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A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001-2011.

Abstract：

BACKGROUND:Mortality risk is lower in married than in unmarried men and women. However, little is known about the association between mortality and relationship status in South Africa where marriage rates are low, migration is common, many couples are not co-resident and HIV prevalence is high. METHOD:Using demographic surveillance data collected from 2001 to 2011, relationship status was categorised as conjugal (partners belong to the same household), non-conjugal (partners do not belong to the same household) or not partnered. Rates of relationship formation and dissolution were calculated by age and sex. Controlling for antiretroviral treatment (ART) introduction in 2005 as well as education, sex-specific and age-specific Cox proportional hazards models were used to investigate the association between relationship status and (1) all-cause mortality and (2) non-AIDS mortality. RESULTS:Before 2005, individuals in conjugal relationships had a lower hazard of all-cause mortality in all age groups than not partnered men and women. Non-conjugal relationships lowered the risk of dying compared with not partnered men and women in fewer age groups. After ART introduction, the protective association of conjugal relationships was weaker but remained generally significant for men and women but not in non-conjugal relationships. In the later period, the association is reversed in young men (20-29 years) with mortality higher in conjugal and non-conjugal relationships compared with men not partnered. The analysis of non-AIDS deaths provided similar results. CONCLUSIONS:The higher degree of social connections within a shared household environment that characterises conjugal relationships affords men and women greater protection against mortality.

journal_name

J Epidemiol Community Health

journal_title

Journal of epidemiology and community health

authors

Channon M,Hosegood V,McGrath N

doi

10.1136/jech-2014-205408

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

56-64

issue

eissn

0143-005X

issn

1470-2738

pii

jech-2014-205408

journal_volume

pub_type

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A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001-2011.