effects of Positive and Negative Support from Children on Widowed Older Adults' Psychological Adjustment: A Longitudinal Analysis

ERIC Educational Resources Information Center

Ha, Jung-Hwa

2010-01-01

Purpose: This article examines the extent to which positive and negative support from children prior to and after spousal loss and changes in support from pre- to post-loss affect widowed older adults' depressive symptoms, anxiety, and anger 18 months following widowhood. Design and Methods: Analyses are based on the Changing Lives of Older…

Zooming in on Life Events: Is Hedonic Adaptation Sensitive to the Temporal Distance from the Event?

ERIC Educational Resources Information Center

Uglanova, Ekaterina A.; Staudinger, Ursula M.

2013-01-01

This paper analyzed the effect of major positive and negative life events (marriage, divorce, birth of child, widowhood, and unemployment) on life satisfaction. For the first time, this study estimated the effects of life events not with a precision of 12 months but of 3 months. Specifically, two questions were addressed: (1) Does the precision of…

Social Dimensions of Personal Growth following Widowhood: A Three-Wave Study.

PubMed

Recksiedler, Claudia; Loter, Katharina; Klaas, Hannah S; Hollstein, Betina; Perrig-Chiello, Pasqualina

2018-01-01

Losing one's spouse is one of the most stressful life events in old age, yet research on positive consequences of overcoming critical life events describes experiences of personal growth for survivors. Because prior studies conceptualized personal growth as a stable accomplishment of an individual, our study challenges this assumption by examining trajectories of personal growth and its links to two aspects of social support. We assume that personal growth is boosted by heightened levels of loss-related social support seeking during early years of widowhood. However, toward the later stages in the bereavement process, we expect personal growth to be fostered by perceived social embeddedness. Data stem from a survey on relationships in later life conducted in 2012, 2014, and 2016 in Switzerland. The final analytical sample consisted of 508 individuals aged 50+ years, who were on average 73 years old and widowed for about 3 years at baseline. Longitudinal explorative factor analyses yielded a 3-factorial solution for personal growth. Random-effects group-specific growth curves were used to examine the trajectories of personal growth and its subdimensions, by different levels of loss-related social support seeking and embeddedness in a supportive network, over the first 8 years of widowhood. Our analyses included time-invariant and time-varying covariates. On average, our findings point to a stable trajectory of personal growth after having become widowed in later life. Group-specific analyses, however, showed different courses in the trajectories for specific subdimensions of personal growth - particularly for spiritual change and appreciation of life. Average marginal effects also yielded group differences by loss-related support seeking in the level of personal growth over time, which highlight the importance of social support seeking, rather than social embeddedness, at all stages of the bereavement process. Findings underline the importance of a longitudinal and linked-lives perspective on personal growth and point to different pathways regarding its various subdimensions. Future research should further examine the validity of personal growth scales for other populations and consider the possibility to experience personal growth already during the anticipation of a traumatic event (e.g., in the case of long-term caretaking). © 2017 S. Karger AG, Basel.

Feeling Lonely Versus Being Alone: Loneliness and Social Support Among Recently Bereaved Persons

PubMed Central

2014-01-01

Objectives. Despite increases in social support following widowhood, loneliness is among the most frequently reported challenges of bereavement. This analysis explores the dynamic relationship between social support and loneliness among recently bereaved older adults. Methods. Using longitudinal data from “Living After Loss” (n = 328), latent growth curve modeling was used to estimate changes in loneliness and social support during the first year and a half of bereavement among older adults aged 50+. Results. Both loneliness and social support declined over the first year and a half of bereavement. Greater social support was associated with lower levels of loneliness overall, but the receipt of social support did not modify one’s expression of loneliness over time. Loneliness was more highly correlated with support from friends than family. Together, social support from both friends and family accounted for 36% of the total variance in loneliness. Discussion. There is conceptual and empirical overlap between the concepts of loneliness and social support, but results suggest that loneliness following widowhood cannot be remedied by interventions aimed only at increasing social support. Social support, especially that from friends, appears to be most effective if it is readily accessible and allows the newly bereaved an opportunity to express him/herself. PMID:24056690

How Widowhood Shapes Adult Children’s Responses to Mothers’ Preferences for Care

PubMed Central

2014-01-01

Objectives. We examine whether recently widowed mothers who needed assistance for a chronic condition, serious illness, or injury were more likely to receive care from the children they preferred as caregivers than were mothers who were divorced or had been widowed for a longer period of time. Method. Data were analyzed from 130 widowed or divorced mothers aged 72–83 in the second wave of the Within-Family Differences Study, all of whom reported needing assistance for a chronic condition or a serious illness or injury within 2 years prior to T2. Results. The findings provided evidence that recent widowhood shapes patterns of caregiving. Analyses revealed that mothers who had been widowed within 4 years were substantially more likely to receive care from adult children whom they had identified several years earlier as preferred caregivers than were mothers who were divorced or had been widowed 4 or more years. Discussion. Research has shown that mothers are at an increased risk for declining psychological well-being when caregiving preferences are not met. Findings from this study suggest that mothers who are divorced or have been widowed for several years may be at greater risk for violation of their caregiving preferences, increasing their vulnerability to declines in psychological well-being. PMID:23825053

Longitudinal Predictors of Institutionalization in Old Age.

PubMed

Hajek, André; Brettschneider, Christian; Lange, Carolin; Posselt, Tina; Wiese, Birgitt; Steinmann, Susanne; Weyerer, Siegfried; Werle, Jochen; Pentzek, Michael; Fuchs, Angela; Stein, Janine; Luck, Tobias; Bickel, Horst; Mösch, Edelgard; Wagner, Michael; Jessen, Frank; Maier, Wolfgang; Scherer, Martin; Riedel-Heller, Steffi G; König, Hans-Helmut

2015-01-01

To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach. In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional fixed-effects logistic regressions (with 201 individuals and 960 observations) were performed to estimate the effects of marital status, depression, dementia, and physical impairments (mobility, hearing and visual impairments) on the risk of admission to old-age home or nursing home. By exploiting the longitudinal data structure using panel econometric models, we were able to control for unobserved heterogeneity such as genetic predisposition and personality traits. The probability of institutionalization increased significantly with occurrence of widowhood, depression, dementia, as well as walking and hearing impairments. In particular, the occurrence of widowhood (OR = 78.3), dementia (OR = 154.1) and substantial mobility impairment (OR = 36.7) were strongly associated with institutionalization. Findings underline the strong influence of loss of spouse as well as dementia on institutionalization. This is relevant as the number of old people (a) living alone and (b) suffering from dementia is expected to increase rapidly in the next decades. Consequently, it is supposed that the demand for institutionalization among the elderly will increase considerably. Practitioners as well as policy makers should be aware of these upcoming challenges.

"Not a replacement": emotional experiences and practical consequences of Israeli second couplehood stepfamilies constructed in old age.

PubMed

Koren, Chaya; Lipman-Schiby, Sharon

2014-12-01

The increase in life expectancy enhances phenomena such as second couplehood in old age following widowhood or divorce as an alternative way of coping with changes that occur with aging. Research on the phenomenon has focused mainly on individual and dyadic perspectives of the repartnered. The aim of this article was to explore repartnering from the stepfamily's perspective, which has scarcely been studied. Nineteen Israeli stepfamilies (38 multigenerational families) were recruited using criterion sampling, of men who repartnered at age 65+ and women at 60+, with children and grandchildren from a lifelong marriage that ended in widowhood or divorce. We audio-recorded and transcribed verbatim 107 semi-structured, qualitative interviews with older partners, their adult children, and grandchildren. Analysis was based on grounded theory and dyadic analysis principles adapted to families. It showed how repartnering in old age changed the family structure, constructing complex stepfamilies, which require further study. Emotional experiences refer to repartnering being a replacement for couplehood but not for parenthood/grandparenthood. Practical consequences refer to "knowing their place" within the stepfamily and included the following subthemes: showing affection; participating in memorials for the deceased spouse; sharing, listening, and assisting. Findings are discussed regarding life course and family life cycle perspectives. Copyright © 2014 Elsevier Inc. All rights reserved.

Recent changes in marriage patterns in rural Bangladesh.

PubMed

Shaikh, K

1997-09-01

"This article considers age at marriage and other aspects of nuptiality in Bangladesh in the context of opportunities to accelerate national development. It suggests that concerted efforts to increase the female age at marriage could produce a number of beneficial effects ranging from reduction in the incidence of divorce and widowhood to a lowering of fertility. It suggests a number of policy and programme measures that could be employed to foster such an increase." excerpt

Does Becoming A Volunteer Attenuate Loneliness Among Recently Widowed Older Adults?

PubMed

Carr, Dawn C; Kail, Ben Lennox; Matz-Costa, Christina; Shavit, Yochai Z

2018-03-02

Loneliness is a significant public health concern, particularly for those who have lost a spouse through widowhood. This study examines whether becoming a volunteer at the time of widowhood is associated with reduction of these risks. A pooled sample of 5,882 married adults age 51+, drawn from the 2006-2014 waves of the Health and Retirement Study, was used to estimate regression models of the relationship between becoming widowed (relative to staying continuously married) and loneliness, and whether the associated loneliness of having lost a spouse is moderated by starting to volunteer (<2 hr, 2+ hr/week). Our results show that for those who become widowed, loneliness is significantly higher than those who stay continuously married. However, starting to volunteer 2+ hr per week is related to attenuated loneliness among the widowed such that widows who volunteer at that intensity have levels of loneliness similar to those of continuously married individuals volunteering at the same intensity. This study suggests higher intensity volunteering may be a particularly important pathway for alleviating loneliness among older adults who have recently become widowed. Results are discussed in light of theory, future research, and potential interventions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The personal communities of men experiencing later life widowhood.

PubMed

Collins, Tracy

2018-05-01

Increasingly men are becoming widowed in later life due in part to a longer life expectancy. Social networks and social support are thought to help buffer the negative consequences of such later life transitions. This paper explores the personal communities of a group of older men experiencing widowhood. Qualitative in-depth interviews were conducted, September 2013-February 2014, with seven older widowers, 71-89 years of age, in North Staffordshire, UK. Interviews included personal community diagrams to identify the structure of the older men's social relationships. Data analysis comprised thematic analysis of interview transcripts and content analysis of personal community diagrams. Three overarching themes were identified from the interview data: "Personal identity and resilience assist transition," "Continuity in personal communities provides stability" and "Changes in social relationships and practices facilitate adaptation." The study identified three types of personal community among the older widowers, comprising different combinations of family, friends and others. The findings illustrate that some older widowers have very restricted personal communities which puts them at greater risk of loneliness and social isolation. The social needs of long-term carers should be addressed as isolation and loneliness can begin long before the death of a spouse. It is important to consider gender differences and preferences when designing interventions for older people in order to promote engagement, social inclusion and well-being. © 2018 John Wiley & Sons Ltd.

Factor structure of depressive symptoms using the EURO-D scale in the over-50s in Europe. Findings from the SHARE project.

PubMed

Portellano-Ortiz, Cristina; Garre-Olmo, Josep; Calvó-Perxas, Laia; Conde-Sala, Josep Lluís

2017-08-31

The aims of this study are: to analyze the factor structure of the EURO-D depression scale; to explore the variables associated with depressive symptoms in the total sample and in the EURO-D factors; and to compare the presence of depressive symptoms and the factor distribution in 15 European countries. 62,182 participants in Wave 5 (2013) of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. The SHARE study and the EURO-D scale. Factor, bivariate and multilevel analyses were performed. Higher levels of depressive symptoms were associated with a poorer self-perception of physical health (η 2 = 0.22) and economic difficulties (η 2 = 0.07). Factor analysis of the EURO-D identified two factors: Suffering and Motivation. Higher levels of depressive symptoms were associated with female gender and younger age (≤60) in the Suffering factor, and with less activity and exercise, older age (≥71), widowhood and lower educational level in the Motivation factor. Poorer self-perception of physical health and economic difficulties were associated with higher depressive symptomatology in both factors. Poorer self-perception of physical health, female gender, economic difficulties, widowhood, lower levels of activity and exercise and lower educational level were associated with higher depressive symptomatology. In the countries of southern Europe, the Motivation factor predominated.

The business of death: a qualitative study of financial concerns of widowed older women.

PubMed

DiGiacomo, Michelle; Lewis, Joanne; Phillips, Jane; Nolan, Marie; Davidson, Patricia M

2015-04-18

The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death. Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.

[Widowhood, loneliness, and health in old age].

PubMed

López Doblas, Juan; Díaz Conde, María Del Pilar

Elderly people are one of the most vulnerable groups in the population as regards loneliness, especially among those living alone. This paper aims to assess the impact of the feeling of loneliness on the elderly, taking into account that the loss of a spouse is the main reason that triggers this feeling. Findings are presented from a qualitative study conducted in Spain. Data were gathered using a focus group approach (8 focus groups, differentiated by gender and place of residence). The data were analysed from a Grounded Theory perspective. Elderly people describe how they experience the feeling of loneliness after becoming widowed. The loss of the spouse brings an emotional vacuum that is impossible to be filled, especially at night. After long-lasting marriages, these older people are confronted with loneliness, both in the home and internally, which very often triggers depressive disorders. As regards health, 2 types of feelings were observed. On the one hand, there is helplessness for fear of accidents or unexpected illnesses when alone at home. On the other hand, they feel uncertainty about the future, as they wonder who will look after them in case of need. Both feelings contribute to activate loneliness. Our findings add to the available knowledge about the close relationship between loneliness, widowhood, and health in old age, and provide qualitative knowledge to supplement what we already know about that relationship through surveys and other quantitative techniques used in social research. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Gender inequalities and demographic behavior.

PubMed

1995-01-01

A summary was provided of the central findings about gender inequalities in Egypt, India, Ghana, and Kenya published by the Population Council in 1994. These countries exhibited gender inequalities in different ways: the legal, economic, and educational systems; family planning and reproductive health services; and the health care system. All countries had in common a high incidence of widowhood. Widowhood was linked with high levels of insecurity, which were linked with high fertility. Children thus became insurance in old age. In Ghana, women's insecurity was threatened through high levels of marital instability and polygyny. In Egypt, insecurity was translated into economic vulnerability because of legal discrimination against women when family systems were disrupted. In India and all four countries, insecurity was reflective of limited access to education, an impediment to economic autonomy. In all four countries, women's status was inferior due to limited control over reproductive decision making about childbearing limits and contraception. In India, the cultural devaluation of girls contributed to higher fertility to satisfy the desire for sons. In India and Egypt, family planning programs were dominated by male-run organizations that were more concerned about demographic objectives than reproductive health. The universal inequality was the burden women carry for contraception. Family planning programs have ignored the local realities of reproductive behavior, family structures, and gender relations. The assumption that husbands and wives have similar fertility goals or that fathers fully share the costs of children is mistaken in countries such as Ghana. Consequently, fertility has declined less than 13% in Ghana, but fertility has declined by over 30% in Kenya. Family planning programs must be aware of gender issues.

Ghosted images: old lesbians on screen.

PubMed

Krainitzki, Eva

2015-01-01

Screen images of old lesbians combine modes of representing female gender, lesbian sexuality, and old age, all of which contain layers of otherness within a hetero-patriarchal and youth-centered society. Analyzing a range of films, from independent to mainstream cinema, this article explores how the ghosted lesbian paradigm intersects with narratives of aging as decline in representations of lesbian characters who are over the age of sixty. The spectral matters of illness, death, mourning, and widowhood inevitably culminate in an unhappy ending. Removed from a lesbian community context, intergenerational continuity vanishes and the old lesbian emerges as the cultural other.

"Why did this happen to me?" Experiences of widowhood among the Vhavenda in Limpopo Province.

PubMed

Davhana-Maselesele, M

2005-12-01

Widows/widowers find it difficult to explain to others how the loss of a spouse has fundamentally changed their lives. They are silent about how they experience losing their spouses/partners to the extent of putting on a face that says that all is well, when there is so much pain, agony and suffering that it becomes unbearable, and which ultimately affects their mental health. In this article the researcher explores and describes the lived experience of widowhood. Guidelines are provided to support widows/widowers and help them to deal with their loss effectively, as gathered from the stories and experiences described by surviving spouses. The researcher believes that this study will be a source of strength, support and hope that, given time, all will be well; it will create a feeling of having others in the same situation to look up to, and will assist them to accept a situation that cannot be changed. A qualitative, phenomenological, exploratory, descriptive and contextual design was chosen as the most appropriate for this study (Morse & Field, 1996:8-9; Burns & Grove, 1993:29). It was seen as the best way of gathering subjective reality from the participants in such a fashion that the surviving spouses sensed the researcher's empathy with their situation. Ethical measures and trustworthiness were dealt with. Data was analysed, using Tesch's Open Coding method (Creswell, 1994:155). Three major themes emerged from the data, namely experiences related to the cause of death; widows/widowers' feelings in response to losing a spouse; and the need to use survival strategies as a way of dealing with their loss. Guidelines are provided to support widows/widowers and help them to deal with their loss effectively, as gathered from the stories and experiences described by surviving spouses.

Abuse, Neglect, and Violence Against Elderly Women in Ghana: Implications for Social Justice and Human Rights.

