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Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Marital status, gender and cardiovascular mortality: Behavioural, psychological distress and metabolic explanations
Author(s): Molloy, Gerard
Stamatakis, Emmanuel
Randall, Gemma
Hamer, Mark
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Keywords: Cardiovascular disease
Health behaviour
Marital status
Public health Social aspects
Coronary heart disease Statistics
Issue Date: Jul-2009
Date Deposited: 29-Jun-2011
Citation: Molloy G, Stamatakis E, Randall G & Hamer M (2009) Marital status, gender and cardiovascular mortality: Behavioural, psychological distress and metabolic explanations. Social Science and Medicine, 69 (2), pp. 223-228.;
Abstract: The intermediate processes through which the various unmarried states can increase the risk of subsequent cardiovascular disease (CVD) mortality are incompletely understood. An understanding of these processes and how they may vary by gender is important for understanding why marital status is strongly and robustly associated with subsequent cardiovascular disease. In a prospective study of 13,889 men and women (mean age 52.3, SD: 11.8 yrs, range 35-95, 56.1% female) without a history of clinically diagnosed CVD, we examined the extent to which health behaviours (smoking, alcohol, physical activity), psychological distress (General Health Questionnaire-12 item) and metabolic dysregulation (obesity levels, and the presence of hypertension and diabetes) account for the association between marital status and cardiovascular mortality. There were 258 cardiovascular deaths over an average follow up of 7.1 (SD=3.3) years. The risk of cardiovascular mortality was greatest in single, never married men and separated/divorced women compared with those that were married in gender stratified models that were adjusted for age and socioeconomic group. In models that were separately adjusted, behavioural factors explained up to 33% of the variance, psychological distress explained up to 10% of the variance and metabolic dysregulation up to 16% of the variance in the observed significant associations between marital status and cardiovascular mortality. Behavioural factors were particularly important in accounting for the relationship between being separated/divorced and cardiovascular mortality in both men and women (33% and 21% of variability, respectively). The present findings suggest that health behaviour, psychological distress and metabolic dysregulation data have varying explanatory power for understanding the observed relationship between CVD mortality and unmarried states.
DOI Link: 10.1016/j.socscimed.2009.05.010
Rights: Published in Social Science and Medicine by Elsevier. Social Science and Medicine, Volume 69, Issue 2, July 2009, pp. 223 - 228.; This is the peer reviewed version of this article.; NOTICE: this is the author’s version of a work that was accepted for publication in Social Science and Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Social Science and Medicine, VOL 69, ISSUE 2, (July 2009). DOI: 10.1016/j.socscimed.2009.05.010

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