Marital status as important social determinant of health: Lithuanian experience : [elektroninis išteklius]
Date |
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2006-08-21 |
Marital status is well known determinant of health. The aim of this study was to examine changes in mortality differentials by marital status during the period of socio-economic transition in Lithuania. Methods: The analysis was based on mortality statistics and census data for 1989 and 2001 for the entire country. Mortality rates were standardized by age. Absolute levels of mortality, as well as methods that yield inequality indices, such as rate ratios (RR) with 95% confidence intervals (CI), were used. Results: The lowest mortality rates were observed among the married population, while the widowed males and the single females were found to be at the highest mortality risk with overall mortality rates being twice higher in males and 1.6 times higher in females (p<0.05).The greatest inequalities were observed in mortality from external causes, where the widowed/married mortality RR for males reached 4.8 (CI: 2.9-6.6) and for the single/married females - 2.4 (CI: 1.9-2.9) in 2001. The magnitude of the marital differentials in overall mortality remained nearly stable both among males and females over the decade. For females, the increase was observed in cardiovascular diseases mortality differentials for the divorced, with the RR being 1.5 in 2001. For males, pattern of inequalities of mortality from cardiovascular diseases by marital status changed, and the single males appeared in the most unfavourable situation in 2001, instead of the widowed in 1989, reporting nearly twice higher mortality in comparison to the married. For overall mortality, mortality from cardiovascular diseases and, particularly, from external causes, marital differentials in males exceeded those in females. Cardiovascular diseases and external causes contributed most considerably to the excess mortality of the unmarried males, while in females cardiovascular diseases made the most significant contribution. Conclusions: General policies for health promotion and disease prevention [...].