PubMed

Sossou, Marie-Antoinette; Yogtiba, Joseph A

2015-01-01

This article discusses abuse and neglect of elderly women in Ghana and the traditional practices that adversely affect their human rights. Their situation is characterized by pervasive poverty, illiteracy, widowhood, predominantly rural dwelling, and subjection to insidious cultural practices and superstitious beliefs. Increase in life expectancy and population trends point to significant increases in the numbers of the elderly women. Breakdown of the extended family support system and the waning of filial obligations are factors affecting their welfare. Accurate data on these abuses is lacking due to cultural inhibitions and non-reporting. Legislations and NGO programs are addressed to combat abuses.

Intimacy and the life cycle in the marital relationships of the Scottish elite during the long eighteenth century.

PubMed

Barclay, Katie

2011-01-01

Traditionally marriage has been treated as one step in the life cycle, between youth and old age, singleness and widowhood. Yet an approach to the life cycle that treats marriage as a single step in a person's life is overly simplistic. During the eighteenth century many marriages were of considerable longevity during which time couples aged together and power dynamics within the home were frequently renegotiated to reflect changing circumstances. This study explores how intimacy developed and changed over the life cycle of marriage and what this meant for power, through a study of the correspondence of two elite Scottish couples.

Turning points and advanced family cycles: aging effect in Mexican homes*

PubMed Central

Montes de Oca, Verónica; Hebrero, Mirna

2017-01-01

Aging in Mexico is a process with several effects in the families and homes. However, the presence of older members in Mexican families has been scarcely analyzed. In this paper we reflect on the experiences of homes with advanced life cycles when turning points happen, such as widowhood, retirement, empty nest stage and when chronic diseases appear, as well as caring processes and family and social networks weakening, and social and institutional support diminution. We analyze some data from the National Survey on Health and Aging in Mexico (Enasem, 2001) considering the gender differences and, specially, health condition of elder people. PMID:29391856

Lessons from history: Surviving old age during The Great Depression in the United States.

PubMed

Matthews, Sarah H; Dunkle, Ruth E

2013-12-01

This paper focuses on 30 couples who received a pension and other services from two private trusts in Detroit, Michigan beginning in 1929 or 1930. Results of the qualitative analysis of case files, which contain notes recorded chronologically for 17 of the couples and then surviving spouses, provide a portrait of older couples' lives prior to a partner's death, circumstances surrounding the death, and changes in the social support systems of widows and widowers until their deaths. Close examination of the experiences of these couples is a reminder of how old age and widowhood were experienced prior to the enactment of public pensions and health insurance in the United States. © 2013.

South African Zulu widows in a time of poverty and social change.

PubMed

Rosenblatt, Paul C; Nkosi, Busisiwe Catherine

2007-01-01

Interviews were carried out with 16 South African Zulu widows. Much of what the widows had to say seemed like what one might hear from widows in economically developed countries, but there were also striking differences. All the widows lived in poverty, and for some their grief seemed much more about the poverty than about the husband's death. Most widows observed a year of traditional ukuzila mourning practices, which made them a threat to others and which is difficult to carry out in the social upheaval of modern South Africa. Widowhood was in some cases a struggle with witchcraft--as cause of the death or as an accusation directed at the widow.

Perceived Self-Competency Among the Recently Bereaved

PubMed Central

Utz, Rebecca L.; Lund, Dale A.; Caserta, Michael S.; deVries, Brian

2011-01-01

This study identified personal resources, features of the marital relationship, and death circumstances that affected perceived self-competency among recently bereaved older adults. Data come from 328 widowed persons who participated in the “Living After Loss” project. Results suggested that those who had more personal resources - namely, income and good health – were the most competent in daily life tasks. Surprisingly, neither death forewarning nor marital quality improved competency after widowhood. Higher competency was associated with more positive mental health outcomes, suggesting that grief is complicated by the need to enhance and/or restore daily life activities as well as the need to deal with the sadness associated with the loss. PMID:21895436

United States public policy and the elderly: the disproportionate risk to the well-being of women.

PubMed

Burkhauser, R V; Duncan, G J

1991-01-01

"Cross-sectional comparisons show that poverty among the aged in the United States has dropped dramatically over the last two decades. We use longitudinal data to identify economic events associated with unfavorable economic outcomes and to trace the influence of these events on women and men at different ages. We find that while social insurance programs appear to prevent severe financial hardship from the most frequent work-related events, they are far less effective in cushioning the economic impact of widowhood and divorce, especially for women. We suggest a number of policy changes that would provide some measure of social insurance against adverse family-related events." excerpt

The impact of stressful life events on excessive alcohol consumption in the French population: findings from the GAZEL cohort study.

PubMed

Tamers, Sara L; Okechukwu, Cassandra; Bohl, Alex A; Guéguen, Alice; Goldberg, Marcel; Zins, Marie

2014-01-01

Major life changes may play a causative role in health through lifestyle factors, such as alcohol. The objective was to examine the impact of stressful life events on heavy alcohol consumption among French adults. Trajectories of excessive alcohol consumption in 20,625 employees of the French national gas and electricity company for up to 5 years before and 5 years after an event, with annual measurements from 1992. We used repeated measures analysis of time series data indexed to events, employing generalized estimating equations. For women, excessive alcohol use increased before important purchase (p = 0.021), children leaving home (p<0.001), and death of loved ones (p = 0.03), and decreased before widowhood (p = 0.015); in the year straddling the event, increased consumption was observed for important purchase (p = 0.018) and retirement (p = 0.002); at the time of the event, consumption decreased for marriage (p = 0.002), divorce, widowhood, and death of loved one (all p<0.001), and increased for retirement (p = 0.035). For men, heavy alcohol consumption increased in the years up to and surrounding the death of loved ones, retirement, and important purchase (all p<0.001), and decreased after (all p<0.001, except death of loved one: p = 0.006); at the time of the event, consumption decreased for all events except for children leaving home and retirement, where we observed an increase (all p<0.001). For women and men, heavy alcohol consumption decreased prior to marriage and divorce and increased after (all p<0.001, except for women and marriage: p = 0.01). Stressful life events promote healthy and unhealthy alcohol consumption. Certain events impact alcohol intake temporarily while others have longer-term implications. Research should disentangle women's and men's distinct perceptions of events over time.

Widow cleansing and inheritance among the Luo in Kenya: the need for additional women-centred HIV prevention options

PubMed Central

Perry, Brian; Oluoch, Lennah; Agot, Kawango; Taylor, Jamilah; Onyango, Jacob; Ouma, Lilian; Otieno, Caroline; Wong, Christina; Corneli, Amy

2014-01-01

Introduction The customs of widow cleansing and widow inheritance are practiced in several communities throughout sub-Saharan Africa. In the Nyanza Province of Kenya, according to tradition, Luo widows are expected to engage in sexual intercourse with a “cleanser,” without the use of a condom, in order to remove the impurity ascribed to her after her husband's death. Luo couples, including widows, are also expected to engage in sex preceding specific agricultural activities, building homes, funerals, weddings, and other significant cultural and social events. Widows who are inherited for the purpose of fulfilling cultural obligation have a higher prevalence of HIV than those who remain un-inherited or are inherited for the purpose of companionship. Methods As part of a larger descriptive qualitative study to inform study procedures for FEM-PrEP, an HIV prevention pre-exposure prophylaxis clinical trial, we conducted 15 semi-structured interviews (SSIs) with widows, 15 SSIs with inheritors, and four focus group discussions with widows in the Bondo and Rarieda districts in Nyanza Province to explore the HIV risk context within widow cleansing and inheritance practices. Thematic qualitative analysis was used to analyze the data. Results The majority of widows reported in the demographic questionnaire being inherited, and most widows in the SSIs described participating in the cleansing ritual. We identified two main themes related to HIV prevention within the context of widow cleansing and inheritance: 1) widows must balance limiting their risk for HIV infection with meeting cultural expectations and ensuring that their livelihood needs are met, and 2) sexual abstinence undermines cultural expectations in widowhood while the use of condoms is deemed inappropriate in fulfilling culturally prescribed sexual rituals, and is often beyond the widow's ability to negotiate. Conclusions Women-controlled HIV prevention methods such as antiretroviral-based oral pre-exposure prophylaxis, vaginal gels, and vaginal rings are needed for HIV-negative widows who engage in sexual rituals related to widowhood. PMID:24973041

Bachelors, Divorcees, and Widowers: Does Marriage Protect Men from Type 2 Diabetes?

PubMed Central

Cornelis, Marilyn C.; Chiuve, Stephanie E.; Glymour, M. Maria; Chang, Shun-Chiao; Tchetgen Tchetgen, Eric J.; Liang, Liming; Koenen, Karestan C.; Rimm, Eric B.; Kawachi, Ichiro; Kubzansky, Laura D.

2014-01-01

While research has suggested that being married may confer a health advantage, few studies to date have investigated the role of marital status in the development of type 2 diabetes. We examined whether men who are not married have increased risk of incident type 2 diabetes in the Health Professionals Follow-up Study. Men (n = 41,378) who were free of T2D in 1986, were followed for ≤22 years with biennial reports of T2D, marital status and covariates. Cox proportional hazard models were used to compare risk of incident T2D by marital status (married vs unmarried and married vs never married, divorced/separated, or widowed). There were 2,952 cases of incident T2D. Compared to married men, unmarried men had a 16% higher risk of developing T2D (95%CI:1.04,1.30), adjusting for age, family history of diabetes, ethnicity, lifestyle and body mass index (BMI). Relative risks (RR) for developing T2D differed for divorced/separated (1.09 [95%CI: 0.94,1.27]), widowed (1.29 [95%CI:1.06,1.57]), and never married (1.17 [95%CI:0.91,1.52]) after adjusting for age, family history of diabetes and ethnicity. Adjusting for lifestyle and BMI, the RR for T2D associated with widowhood was no longer significant (RR:1.16 [95%CI:0.95,1.41]). When allowing for a 2-year lag period between marital status and disease, RRs of T2D for widowers were augmented and borderline significant (RR:1.24 [95%CI:1.00,1.54]) after full adjustment. In conclusion, not being married, and more specifically, widowhood was more consistently associated with an increased risk of type 2 diabetes in men and this may be mediated, in part, through unfavorable changes in lifestyle, diet and adiposity. PMID:25229473

Bachelors, divorcees, and widowers: does marriage protect men from type 2 diabetes?

PubMed

Cornelis, Marilyn C; Chiuve, Stephanie E; Glymour, M Maria; Chang, Shun-Chiao; Tchetgen Tchetgen, Eric J; Liang, Liming; Koenen, Karestan C; Rimm, Eric B; Kawachi, Ichiro; Kubzansky, Laura D

2014-01-01

While research has suggested that being married may confer a health advantage, few studies to date have investigated the role of marital status in the development of type 2 diabetes. We examined whether men who are not married have increased risk of incident type 2 diabetes in the Health Professionals Follow-up Study. Men (n = 41,378) who were free of T2D in 1986, were followed for ≤22 years with biennial reports of T2D, marital status and covariates. Cox proportional hazard models were used to compare risk of incident T2D by marital status (married vs unmarried and married vs never married, divorced/separated, or widowed). There were 2,952 cases of incident T2D. Compared to married men, unmarried men had a 16% higher risk of developing T2D (95%CI:1.04,1.30), adjusting for age, family history of diabetes, ethnicity, lifestyle and body mass index (BMI). Relative risks (RR) for developing T2D differed for divorced/separated (1.09 [95%CI: 0.94,1.27]), widowed (1.29 [95%CI:1.06,1.57]), and never married (1.17 [95%CI:0.91,1.52]) after adjusting for age, family history of diabetes and ethnicity. Adjusting for lifestyle and BMI, the RR for T2D associated with widowhood was no longer significant (RR:1.16 [95%CI:0.95,1.41]). When allowing for a 2-year lag period between marital status and disease, RRs of T2D for widowers were augmented and borderline significant (RR:1.24 [95%CI:1.00,1.54]) after full adjustment. In conclusion, not being married, and more specifically, widowhood was more consistently associated with an increased risk of type 2 diabetes in men and this may be mediated, in part, through unfavorable changes in lifestyle, diet and adiposity.

Widow cleansing and inheritance among the Luo in Kenya: the need for additional women-centred HIV prevention options.

PubMed

Perry, Brian; Oluoch, Lennah; Agot, Kawango; Taylor, Jamilah; Onyango, Jacob; Ouma, Lilian; Otieno, Caroline; Wong, Christina; Corneli, Amy

2014-01-01

The customs of widow cleansing and widow inheritance are practiced in several communities throughout sub-Saharan Africa. In the Nyanza Province of Kenya, according to tradition, Luo widows are expected to engage in sexual intercourse with a "cleanser," without the use of a condom, in order to remove the impurity ascribed to her after her husband's death. Luo couples, including widows, are also expected to engage in sex preceding specific agricultural activities, building homes, funerals, weddings, and other significant cultural and social events. Widows who are inherited for the purpose of fulfilling cultural obligation have a higher prevalence of HIV than those who remain un-inherited or are inherited for the purpose of companionship. As part of a larger descriptive qualitative study to inform study procedures for FEM-PrEP, an HIV prevention pre-exposure prophylaxis clinical trial, we conducted 15 semi-structured interviews (SSIs) with widows, 15 SSIs with inheritors, and four focus group discussions with widows in the Bondo and Rarieda districts in Nyanza Province to explore the HIV risk context within widow cleansing and inheritance practices. Thematic qualitative analysis was used to analyze the data. The majority of widows reported in the demographic questionnaire being inherited, and most widows in the SSIs described participating in the cleansing ritual. We identified two main themes related to HIV prevention within the context of widow cleansing and inheritance: 1) widows must balance limiting their risk for HIV infection with meeting cultural expectations and ensuring that their livelihood needs are met, and 2) sexual abstinence undermines cultural expectations in widowhood while the use of condoms is deemed inappropriate in fulfilling culturally prescribed sexual rituals, and is often beyond the widow's ability to negotiate. Women-controlled HIV prevention methods such as antiretroviral-based oral pre-exposure prophylaxis, vaginal gels, and vaginal rings are needed for HIV-negative widows who engage in sexual rituals related to widowhood.

Family extension and the elderly: economic, demographic, and family cycle factors.

PubMed

Kobrin, F E

1981-05-01

This paper reports on the results of applying a multivariate regression model of living arrangements choices to census data on the 1970 U. S. population of nonmarried, nonparenting adults. The model examines the factors affecting living with (1) relatives or (2) living alone or with nonrelatives. These factors include sex, income, marital history, and age. In addition, the model tests whether living arrangements choices differ for the elderly relative to other ages. The analysis shows that higher income, the experience of divorce, and being male are all associated with a higher probability of nonfamily living. Widowhood has the same effect, but only for women. The central finding, however, is that there is no special role for the elderly in living arrangements choices.

Stress and wellbeing during chronic illness and partner death in later-life: the role of social support.

PubMed

Karantzas, Gery C; Gillath, Omri

2017-02-01

Chronic illness and the death of a romantic partner are two of the most significant stressors reported by older adults, resulting in various physical and mental health consequences. Evidence suggests that social support is a key factor in understanding the association between chronic illness and widowhood and the wellbeing of older adults. Nevertheless, research into social support is often approached in an atheoretical manner when investigating these stressors in older adulthood. We attempt to address this theoretical chasm by proposing an integrative model to explain social support processes in older couples which draws on models of social support and attachment theory. Our model provides an important framework for understanding existing research findings as well as guiding future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Women's attitudes toward forming new partnerships in widowhood: The search for "your own someone" and for freedom.

PubMed

Hasmanová Marhánková, Jaroslava

2016-01-01

This text is based on an analysis of 20 biographical interviews with women who are both retired and have been widowed. The text discusses women's attitudes toward beginning new intimate relationships and the kinds of partnerships some of them have formed in old age. The author discusses the role of gender and gendered behavior in the institution of marriage as an important factor influencing women's attitudes toward remarrying. The experience of being widowed is an important transition that, besides trauma and difficulties, also presents an opportunity to escape from the previous gender norms and expectations. The significance of these changes, which often open up opportunities for alternative forms of self-fulfillment, become part of the strategies that women select when entering future partnership arrangements.

The changing relationship between education and marriage in the United States, 1940-2000.

PubMed

Torr, Berna M

2011-01-01

In 1940, when gender specialization was high, there was a negative relationship between education and marriage for women. College-educated women were least likely to be currently married and most likely to be never married. Declines in specialization were accompanied by a transition in this relationship. By 2000, when gender specialization was low, there was a positive relationship between education and marriage for women. College-educated women were most likely to be currently married, in part because they were more likely to stay married or remarry after divorce or widowhood. This transition occurred earlier and more completely for black women than for white women. These changes suggest that the relationship between education and marriage is shaped in part by the gender-role context.

The Changing Relationship between Education and Marriage in the United States, 1940–2000

PubMed Central

Torr, Berna M.

2013-01-01

In 1940, when gender specialization was high, there was a negative relationship between education and marriage for women. College-educated women were least likely to be currently married and most likely to be never married. Declines in specialization were accompanied by a transition in this relationship. By 2000, when gender specialization was low, there was a positive relationship between education and marriage for women. College-educated women were most likely to be currently married, in part because they were more likely to stay married or remarry after divorce or widowhood. This transition occurred earlier and more completely for black women than for white women. These changes suggest that the relationship between education and marriage is shaped in part by the gender-role context. PMID:22164893

HIV status, gender, and marriage dynamics among adults in Rural Malawi

PubMed Central

Anglewicz, Philip; Reniers, Georges

2014-01-01

Marriage and partnerships bring about non-negligible health risks in populations with generalized HIV epidemics, and concerns about the possible transmission of HIV thus often factor in the decision-making about partnership formation and dissolution. The awareness of and responses to HIV risk stemming from regular sexual partners have been well documented in African populations, but few studies have estimated the effects of observed HIV status on marriage decisions and outcomes. We study marriage dissolution and remarriage using longitudinal data with repeated HIV and marital status measurements from rural Malawi. Results indicate that HIV positive individuals face greater risks of union dissolution (both via widowhood and divorce) and lower remarriage rates. Modeling studies suggest that the exclusion of HIV positives from the marriage or partnerships market will decelerate the propagation of HIV. PMID:25469927

Aging of Indian women in India: the experience of older women in formal care homes.

