Effects of marital status on the risk of mortality in poor and non-poor neighborhoods

PURPOSE: The purpose of this paper is to consider whether the mortality risks associated with marital status are conditioned by the socioeconomic quality of neighborhoods. METHODS: The analysis is based on the first National Health and Nutrition Examination Survey 1971–1974 (NHANES I), and the 1987 NHANES I Epidemiologic Followup Survey (NHEFS). Cox proportional hazards regressions were used to assess whether the effect of marital status on the risk of all-cause and cause-specific mortality is altered by local area poverty. Analyses are stratified by age, sex, and urbanicity. RESULTS: The interaction between neighborhood poverty and marital status is suggested for non-elderly men, particularly for cancer mortality and for men in urban areas. Interaction effects are evident among older women residing in urban areas. CONCLUSIONS: The absence of a spouse elevates the risk of mortality but this risk is moderately higher in impoverished neighborhoods, notably in urbanized areas, for non-elderly men and elderly women. Future studies with larger samples of non-married persons where marital status changes are incorporated are needed to improve our understanding of the joint mortality effects of local area poverty and marital status.