Estimating adult mortality levels from information on widowhood

Summary A range of indirect techniques has been developed for mortality estimation in societies lacking adequate vital registration records. Information on orphanhood has been widely used as an estimator of adult mortality, with generally plausible results. Doubts have remained, however, about potential biases, and the method is less satisfactory for the estimation of male mortality. Information on widowhood, or more strictly the survival of first spouse, has several possible advantages over information on orphanhood. Model first marriage functions and model life tables are used to calculate proportions widowed of first spouse, for both females and males, by marital duration and by age. These proportions widowed are then related to life table survivorship probabilities to provide weighting factors for the conversion of observed proportions widowed into estimates of survivorship probabilities. The application of the method is illustrated with data collected by the 1974 post-enumeration survey of Bangladesh, with apparently encouraging results.     

African-American marriage in 1910: Beneath the surface of census data

This paper examines the quality of information about marital status, marital duration, and marriage order among African-American women in the U.S. Census of 1910. It compares the reported prevalence of widowhood to estimates of widowhood based on the mortality of black men and on the ages of women at first marriage. It also compares the reported distributions of duration of first marriage to estimates based on mortality and on age at first marriage. It concludes that census reports are subject to serious error. Widowhood is overreported, and marital turnover appears to have been faster than implied by census reports. The prevalance of "own children" is used to confirm these conclusions and to suggest motivations for misreporting.     

Fertility and mortality estimation from the Panama Retrospective Demographic Survey, 1976

Summary Data from the Retrospective Demographic Survey of Panama offer a unique opportunity to test a wide range of methods for estimating indirectly basic demographic parameters from inaccurate and incomplete data. Our primary emphasis is to evaluate methods for estimating adult mortality from information on widowhood and orphanhood, though estimates of childhood mortality obtained from information on sibling and child survivorship are assessed as well. The results for most of the estimating procedures are consistent; this finding is encouraging because it lends support to the hypothesis that the techniques can provide good estimates of mortality. Methods which produce results which are inconsistent provide valuable lessons. In particular, methods for providing unconditional estimates of values ofl (x) for adults by combining directly information on childhood mortality and adult mortality are shown to produce estimates which predominantly reflect the level of childhood mortality employed. Furthermore, within-method consistency of estimates appears to be a very poor indicator of reliable performance of the estimating technique or quality of data, since most methods yielded estimates which were internally consistent, though estimates made by different methods could differ considerably. In summary, the analysis indicates a birth rate of around 35 per thousand, a death rate of around 7.5 per thousand, a total fertility ratio of about 4.8, and expectations of life at birth of approximately 59 and 64 years for men and women respectively.     

Sex differences in life cycle measures of widowhood

Using formulas which measure life cycle characteristics of widowhood as a function of life table survivorship and age at marriage, we illustrate changes in patterns of widowhood and widowerhood since 1950, as well as differences by race, by age of bride and of groom, and by age differences between spouses. Although the current inequality in the risks of widowhood and widowerhood for the average couple is mostly due to sex differences in mortality, a one year age difference between spouses has about the same impact as does a one year difference in life expectancy. Calculations based on current distributions of age of groom by age of bride indicate that the older the age of groom, the greater the age difference between spouses and the higher the likelihood of a woman outliving her husband: the typical groom who marries in his fifties faces a 4 to 1 chance that he will be outlived by his spouse.     

丧偶对中国老人死亡风险的影响——年龄组差异及其健康因素的作用

基于"中国老人健康长寿影响因素研究数据"(1998~2008),利用Cox比例风险模型分析丧偶对老人死亡风险的影响及其健康因素的调节作用,并深入讨论此影响的年龄组差异。结果发现:老人丧偶与其死亡风险有非常显著的关系,在控制健康变量后,这种关系仍然显著存在,不过有很大程度的减弱。此外,长期丧偶对死亡风险的影响不存在显著的年龄组差异,而新丧偶对低龄老人死亡风险的影响要远大于对高龄老人的影响。     

Hiv status and union dissolution in Sub-saharan Africa: The case of Rakai,Uganda

Little is known about the impact of HIV infection on the disruption of families through separation, divorce, and widowhood. Using life tables and multinomial logistic regression, this research examined the influence of HIV status on the risk of separation or divorce and widowhood among women in Rakai, Uganda. The multivariate results revealed that dissolution is more common among HIV-infected women and that infected women in HIV-discordant couples are especially likely to face separation or divorce than women in other HIV-status couples. These results highlight women's vulnerability to the social impact of HIV infection and the importance of dyadic studies of the disruption of unions.     

