Increased hospitalization risk for recently widowed older women and protective effects of social contacts

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.     

'Is anybody listening?' The experiences of widowhood for older Australian women

This paper discusses preliminary findings from participants in the baseline survey of the Australian Longitudinal Study on Women's Health (Women's Health Australia: WHA) who reported their marital status as widowed. A total of 12,624 women, aged 70-75 years, completed a self-administered 260-item questionnaire, and 4335 of these women were widowed. Many of these women provided additional qualitative comments about their health, social and financial circumstances after the death of their spouse. This paper presents a thematic analysis of the qualitative comments and builds on the findings of the quantitative analysis of baseline data. The aims of this part of the study are to examine the short- and long-term effects of widowhood on the health and wellbeing of older women and to explore the process of change they experience after the death of a spouse. Preliminary findings suggest that, as a key life event, widowhood has an initial negative impact on the health and wellbeing of older women, but in the long term it may be accompanied by a positive shift into a new life phase.     

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.     

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。     

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 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.     

Aging of Indian Women in India: The Experience of Older Women in Formal Care Homes

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for ‘pay and stay homes’, an emerging type of old age home in India. Majority of the 97 women residents of ‘pay and stay’ homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.     

The timing of falls into poverty after retirement and widowhood

A major concern of workers, even those financially prepared for retirement, is that a small risk of poverty may grow over time. Cross-sectional data showing that older cohorts have higher poverty rates substantiate this concern. Using data from the Retirement History Study, we analyze changes in the hazard of entering poverty as a cohort of elderly couples retire and age and the wives are widowed. The initial fall into poverty among those who were not poor before the husband retired is more closely linked to the event of retirement or widowhood than to the slowly eroding household income over the period of retirement and widowhood. The death of her retired husband puts a wife in economic jeopardy whether this shock occurs one year after his retirement or some years later.     

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.     

Estimating the incidence of widow and widower re-marriages in India from census data

Summary In this paper we develop a method for estimating the incidence of widow and widower re-marriages from the current marital status data given in a census or survey. The method basically consists of reversing the procedure of estimating adult mortality from information on widowhood status. The method is applied to the all-India data from the Census of 1971. The principal result is that about one-third of the ever widowed women and slightly fewer than two-thirds of the ever widowed men were currently remarried in 1971. Similar application of the method to earlier censuses, and to state-level data, may provide answers to some of the riddles in Indian sociology.     

New partnerships in widowhood in Spain: Realities and desires

ABSTRACT

Widowhood has traditionally been associated with the end of the family cycle; however, social and generational transformations in Spain are providing a new context for the development of new partnerships in widowhood. This study analyzes widowed persons who have found new partners and those who would be willing to do so, focusing on their characteristics and motives and related sociodemographic factors. Research is based on a sample of 306 widows and widowers in Spain taken from the survey Social Networks and Well-Being. The results reveal the importance of sociodemographic factors for both those who wish to have a partner as well as for those who have one. For the former, elements associated with quality of life are very important, while among those with a new partner, the key is not having an extensive family support network. The principal motives for looking for a new relationship are related to enjoying life more and not feeling alone; while those who reject a new relationship do so because of the belief that their lost partner is irreplaceable.     

Remarriage patterns among recent widows and widowers

Remarriage is one of the most important determinants of physical and economic well-being among the widowed. The goal of this study is to estimate how hazard rates for remarriage vary among widows and widowers on the basis of both observable and unobservable characteristics. The remarriage estimates rely on nationally representative samples of widows and widowers from the Panel Study of Income Dynamics. Continuous-time hazard rate regressions indicate strong age and duration dependence effects for middle-aged widows and widowers and for older widowers. Among middle-aged widows, blacks and those with dependent children in the home have lower rates of remarriage. For middle-aged widowers, living in urbanized areas limits the prospects of remarriage. For older widowers, education and, to some extent, economic status appear to have positive effects on the remarriage rates. Overall, age and time since widowhood have the strongest and most consistent effects on remarriage rates for different widowed groups.     

Identifying and dismantling racism in Australian perinatal settings: Reframing the narrative from a risk lens to intentionally prioritise connectedness and strengths in providing care to First Nations families

IntroductionThe perinatal period is a time when provision of responsive care offers a life course opportunity for positive change to improve health outcomes for mothers, infants and families. Australian perinatal systems carry the legacy of settler-colonialism, manifesting in racist events and interactions that First Nations parents encounter daily.ObjectiveThe dominance of a western risk lens, and conscious and unconscious bias in the child protection workforce, sustains disproportionately high numbers of First Nations infants being removed from their parents’ care. Cascading medical interventions compound existing stressors and magnify health inequities for First Nations women.DesignCritical discourse was informed by Indigenous ways of knowing, being and doing via targeted dialogue with a group of First Nations and non-Indigenous experts in Australian perinatal care who are co-authors on this paper. Dynamic discussion evolved from a series of yarning circles, supplemented by written exchanges and individual yarns as themes were consolidated.ResultsFirst Nations maternity services prioritise self-determination, partnership, strengths and communication and have demonstrated positive outcomes with, and high satisfaction from First Nations women. Mainstream perinatal settings could be significantly enhanced by embracing similar principles and models of care.Conclusions and relevanceThe Australian Anti-racism in Perinatal Practice (AAPP) Alliance calls for urgent transformations to Australian perinatal models of care whereby non-Indigenous health policy makers, managers and clinicians take a proactive role in identifying and redressing ethnocentrism, judgemental and culturally blind practices, reframing the risk narrative, embedding strength-based approaches and intentionally prioritising engagement and connectedness within service delivery.     

