Moon · PloS one 2011 · systematic review and meta-analysis · n=2,263,888 subjects (15 prospective cohort studies)

Widowhood and mortality: a meta-analysis.

Cited 196 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of prospective cohort studies

PubMed 21858130 · doi:10.1371/journal.pone.0023465 · record verified 2026-08-26

What was done

A random-effects meta-analysis was conducted across 15 prospective cohort studies with 2,263,888 total participants to calculate relative risk (RR) for mortality following spousal bereavement. Subgroup and meta-regression analyses evaluated differences by time since bereavement (<6 months vs. >6 months), age (<65 vs. ≥65 years), and gender.

What was found

Widowhood showed a statistically significant positive association with mortality. The excess risk was notably higher in the first six months after bereavement (RR = 1.41, 95% CI: 1.26–1.57) compared to after six months (RR = 1.14, 95% CI: 1.10–1.18). The effect did not differ significantly by age group (<65 vs. ≥65 years, P = 0.25). By gender, men experienced a statistically significant increase in mortality (RR = 1.23, 95% CI: 1.18–1.28), whereas the effect in women was not statistically significantly different from the null (RR = 1.04, 95% CI: 1.00–1.08).

Why it matters

This study provides large-scale pooled evidence quantifying the widowhood effect, demonstrating that excess mortality risk is concentrated in the acute period following spousal loss and is markedly stronger among widowed men than widowed women.

Limits

All included studies were observational cohorts, leaving potential for residual confounding from shared lifestyle, environmental, or socioeconomic factors. The abstract does not report specific causes of death, geographic distribution of cohorts, or the degree of heterogeneity across the included studies.

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