PubMed

Kalavar, Jyotsna M; Jamuna, D

2011-01-01

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for 'pay and stay homes', an emerging type of old age home in India. Majority of the 97 women residents of 'pay and stay' homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.

Social isolation and loneliness among older people: issues and future challenges in community and residential settings.

PubMed

Grenade, Linda; Boldy, Duncan

2008-08-01

Although often associated with older age, loneliness and social isolation are not well understood in terms of their prevalence, risk and protective factors. Evidence suggests that only a minority of community-dwelling older people are "severely" lonely or isolated, however a number of factors need to be considered to fully understand the extent and significance of the problem. Community-based studies have identified a variety of risk factors for loneliness/isolation including widowhood, no (surviving) children, living alone, deteriorating health, and life events (eg, loss and bereavement). Having a confidant has been identified as a protective factor for loneliness. However, evidence is often unclear or inconclusive, especially within residential settings. We identified the need to conduct more residential care-focused research; the importance of addressing a variety of methodological concerns; and the need for practitioners to develop intervention programs that are appropriately targeted, evidence-based and evaluated.

Older widows' perspectives on sexuality: A life course perspective.

PubMed

Kasif, Talia; Band-Winterstein, Tova

2017-04-01

Sexuality is a significant component in human experience and has an important impact on the individual's general well-being. Life course events and the social construction of sexuality lead older widows to reflect upon their sexuality. To explore and describe the ways in which older widows construct and perceive their sexuality along the life course. A phenomenological-qualitative approach was conducted. Data collection was performed through in-depth, semi-structured interviews with 17 widows, between the ages of 62-91, followed by content analysis. Three major themes emerged: (a) Approaching sexuality: Conservative vs. progressive attitudes; (b) Multiple ways of perceiving sexuality: Constructing a sexual identity along the life course; and (c) Sexual self-perception: Integrating late life and widowhood. Sexuality among widows in later life includes continuity and change processes. In the context of social construction, sexuality is a subject that should be examined in greater depth. Copyright © 2017 Elsevier Inc. All rights reserved.

Marital Biography and Health at Mid-Life*

PubMed Central

Hughes, Mary Elizabeth; Waite, Linda J.

2011-01-01

This article develops a series of hypotheses about the long-term effects of one’s history of marriage, divorce, and widowhood on health, and it tests those hypotheses using data from the Health and Retirement Study. We examine four dimensions of health at mid-life: chronic conditions, mobility limitations, self-rated health, and depressive symptoms. We find that the experience of marital disruption damages health, with the effects still evident years later; among the currently married, those who have ever been divorced show worse health on all dimensions. Both the divorced and widowed who do not remarry show worse health than the currently married on all dimensions. Dimensions of health that seem to develop slowly, such as chronic conditions and mobility limitations, show strong effects of past marital disruption, whereas others, such as depressive symptoms, seem more sensitive to current marital status. Those who spent more years divorced or widowed show more chronic conditions and mobility limitations. PMID:19711810

[The social relegation of widows living with HIV in the time of ART in Senegal].

PubMed

Desclaux, A; Boye, S; Taverne, B

2014-10-01

While prolonged widowhood is unusual in Senegalese society, some women living with HIV receiving antiretroviral therapy for ten years remained widows. Are they maintained in this situation for refusing or being unable to remarry? To understand the conditions and the reasons for this lack of "matrimonial normalization", a qualitative interview study was conducted in Dakar with 31 widows. Their living conditions are mostly marked by economic difficulties, dependence on host families, and responsibilities visà-vis their children. They refuse to remarry, regret not being able to, or wish to without success, despite the existence locally of social forms of marital union that would respond to their situation. The refusal to disclose their HIV status combined with self-stigma prevent them from improving their condition. This form of social vulnerability that remains beyond the restoration of health is ignored by public policy and HIV/AIDS community based organizations claims. It should be acknowledged and considered for defending PLWAs' rights.

Fertility, infertility and child survival of Somali women.

PubMed

Omar, M M; Högberg, U; Bergström, B

1994-09-01

The relationship of reproductive patterns, some socio-economic factors and child survival was studied in 766 rural Somali women. A structured questionnaire was the method of data collection. Teenage marriage was the norm for the women, and divorce was very common. The mean number of live births was 5.2, and the mean number of surviving children was 3.7. 2/3 of the women aged 45+ had a parity of 6 or more, about one third had had at least one miscarriage and one fifth had experienced one stillbirth. Primary infertility was observed in 7% of the women aged 45+, while 20% were considered subfertile. Verbal autopsy showed that mortality was highest among infants and accounted for 63% of the child deaths. Major causes of death were neonatal tetanus, diarrhoea and respiratory diseases. Child survival and reproductive outcome ratios were found to be negatively related to the increasing age of the mother and parity. Divorce and widowhood were also found to be associated with low child survival.

Economic well-being following marital termination: a comparison of widowed and divorced women.

PubMed

Morgan, L A

1989-03-01

Several studies of divorced and widowed women show increased odds of becoming poor following the termination of marriage. Both cross-sectional and longitudinal data suggest that the end of marriage is correlated with higher poverty rates. Less is know, however, about factors that influence economic well-being over time, and whether these factors are similar for widows and divorced women. This analysis uses data from the National Longitudinal Surveys cohort of mature women (1967-1982) to examine the probability of becoming poor after widowhood or divorce among mid-life women, and factors that seem to influence economic well-being. Findings show that 40% of widows and over 1/4 of divorced women fall into poverty for at least some time during the 1st 5 years after leaving marriage. The type of marital transition experienced by the woman is not a significant factor in economic well-being, but both age and prior economic standing have positive estimated effects.

Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa.

PubMed

Tenkorang, Eric Y

2014-03-01

Studies on associations between marriage and HIV infection among women in sub-Saharan Africa are generally inconclusive. Not enough is known about HIV risks among divorced and widowed women. This study examined the relationship between marital status and HIV infection among women in seven sub-Saharan African countries. Retrospective data from the Demographic and Health Surveys were combined with HIV biomarker data from the AIDS Indicator Survey (AIS) for analysis. Random-effects complementary log-log models were applied to examine the relationship between marital status and HIV risks controlling for theoretically relevant covariates. Compared to never-married women, widowed women were significantly more likely to be HIV positive. Similarly, married women were more likely to be infected with HIV, compared to never-married women in Lesotho and Zimbabwe. In Tanzania and Zimbabwe, divorced women had higher risks of HIV infection, compared to never-married women. Findings suggest that specific HIV programs be directed at vulnerable women, in particular those widowed. Similar programs are needed for both poorer and wealthier women.

A Multistate Life Table Analysis of Union Regimes in the United States: Trends and Racial Differentials, 1970–2002

PubMed Central

Morgan, S. Philip; Wang, Zhenglian; Gu, Danan; Yang, Chingli

2013-01-01

We estimate trends and racial differentials in marriage, cohabitation, union formation and dissolution (union regimes) for the period 1970–2002 in the United States. These estimates are based on an innovative application of multistate life table analysis to pooled survey data. Our analysis demonstrates (1) a dramatic increase in the lifetime proportions of transitions from never-married, divorced or widowed to cohabiting; (2) a substantial decrease in the stability of cohabiting unions; (3) a dramatic increase in mean ages at cohabiting after divorce and widowhood; (4) a substantial decrease in direct transition from never-married to married; (5) a significant decrease in the overall lifetime proportion of ever marrying and re-marrying in the 1970s to 1980s but a relatively stable pattern in the 1990s to 2000–2002; and (6) a substantial decrease in the lifetime proportion of transition from cohabiting to marriage. We also present, for the first time, comparable evidence on differentials in union regimes between four racial groups. PMID:24179311

Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study

PubMed Central

Cheung, Teris; Yip, Paul S.F.

2015-01-01

Recent epidemiological data suggests 13.3% of Hong Kong residents suffered from Common Mental Disorders, most frequently mixed anxiety and depressive disorder. This study examines the weighted prevalence and associated risk factors of depression, anxiety and stress among Hong Kong nurses. A total of 850 nurses were invited to participate in this cross-sectional study. Participants completed the Depression, Anxiety and Stress Scale 21 and multiple logistic regression was used to determine significant relationships between variables. Chronic past-year illness and poor self-perceived mental health were significant correlates of past-week depression, anxiety and stress. It confirmed further positive correlations between depression and divorce, widowhood and separation, job dissatisfaction, disturbance with colleagues, low physical activity levels and sleep problems. Marital status; general medicine; sleep problems, and a lack of leisure significantly correlated with anxiety. Stress was significantly associated with younger age, clinical inexperience, past-year disturbance with colleagues, low physical activity, no leisure and drinking alcohol. Nurses were more depressed, anxious and stressed than the local general population, with over one-third of our respondents classified as subject to these disorders. PMID:26371020

Worry about not having a caregiver and depressive symptoms among widowed older adults in China: the role of family support.

PubMed

Xu, Ling; Li, Yawen; Min, Joohong; Chi, Iris

2017-08-01

Using the stress-coping framework, this study examined whether worry about not having a caregiver in old age was associated with depressive symptoms among widowed Chinese older adults, including the moderating effects of self-perceived family support. Using a sample of 5331 widowed adults aged 60 years old or older from the 2006 National Sample Survey of the Aged Population in Urban/Rural China, we regressed measures of depressive symptoms on worry about not having a caregiver. We also tested moderation effects of family support. Individuals who were worried about not having a caregiver reported significantly higher levels of depressive symptoms. Feeling that their children are filial, having instrumental support from children, and having only daughters moderated the effects of worry about not having a caregiver on depressive symptoms. Our findings indicate the detrimental effects of worry about not having a caregiver on the psychological well-being of widowed older adults. This study also highlights some forms of family support that may help reduce such negative effects of widowhood.

Widowhood and Mortality: A Meta-Analysis and Meta-Regressiona

PubMed Central

Roelfs, David J.; Shor, Eran; Curreli, Misty; Clemow, Lynn; Burg, Matthew M.; Schwartz, Joseph E.

2013-01-01

The study of spousal bereavement and mortality has long been a major topic of interest for social scientists, but much remains unknown with respect to important moderating factors such as age, follow-up duration, and geographic region. The present study examines these factors using meta-analysis. Keyword searches were conducted in multiple electronic databases, supplemented by extensive iterative hand searches. We extracted 1381 mortality risk estimates from 124 publications, providing data on more than 500 million persons. Compared to married people, widowers had a mean hazard ratio (HR) of 1.23 (95% confidence interval [CI], 1.19–1.28) among HRs adjusted for age and additional covariates and a high subjective quality score. The mean HR was higher for men (HR, 1.27; 95% CI, 1.19–1.35) than for women (HR, 1.15; 95% CI: 1.08–1.22). A significant interaction effect was found between gender and mean age, with HRs decreasing more rapidly for men than for women as age increased. Other significant predictors of HR magnitude included sample size, geographic region, level of statistical adjustment, and study quality. PMID:22427278

Blood lipids and lipoproteins in married and formerly married women.

PubMed

Kushnir, T; Kristal-Boneh, E

1995-01-01

As part of the Cardiovascular Occupational Risk Factors Determination in Israel (CORDIS) study, the association between marriage termination (divorce/separation or widowhood) and blood lipids and lipoproteins was examined in a sample of 351 healthy women employed in industry. Eighty-seven former spouses were each matched with three married women (N = 264) for age, number of children, smoking status, and type of job (blue/white collar). After controlling for age, number of cigarettes per day, leisure sport participation, and daily coffee consumption, former spouses in the younger women group (younger than 45 years) had significantly higher total cholesterol, total cholesterol ratio, and LDL levels than married women. Among older women (> or = 45 years), there were no significant differences. Significantly more younger former spouses had abnormally high cholesterol and LDL levels. In both age groups, former spouses smoked more cigarettes daily. These differences between the marital status groups may be explained by stress effects and changes in primary prevention practices. If replicated, such findings would delineate a population in need of intervention to reduce disease risk.

Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study.

PubMed

Cheung, Teris; Yip, Paul S F

2015-09-07

Recent epidemiological data suggests 13.3% of Hong Kong residents suffered from Common Mental Disorders, most frequently mixed anxiety and depressive disorder. This study examines the weighted prevalence and associated risk factors of depression, anxiety and stress among Hong Kong nurses. A total of 850 nurses were invited to participate in this cross-sectional study. Participants completed the Depression, Anxiety and Stress Scale 21 and multiple logistic regression was used to determine significant relationships between variables. Chronic past-year illness and poor self-perceived mental health were significant correlates of past-week depression, anxiety and stress. It confirmed further positive correlations between depression and divorce, widowhood and separation, job dissatisfaction, disturbance with colleagues, low physical activity levels and sleep problems. Marital status; general medicine; sleep problems, and a lack of leisure significantly correlated with anxiety. Stress was significantly associated with younger age, clinical inexperience, past-year disturbance with colleagues, low physical activity, no leisure and drinking alcohol. Nurses were more depressed, anxious and stressed than the local general population, with over one-third of our respondents classified as subject to these disorders.

Psychosocial Factors Associated with Longevity in the United States: Age Differences between the Old and Oldest-Old in the Health and Retirement Study

PubMed Central

Ailshire, Jennifer A.; Crimmins, Eileen M.

2011-01-01

Recent growth in the number of adults surviving to advanced ages raises questions about the quality of life associated with increased longevity. Psychosocial factors have received relatively little attention in research on quality of life among the oldest-old. This study uses nationally representative data on older US adults to examine how social relationships, feelings of loneliness, and satisfaction with life and the aging experience differ between the oldest-old, those who have survived to age 90 or older, and older adults in their 70s. We find that the oldest-old are able to maintain social relationships with family and friends and receive more social support than younger elderly adults. Yet, the oldest-old are more likely to feel lonely due to their greater rates of widowhood. Satisfaction with life was higher among the oldest-old, but the oldest-old had more negative perceptions of the aging experience. Psychosocial dimensions of longevity should be considered in research on quality of life among the oldest-old. PMID:22028969

Psychosocial Factors Associated with Longevity in the United States: Age Differences between the Old and Oldest-Old in the Health and Retirement Study.

PubMed

Ailshire, Jennifer A; Crimmins, Eileen M

2011-01-01

Recent growth in the number of adults surviving to advanced ages raises questions about the quality of life associated with increased longevity. Psychosocial factors have received relatively little attention in research on quality of life among the oldest-old. This study uses nationally representative data on older US adults to examine how social relationships, feelings of loneliness, and satisfaction with life and the aging experience differ between the oldest-old, those who have survived to age 90 or older, and older adults in their 70s. We find that the oldest-old are able to maintain social relationships with family and friends and receive more social support than younger elderly adults. Yet, the oldest-old are more likely to feel lonely due to their greater rates of widowhood. Satisfaction with life was higher among the oldest-old, but the oldest-old had more negative perceptions of the aging experience. Psychosocial dimensions of longevity should be considered in research on quality of life among the oldest-old.

Psychological Aspects of Widowhood and Divorce

PubMed Central

Trivedi, J. K.; Sareen, Himanshu; Dhyani, Mohan

2009-01-01

Despite advances in standard of living of the population, the condition of widows and divorced women remains deplorable in society. The situation is worse in developing nations with their unique social, cultural and economic milieu, which at times ignores the basic human rights of this vulnerable section of society. A gap exists in life expectancies of men and women in both developing and developed nations. This, coupled with greater remarriage rates in men, ensures that the number of widows continues to exceed that of widowers. Moreover, with women becoming more educated, economically independent and aware of their rights, divorce rates are increasing along with associated psychological ramifications. The fact that widowed/divorced women suffer from varying psychological stressors is often ignored. It has been concluded in various studies that such stressors could be harbingers of psychiatric illnesses (e.g., depression, anxiety, substance dependence), and hence should be taken into account by treating physicians, social workers and others who come to the aid of such women. A change in mindset of the society is required before these women get their rightful place, for which a strong will is needed in the minds of the people, and in law-governing bodies. PMID:21836778

Gender differences in the reasons for participation in spouse sharing among the Okun in Nigeria.

PubMed

Osagbemi, M O; Adepetu, A A

2001-08-01

This report examines the reasons for participation in spouse sharing among the Okun with a view to identifying some factors that may present particular obstacles to women and enhance their vulnerability to the practice. A total of 1029 sexually active respondents in 5 settlements where spouse sharing is being practiced participated in the questionnaire survey aspect of the study, while 82 respondents participated in the focus group discussions. About 65% of respondents reported having ale or alase and were involved in the practice of spouse sharing. Reasons for involvement in spouse sharing include the need for economic support, sexual satisfaction, increased social status, procreation, the problems of separation/divorce and widowhood. The focus group discussions revealed a possible exploitation of the gender-based economic weakness of the women by the men in the initiation and sustenance of the practice in the Okun communities. It is recommended that for any program to achieve a considerable reduction in the practice, differences in the reasons for participation in spouse sharing among the men and women must be documented with a view to solving those problems that compel women to participate.