Wearing the Garment of Widowhood: Variations in Time Since Spousal Loss Among Community-Dwelling Older Adults

We examine how the passage of time since spousal loss varies by social and demographic characteristics, using data from the University of Alabama at Birmingham Study of Aging. In multivariate analyses, African American race, female sex, lower income, and higher risk of social isolation had significant and independent associations with variation in time since spousal loss. African American women were at highest risk for long-term widowhood. Accurate characterizations of widowhood among community-dwelling older adults must consider variation in the length of time individuals are living as widowed persons and socioeconomic concomitants of long-term widowhood.     

Wives and ex-wives: A new test for homogamy bias in the widowhood effect

Increased mortality following the death of a spouse (the “widowhood effect”) may be due to (1) causation, (2) bias from spousal similarity (homogamy), or (3) bias from shared environmental exposures. This article proposes new tests for bias in the widowhood effect by examining husbands, wives, and ex-wives in a longitudinal sample of over 1 million elderly Americans. If the death of an ex-wife has no causal effect on the mortality of her husband, then an observed association between the mortality of an ex-wife and her husband may indicate bias, while the absence of an effect of an ex-wife’s death on her husband’s mortality would discount the possibility of homogamy bias (and also of one type of shared-exposure bias). Results from three empirical tests provide strong evidence for an effect of a current wife’s death on her husband’s mortality yet no statistically signifi cant evidence for an effect of an ex-wife’s death on her husband’s mortality. These results strengthen the causal interpretation of the widowhood effect by suggesting that the widowhood effect is not due to homogamy bias to any substantial degree.     

Reproductive histories of Chinese women in rural Taiwan

In the summer of 19 5 3, a 3 % sample of the households in a rural area of Taiwan was enumerated. Special attention was paid to the fertility histories of women and, among other information, dates of births of live-born children to women living at the survey date were obtained. The data were extracted from registration records, occasionally checked by personal interview.

Women aged 45–64 had borne an average of 7.1 children. The oldest cohorts (women over 65 at survey) appeared to have a lower fertility. This is in part due to the reduction in the incidence of early widowhood, caused by the improved mortality of men since the beginning of the century.

The data are further analysed by parity and age at marriage.

Tabulations of the intervals between births of successive order, show that these remain constant with increasing birth order at about 2.7 years. The age at the last confinement was about 40 years.     

Exploring the Myth of Unhappiness in Former Communist Countries: The Roles of the Sex Gap in Life Expectancy and the Marital Status Composition

National average happiness and the difference in happiness between women and men are positively correlated in European countries. This study focuses on this cross-country relationship and tests (1) whether, after controlling for socio-economic factors, the correlation is attributed to their direct relationship, or, alternatively, explained by the sex difference in life expectancy, and (2) whether the correlation is not only exogenously explained but also endogenously generated by the sex difference in life expectancy. Performing regression analyses, this study shows that the correlation between happiness and its sex difference is spurious, and that the sex difference in life expectancy generates this correlation and accounts for about one-third of the correlation. A decline in happiness influences men’s mortality more than women’s, and widens the life expectancy gap between women and men. This in turn raises the widowhood ratio among women, lowers women’s average happiness, and reduces the happiness gap between women and men. The results obtained in this study points to the importance of controlling for the demographic composition of the population when we use aggregate happiness measures as national happiness indicators.     

Older Widows' Early Bereavement Adjustments

Older Black women, categorically rank at the top with regards to the greatest incidence of poverty. This paper examines the construct of poverty and the salient factors that contribute to poverty among older Black women. An analysis of the various factors: income, Social Security, private pensions, widowhood, labor force participation and education, all of which contribute to the impoverishment of women in late life, are explored. Implications for policy as well as recommendations to reduce poverty among older Black women are provided.     

