TY - JOUR
T1 - Smoking and Physical Activity Explain the Increased Mortality Risk Following Marital Separation and Divorce
T2 - Evidence From the English Longitudinal Study of Ageing
AU - Bourassa, Kyle J.
AU - Ruiz, John M.
AU - Sbarra, David A.
N1 - Funding Information:
The data were made available through the UK Data Archive. ELSA was developed by a team of researchers based at the NatCen Social Research, University College London and the Institute for Fiscal Studies. The data were collected by NatCen Social Research. The funding is provided by the National Institute of Aging in the USA, and a consortium of UK government departments coordinated by the Office for National Statistics. The developers and funders of ELSA and the Archive do not bear any responsibility for the analyses or interpretations presented here. The third author's work on this paper was supported in part by a grant from the National Institute of Child Health & Human Development (HD#069498). We (the three authors) declare that we do not have any additional funding sources beyond those reported.
Funding Information:
Acknowledgments The data were made available through the UK Data Archive. ELSA was developed by a team of researchers based at the NatCen Social Research, University College London and the Institute for Fiscal Studies. The data were collected by NatCen Social Research. The funding is provided by the National Institute of Aging in the USA, and a consortium of UK government departments coordinated by the Office for National Statistics. The developers and funders of ELSA and the Archive do not bear any responsibility for the analyses or interpretations presented here. The third author’s work on this paper was supported in part by a grant from the National Institute of Child Health & Human Development (HD#069498). We (the three authors) declare that we do not have any additional funding sources beyond those reported.
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: Marital separation and divorce are associated with an increased risk of early mortality, but the specific biobehavioral pathways that explain this association remain largely unknown. Purpose: This study sought to identify the putative psychological, behavioral, and biomarker variables that can help explain the association of being separated or divorced and increased risk for early mortality. Methods: Using data from the English Longitudinal Study of Ageing, a representative community sample of aging adults (N = 5,786), we examined the association of marital status and life satisfaction, health behaviors measured 2 years later, biomarkers measured 4 years later, and mortality outcomes from the subsequent 4 years. Results: Consistent with prior literature, older adults who were separated/divorced evidenced greater risk of mortality relative to those in intact marriages over the study period, OR = 1.46, 95% CI [1.15, 1.86]. Marital status was associated with lower levels of life satisfaction, β = -0.22 [-0.25, -0.19] and greater likelihood of smoking 2 years later β = 0.17 [0.13, 0.21]. Lower life satisfaction predicted less frequent physical activity 2 years later, β = 0.07 [0.03, 0.10]. Smoking, but not physical activity, predicted poorer lung functioning 2 years later, β = -0.43 [-0.51, -0.35], and poorer lung function predicted increased likelihood of mortality over the following 4 years, β = -0.15 [-0.27, -0.03]. There was a significant total indirect effect of marital status on mortality through these psychological, behavioral, and biomarker variables, β = 0.03 [0.01, 0.05], which fully explained this mortality risk. Conclusions: For separated/divorced adults, differences in life satisfaction predict health behaviors associated with poorer long-term lung function, and these intermediate variables help explain the association between marital dissolution and increased risk of earlier mortality.
AB - Background: Marital separation and divorce are associated with an increased risk of early mortality, but the specific biobehavioral pathways that explain this association remain largely unknown. Purpose: This study sought to identify the putative psychological, behavioral, and biomarker variables that can help explain the association of being separated or divorced and increased risk for early mortality. Methods: Using data from the English Longitudinal Study of Ageing, a representative community sample of aging adults (N = 5,786), we examined the association of marital status and life satisfaction, health behaviors measured 2 years later, biomarkers measured 4 years later, and mortality outcomes from the subsequent 4 years. Results: Consistent with prior literature, older adults who were separated/divorced evidenced greater risk of mortality relative to those in intact marriages over the study period, OR = 1.46, 95% CI [1.15, 1.86]. Marital status was associated with lower levels of life satisfaction, β = -0.22 [-0.25, -0.19] and greater likelihood of smoking 2 years later β = 0.17 [0.13, 0.21]. Lower life satisfaction predicted less frequent physical activity 2 years later, β = 0.07 [0.03, 0.10]. Smoking, but not physical activity, predicted poorer lung functioning 2 years later, β = -0.43 [-0.51, -0.35], and poorer lung function predicted increased likelihood of mortality over the following 4 years, β = -0.15 [-0.27, -0.03]. There was a significant total indirect effect of marital status on mortality through these psychological, behavioral, and biomarker variables, β = 0.03 [0.01, 0.05], which fully explained this mortality risk. Conclusions: For separated/divorced adults, differences in life satisfaction predict health behaviors associated with poorer long-term lung function, and these intermediate variables help explain the association between marital dissolution and increased risk of earlier mortality.
KW - Life satisfaction
KW - Lung function
KW - Marital status
KW - Mortality
KW - Physical activity
KW - Smoking
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U2 - 10.1093/abm/kay038
DO - 10.1093/abm/kay038
M3 - Article
C2 - 29796660
AN - SCOPUS:85062169320
SN - 0883-6612
VL - 53
SP - 255
EP - 266
JO - Annals of Behavioral Medicine
JF - Annals of Behavioral Medicine
IS - 3
ER -