[Factors that influence the sexuality of the elderly: an integrative review].

PubMed

Alencar, Danielle Lopes de; Marques, Ana Paula de Oliveira; Leal, Márcia Carréra Campos; Vieira, Júlia de Cássia Miguel

2014-08-01

The scope of this article is to analyze the scientific evidence addressing the factors that influence the sexuality of the elderly. It involved an online search carried out in pairs, including original articles published between 2006 and October 2011 in Portuguese, English or Spanish, which fulfilled the requirements of the study. The MEDLINE, LILACS, CidSaúde and BDENF databases were used with the key words: sexualidade e idoso / sexuality and elderly / sexualidad y anciano. The articles selected were assessed for methodological quality using two instruments, namely CASP and the Hierarchical Classification of Evidence. After analysis, 15 articles were included in the review, which discuss the culture of asexuality of the elderly, whereby the experience of sexuality only prevails among younger people. The absence of the partner due to widowhood, attributing value to beauty standards of the young, the occurrence of disease, use of medication, and changes in sexual physiology were identified as important factors that influence the sexuality of the elderly. The conclusion drawn is that social and cultural factors, changes in body physiology, and the occurrence of disease interfere with the sexuality of the elderly, making it necessary for nursing professionals to be proactive in debunking myths and providing orientation.

Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi.

PubMed

Mkandawire-Valhmu, Lucy; Wendland, Claire; Stevens, Patricia E; Kako, Peninnah M; Dressel, Anne; Kibicho, Jennifer

2013-01-01

The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

Friend and Family Contact and Support in Early Widowhood

PubMed Central

2014-01-01

Objectives. This study explored the relative contributions of friends and family to the social and emotional well-being of women and men in the first 2–6 months following the death of their spouse or partner. Methods. Three hundred and twenty-eight widowed men (39%) and women aged 50 and older completed self-administered questionnaires that included measures of contact and satisfaction with friends and family, as well as measures of affective (i.e., grief and depression) and self-evaluative (i.e., coping self-efficacy, mastery, self-esteem) responses to loss. Results. Regression analyses supported the positive features of social support and interaction but particularly highlight the role of friends: ease of contact and satisfaction with friendship support were associated with more positive self-evaluative aspects of loss; greater frequency of friendship help was associated with more negative affective reactions, whereas higher satisfaction with friendship support was associated with more positive affective reactions. Discussion. These analyses support the voluntary and socializing functions of friendship and social support, bolstering individuals during stressful life transitions, advancing our understanding of the underexamined and particularly distinct functions of friendship in the early phases of spousal loss. PMID:24170717

The gray divorce revolution: rising divorce among middle-aged and older adults, 1990-2010.

PubMed

Brown, Susan L; Lin, I-Fen

2012-11-01

Our study documents how the divorce rate among persons aged 50 and older has changed between 1990 and 2010 and identifies the sociodemographic correlates of divorce among today's middle-aged and older adults. We used data from the 1990 U.S. Vital Statistics Report and the 2010 American Community Survey (ACS) to examine the change in the divorce rate over time. ACS data were analyzed to determine the sociodemographic correlates of divorce. The divorce rate among adults aged 50 and older doubled between 1990 and 2010. Roughly 1 in 4 divorces in 2010 occurred to persons aged 50 and older. Demographic characteristics, economic resources, and the marital biography were associated with the risk of divorce in 2010. The rate of divorce was 2.5 times higher for those in remarriages versus first marriages, whereas the divorce rate declined as marital duration rose. The traditional focus of gerontological research on widowhood must be expanded to include divorce as another form of marital dissolution. Over 600,000 people aged 50 and older got divorced in 2010 but little is known about the predictors and consequences of divorces that occur during middle and later life.

Former Stepparents’ Contact With Their Stepchildren After Midlife

PubMed Central

2013-01-01

Objectives. Based on the life course perspective and gender differences in stepparental roles, this study examines frequency of social contact between mid- to late-life stepparents and their stepchildren after stepparents’ marriage to their stepchildren’s biological parent has been dissolved through widowhood or divorce. Method. Using 5 waves of panel data on stepparent–stepchild pairs from the Health and Retirement Study (N = 12,947 stepchild observations on 4,063 stepchildren belonging to 1,663 stepparents) spanning 10 years (1998–2008), I estimate ordered logit multilevel models predicting former stepparent–stepchild contact frequency. Results. Results indicate that former stepparents have notably less frequent contact with their stepchildren than current stepparents, particularly following divorce. Widowed stepparents’ contact with their stepchildren diminishes gradually following union disruption, whereas divorced stepparents’ contact frequency drops abruptly. Former stepfathers have less contact with their stepchildren than former stepmothers. Finally, I uncover evidence of the moderating role of (step)parents’ marriage length and stepparents’ number of biological children on widowed stepparent–stepchild contact frequency. Discussion. Older stepparents’ social contact with their stepchildren is largely conditional on stepparents’ enduring marital bond to their stepchildren’s biological parent. This study contributes to a growing literature portraying relatively weak ties between older adults and their stepchildren. PMID:23591569

The relationship between mortality and time since divorce, widowhood or remarriage in Norway.

PubMed

Berntsen, Kjersti Norgård; Kravdal, Oystein

2012-12-01

The chance of dying within any given year probably depends not only on marital status in that year but also on earlier partnership history. There is still not much knowledge about such effects, however. Our intention is to see how mortality is associated with time since divorce, bereavement and remarriage and time between marital disruption and remarriage. We use register data that include the entire Norwegian population aged 40-89 from 1970 to 2008 (70,701,767 person-years of exposure and 1,484,281 deaths). The excess mortality of divorced men compared to their married counterparts increases with time since divorce, while there is no such trend among divorced women. The pattern is opposite for the widowed, among whom there are indications of a more sharply positive association with time since bereavement for women than for men, though the association is rather weak for both sexes. The remarried have higher mortality than the first-time married, with one surprising exception: men who have remarried after a period of less than 10 years as divorced or widowed have the same mortality as the married. There is no clear association between mortality and time since remarriage. We discuss possible reasons for these patterns. Copyright © 2012 Elsevier Ltd. All rights reserved.

Age and Gender Differences in Social Network Composition and Social Support Among Older Rural South Africans: Findings From the HAALSI Study.

PubMed

Harling, Guy; Morris, Katherine Ann; Manderson, Lenore; Perkins, Jessica M; Berkman, Lisa F

2018-03-26

Drawing on the "Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa" (HAALSI) baseline survey, we present data on older adults' social networks and receipt of social support in rural South Africa. We examine how age and gender differences in social network characteristics matched with patterns predicted by theories of choice- and constraint-based network contraction in older adults. We used regression analysis on data for 5,059 South African adults aged 40 and older. Older respondents reported fewer important social contacts and less frequent communication than their middle-aged peers, largely due to fewer nonkin connections. Network size difference between older and younger respondents was greater for women than for men. These gender and age differences were explicable by much higher levels of widowhood among older women compared to younger women and older men. There was no evidence for employment-related network contraction or selective retention of emotionally supportive ties. Marriage-related structural constraints impacted on older women's social networks in rural South Africa, but did not explain choice-based network contraction. These findings suggest that many older women in rural Africa, a growing population, may have an unmet need for social support.

The Gray Divorce Revolution: Rising Divorce Among Middle-Aged and Older Adults, 1990–2010

PubMed Central

2012-01-01

Purpose. Our study documents how the divorce rate among persons aged 50 and older has changed between 1990 and 2010 and identifies the sociodemographic correlates of divorce among today’s middle-aged and older adults. Design and Method. We used data from the 1990 U.S. Vital Statistics Report and the 2010 American Community Survey (ACS) to examine the change in the divorce rate over time. ACS data were analyzed to determine the sociodemographic correlates of divorce. Results. The divorce rate among adults aged 50 and older doubled between 1990 and 2010. Roughly 1 in 4 divorces in 2010 occurred to persons aged 50 and older. Demographic characteristics, economic resources, and the marital biography were associated with the risk of divorce in 2010. The rate of divorce was 2.5 times higher for those in remarriages versus first marriages, whereas the divorce rate declined as marital duration rose. Implications. The traditional focus of gerontological research on widowhood must be expanded to include divorce as another form of marital dissolution. Over 600,000 people aged 50 and older got divorced in 2010 but little is known about the predictors and consequences of divorces that occur during middle and later life. PMID:23052366

Depression and anxiety among war-widows of Nepal: a post-civil war cross-sectional study.

PubMed

Basnet, Syaron; Kandel, Pragya; Lamichhane, Prabhat

2018-02-01

Thousands of Nepalese women were widowed as a consequence of a decade (1996-2006) long civil war in Nepal. These women are at grave risk of mental health problems due to both traumatic experiences and violation of natural order of widowhood. The present study explores the depression and anxiety among war-widows. In 2012, a cross-sectional study was designed to interview 358 war-widows using validitated Beck Depression Inventory and Beck Anxiety Inventory in four districts of Nepal - Bardiya, Surkhet, Sindhupalchowk and Kavrepalanchowk with history of high conflict intensity. The prevalence of depression and anxiety was 53% and 63% respectively. Financial stress was significantly associated with depression (2.67, 95% CI: 1.40-5.07) and anxiety (2.37, 95% CI: 1.19-4.72). High autonomy of women as compared to low autonomy, high social support as compared to low social support and literacy as opposed to illiteracy was associated with less likelihood of depression and anxiety. Our results suggest high magnitude of depression and anxiety among war-widows in Nepal. Future policy efforts should be directed at providing mental health services to identify mental health issues among conflict affected individuals with focus on education, employment and activities to promote social support and autonomy at community.

Predictors of perceived togetherness in very old men and women: a 5-year follow-up study.

PubMed

Tiikkainen, P; Leskinen, E; Heikkinen, R-L

2008-01-01

Although a considerable amount of research has been carried out on older adults' social ties, most of it has focused on quantitative aspects and on cross-sectional samples. In this study, the subjective aspect of social interaction is described by the concept of perceived togetherness. The aim of this study was to examine the extent to which different factors predict perceived togetherness in men and women over a 5-year period. It also addresses the question of whether it is possible to identify different subgroups in perceived togetherness. The data were collected with structured interviews and laboratory tests from 225 elderly people at ages 80 and 85. The results showed that the predictors of perceived togetherness partly differed between sexes as well as within the groups of males and females. Predictors common to both genders were contacts with friends, less depressive symptoms, higher education level and better coping with instrumental activities of daily living (IADLs). The findings indicated the importance of friends. Widowhood and self-rated health were predictors in women but not in men. Moreover, there appeared to be two subgroups of women and men in perceived togetherness; these were labeled "socially embedded", "socially isolated", "socially active" and "solitary". The results indicate diversity in perceived togetherness and its predictors. More attention should be paid to individual differences in order to prevent loneliness and to promote older adults' well-being.

Life Interrupted: Parents' Positivity and Negativity Toward Children Following Children's and Parents' Transitions Later in Life.

PubMed

Hammersmith, Anna M

2018-03-14

Parents' and children's lives are interwoven over the life course. Parents' positivity and negativity toward children relate to children's and parents' transitions, although the nature of this relationship is unclear. This study investigated the extent to which transitions-like those tied to residence, unions, employment, parenthood, and health-related to parents' positivity and negativity. This study used the Health and Retirement Study's Psychosocial Survey from 2006 and 2010 to examine how parents' and children's transitions related to parents' positivity and negativity toward children. Children's residential independence, parents' return to employment, and widowhood increased parents' positivity. Parents' negativity was higher when children moved home or lost employment, while negativity was lower when any child divorced and following the parent's divorce. The analyses also revealed children's transitions-moving in and employment loss-mattered more than the parent's own divorce for negativity. Children's transitions indicating parenting success or children's support needs-like residential, employment, and union transitions-linked to parents' positivity and negativity toward children. Parents' transitions related to positivity and negativity were also likely related to support and strength of ties between parents and children. Moreover, children's transitions matter more than parental divorce when considering negativity, although dependent on child's transition type. This study has implications for older adults, especially as parents' feelings toward children are indicative of late-life well-being and potential support avenues.

Factors associated with the consumption of psychotropic drugs in a cohort of men and women aged 50 and over.

PubMed

Empereur, F; Baumann, M; Alla, F; Briançon, S

2003-02-01

The use of psychotropic drugs has increased continuously over recent years in industrialized countries. In Europe, France has the highest consumption of such drugs. The aim of this study was to identify the sociodemographic and medical factors associated with the use of psychotropic agents. Data, collected as part of the SUVIMAX (SUpplementation en VItamines et sels Mineraux AntioXydants) prevention trial, from a self- administered questionnaire involving 7299 subjects aged 45-60 years, were subjected to logistic regression analysis. A total of 467 subjects used psychotropic drugs (8.4% of the women, 4.6% of the men). Use of psychotropic drugs increased in subjects of both sexes with past history of depression, perception of poor health and use of other drug treatments. Widowhood in men [odds ratio (OR) = 3.4; 95% CI = 1.6-7.3] and divorce in women (OR = 2; 95% CI = 1.2-3.2) were also associated with an increased use of psychotropic drugs. Interaction was demonstrated between educational level and occupational satisfaction in men (OR = 2.9; 95% CI = 1.5-5.8) and between perception of health status and use of other types of medication in women (OR = 6.5; 95% CI = 4.6-9.5). The results of our study are consistent with those of others in demonstrating that specific socio-occupational factors in men and specific medical factors in women influence extent of use of psychotropic drugs.

Divergent Gene Expression Responses to Complicated Grief and Non-complicated Grief

PubMed Central

Irwin, Michael R.; Arevalo, Jesusa M. G.; Cole, Steven W.

2014-01-01

The “widowhood effect” (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2 years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. PMID:24380850

Social network changes and life events across the life span: a meta-analysis.

PubMed

Wrzus, Cornelia; Hänel, Martha; Wagner, Jenny; Neyer, Franz J

2013-01-01

For researchers and practitioners interested in social relationships, the question remains as to how large social networks typically are, and how their size and composition change across adulthood. On the basis of predictions of socioemotional selectivity theory and social convoy theory, we conducted a meta-analysis on age-related social network changes and the effects of life events on social networks using 277 studies with 177,635 participants from adolescence to old age. Cross-sectional as well as longitudinal studies consistently showed that (a) the global social network increased up until young adulthood and then decreased steadily, (b) both the personal network and the friendship network decreased throughout adulthood, (c) the family network was stable in size from adolescence to old age, and (d) other networks with coworkers or neighbors were important only in specific age ranges. Studies focusing on life events that occur at specific ages, such as transition to parenthood, job entry, or widowhood, demonstrated network changes similar to such age-related network changes. Moderator analyses detected that the type of network assessment affected the reported size of global, personal, and family networks. Period effects on network sizes occurred for personal and friendship networks, which have decreased in size over the last 35 years. Together the findings are consistent with the view that a portion of normative, age-related social network changes are due to normative, age-related life events. We discuss how these patterns of normative social network development inform research in social, evolutionary, cultural, and personality psychology. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Prevalence of cognitive and functional impairment in a community sample in Ribeirão Preto, Brazil.

PubMed

Lopes, Marcos A; Hototian, Sergio R; Bustamante, Sonia E Z; Azevedo, Dionísio; Tatsch, Mariana; Bazzarella, Mário C; Litvoc, Júlio; Bottino, Cássio M C

2007-08-01

This study aimed at estimating the prevalence of cognitive and functional impairment (CFI) in a community sample in Ribeirão Preto, Brazil, evaluating its distribution in relation to various socio-demographic and clinical factors. The population was a representative sample aged 60 and older, from three different socio-economic classes. Cluster sampling was applied. Instruments used to select CFI (a syndromic category that does not exclude dementia): 'Mini Mental State Examination' (MMSE), 'Fuld Object Memory Evaluation' (FOME), 'Informant Questionnaire on Cognitive Decline in the Elderly' (IQCODE), 'Bayer Activities of Daily Living Scale' (B-ADL) and clinical interviews. The data obtained were submitted to bivariate and logistic regression analysis. A sample of 1.145 elderly persons was evaluated, with a mean age of 70.9 years (60-100; DP: 7.7); 63.4% were female, and 52.8% had up to 4 years of schooling. CFI prevalence was 18.9% (n = 217). Following logistic regression analysis, higher age, low education, stroke, epilepsy and depression were associated with CFI. Female sex, widowhood, low social class and head trauma were associated with CFI only on bivariate analysis. CFI prevalence results were similar to those found by studies in Brazil, Puerto Rico and Malaysia. Cognitive and functional impairment is a rather heterogeneous condition which may be associated with various clinical conditions found in the elderly population. Due to its high prevalence and association with higher mortality and disability rates, this clinical syndrome should receive more attention on public health intervention planning.

Understanding causal associations between self-rated health and personal relationships in older adults: A review of evidence from longitudinal studies.

PubMed

Craigs, Cheryl L; Twiddy, Maureen; Parker, Stuart G; West, Robert M

2014-01-01

As we age we experience many life changes in our health, personal relationships, work, or home life which can impact on other aspects of our life. There is compelling evidence that how we feel about our health influences, or is influenced by, the personal relationships we experience with friends and relatives. Currently the direction this association takes is unclear. To assess the level of published evidence available on causal links between self-rated health and personal relationships in older adults. MEDLINE, CINAHL, and PsycINFO searches from inception to June 2012 and hand searches of publication lists, reference lists and citations were used to identify primary studies utilizing longitudinal data to investigate self-rated health and personal relationships in older adults. Thirty-one articles were identified. Only three articles employed methods suitable to explore causal associations between changes in self-rated health and changes in personal relationships. Two of these articles suggested that widowhood leads to a reduction in self-rated health in the short term, while the remaining article suggested a causal relationship between self-rated health and negative emotional support from family or friends, but this was complex and mediated by self-esteem and sense of control. While there is an abundance of longitudinal aging cohorts available which can be used to investigate self-rated health and personal relationships over time the potential for these databases to be used to investigate causal associations is currently not being recognized. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Race, Marital History, and Risks for Stroke in US Older Adults.