Social support promoting health in older women

Given the aging of women and their increased risk for health problems, it is important to explicate factors that may foster health promotion. While social support has been a concept of interest in predicting health promotion in women, the concept has been inconsistently defined and poorly explicated. A qualitative study was conducted to describe the types and processes of social support for health promotion in older women. Focus group interviews with 51 women, aged 55-93, were held. Data were analyzed using open coding to categorize data with attention to consistency and variance. Data explicated aspects of social support unique to health promotion in community-dwelling older women. Broad categories identified included connectedness and collectivism. Findings validate existing conceptualizations and provide an expanded perspective of social support by demonstrating aspects of support unique to the social context of older, community-dwelling women. Findings also provide a basis for development of socially relevant interventions designed to promote health and optimize health outcomes in older women.     

“Paper,face-to-face and on my mobile please”: A survey of women’s preferred methods of receiving antenatal education

BackgroundAntenatal education prepares women for childbirth and can be delivered face-to-face, in hard-copy and electronically. Smartphones allow access to online learning and internet searching is common among pregnant women. It is unclear which mode of health information delivery women prefer.AimThis study aimed to investigate how women at one Local Health District (LHD) preferred to receive health information during pregnancy and the early postnatal period.MethodsWe developed a survey to gather data on women’s preferences for educational information. Women who were discharged from one LHD, in NSW Australia, were invited, in 2019, to participate in a simple 14 question survey, either online or in hard copy format.FindingsIn total, 685 women completed the survey which represented a 40% response rate over a period of two months. The survey revealed women commonly used smart phones, or other devices, to source information. Despite this, most women preferred to receive antenatal education via non-electronic methods. Of note many participants felt underprepared for the post-birth period. The method of survey completion, whether hardcopy or online, aligned with individuals’ preferences for information delivery.ConclusionNon-electronic methods of education delivery were the preferred method for most women, and this was consistent across all educational, cultural and socioeconomic levels. Women sought information online, or through apps, but these options did not always meet their knowledge needs, especially regarding the postnatal period. We recommend that hospitals continue to provide information in a variety of modes, as exclusively electronic methods may marginalise groups of women.     

Stability and change in temporal distance between the elderly and their children

Drawing on a developmental model of late-life migration, this paper investigates how older people’s health and social characteristics influence stability and change in their temporal distance from their children. Data from the Longitudinal Study of Aging are used to examine both discrete transitions and continuous change in distance over a four-year period. Decline in older parents’ physical health increased the propensity of parents and children to become temporally closer to each other. Among those parent-child pairs who had become closer, the conjunction of declining health and widowhood increased both the degree of non-coresident proximity and the likelihood of transition to coresidence. The findings portray a geographically resilient family that adjusts to the changing needs of its older members.     

Transforming mental health services to address gender disparities in depression risk factors

ABSTRACT

Depression in older women is a significant and growing problem. Women who experience life stressors across the life span are at higher risk for developing depression than their male counterparts. Research has focused primarily on identifying and reducing the symptoms of depression for the general aging population, disregarding gender-specific differences in the foundational causes of depression. This article examines how women’s unique experiences influence the development of depression and highlights how the current mental health system could better meet older women’s needs by moving from a gender-neutral model to one that emphasizes women’s experiences.     

Health, widowhood, and family support in the North and South Pacific: a comparative study

This paper compares the impacts of health and widowhood on the level of support received by elderly women living in small island communities within the Philippines and Fiji. Using a theoretical perspective of ongoing reciprocal exchange as opposed to altruistic support within household economies, this paper reviews the impacts of disability and economic contributions on the level of support an elderly female receives. It is hypothesized that as the health of the widow declines her access to care will also diminish due to an inability to contribute to the household economies of the extended family. This paper extends existing work on health and family support of widowed females in the developing world by performing a cross-national comparative analysis as well as by explicitly testing the assumptions of altruism that are a central assumption of most models of long-term care in underdeveloped nations.     

Posttraumatic Stress Disorder and Older Women

SUMMARY

This article examines the literature related to the identification and treatment of posttraumatic stress disorder in older women. From this review, several key findings emerge. Consistent in the research literature is the fact that American women are more at risk for PTSD than are men as a result of the high frequency of sexual and domestic physical abuse that women experience. Studies on older women and PTSD indicate that older women are under-diagnosed and are more typically perceived as suffering from depression, anxiety or poor physical health. It was found consistently that older women who present with age-related stressors may not be asked about earlier trauma history or it may not be understood within the context of trauma-related variables. In several research studies, trauma history was often not identified either as a result of current assessment practice or because women from certain age cohorts did not disclose trauma-related data to health professionals. Key researchers emphasize the necessity of clinicians, staff and medical personnel to attend to the historical variables present in trauma histories of older women. Researchers underscore the importance of understanding the impact of early and repeated trauma, especially interpersonal trauma, on the physical health and social functioning of older women–even though a significant amount of time may have elapsed since exposure. These findings indicate that further study of PTSD in older women is warranted. The paper concludes with a discussion of assessment and treatment options.