Widowhood and spirituality: coping responses to bereavement

Nearly half of women age 65 or older are widows and nearly 70% of these women live alone. Because older women are three times more likely than their male counterparts to be widowed, widowhood has been labeled a primarily female phenomenon. This review article has two aims: (a) to discuss the impact of widowhood on the lives of older women and (b) to discuss how religion and spirituality may be used as coping methods for conjugal loss. After reviewing the literature the authors conclude that older women use religious coping as well as religious and spiritual beliefs and behaviors to facilitate positive adjustment to the loss of a spouse.     

Widowhood and Spirituality: Coping Responses to Bereavement

SUMMARY

Nearly half of women age 65 or older are widows and nearly 70% of these women live alone. Because older women are three times more likely than their male counterparts to be widowed, widowhood has been labeled a primarily female phenomenon. This review article has two aims: (a) to discuss the impact of widowhood on the lives of older women and (b) to discuss how religion and spirituality may be used as coping methods for conjugal loss. After reviewing the literature the authors conclude that older women use religious coping as well as religious and spiritual beliefs and behaviors to facilitate positive adjustment to the loss of a spouse.     

The effect of child mortality experience on subsequent fertility: in Pakistan and Bangladesh

Summary This paper presents an empirical analysis of the effects, behavioural and biological, of child mortality experience on subsequent fertility in two South Asian Islamic nations. Data for the investigation came from retrospective pregnancy histories of 2,910 currently married women interviewed in the Pakistan National Impact Survey (1968-69) and from longitudinal vital registration data (1966-2070) of 5,236 women residing in a rural area of Bangladesh collected by the Cholera Research Laboratory. The aim of this study was to assess the importance of the child-replacement motivational response to child death experience after biological effects have been controlled adequately. A common approach employed previously has been to examine cumulative fertility according to child death experience. In Pakistan and Bangladesh, a consistently positive relationship was demonstrated between the number of children ever born and the number of child deaths. This method, however, did not exclude the inverse relationship, the influence of fertility on mortality, nor did it dissect out behavioural from biological effects. Utilizing a measure of subsequent fertility, live-birth-to-live-birth intervals, the study further illustrated another common pitfall. Since the risk of infant death, which leads to shorter birth intervals, is associated with the mother's reproductive history, women with child mortality experience are more likely to experience shorter intervals because of the biological effect of subsequent infant death. Behavioural influences may, therefore, be observed by considering only those birth intervals in which the first-born child survives to the end of the interval. With these limitations controlled, very few, if any, behavioural influences were noted in the Pakistan and Bangladesh data. Median birth intervals in Pakistan varied between 35-43 and 41-42 months, increasing with parity. Within each parity group, no consistent difference was observed between women with and without previous child loss. In Bangladesh, the median birth interval for all women with a surviving infant was 37-2 months. This was shortened to 24-31 months by an infant death. When intervals with infant deaths were excluded, little or no behavioural influence was detected among women of the same parity, but with varying levels of previous child loss. Even without behavioural effects, elimination of infant mortality in Bangladesh would reduce fertility by prolonging the average period of post-partum sterility. In the Bangladesh setting, however, the size of the effect was only about four per cent. This modest effect, more-over, was counterbalanced by an overall increase of net reproduction by seven per cent due to better survivorship of infants.     

African widows: anthropological and historical perspectives

Variety characterizes widows' experiences around the world and in Africa south of the Sahara. This article explores the socioeconomic and cultural contexts of African widowhood, using anthropological studies in a number of African societies, including the author's research among Abaluyia of western Kenya. Some features of African widowhood are characteristic of African women's lives regardless of their marital status: their embeddedness in kinship systems and dependence on those systems for claims to productive resources, their economic self-reliance (which does not mean prosperity), strongly gendered divisions of labor, and the pervasiveness of patriarchal gender relations. Other features are specific to widowhood, including remarriage, issues of personal autonomy, and loss of status, access to productive resources and social support. Colonial and postcolonial historical transformations, including Africa's current dire economic situation and the AIDS epidemic, are considered in relation to widows' lives. An interesting question (given the theme of this edited volume) is whether a husband' s death puts African widows "on their own again," and whether, given African systems of kinship and marriage, most African women (and indeed men, too) can ever be said to be "on their own."     

