Content area
Abstract
In Chapter I, I review the protection and selection hypotheses and the empirical evidence for each and discuss the issue of measuring mortality differentials by marital status.
Results from Chapter II indicate that mortality differentials by marital status in diverse social settings exhibit similar patterns. Specifically, unmarried women have lower excess mortality than unmarried men; divorced men have the highest death rates among unmarried groups; widowed and divorced persons in their twenties and thirties have particularly high excess mortality; and excess mortality of unmarried persons has generally increased over the past two to three decades. One notable outlier to these patterns is Japan in which the excess mortality of single persons is especially high, and excess mortality for single persons has declined over the past three decades. There is some evidence for the operation of selection factors in determining the increased mortality among unmarried persons.
Chapter III compares marital status differentials in mortality at older ages (above age 65) with those at younger ages for Japan and Sweden. Unmarried persons at older ages have lower relative mortality ratios than those at younger ages and lower mortality ratios among the elderly are also characterized by small variations by age, gender, unmarried state, and country. The use of the three alternative measures does not substantially alter our conclusions with regard to differences between men and women, among the three unmarried states, and between Japan and Sweden in marital status differential in mortality. When we focus on age patterns, however, it does make a difference as to which measure we use.
The focus of Chapter IV is marital-status specific death rates by cause of death. Relative mortality ratios are substantially higher for external causes, mental disorders, infectious diseases and cirrhosis of the liver than for all other chronic diseases. Chronic diseases account for a larger part of the excess mortality of unmarried persons. Stroke and suicide are the two most important causes of high mortality among unmarried persons in Japan; ischemic heart disease is most important in the U.S.
In Chapter V, I summarize findings for the entire study. (Abstract shortened with permission of author.)
