Frank M. Ahern, PhD¹, Debra A. Heller, PhD², Carol H. Gold, PhD¹, Kristine E. Pringle, MS², and Theresa V. Brown, MPA³. (1) Department of Biobehavioral Health, The Pennsylvania State University, 315 East Health and Human Development, University Park, PA 16802, 814-863-0185, f4a@psu.edu, (2) The PACE Program, First Health Services Corporation, 4000 Crums Mill Rd, Suite 301, Harrisburg, PA 17112, (3) The PACE Program, Pennsylvania Department of Aging, 555 Walnut St., 5th Floor, Harrisburg, PA 17101

Studies have shown that bereavement increases the risk of mortality for the surviving spouse, but results are inconsistent for differential gender effects, the time course of risk, and whether risk is affected by spousal health. We examined the survival of 6,192 couples enrolled in Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly (PACE) program who responded to a 1997 mail survey on health-related quality of life (HRQOL). Follow-up mortality data (1997-2001) were obtained from state vital statistics data.

Proportional hazards regression was used to examine survival. Covariates included baseline HRQOL, drug use, and demographics, with widowhood as a time-varying covariate. As expected, males had a higher hazard rate (HR=1.98, p<0.0001) and risk increased with age (HR=1.07, p<0.0001). Self-rated fair or poor health at baseline increased risk (HR=1.65, p<0.0001). CDC's measure of "healthy days", which incorporates physical and emotional health, independently predicted survival, with a 2% decrease in risk for each additional healthy day per month (HR=0.98, p<0.0001).

Widowhood increased risk (HR=1.31, p=0.002), but the effect was not significantly greater for widowers as opposed to widows. Across all groups, having a spouse in fair or poor health had a protective effect on one’s own survival (HR=0.84, p<0.0001) although the mechanism for this effect is unclear. Among widowed individuals, prior spousal poor health also moderated the increased risk associated with widowhood (interaction HR=0.80, p=0.06). These results suggest that spousal health has a significant impact on survival. Additional results on the time course of bereavement on mortality and effects of disease will be presented.

Learning Objectives:

• 3. Describe an analytic approach for assessing the impact of bereavement and other risk factors on mortality.
  7. Recognize factors that may mediate the impact of bereavement on short-term and long-term mortality.
  11. Understand the impact that spousal health has on the widowhood experience and mortality.
  15. Discuss changes in risk for widowed individuals that may occur over time following widowhood.

Keywords: Health Risks, Mortality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.