Meta-analysis of marital dissolution and mortality: reevaluating the intersection of gender and age.
Level 1 - systematic review of randomized trials
Meta-analysis of observational cohort studies (by design analogy, non-clinical CEBM)
PubMed 22534377 · doi:10.1016/j.socscimed.2012.03.010
What was done
Authors conducted meta-analyses and meta-regressions on 625 mortality risk estimates from 104 studies published between 1955 and 2011, covering 24 countries and over 600 million persons. They evaluated the association between marital dissolution (divorce and separation) and mortality, analyzing moderators including gender, age, sample size, geography, and covariate adjustment.
What was found
The mean hazard ratio (HR) for mortality among estimates adjusted for age and additional covariates was 1.30 (95% CI, 1.23-1.37). Mortality risk was higher for men (HR, 1.37; 95% CI, 1.27-1.49) than for women (HR, 1.22; 95% CI, 1.13-1.32), though this sex difference decreased with advancing mean age. Additional significant moderators included study sample size, geographic origin (Western Europe, Israel, United Kingdom, and former Commonwealth nations), and adjustment for general health status.
Why it matters
This large meta-analysis confirms a robust association between marital dissolution and elevated mortality across international cohorts, highlighting that excess risk is most pronounced among younger men.
Limits
All included studies were observational, limiting causal inference and leaving open the possibility of residual confounding or health-selection bias. The abstract does not report specific causes of death, heterogeneity statistics, or how time since dissolution was handled.
Cited by
- supports The mortality risk associated with divorce is significantly higher for men than for women.