Variation in the Effect of Widowhood on Mortality by the Causes of Death of Both Spouses

Objectives: We investigate the effect of spousal bereavement on mortality, and we extend prior work by documenting cause-specific bereavement effects by the causes of death both of the pre-decedent spouse and the bereaved survivor.

Methods: We examined a nationally representative cohort of 373,189 elderly married couples in the United States, followed from 1993 to 2002, using competing-risk and Cox models. Covariates included the baseline health of both spouses.

Results: In both men and women, there is significant variation in the effect of widowhood on mortality as a function of the causes of death of both spouses. The death of a spouse due to almost all causes, including various cancers, infections, and cardiovascular diseases, increases the mortality of the surviving spouse, albeit to varying degrees. Conversely, the death of a spouse increases survivor’s cause-specific mortality for almost all causes, including cancers, infections, and cardiovascular diseases, albeit to varying degrees.

Conclusions: The effect of widowhood on mortality varies substantially by the causes of death of both spouses, suggesting that the widowhood effect is not restricted to one aspect of human biology.