PubMed

Dupre, Matthew E

2016-09-01

Stroke is among the leading causes of disability and death in the United States, and racial differences are greater for stroke than for all other major chronic diseases. Considering the equally sizeable racial disparities in marital life and associated risks across adulthood, the current study hypothesizes that black-white differences in marital history play an important role in the large racial inequalities in the incidence of stroke. The major objective are to (i) demonstrate how marital history is associated with the incidence of stroke, (ii) examine how marital factors mediate and/or moderate racial disparities in stroke, and (iii) examine the factors that may explain the associations. Using retrospective and prospective data from the Health and Retirement Study ( n = 23,289), the results show that non-Hispanic (NH) blacks have significantly higher rates of marital instability, greater numbers of health-risk factors, and substantially higher rates of stroke compared with NH whites. Contrary to the cumulative disadvantage hypothesis, findings from discrete-time-hazard models show that the effects of marital history are more pronounced for NH whites than for NH blacks. Risks for stroke were significantly higher in NH whites who were currently divorced, remarried, and widowed, as well as in those with a history of divorce or widowhood, compared with NH whites who were continuously married. In NH blacks, risks for stroke were elevated only in those who had either never married or had been widowed-with no significant risks attributable to divorce. The potential mechanisms underlying the associations are assessed, and the implications of the findings are discussed.

Early Parental Death and Remarriage of Widowed Parents as Risk Factors for Alzheimer’s Disease. The Cache County Study

PubMed Central

Norton, Maria C.; Smith, Ken R.; Østbye, Truls; Tschanz, JoAnn T.; Schwartz, Sarah; Corcoran, Chris; Breitner, John C. S.; Steffens, David C.; Skoog, Ingmar; Rabins, Peter V.; Welsh-Bohmer, Kathleen A.

2011-01-01

Objectives Early parental death is associated with lifelong tendencies toward depression and chronic stress. We tested the hypothesis that, early parental death is associated with higher risk for Alzheimer’s disease (AD) in offspring. Design A population-based epidemiological study of dementia with detailed clinical evaluations, linked to one of the world’s richest sources of objective genealogical and vital statistics data. Setting Home visits with residents of a rural county in northern Utah. Participants 4,108 subjects, aged 65-105. Measurements Multi-stage dementia ascertainment protocol implemented in four triennial waves, yielding expert consensus diagnoses of 570 participants with AD and 3,538 without dementia. Parental death dates, socioeconomic status and parental remarriage after widowhood were obtained from the Utah Population Database, a large genealogical database linked to statewide birth and death records. Results Mother’s death during subject’s adolescence was significantly associated with higher rate of AD in regression models that included age, gender, education, APOE genotype, and socioeconomic status. Father’s death before subject age 5 showed a weaker association. In stratified analyses, associations were significant only when the widowed parent did not remarry. Parental death associations were not moderated by gender or APOE genotype. Findings were specific to AD and not found for non-AD dementia. Conclusions Parental death during childhood is associated with higher prevalence of AD, with different critical periods for father’s vs. mother’s death, with strength of these associations attenuated by remarriage of the widowed parent. PMID:21873837

A study on cognitive status of 50 years and above aged non-demented women in a rural area of West Bengal.

PubMed

Saha, Sanjay Kumar; Sanyal, Debasish; Bhattacharyya, Agnihotri; Bhattacharyya, Ranjan; Barman, Neepamanjari; Mukherjee, Anindya

2010-11-01

The prevalence of ageing population is increasing not only in developed countries but also in developing world like India. Epidemiological reports about cognitive impairment or dementia in elderly people from developing countries are scarce. To study the cognitive status of women more than 50 years of age and to study the relationship of sociodemographic factors with cognitive status of the study subjects a descriptive epidemiological, community based cross-sectional survey was done involving 179 old women of 50 years and above in the rural field practice area of All India Institute of Hygiene and Public Health, Kolkata. The data were analysed using Epi-info 6.04, software packages. The mean age of the sample was 64.0 +/- 7.6 years. In the total sample, 53 subjects (29.6%) were in 50-59 years, 83 (43.4%) in 60-69 years, 34 (19%) in 70-79 years and 9 (5%) in women who were more than 80 years old. The cognitive defect was found to be 42.4% in elderly women .The variables like age > 70 years, widowhood, low per capita income, economic dependence, non-support from children, not staying with own children and having no satisfaction with life, were found to be significantly associated with cognitive defect. On (stepwise) multiple regression analysis these factors together contributed to 37% of cognitive impairment among these women. Prevalence of cognitive defect of more than 40% in the elderly women of this study emphasises the need for more attention and more social security measures for this neglected group.

Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers.

PubMed

Maslow, Carey B; Caramanica, Kimberly; Welch, Alice E; Stellman, Steven D; Brackbill, Robert M; Farfel, Mark R

2015-06-01

The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster. © 2015 International Society for Traumatic Stress Studies.

Marital status, health and mortality.

PubMed

Robards, James; Evandrou, Maria; Falkingham, Jane; Vlachantoni, Athina

2012-12-01

Marital status and living arrangements, along with changes in these in mid-life and older ages, have implications for an individual's health and mortality. Literature on health and mortality by marital status has consistently identified that unmarried individuals generally report poorer health and have a higher mortality risk than their married counterparts, with men being particularly affected in this respect. With evidence of increasing changes in partnership and living arrangements in older ages, with rising divorce amongst younger cohorts offsetting the lower risk of widowhood, it is important to consider the implications of such changes for health in later life. Within research which has examined changes in marital status and living arrangements in later life a key distinction has been between work using cross-sectional data and that which has used longitudinal data. In this context, two key debates have been the focus of research; firstly, research pointing to a possible selection of less healthy individuals into singlehood, separation or divorce, while the second debate relates to the extent to which an individual's transitions earlier in the life course in terms of marital status and living arrangements have a differential impact on their health and mortality compared with transitions over shorter time periods. After reviewing the relevant literature, this paper argues that in order to fully account for changes in living arrangements as a determinant of health and mortality transitions, future research will increasingly need to consider a longer perspective and take into account transitions in living arrangements throughout an individual's life course rather than simply focussing at one stage of the life course. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Social Disadvantage and Network Turnover

PubMed Central

2015-01-01

Objectives. Research shows that socially disadvantaged groups—especially African Americans and people of low socioeconomic status (SES)—experience more unstable social environments. I argue that this causes higher rates of turnover within their personal social networks. This is a particularly important issue among disadvantaged older adults, who may benefit from stable networks. This article, therefore, examines whether social disadvantage is related to various aspects of personal network change. Method. Social network change was assessed using longitudinal egocentric network data from the National Social Life, Health, and Aging Project, a study of older adults conducted between 2005 and 2011. Data collection in Wave 2 included a technique for comparing respondents’ confidant network rosters between waves. Rates of network losses, deaths, and additions were modeled using multivariate Poisson regression. Results. African Americans and low-SES individuals lost more confidants—especially due to death—than did whites and college-educated respondents. African Americans also added more confidants than whites. However, neither African Americans nor low-SES individuals were able to match confidant losses with new additions to the extent that others did, resulting in higher levels of confidant network shrinkage. These trends are partly, but not entirely, explained by disadvantaged individuals’ poorer health and their greater risk of widowhood or marital dissolution. Discussion. Additional work is needed to shed light on the role played by race- and class-based segregation on group differences in social network turnover. Social gerontologists should examine the role these differences play in explaining the link between social disadvantage and important outcomes in later life, such as health decline. PMID:24997286

Constitution, 1989. [Selected provisions].

PubMed

1989-01-01

Chapter XII of the Hungarian Constitution, 1989, details the Fundamental Rights and Duties of Citizens. Everyone lawfully within the territory of Hungary has the right to liberty of movement and the freedom to choose his or her residence, except when restricted by law, including the right to leave his or her residence or county. The Republic of Hungary grants asylum to foreign citizens who were persecuted for racial, religious ethnic, linguistic, or political reasons. Men and women shall equally enjoy all civil, political, economic, social and political rights. Mothers are entitled to special care and protection before and after childbirth; women and juveniles are protected at work by special regulations. Every child has the right to special care an assistance from his or her family, the State, and society, for appropriate physical, spiritual, and moral development. Parents shall decide the kind of education their children receive. Hungary grants equal rights to all person within its territories, without regard to race, color, sex, language, religion, political, or other opinion, national, and social origin, property, birth and other status. Prejudicial discrimination shall be severely punished. Everyone has the right to work, to the free choice of employment and profession and to equal pay for equal work. Citizens have the right to social security, including social services necessary in old age, sickness, disability, widowhood, orphanhood an unemployment through no fault of their own. Hungary guarantees the right to culture for its citizens and realized this right by free and compulsory elementary education, by secondary and higher education which is accessible to all on the basis of capacity, and by the financial support of those receiving an education.

Together and apart: a typology of re-partnering in old age.

PubMed

Koren, Chaya

2014-08-01

The human need for love, friendship, and physical contact, and the fear of loneliness do not diminish with age. Widowhood and late-life divorce and increased life expectancy are likely to lead to alternative relationships, such as re-partnering. The purpose of this paper is to explore interplays between emotional and physical components of re-partnering in old age. Theoretical sampling of 20 couples included men who re-partnered at the age of 65+ years and women at the age of 60+ years, following termination of lifelong marriages due to death or divorce. Living arrangements included married or unmarried cohabitation under the same roof or in separate homes. Forty semi-structured interviews were tape-recorded and transcribed verbatim. The couple was the unit of analysis. Interplays between physical and emotional dimensions were examined using five abductive parameters derived from data analysis resulting in a fourfold typology of emotional and physical closeness/distance in re-partnering in old age: (1) living together (physically and emotionally); (2) living apart (physically) together (emotionally); (3) living together (physically) apart (emotionally); and (4) living apart (physically and emotionally). Findings revealed types of partner relationships that are different from lifelong marriages. The typology could help professionals working with older persons regarding what to expect in re-partnering in old age and be included in developmental theories as an option in old age. A quantitative tool for research and therapy purposes, entitled The Re-partnering in Old Age Typology Scale (RPOAT Scale), based on abductive parameters, could be established for measuring re-partnering relationship quality and classifying re-partnering couples.

[Poverty and disease: users of the primary care social services of a primary care center].

PubMed

Doz Mora, J F; Mengual, L; Torné, M; Bonilla, P

1994-06-15

To find the individual and socio-family characteristics of that sector of the population which uses Primary Care Social Services (PCSS) at the Primary Care Centre (PCC) and the social problems which occasion demand. A retrospective descriptive study, based on checking over social work case files. A PCC situated in Barcelona's second industrial belt, serving a population with a low socio-economic level. The population group under study were the users with social work files open from January 1st 1985 to July 31st 1991 (a total of 690 case histories). A representative sample of 296 was selected. In comparison with the population of the basic Health Area, the user population of the PCSS at the PCC was predominantly women, and had an older average age, a higher proportion of divorce/separation and widowhood, and, in the labour context, higher unemployment and retirement. A high proportion of one-parent families (12.8%) was found. Analysis of the work situation showed that 50% of the workers were temporary and 75% of the unemployed received no benefit. 51% of the retired people received the minimum pension and 11% received no pension. Monthly family income, recorded for 46.5% of the cases, was 75,362 pesetas (SD 37,643). The most common problems were those related to the "HEALTH" section (61%). The user population of the PCSS at the PCC is, in socio-economic terms, deteriorated, a condition closely related to the development of chronic illnesses. Tackling health inequalities from Primary Care is under discussion.

Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study

PubMed Central

2011-01-01

Background The conflict in eastern Democratic Republic of the Congo (DRC) is the deadliest since World War II. Over a decade of fighting amongst an array of armed groups has resulted in extensive human rights abuses, particularly the widespread use of sexual violence against women. Methods Using a mixed-methods approach, we surveyed a non-random sample of 255 women attending a referral hospital and two local non-governmental organizations to characterize their experiences of sexual and gender-based violence (SGBV). We then conducted focus groups of 48 women survivors of SGBV to elaborate on survey findings. Quantitative and qualitative data underwent thematic and statistical analysis respectively. Findings Of the women surveyed, 193 (75.7%) experienced rape. Twenty-nine percent of raped women were rejected by their families and 6% by their communities. Thirteen percent of women had a child from rape. Widowhood, husband abandonment, gang rape, and having a child from rape were significant risk factors for social rejection. Mixed methods findings show rape survivors were seen as "contaminated" with HIV, contributing to their isolation and over 95% could not access prophylactic care in time. Receiving support from their husbands after rape was protective against survivors' feelings of shame and social isolation. Interpretation Rape results not only in physical and psychological trauma, but can destroy family and community structures. Women face significant obstacles in seeking services after rape. Interventions offering long-term solutions for hyper-vulnerable women are vital, but lacking; reintegration programs on SGBV for women, men, and communities are also needed. PMID:22047181

Natural menopause among women below 50 years in India: A population-based study.

PubMed

Pallikadavath, Saseendran; Ogollah, Reuben; Singh, Abhishek; Dean, Tara; Dewey, Ann; Stones, William

2016-09-01

The age at which menopause naturally occurs may reflect nutritional and environmental circumstances as well as genetic factors. In this study we examined natural menopause as a marker of women's health at the population level in India and in some major States. Data from the Indian District Level Household Survey (DLHS) carried out during 2007-2008 covering 643,944 ever-married women aged 15-49 yr were used; women of older ages were not included in this survey. Since not all women in this age group had achieved natural menopause at the time of survey, Cox proportional hazard regression models were employed to obtain the median age of women reporting a natural menopause, excluding those who underwent hysterectomy. Hazard ratios (HRs) were estimated for key socio-economic and reproductive variables that could potentially affect the age at natural menopause <40 yr. Overall, menopause prior to age 40 was reported by approximately 1.5 per cent of women. In the national data set, significant associations with age at natural menopause were identified with marriage breakdown or widowhood, poverty, Muslim religious affiliation, 'scheduled caste' status, not having received schooling, rural residence, having never used contraceptive pills, not been sterilized or had an abortion, low parity and residence in the western region. Within data from five selected States examined separately, the strength of these associations varied. Associations of natural menopause with sociocultural, family planning and demographic variables were noted. Most importantly, there was an association with poverty that would require further investigation as to causality. The proportion of women experiencing early menopause may represent a useful overall indicator of women's health. The data are reassuring with regard to possible late effects of sterilization on ovarian function.

Debt, shame, and survival: becoming and living as widows in rural Kerala, India

PubMed Central

2012-01-01

Background The health and well-being of widows in India is an important but neglected issue of public health and women’s rights. We investigate the lives of Indian women as they become widows, focussing on the causes of their husband’s mortality and the ensuing consequences of these causes on their own lives and identify the opportunities and challenges that widows face in living healthy and fulfilling lives. Methods Data were collected in a Gram Panchayat (lowest level territorial decentralised unit) in the south Indian state of Kerala. Interviews were undertaken with key informants in order to gain an understanding of local constructions of ‘widowhood’ and the welfare and social opportunities for widows. Then we conducted semi-structured interviews with widows in the community on issues related to health and vulnerability, enabling us to hear perspectives from widows. Data were analysed for thematic content and emerging patterns. We synthesized our findings with theoretical understandings of vulnerability and Amartya Sen’s entitlements theory to develop a conceptual framework. Results Two salient findings of the study are: first, becoming a widow can be viewed as a type of ‘shock’ that operates similarly to other ‘economic shocks’ or ‘health shocks’ in poor countries except that the burden falls disproportionately on women. Second, widowhood is not a static phenomenon, but rather can be viewed as a multi-phased process with different public health implications at each stage. Conclusion More research on widows in India and other countries will help to both elucidate the challenges faced by widows and encourage potential solutions. The framework developed in this paper could be used to guide future research on widows. PMID:23126457

Falling through the cracks: a qualitative study of HIV risks among women who use drugs and alcohol in Northeast India

PubMed Central

2013-01-01

Background HIV risks for women who inject drugs and those who engage in sex work are well documented. Women who are dependent on non-injecting drugs and alcohol are also likely to have increased vulnerability to HIV infection, but until they actually inject drugs or engage in sex work, are unlikely to come to the attention of HIV prevention programs. Methods We undertook a qualitative study involving nine focus group discussions (FGDs) and 27 key informant interviews to investigate the context of female drug and alcohol use in two high HIV prevalence states of India (Manipur and Nagaland) and to describe their HIV risks. The FGD and interview transcripts were thematically analyzed Results The women were relatively young (mean age 31 years in Manipur and 28 years in Nagaland), but 64% in Manipur and 35% in Nagaland were widowed or divorced. Both heroin and alcohol were commonly used by the women from Manipur, while alcohol was primarily used by the women from Nagaland, especially in the context of ‘booze joints’ (illicit bars). Reasons for drug and alcohol use included: to avoid symptoms of withdrawal, to suppress emotional pain, to overcome the shame of sex work, pleasure, and widowhood. HIV vulnerability was clearly described, not only in relation to injecting drug use and sex work, but also alcohol consumption. Conclusions The contribution of alcohol use to the HIV vulnerability of women is not currently considered when HIV prevention programs are being designed and implemented leaving a group of high-risk women uncovered by much needed services such as treatment for a range of health problems including alcohol dependence. PMID:23360360

Marital status and mortality: Does family structure in childhood matter?