Investigating the mechanism of marital mortality reduction: The transition to widowhood and quality of health care

While it is well known that the widowed suffer increased mortality risks, the mechanism of this survival disadvantage is still under investigation. In this article, we examine the quality of health care as a possible link between widowhood and mortality using a unique data set of 475,313 elderly couples who were followed up for up to nine years. We address whether the transition to widowhood affects the quality of care that individuals receive and explore the extent to which these changes mediate the elevated mortality hazard for the widowed. We analyze six established measures of quality of health care in a fixed-effect framework to account for unobserved heterogeneity. Caregiving and acute bereavement during the transition to widowhood appear to distract individuals from taking care of their own health care needs in the short run. However, being widowed does not have long-term detrimental effects on individuals’ ability to sustain contact with the formal medical system. Moreover, the short-run disruption does not mediate the widowhood effect on mortality. Nevertheless, long after spousal death, men suffer from a decline in the quality of informal care, coordination between formal and informal care, and the ability to advocate and communicate in formal medical settings. These findings illustrate women’s centrality in the household production of health and identify important points of intervention in optimizing men’s adjustment to widowhood.     

Widowhood,family size,and post-reproductive Mortality: a comparative Analysis of three populations in Nineteenth-Century Europe

Researchers from a number of disciplines have offered competing theories about the effects oJ childbearing on parents 'postreproductive longevity. The "disposable soma theory" argues that investments in somatic maintenance increase longevity but reduce childbearing. "Maternal depletion" models suggest that the rigors of childrearing increase mortality in later years. Other researchers consider continued childbearing a sign of healthy aging and a predictor of future longevity. Empirical studies have produced inconsistent and contradictory results. Our focus is on the experience of widowhood, which has been ignored in previous studies. We hypothesize that the death of a spouse is a stressful event with long-term consequences for health, especially for women with small children. Data are drawn from historical sources in Sweden, Belgium, and the Netherlands from 1766 to 1980. Postreproductive mortality was highest among young widows with larger families in all three samples. Age at last birth had little or no effect. We conclude that raising children under adverse circumstances can have long-lasting, harmful effects on a mother's health.     

Demographic aspects of fertility in Thailand

Abstract Data from a national rural and urban sample survey are analysed in order to examine various demographic aspects of fertility in Thailand. Marital fertility rates found for Thailand are among the highest in Asia. Particularly noteworthy is the persistence of high fertility at older ages of childbearing for rural women. Cumulative fertility shows a pronounced relationship with age at marriage and current marital status. Women who marry at an older age or who experience disruption of their marriages are clearly more likely to have fewer children ever born. Differences in both current and cumulative fertility are strongly associated with residence. Rural women who constitute the vast majority of Thai women, experience the highest fertility, Bangkok-Thonburi women experience the lowest fertility and provincial urban women are characterized by an intermediate fertility level which is closer, however, to the experience of their counterparts in the capital than in the countryside. Rural-urban fertility differences are mitigated but by no means eliminated by differences in infant mortality. In both rural and urban areas a positive association between cumulative fertility and infant morality is evident. Breast-feeding, commonly practised for extended periods-among both rural and urban Thai women, undoubtedly serves to some extent as an intervening variable in this relationship. A comparison of current fertility with cumulative fertility strongly suggests that a decline in marital fertility has been under way recently among urban women, especially those residing in the capital, but not at all among rural women. Although it seems safe to assume that the urban fertility decline results in large part from an increasing use of contraception among urban women, those still in the reproductive ages who were using or had previously used birth control were characterized by higher cumulative fertility than women who had never practised contraception. Evidently couples resort to family planning only late in the family building process after they have already achieved or exceeded the number of children they wish to have.     

Increased Hospitalization Risk for Recently Widowed Older Women and Protective Effects of Social Contacts

SUMMARY

This study examines effects of recent widowhood on health for a nationally representative sample of older women in the United States. Mediating effects of social connectedness on the health of recently widowed women are also explored. Using data from the 1984–1990 Longitudinal Study of Aging and Medicare claims, discrete-time hazard models estimate the risk of hospitalization for any 30-day period for women who were married at the time of the baseline survey (n = 1,138). Compared to women who are not recently widowed, those recently widowed have a 40% higher risk of hospitalization. Social connectedness, measured by having phoned a friend/neighbor or family member in the period prior to the baseline survey, significantly decreases hospitalization risk for the recently widowed. The findings indicate that recent widowhood has a large adverse effect on the health of older women. Results highlight the need to provide additional support to recently widowed older women.