PubMed

Kang, Jeong-Han; Kim, Jibum; Lee, Min-Ah

2016-06-01

It is well known that marital status is significantly associated with mortality risk. Little is known, however, regarding whether and how the effects of marital status are moderated by one's own family structure in childhood. The purposes of this study are to examine whether marital status (i.e., family structure in adulthood) and living with both biological parents in childhood (i.e., family structure in childhood) are associated with mortality risk, and whether and how the effects of marital status vary depending on family structure in childhood and gender. We analyze the risk of death in five waves of the General Social Survey (GSS) from 1994 through 2002 after linking the GSS data to death certificate data from the National Death Index through 2008. The findings indicate that being widowed increases the risk of mortality, while living with both parents in childhood lowers it. Interestingly, analysis of the interaction between marital status and family structure in childhood reveals that the disadvantage of widowhood in terms of mortality is significantly stronger for those who lived with both parents in childhood than for those who did not. Subsample analysis by gender shows that the moderating effect of living with both parents is largely equal across men and women, though statistically more robust for men. These findings suggest that living with both parents during childhood may increase vulnerability to marital disruptions due to unwanted life events such as spousal loss. Childhood advantages, ironically, may form more stressful contexts of spousal loss by lowering one's adaptability or immunity to adulthood hardships, especially when the hardships in adulthood are characteristically opposite from the childhood advantages. Copyright © 2016 Elsevier Ltd. All rights reserved.

A review of patients with advanced cervical cancer presenting to palliative care services at Queen Elizabeth Central Hospital in Blantyre, Malawi.

PubMed

Bates, M J; Mijoya, A

2015-09-01

Cervical cancer is the commonest cancer affecting women in Malawi, which has the highest rate of this disease in the world. Most cases are diagnosed at an advanced stage. To describe the symptom burden, palliative care interventions, and outcomes of cervical cancer patients who entered care at Tiyanjane Clinic in Blantyre, Malawi, between January and December 2012. We reviewed the case files of 72 patients presenting to our hospital-based palliative care service over one year. The mean age was 49.5 years. Twenty-six patients (36%) were HIV-positive and the majority of these (n = 22; 85%) were on antiretroviral medication at presentation to palliative care. Pain (n = 66; 92%), vaginal discharge (n = 44; 61%), and unpleasant odour (n = 37; 51%) were commonly reported. Over a third of patients (n = 26; 36%) reported pain in two or more sites. Fourteen patients (19%) reported vaginal bleeding. Spousal breakdown (through widowhood or divorce) was noted in over half (n = 41; 57%) of all cases. Pain relief was provided to 69 (96%) of the patients (morphine to 40 patients; 56%). Common interventions provided included metronidazole tablets (used vaginally), sanitary items, and counselling. At the end of the study period, 18 patients (25%) were still under the care of palliative services. Access to medications such as morphine, metronidazole and tranexamic acid can improve quality of life, even when radiotherapy is limited. Health care teams require necessary skills and training, including how to perform a comprehensive assessment, with an emphasis on the provision of psychosexual counselling, to assist with the complexity of symptoms occurring in this vulnerable group.

Natural menopause among women below 50 years in India: A population-based study

PubMed Central

Pallikadavath, Saseendran; Ogollah, Reuben; Singh, Abhishek; Dean, Tara; Dewey, Ann; Stones, William

2016-01-01

Background & objectives: The age at which menopause naturally occurs may reflect nutritional and environmental circumstances as well as genetic factors. In this study we examined natural menopause as a marker of women's health at the population level in India and in some major States. Methods: Data from the Indian District Level Household Survey (DLHS) carried out during 2007-2008 covering 643,944 ever-married women aged 15-49 yr were used; women of older ages were not included in this survey. Since not all women in this age group had achieved natural menopause at the time of survey, Cox proportional hazard regression models were employed to obtain the median age of women reporting a natural menopause, excluding those who underwent hysterectomy. Hazard ratios (HRs) were estimated for key socio-economic and reproductive variables that could potentially affect the age at natural menopause <40 yr. Results: Overall, menopause prior to age 40 was reported by approximately 1.5 per cent of women. In the national data set, significant associations with age at natural menopause were identified with marriage breakdown or widowhood, poverty, Muslim religious affiliation, ‘scheduled caste’ status, not having received schooling, rural residence, having never used contraceptive pills, not been sterilized or had an abortion, low parity and residence in the western region. Within data from five selected States examined separately, the strength of these associations varied. Interpretation & conclusions: Associations of natural menopause with sociocultural, family planning and demographic variables were noted. Most importantly, there was an association with poverty that would require further investigation as to causality. The proportion of women experiencing early menopause may represent a useful overall indicator of women's health. The data are reassuring with regard to possible late effects of sterilization on ovarian function. PMID:28139535

Self-esteem across the second half of life: The role of socioeconomic status, physical health, social relationships, and personality factors.

PubMed

von Soest, Tilmann; Wagner, Jenny; Hansen, Thomas; Gerstorf, Denis

2018-06-01

Self-esteem development across adulthood has been in the center of interest for some time now. However, not much is known about factors that shape self-esteem and its development in the second half of life and whether the factors differ with age and gender. To examine these questions, this study uses 2-wave data from the population-based NorLAG study in Norway (N = 5,555; M age = 58 years; 51% women) and combines self-report data on self-esteem and personality with registry-based information on socioeconomic status (education, income, unemployment), health problems (sick leave, lifetime history of disability), and social relationships (cohabiting partner, lifetime history of divorce and widowhood). Results from latent change score models revealed that self-esteem peaked at around age 50 and declined thereafter. More importantly, lower socioeconomic status, not having a cohabiting partner, unemployment, and disability were each uniquely associated with lower levels of self-esteem and/or steeper declines in self-esteem over the 5-year study period. Over and above registry-based information, personality characteristics were relevant, with a more mature personality being associated with higher self-esteem level. Emotionally stable participants also showed less pronounced declines in self-esteem. Moreover, associations of disability and of emotional stability with self-esteem level were weaker with advancing age. Among women, self-esteem level was more strongly associated with emotional stability and less strongly with openness, compared to men. Our findings demonstrate the utility of registry-based information and suggest that physical health, social relationships, and personality factors are in manifold ways uniquely associated with self-esteem and its development later in life. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Risk Factor Detection as a Metric of STARHS Performance for HIV Incidence Surveillance Among Female Sex Workers in Kigali, Rwanda

PubMed Central

Braunstein, Sarah L; van de Wijgert, Janneke H; Vyankandondera, Joseph; Kestelyn, Evelyne; Ntirushwa, Justin; Nash, Denis

2012-01-01

Background: The epidemiologic utility of STARHS hinges not only on producing accurate estimates of HIV incidence, but also on identifying risk factors for recent HIV infection. Methods: As part of an HIV seroincidence study, 800 Rwandan female sex workers (FSW) were HIV tested, with those testing positive further tested by BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays. A sample of HIV-negative (N=397) FSW were followed prospectively for HIV seroconversion. We compared estimates of risk factors for: 1) prevalent HIV infection; 2) recently acquired HIV infection (RI) based on three different STARHS classifications (BED alone, Ax-AI alone, BED/Ax-AI combined); and 3) prospectively observed seroconversion. Results: There was mixed agreement in risk factors between methods. HSV-2 coinfection and recent STI treatment were associated with both prevalent HIV infection and all three measures of recent infection. A number of risk factors were associated only with prevalent infection, including widowhood, history of forced sex, regular alcohol consumption, prior imprisonment, and current breastfeeding. Number of sex partners in the last 3 months was associated with recent infection based on BED/Ax-AI combined, but not other STARHS-based recent infection outcomes or prevalent infection. Risk factor estimates for prospectively observed seroconversion differed in magnitude and direction from those for recent infection via STARHS. Conclusions: Differences in risk factor estimates by each method could reflect true differences in risk factors between the prevalent, recently, or newly infected populations, the effect of study interventions (among those followed prospectively), or assay misclassification. Similar investigations in other populations/settings are needed to further establish the epidemiologic utility of STARHS for identifying risk factors, in addition to incidence rate estimation. PMID:23056162

Relationship between serum selenium, sociodemographic variables, other trace elements and lipid profile in an adult Spanish population.

PubMed

González-Estecha, Montserrat; Palazón-Bru, Irene; Bodas-Pinedo, Andrés; Trasobares, Elena; Palazón-Bru, Antonio; Fuentes, Manuel; Cuadrado-Cenzual, M Ángeles; Calvo-Manuel, Elpidio

2017-09-01

Several studies have shown an inverse relationship between selenium status and cardiovascular health, although epidemiologic evidence yielded by the randomized trials did not find a beneficial effect of selenium administration. The aim of this study was to analyze the association between serum selenium levels and lipid profile adjusted by age, sex and other associated factors among a general adult population in Spain. We recruited 372 hospital employee volunteers (60 men and 312 women) with a mean age of 47 (SD: 10.9), whom were given a standardized questionnaire. Serum selenium concentration was measured by electrothermal atomization atomic absorption spectrometry. Serum copper and zinc concentrations were measured using flame atomic absorption spectrometry. The mean of serum selenium was 79.5μg/L (SD: 11.7) with no sex-dependent differences. In the multivariate linear regression analysis, the associated factors with the mean levels of selenium were: age (β=0.223; CI 95%: 0.101-0.345), p<0.001; widowhood (β=-9.668; CI 95%: -17.234 to -2.102), p=0.012; calcium supplements (β=3.949; CI 95%: 0.059-7.838), p=0.047; zinc (β=0.126; CI 95%: 0.013-0.238), p=0.028 and glucose (β=0.172; CI 95%: 0.062- 0.281), p=0.002; Participants with serum selenium≥79.5μg/L were 1.98 (OR=1.98; CI 95% 1.17-3.35; p=0.011) and 2.04 times (OR=2.04; CI 95% 1.06-3.97; p=0.034) more likely to have cholesterol ≥200mg/dL and LDL-c ≥100mg/dL respectively than those with serum selenium <79.5μg/L. Higher selenium was positively associated with increased total and LDL cholesterol but not with HDL-c and triglycerides. More studies are needed in order to confirm the lower serum selenium findings in widows. Copyright © 2016 Elsevier GmbH. All rights reserved.

Depression in an older adult rural population in India.

PubMed

Sinha, Sati P; Shrivastava, Saurabh R; Ramasamy, Jegadeesh

2013-10-01

With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. In India, increased life expectancy led to a rise in the older adult population between 2001 and 2011, expected to reach 324 million by 2050. To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community. A cross-sectional descriptive study was conducted in February and March 2012 in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of 5948, 3.1% of whom are aged ≥60 years. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent (a thumbprint was taken if the person was illiterate), participants were assessed face to face for depression using the Short Form Geriatric Depression Scale. The inclusion criterion was a score >24 on the mini-mental state examination. Final sample size was 103. Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version 17. Of 103 respondents interviewed, 73 (70.9%) were aged 60-69 years and 58 (56.3%) were male. Forty-four (42.7%) individuals (17 males, 27 females) were found to be depressed; 23 (22.3%) with mild depression, 14 (13.6%) moderate depression and 7 (6.8%) severe depression. Female sex and widowhood were significantly associated with depression. Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more comprehensive strategy in this community for timely interventions to promote mental health and prevent geriatric depression.

Culture and fertility in the Nepal Himalayas: a test of a hypothesis.

PubMed

Ross, J L

1984-01-01

In the Nepal Himalayas the Tibetan sociocultural system of fraternal polyandry (the form of marriage where 1 woman has 2 or more brothers as husbands) reduces aggregate fertility whereas Hindu marriage patterns appear to maximize fertility since there is very early and universally monogamous marriages. Over an 18-month period, reseach in the upper reaches of the Humla Distrist of northwestern Nepal focused upon 2 culturally distinct but geographically contiguous communities. 1 is Nepali speaking and high-caste Hindu; the other, Tibetan speaking and Buddhist. The 2 populations present a relatively unique natural laboratory in which several key factors (geographic, environmental and economic) are controlled. Population dynamics in these 2 communities are principally determined by patterns of fertility and mortality. A summary of a number of characteristics of the population dynamics of these 2 populations (e.g., age at 1st birth, birth interval, crude birth rate, completed fertility rate, general fertility rate, % children surviving), shows that they are more alike than dissimilar. Fertility levels between the Hindu and Tibetan population are virtually the same. While Tibetan fraternal polyandry does reduce aggregate fertility, the hypothesis that the Tibetans would have a substantially lower fertility rate than the Hindus is false, because the effects of fraternal polyandry are roughly balanced by the effects of post-widowhood celibacy among the Hindus. This study points up an important issue often overlooked in demographic analysis. Aggregate statistics such as the completed fertility rate, while important, can be deceptive, since very different factors can produce the same result at any given point in time. Diachronically, however, these underlying facotrs may change very differently. For example, fraternal poyandry is highly susceptiable to change because of the constant reevaluation of the opportunity costs associated with its practice. Anticipating the potential cause and directions of future change illustrates an important point. It is imperative in demographic analysis to elucidate the sociocultural factors underlying the reproductive performance of the populations. Culture and population dynamics are intimately intertwined in these communities.

Association of adverse childhood environment and 5-HTTLPR Genotype with late-life depression.

PubMed

Ritchie, Karen; Jaussent, Isabelle; Stewart, Robert; Dupuy, Anne-Marie; Courtet, Philippe; Ancelin, Marie-Laure; Malafosse, Alain

2009-09-01

Neurobiological and clinical studies suggest that childhood maltreatment may result in functional and structural nervous system changes that predispose the individual to depression. This vulnerability appears to be modulated by a polymorphism in the serotonin gene-linked promoter region (5-HTTLPR). Little is known, however, about the persistence of this vulnerability across the life span, although clinical studies of adult populations suggest that gene-environment interaction may diminish with aging. Depressive symptomatology and adverse and protective childhood events were examined in a population of 942 persons aged 65 years and older, taking into account sociodemographic characteristics and proximal competing causes of depression (widowhood, recent life events, vascular and neurologic disorder, and disability). Subjects were recruited between March 1999 and February 2001 and were diagnosed as depressed if they met 1 of 3 criteria: a diagnosis of major depression on the Mini-International Neuropsychiatric Interview, a score higher than 16 on the Center for Epidemiologic Studies-Depression Scale, or current treatment with an antidepressant. Exposure to traumatic events in childhood doubled the risk of late-life depression and increased the risk of repeated episodes. Not all events were found to be pathogenic; significant risk was associated with excessive sharing of parental problems, poverty or financial difficulties, mental disorder in parents, excessive physical punishment, verbal abuse from parents, humiliation, and mistreatment by an adult outside the family. Interactions were observed between the 5-HTTLPR long (L) allele, poverty, and excessive sharing of parental problems. Certain types of childhood trauma continue to constitute risk factors for depression in old age, outweighing more proximal causes. Gene environment vulnerability interaction is linked in older age to the L-carrying genotype, modulating the effects of general environmental conditions rather than aggressive acts on the individual, perhaps due to increased cardiac reactivity. Copyright 2009 Physicians Postgraduate Press, Inc.

Women's health: beyond reproductive years.

PubMed

Laskar, Ananya Ray

2011-01-01

With changing demographic profile India has more older women than men as life expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging process reflect biological, economic, and social differences. Both social and health needs of the older women are unique and distinctive as they are vulnerable. The social problems revolve around widowhood, dependency, illiteracy and lack of awareness about the policies and programmes from which they can benefit. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological problems. Lifestyle diseases form another single-most important group of health problems in the elderly women. The risk of cardiovascular disease doubles with the outcome being poorer than men. The most common causes of death among women above the age of 60 years are stroke, ischemic heart disease and COPD. Hypertensive heart disease and lower respiratory tract infections contribute to mortality in these women. Common malignancies viz. Cervical, breast and uterus in women are specific to them and account for a sizeable morbidity and mortality. In a study done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-46.8%) were very common in postmenopausal women. Half or more women had high salt and fat intake, low fruit and vegetable intake and stress. There is a need to recognize the special health needs of the women beyond the reproductive age, to be met through strengthening and reorienting the public health services at all levels starting from primary health care to secondary till tertiary care level with adequate referral linkages. All policies and programs need to have a gender perspective. At present there is lack of sensitization and appropriate training of the health personnel in dealing with the needs of elderly. Women too need to be aware to adopt healthy lifestyle and seek timely care.

Don't let the suffering make you fade away: an ethnographic study of resilience among survivors of genocide-rape in southern Rwanda.

PubMed

Zraly, Maggie; Nyirazinyoye, Laetitia

2010-05-01

Rape has been used in contemporary armed conflicts to inflict physical, psychological, cultural and social damage. In endeavoring to address the psychological damage of collective violence, some researchers and global health practitioners are turning toward post-conflict mental health promotion approaches that centrally feature resilience. Though previous findings from resilience and coping research are robust, few studies have actually investigated resilience among genocide-rape survivors in cultural context in non-Western settings. This paper presents ethnographic data gathered over 14 months (September 2005 to November 2006) in southern Rwanda on resilience among genocide-rape survivors who were members of two women's genocide survivor associations. Study methods included a content analysis of a stratified purposive sample of 44 semi-structured interviews, as well as participant-, and non-participant-observation. Resilience among genocide-rape survivors in this context was found to be shaped by the cultural-linguistic specific concepts of kwihangana (withstanding), kwongera kubaho (living again), and gukomeza ubuzima (continuing life/health), and comprised of multiple sociocultural processes that enabled ongoing social connection with like others in order to make meaning, establish normalcy, and endure suffering in daily life. The results of this research show that the process of resilience among genocide-rape survivors was the same regardless of whether genocide survivor association membership was organized around the identity of genocide-rape survivorship or the identity of widowhood. However, the genocide-rape survivors' association members were more involved with directing resilience specifically toward addressing problems associated with genocide-rape compared to the members of the genocide widows' association. The findings from this research suggest that ethnographic methods can be employed to support resilience-based post-conflict mental health promotion efforts through facilitating collective sexual violence survivors to safely socially connect around their shared experiences of rape, neutralizing social threats of stigma and marginalization. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

"She mixes her business": HIV transmission and acquisition risks among female migrants in western Kenya.

PubMed

Camlin, Carol S; Kwena, Zachary A; Dworkin, Shari L; Cohen, Craig R; Bukusi, Elizabeth A

2014-02-01

Migration and HIV research in sub-Saharan Africa has focused on HIV risks to male migrants, yet women's levels of participation in internal migration have met or exceeded those of men in the region. Moreover, studies that have examined HIV risks to female migrants found higher risk behavior and HIV prevalence among migrant compared to non-migrant women. However, little is known about the pathways through which participation in migration leads to higher risk behavior in women. This study aimed to characterize the contexts and processes that may facilitate HIV acquisition and transmission among migrant women in the Kisumu area of Nyanza Province, Kenya. We used qualitative methods, including 6 months of participant observation in women's common migration destinations and in-depth semi-structured interviews conducted with 15 male and 40 female migrants selected from these destinations. Gendered aspects of the migration process may be linked to the high risks of HIV observed in female migrants - in the circumstances that trigger migration, livelihood strategies available to female migrants, and social features of migration destinations. Migrations were often precipitated by household shocks due to changes in marital status (as when widowhood resulted in disinheritance) and gender-based violence. Many migrants engaged in transactional sex, of varying regularity, from clandestine to overt, to supplement earnings from informal sector trading. Migrant women are at high risk of HIV transmission and acquisition: the circumstances that drove migration may have also increased HIV infection risk at origin; and social contexts in destinations facilitate having multiple sexual partners and engaging in transactional sex. We propose a model for understanding the pathways through which migration contributes to HIV risks in women in high HIV prevalence areas in Africa, highlighting potential opportunities for primary and secondary HIV prevention at origins and destinations, and at key 'moments of vulnerability' in the migration process. Copyright © 2013 Elsevier Ltd. All rights reserved.

Marital status, education, and income in relation to the risk of esophageal and gastric cancer by histological type and site.

PubMed

Lagergren, Jesper; Andersson, Gunnar; Talbäck, Mats; Drefahl, Sven; Bihagen, Erik; Härkönen, Juho; Feychting, Maria; Ljung, Rickard

2016-01-15

Marital status, income, and education might influence the risk of esophageal and gastric cancer, but the literature is limited. A large study addressing subtypes of these tumors was used to clarify these associations. A nationwide, Swedish population-based cohort study from 1991 to 2010 included individuals who were 50 years old or older. Data on exposures, covariates, and outcomes were obtained from well-maintained registers. Four esophagogastric tumor subtypes were analyzed in combination and separately: esophageal adenocarcinoma, esophageal squamous cell carcinoma, cardia adenocarcinoma, and noncardia gastric adenocarcinoma. Poisson regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Analyses were stratified by sex and adjusted for confounders. Among 4,734,227 participants (60,634,007 person-years), 24,095 developed esophageal or gastric cancer. In comparison with individuals in a long marriage, increased IRRs were found among participants who were in a shorter marriage or were never married, remarried, divorced, or widowed. These associations were indicated for each tumor subtype but were generally stronger for esophageal squamous cell carcinoma. Higher education and income were associated with decreased IRRs in a seemingly dose-response manner and similarly for each subtype. In comparison with the completion of only primary school, higher tertiary education rendered an IRR of 0.64 (95% CI, 0.60-0.69) for men and an IRR of 0.68 (95% CI, 0.61-0.75) for women. Comparing participants in the highest and lowest income brackets (highest 20% vs lowest 20%) revealed an IRR of 0.74 (95% CI, 0.70-0.79) for men and an IRR of 0.83 (95% CI, 0.76-0.91) for women. Divorce, widowhood, living alone, low educational attainment, and low income increase the risk of each subtype of esophageal and gastric cancer. These associations require attention when high-risk individuals are being identified. Cancer 2016;122:207-212. © 2015 American Cancer Society. © 2015 American Cancer Society.

“She mixes her business”: HIV transmission and acquisition risks among female migrants in western Kenya

PubMed Central

Camlin, Carol S.; Kwena, Zachary A.; Dworkin, Shari L.; Cohen, Craig R.; Bukusi, Elizabeth A.

2014-01-01

Migration and HIV research in sub-Saharan Africa has focused on HIV risks to male migrants, yet women’s levels of participation in internal migration have met or exceeded those of men in the region. Moreover, studies that have examined HIV risks to female migrants found higher risk behavior and HIV prevalence among migrant compared to non-migrant women. However, little is known about the pathways through which participation in migration leads to higher risk behavior in women. This study aimed to characterize the contexts and processes that may facilitate HIV acquisition and transmission among migrant women in the Kisumu area of Nyanza Province, Kenya. We used qualitative methods, including 6 months of participant observation in women’s common migration destinations and in-depth semi-structured interviews conducted with 15 male and 40 female migrants selected from these destinations. Gendered aspects of the migration process may be linked to the high risks of HIV observed in female migrants— in the circumstances that trigger migration, livelihood strategies available to female migrants, and social features of migration destinations. Migrations were often precipitated by household shocks due to changes in marital status (as when widowhood resulted in disinheritance) and gender-based violence. Many migrants engaged in transactional sex, of varying regularity, from clandestine to overt, to supplement earnings from informal sector trading. Migrant women are at high risk of HIV transmission and acquisition: the circumstances that drove migration may have also increased HIV infection risk at origin; and social contexts in destinations facilitate having multiple sexual partners and engaging in transactional sex. We propose a model for understanding the pathways through which migration contributes to HIV risks in women in high HIV prevalence areas in Africa, highlighting potential opportunities for primary and secondary HIV prevention at origins and destinations, and at key ‘moments of vulnerability’ in the migration process. PMID:24565152

Association of Ovarian Tumor β2-Adrenergic Receptor Status with Ovarian Cancer Risk Factors and Survival.

PubMed

Huang, Tianyi; Tworoger, Shelley S; Hecht, Jonathan L; Rice, Megan S; Sood, Anil K; Kubzansky, Laura D; Poole, Elizabeth M

2016-12-01

The β 2 -adrenergic signaling pathway mediates the effects of chronic stress on ovarian cancer progression in mouse models. The relevance of this pathway to human ovarian cancer remains unknown. We assessed tumor expression of β 2 -adrenergic receptor (ADRB2) using tissue microarrays in 237 ovarian cancer cases from the Nurses' Health Studies (NHS/NHSII). Competing risks Cox regression was used to evaluate whether associations of reproductive, hormonal, and psychosocial factors with ovarian cancer risk differed by ADRB2. We also examined the association between tumor ADRB2 expression and ovarian cancer survival. Forty-five (19%) cases were positive for ADRB2 staining. High levels of anxiety symptoms were positively associated with ADRB2-positive tumors (HR, 2.59; 95% confidence interval [CI], 1.15-5.84) but not with ADRB2-negative tumors (HR, 1.16; 95% CI, 0.81-1.66; P heterogeneity = 0.07). We observed similar results for depression. No associations were observed for job strain, caregiving stress, or widowhood for either positive or negative ADRB2 status. Lifetime ovulatory years were more strongly associated with ADRB2-positive tumors (HR per 5 years, 1.60; 95% CI, 1.15-2.21) compared with ADRB2-negative tumors (HR, 1.11; 95% CI, 0.96-1.27; P heterogeneity = 0.04). Significant heterogeneity by ADRB2 was also observed for parity (P heterogeneity = 0.01), oral contraceptive use (P heterogeneity = 0.03), and age at menopause (P heterogeneity = 0.04). Tumor expression of ADRB2 was not associated with ovarian cancer mortality (HR, 1.05; 95% CI, 0.69-1.59). Several stress- and ovulation-related factors were differentially associated with ovarian tumors responsive to β 2 -adrenergic signaling. Replication in larger studies is warranted to confirm the role of β 2 -adrenergic signaling in ovarian cancer etiology. Cancer Epidemiol Biomarkers Prev; 25(12); 1587-94. ©2016 AACR. ©2016 American Association for Cancer Research.

Widows banding together.

PubMed

Owen, M

1995-01-01

In 1988, in India, more than 500 widows shocked their neighbors (and themselves) by gathering in the main square of a town to demand their pensions, legal protection so they could stay in their homes, their inheritance rights, the ability to retain their dead husband's portion of land, and proper remuneration for their labor. This event, organized by Shramjivi Samaj, a local trade union of the poor, was extremely successful in drawing public attention and public support to the formerly hidden problems of widows in a patriarchal society. SEWA, the Self-Employed Widows' Association, has expanded its programs to assist not only the already widowed but to prepare all women for eventual widowhood. SEWA members can acquire life and disability insurance on their husbands and can receive support in their efforts to protect their land from unfair claims. The Bangladesh Committee for Rural Advancement (BRAC) has trained paralegals to help enforce the aspects of Muslim law which protect widows. In Uganda, the International Federation of Women Lawyers and the Ministry of Women's Affairs helped groups of widows testify before officials in Kampala as part of a larger demonstration. Such actions not only draw public attention to the plight of widows, they also give widows the courage to demand justice from their own in-laws. The groups Philly Lutaya and TASO (the AIDS support organization) help AIDS widows in obtaining the necessities of life. TASO also trains widows to be counselors and teaches women how to write wills to protect their children. In Ghana, a grassroots "Ministry of Widows" rescues women banished from their homes and helps them find income-generating activities. In Kenya, the Widows and Orphans Societies help AIDS widows. In Africa, the widow's associations are relief and welfare-orientated. In India, the victim image has been shed, and women are becoming empowered. Widows are realizing that the support of other widows can replace and even surpass that received from their husbands. Although the plight of widows has received little attention from the international women's movement, the fact that widows are free from conjugal control and are faced with the necessity to earn a living makes them ideal agents of change.

Parental HIV disclosure in Burkina Faso: experiences and challenges in the era of HAART.

PubMed

Tiendrebeogo, Georges; Hejoaka, Fabienne; Belem, Edwige Mireille; Compaoré, Pascal Louis Germain; Wolmarans, Liezel; Soubeiga, André; Ouangraoua, Nathalie

2013-07-01

Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However, limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex, parent's older age, parent's marital history and number of children. After adjustment, it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases, children suspected, and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However, parents who disclosed to their children did not experience blame nor was their secret revealed. Rather, children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However, whether aware or not of their parents' HIV-positive status, children contribute positively to the care of parents living with HIV. Perceptions about children's vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally, without institutional counselling support, disclosure to children remains a challenge for both parents and children, which suggests a need for rethinking of current counselling practices.

Health transitions in recently widowed older women: a mixed methods study

PubMed Central

2013-01-01

Background Older recently widowed women are faced with increased health risks and chronic conditions associated not only with bereavement, but also, older age. Loss and grief, adjusting to living alone, decreased income, and managing multiple chronic conditions can impact on older women’s ability to transition following recent spousal bereavement. Providing appropriate, timely, and effective services to foster this life transition is of critical importance, yet few services directed towards these women exist in Australia, and there is little data describing the experiences of women and their support needs at this time. Methods We conducted a longitudinal mixed method study using in-depth semi-structured interviews and questionnaires that were administered three times over a twelve month period to understand the experiences and needs of older women in the period following their husbands’ deaths. Descriptive statistics and Interpretive Phenomenological Analysis were used to analyse quantitative and qualitative data, respectively, prior to data integration. Results Participants were twenty-one community-dwelling recently widowed older women who were an average age of 71 (SD 6.13) years. The majority of participants scored within normal ranges of depression, anxiety, and stress, yet a subset of participants had elevated levels of each of these constructs (37%, 27%, and 19%, respectively) throughout the study period. Positive self-reports of general health predominated, yet 86% of participants were living with one or more chronic condition and taking an average of 4 medications per day. The majority (76%) experienced exacerbations of existing conditions or were diagnosed with a new illness in the early bereavement period, leading to planned and unplanned hospitalisations and other health service use. Qualitative data provided insight into these experiences, the meanings women ascribed to them, and their reasons for enacting certain health risk behaviours. Conclusions The combination of co-morbidities, polypharmacy, and risk behaviors impacted on medication management and appeared associated with health events. The feminization of ageing and an increasing number of older women living alone with multiple chronic conditions represent significant challenges to health services and societal support systems. Older women’s transition to widowhood signals concomitant health transitions and multidimensional support needs. PMID:23597163

Characterizing sexual histories of women before formal sex-work in south India from a cross-sectional survey: implications for HIV/STI prevention.

PubMed

Mishra, Sharmistha; Ramanaik, Satyanarayana; Blanchard, James F; Halli, Shiva; Moses, Stephen; Raghavendra, T; Bhattacharjee, Parinita; Lorway, Rob; Becker, Marissa

2012-09-28

Interventions designed to prevent HIV and STIs in female sex-workers (FSWs) reach women after they formally enter the sex-trade. We aimed to characterize the pattern of sexual behaviour among FSWs from first-sex to when they identify as sex-workers (transition period) in a region with traditional (historically characterized by dedication into sex-work at first-sex) and non-traditional forms of sex-work. We conducted a cross-sectional survey of 246 traditional and 765 non-traditional FSWs across three districts in Karnataka, India. We performed univariate and multivariate logistic regression to profile FSWs most likely to engage in a commercial first-sex before identifying as a sex-worker. Sexual life-course patterns were distinguished using univariate and multivariate linear regression based on key events associated with length of transition period. Overall, 266 FSWs experienced a commercial first-sex, of whom 45.9% (95% CI: 38.2,53.7) continued a long-term relationship with the first partner. In adjusted analysis, traditional FSWs were more likely to experience a commercial first-sex (AOR 52.5, 95% CI: 27.4,100.7). The average transition time was 8.8 years (SD 3.9), but there was considerable variability between respondents. Among women who experienced a commercial first-sex, a slower transition was independently associated with non-traditional sex-work, the presence of long-term partnerships during the transition period, and ongoing partnerships at time of entry into sex-work. In the absence of a commercial first-sex, a faster transition was associated with traditional sex-work and the dissolution of long-term partnerships, while a slower transition was associated with the presence of long-term partnerships and widowhood. Only 18.5% (95% CI: 12.7,26.2) and 47.3% (95% CI: 32.7,62.3) of women reported 'always' condom use with their long-term and occasional partners during the transition period, respectively. FSWs identify as sex-workers several years after becoming sexually active, even when the first-sex is commercial in nature. Long-term partnerships are common after a commercial first-sex, and are associated with a delay in formally entering the sex-trade. The findings call for a better understanding of HIV/STI risk before FSWs identify as sex-workers, and an adaptive programme to reach this period of vulnerability.

Towards A Suicide Free Society: Identify Suicide Prevention As Public Health Policy*

PubMed Central

Singh, Ajai R.; Singh, Shakuntala A.

2004-01-01

Suicide is amongst the top ten causes of death for all age groups in most countries of the world. It is the second most important cause of death in the younger age group (15-19 yrs.) , second only to vehicular accidents.Attempted suicides are ten times the successful suicide figures, and 1-2% attempted suicides become successful suicides every year. Male sex, widowhood, single or divorced marital status, addiction to alcohol ordrugs, concomitant chronic physical or mental illness, past suicidal attempt, adverse life events, staying in lodging homes or staying alone,or in areas with a changing population, all these conditions predispose people to suicides. The key factor probably is social isolation. An important WHO Study established that out of a total of 6003 suicides,98% had a psychiatric disorder. Hence mental health professionals havean important role to play in the prevention and management of suicide.Moreover, social disintegration also increases suicides, as was witnessed in the Baltic States following collapse of the Soviet Union. Hence, reducing social isolation, preventing social disintegration and treating mental disorders is the three pronged attack that must be the crux of any public health programme to reduce/prevent suicide. This requires an integrated effort on the part of mental health professionals (including crisis intervention and medication/psychotherapy), governmental measures to tackle poverty and unemployment, and social attempts toreorient value systems and prevent sudden disintegration of norms and mores. Suicide prevention and control is thus a movement which involves the state, professionals, NGOs, volunteers and an enlightened public.Further, the Global Burden of Diseases Study has projected a rise of more than 50% in mental disorders by the year 2020 (from 9.7% in 1990to 15% in 2020). And one third of this rise will be due to Major Depression. One of the prominent causes of preventable mortality issuicidal attempts made by patients of Major Depression. Therefore facilities to tackle this condition need to be set up globally on a warfooting by governments, NGOs and health care delivery systems, if morbidity and mortality of the world population has to be seriously controlled . The need, first of all, is to identify suicide prevention as public health policy, just as we think in terms of Malaria or Polio eradication, or have achieved smallpox eradication. PMID:22815599

Couples' communication before the wife's death to cancer and the widower's feelings of guilt or regret after the loss - a population-based investigation.

PubMed

Jonasson, Junmei Miao; Hauksdóttir, Arna; Nemes, Szilard; Surkan, Pamela J; Valdimarsdóttir, Unnur; Onelöv, Erik; Steineck, Gunnar

2011-07-01

To investigate the association between couples' communication before the wife's death to cancer and the widower's feelings of guilt and regret after the loss, in a population-based data. Men (n=907) younger than 80 years and living in Sweden, who had lost their wives due to cancer, were asked 4-5 years after their loss to answer an anonymous postal questionnaire it included questions about the couple's end-of-life communication during the last 3 months of life and the widower's feelings of guilt or regret during the first 6 months after the wife's death. During the last 3 months of their wives' lives, men who had not talked about the impending death with their wives had a higher risk of experiencing feelings of guilt than men who did talk (relative risk (RR) 2.0, 95% confidence interval [CI] 1.2-3.4). Men who were not able to spend as much time as they wished with their wives had an increase in the risk of having feelings of guilt twice that of men who spent time (RR 2.0 95% CI 1.5-2.7). Men who did not talk with their wives about how they could cope practically or emotionally after the death had elevated risks of guilt feelings compared with men who talked (RR 1.8, 95% CI 1.0-3.0; RR 1.7, 95% CI 1.0-2.9, respectively). Men who realised it was too late to discuss the impending death had an increased risk of guilt feelings (RR 4.3, 95% CI 2.9-6.6). Men who thought that not everything had been brought to closure before their wives' deaths had 3.3 times increased risk of guilt feeling (RR 3.3, 95% CI 1.7-6.4). A man who does not have end-of-life discussions with his wife during the last 3 months before her death from cancer may be subject to a significantly greater risk of experiencing feelings of guilt or regret in widowhood than men who did engage in such discussions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Characterizing sexual histories of women before formal sex-work in south India from a cross-sectional survey: implications for HIV/STI prevention

PubMed Central

2012-01-01

Background Interventions designed to prevent HIV and STIs in female sex-workers (FSWs) reach women after they formally enter the sex-trade. We aimed to characterize the pattern of sexual behaviour among FSWs from first-sex to when they identify as sex-workers (transition period) in a region with traditional (historically characterized by dedication into sex-work at first-sex) and non-traditional forms of sex-work. Methods We conducted a cross-sectional survey of 246 traditional and 765 non-traditional FSWs across three districts in Karnataka, India. We performed univariate and multivariate logistic regression to profile FSWs most likely to engage in a commercial first-sex before identifying as a sex-worker. Sexual life-course patterns were distinguished using univariate and multivariate linear regression based on key events associated with length of transition period. Results Overall, 266 FSWs experienced a commercial first-sex, of whom 45.9% (95% CI: 38.2,53.7) continued a long-term relationship with the first partner. In adjusted analysis, traditional FSWs were more likely to experience a commercial first-sex (AOR 52.5, 95% CI: 27.4,100.7). The average transition time was 8.8 years (SD 3.9), but there was considerable variability between respondents. Among women who experienced a commercial first-sex, a slower transition was independently associated with non-traditional sex-work, the presence of long-term partnerships during the transition period, and ongoing partnerships at time of entry into sex-work. In the absence of a commercial first-sex, a faster transition was associated with traditional sex-work and the dissolution of long-term partnerships, while a slower transition was associated with the presence of long-term partnerships and widowhood. Only 18.5% (95% CI: 12.7,26.2) and 47.3% (95% CI: 32.7,62.3) of women reported ‘always’ condom use with their long-term and occasional partners during the transition period, respectively. Conclusions FSWs identify as sex-workers several years after becoming sexually active, even when the first-sex is commercial in nature. Long-term partnerships are common after a commercial first-sex, and are associated with a delay in formally entering the sex-trade. The findings call for a better understanding of HIV/STI risk before FSWs identify as sex-workers, and an adaptive programme to reach this period of vulnerability. PMID:23020789

[Living arrangements and social networks of elders. A selection of findings from a NESTOR-Study].

PubMed

Knipscheer, C P; Dykstra, P A; van Tilburg, T G; de Jong-Gierveld, J

1998-06-01

This article presents an overview of the design and results of the NESTOR survey 'Living Arrangements and Social Networks of Older Adults', an empirical study, started in 1992, among a representative sample of 4495 people, aged 55-89, selected from the population registers of 11 municipalities in the Netherlands. Questions were asked about living arrangements, the composition and functions of social networks, and important transitions in the marital, parental and occupational careers. The results indicated a wide diversity in living arrangements and social networks, a diversity which is particularly visible among the young old. They not only have larger networks, but are also more likely to live alone, to be divorced and to participate in shared housing arrangements. The networks vary considerably in size, from 0 to more than 40 important relationships. The decrease in network size with age appears to be directly related to specific life events such as widowhood, physical handicaps, residential moves etc. About 2/3 of the relationships are family relationships: parents, children (in law), grandchildren (in law), brothers and sisters (in law), uncles and aunts. Older people tend to be in touch at least once a month with the majority of close family members. The intensity of supportive exchanges (giving and receiving instrumental and emotional support in the twelve relationships with the highest levels of contact) is moderate, however mostly in balance. Only the very old receive somewhat more instrumental support and give considerably less than the 'young-old'. We studied the shift in balance between giving and receiving over a period of 12 months among a small proportion of the sample, checking a central hypothesis of exchange theory. In some cases a new balance evolves. In others the relationship continues to exist for a number of reasons, despite the imbalance. Early life experiences appear to be important for later life outcomes. Those who experienced the divorce of their parents before the age of 15 or those whose parents lived apart permanently (e.g. unmarried mothers) have a smaller social network and feel more lonely. Marital history has an impact on patterns of informal and formal care. E.g., those respondents without a partner who have children are less likely to use formal care than those who are childless. Among divorced elderly the use of formal care not only varies between men and women but also differs according to the marriage in which the children are born, first or second marriage. Occupational history is strongly related to the income level of older women living alone.

Epidemiology of HIV and hepatitis C infection among women who inject drugs in Northeast India: a respondent-driven sampling study.

PubMed

McFall, Allison M; Solomon, Sunil S; Lucas, Greg M; Celentano, David D; Srikrishnan, Aylur K; Kumar, Muniratnam S; Mehta, Shruti H

2017-08-01

Despite extensive research on HIV and hepatitis C (HCV) among people who inject drugs (PWID), there remains a gap in knowledge on the burden among women who inject drugs and their unique contexts and risk factors. This analysis compares HIV and HCV prevalence in female and male PWID and estimates injection and sexual risk correlates of prevalent HIV and HCV infection among women in Northeast India. Cross-sectional sample accrued using respondent-driven sampling. Seven cities in Northeast India, 2013. A total of 6457 adult PWID. Participants completed an interviewer-administered survey. HIV infection was diagnosed on-site and HCV antibody testing was performed on stored specimens. HIV and HCV prevalence estimates were stratified by gender. Among women, the association of risk correlates with HIV and HCV were estimated using multi-level logistic regression models. A total of 796 (15.9%) of the PWID were women, of whom 52.9% [95% confidence interval (CI) = 49.3-56.5%] were HIV-infected and 22.3% (CI = 19.9-24.7%) were HCV-infected. HIV and HCV prevalence among men was 17.4% (CI = 16.9-24.7%) and 30.4% (CI = 31.2-32.0%), respectively. Among women, correlates of HIV were widowhood [adjusted odds ratio (aOR) versus currently married = 4.03, CI = 2.13-7.60] and a higher number of life-time sexual partners (aOR ≥8 versus none = 3.08, CI = 1.07-8.86). Correlates of HCV were longer injection duration (aOR per 10 years = 1.70, CI = 1.25-2.27), injecting only heroin and a combination of drugs (aOR versus pharmaceuticals only = 5.63, CI = 1.68-18.9 and aOR = 2.58, CI = 1.60-4.16, respectively), sharing needles/syringes (aOR = 2.46, CI = 1.29-4.56) and a larger PWID network (aOR ≥ 51 versus 1-5 = 4.17, CI = 2.43-7.17). Women who inject drugs in Northeast India have a high HIV prevalence, which was more than double their hepatitis C (HCV) prevalence, an opposite pattern than is observed typically among male PWID. HIV infection is associated with sexual risk factors while injection-related behaviors appear to drive HCV infection. © 2017 Society for the Study of Addiction.

With progress for some. Women and development in India.

PubMed

Mazumdar, V

1984-07-01

The Committee on the Status of Women in India recognized early in its investigation that the anti-discrimination approach, reflected in laws and dependence on education, legal equality, and the franchise as major instruments for women's development, had failed to bring about a meaningful improvement in women's status. Significant processes of decline in women's status which had begun much earlier had continued unchecked after independence in 1947 and were actually accelerated by development planning. Demographic statistics which show a decline in the proportion of women in the Indian population, a declining female economic participation rate since the early 20th century, and a high rate of female migration caused by economic distress and declining employment opportunities, and rising number and proportion of women illiterates, provide evidence of the decline in women's status in India. A search for the reasons why earlier policy had failed led to realization that development aggravated the inequalities persisting within traditional roles. Women in the working sectorsof the population had traditionally played major roles in agriculture, industry, and services, but the official 5-Year Plans of the Indian government had totally ignored their contribution. Statutory laws which tried to ensure women's equality were modelled very often of the laws in industrialized societies and tended to ignore the uncoded customary laws that were closer to the realities of poor women's lives. The right of divorce, of remarriage after widowhood, and of a share of property, which were traditionally denied to elite women, were generally prevalent among the lower cases and tribes by custom, but the influence of elite culture has been eroding them for a long time. Statutory laws brought some relief to women of the elite, but not to the poor. Various working groups have identified strategies to reverse the economic marginalization of women, but acceptance of their recommendations has been halting and ambivalent. The response from implementing agencies has been extremely slow and unimaginative. The government faces problems of slowing economic growth, inflation, and rising poverty, and has not yet given priority to the issuse of women's employment and development. The only sectors in which recognition has been given to the link between women's development and general economic development are the anti-poverty programs, especially in rural areas, and competent personnel, especially at the local level where implementation occurs. The issues of dowry deaths and other violence against women have remains to be assessed.

Age difference asymmetry and a two-sex perspective.

PubMed

Ni Bhrolchain, M

1992-01-01

Age differences in marriage are examined using data from the Marriage and Divorce Statistics, Series FM2, 1966-87, in England and Wales. Specifically, there is a description of differentials in the spousal age gap by sex and marital status of the partner, trends in the age differences between spouses, the components of change in age differences, i.e., changing age at marriage, and changes in partner's marital status. Data were unavailable to answer whether or not changes in opportunity or constraint (shifts in age/sex distribution) or changing preferences in relation to age differences or both affected the shifts, but plausible interpretations are provided. The difference in ages is evident in the pattern of mean age difference in 1987 for single brides (3.0 years) and the mean gap for bachelors (1.6 years). These figures are still different from the 2.1-year gap in the marriages of 2 single partners or the 2.6-year gap for all marriages. The mean age of 1st marriages is 2.2 for both sexes, 1.6 for men and 3.0 for women. for 2nd and later marriages the pattern is reversed, where divorced women remarry to men averaging 1.7 years older while divorced men remarry a woman 5.3 years younger. The gaps among the widowed are 1.9 years for women and 6.7 years for men. The reasons for the differentials are that not all single men marry single women and the reverse, and that age differences depend on sex, marriage order for both sexes, and marital status of the partner. The longitudinal pattern of age differences being larger in remarriages than in 1st marriages is exhibited for male remarriages only; for women in remarriages the age difference is shortened from 3.0 years to 1.7 years. In comparing time trends, 1) the mean age gap is consistently larger in women's than in men's 1st marriages with a larger gap appearing closer to the present; 2) the age differences have fluctuated over time; 3) the gap in men's and women's marriages were similar up to 1970 and, between 1970-83, the age differences in women's 1st marriages increased and men's decreases; and 4) the low of 1.6 years' age difference for bachelors was the same in 1987 and 1901-5. A summary in table form is provided of the studies conducted which show variation over time in the average age difference between spouses. The implications of age differences are that calculations of the probability of widowhood will be affected as well as simulations of family and household processes. It is concluded that accurate demographic accounting requires a 2-sex perspective. Retrospective surveys should collect marital histories of men and women, particularly due to the high rates of divorce and remarriage.

[African population growth: status and prospects].

PubMed

Tabutin, D

1991-01-01

Despite great improvements over the past several years, the quality of demographic data in Africa is still a problem, and Africa remains the least well known continent. Population growth is extremely rapid, with all countries growing at annual rates of over 3%. The natural increase rate even shows some signs of increasing slightly in the next decade or so. Africa's population was estimated at 220 million in 1950, 650 million at present, and is projected at 1.5 billion by 2025. Africans represented 9% of the world population in 1960, but will increase to 19% around 2025. The rapid population growth is the result of declining mortality since the 1950s unmatched by changes in fertility. There are significant socioeconomic and rural-urban mortality differentials in Africa, but as yet only highly educated urbanites have measurably reduced their family size. 2 consequences of this rapid growth are the youth of the population, with almost 50% under 20 years, and its high density in some areas. By 2025, 18 countries will have densities of over 100 persons per sq km. Almost everywhere in Africa, family sizes are at least 6 children/woman. 3 factors explaining this high level of fertility are the earliness and universality of marriage, rates of contraceptive usage of only 4-10% in most countries, and declining durations of breast feeding and sexual abstinence, which traditionally served as brakes on fertility. As a rule, women marry young and remain married until the end of their reproductive years. Divorce and widowhood are common, but remarriage is usually rapid if the woman is still of reproductive age. Life expectancy at birth in sub-Saharan Africa has increased from some 36 years around 1950 to 50 years at present. Progress in control of mortality, and especially infant mortality, has been slower than expected, and Africa still has by far the lowest life expectancy of any major region. Regional, rural-urban, and socioeconomic mortality differentials are considerable and sometimes increasing. In some countries the gaps in life expectancy between rural and urban residents or between social classes are as high as 15 or 20 years. The major causes of death have scarcely changed in 2 or 3 decades: diarrhea, measles, acute respiratory infections, tetanus, malaria, all aggravated by malnutrition and the new scourge of AIDS. Migration and urbanization remain major components of family survival strategies. The increasing pace of urbanization has brought a decline in urban living standards. About half of the world's refugees and displaced persons are in Africa. It was not its demography that brought Africa to its current position of underdevelopment, but population will exercise enormous pressure on available resources. Already for the continents as a whole, food production is increasing less rapidly than population. The challenges are immense: from now until 2000, the working age population will increase by 49% and the school age population (6-11 years) by 58%.

Marital history, health and mortality among older men and women in England and Wales.

PubMed

Grundy, Emily M D; Tomassini, Cecilia

2010-09-15

Health benefits of marriage have long been recognised and extensively studied but previous research has yielded inconsistent results for older people, particularly older women. At older ages accumulated benefits or disadvantages of past marital experience, as well as current marital status, may be relevant, but fewer studies have considered effects of marital history. Possible effects of parity, and the extent to which these may contribute to marital status differentials in health, have also been rarely considered. We use data from the Office for National Statistics Longitudinal Study, a large record linkage study of 1% of the population of England & Wales, to analyse associations between marital history 1971-1991 and subsequent self-reported limiting long-term illness and mortality in a cohort of some 75,000 men and women aged 60-79 in 1991. We investigate whether prior marital status and time in current marital status influenced risks of mortality or long term illness using Poisson regression to analyse mortality differentials 1991-2001 and logistic regression to analyse differences in proportions reporting limiting long-term illness in 1991 and 2001. Co-variates included indicators of socio-economic status at two or three points of the adult life course and, for women, number of children borne (parity). Relative to men in long-term first marriages, never-married men, widowers with varying durations of widowerhood, men divorced for between 10 and twenty years, and men in long-term remarriages had raised mortality 1991-2001. Men in long-term remarriages and those divorced or widowed since 1971 had higher odds of long-term illness in 1991; in 2001 the long-term remarried were the only group with significantly raised odds of long-term illness. Among women, the long-term remarried also had higher odds of reporting long-term illness in 1991 and in 2001 and those remarried and previously divorced had raised odds of long-term illness and raised mortality 1991-2001; this latter effect was not significant in models including parity. All widows had raised mortality 1991-2001 but associations between widowhood of varying durations and long-term illness in 1991 or 2001 were not significant once socio-economic status was controlled. Some groups of divorced women had higher mortality risks 1991-2001 and raised odds of long-term illness in 1991. Results for never-married women showed a divergence between associations with mortality and with long-term illness. In models controlling for socio-economic status, mortality risk was raised but the association with 1991 long-term illness was not significant and in 2001 never-married women had lower odds of reporting long-term illness than women in long-term first marriages. Formally taking account of selective survival in the 20 years prior to entry to the study population had minor effects on results. Results were consistent with previous studies in showing that the relationship between marital experience and later life health and mortality is considerably modified by socio-economic factors, and additionally showed that taking women's parity into account further moderated associations. Considering marital history rather than simply current marital status provided some insights into differentials between, for example, remarried people according to prior marital status and time remarried, but these groups were relatively small and there were some disadvantages of the approach in terms of loss of statistical power. Consideration of past histories is likely to be more important for later born cohorts whose partnership experiences have been less stable and more heterogeneous.