My transition to unmarried probably vastly increased my chances of a long life.
My story; I would still be leading a life of quiet desperation.
Why my stroke was the best thing to ever happen to me
I've been living alone now for 10+ years. I can't see getting married, it would severely limit my traveling and social connections. But there are quite a few old college roommates which could work.
Martha Gellhorn on her relationship with Ernest Hemingway
I do very well without marriage
I'd rather sin respectably any day of the week
Ernest thinks, of course, that marriage saves you a lot of trouble and he is all for it,
I think sin is very clean, there are no strings attached to it
The latest here:
Marital Transition and Risk of Stroke
Abstract
Background and Purpose—
There have been consistent findings reported that marital transition (ie, change in marital status during a given time period) is associated with risk of cardiovascular disease; however, few studies have been conducted on stroke risk, particularly stroke subtypes. Moreover, no studies have examined the moderating effect of living arrangement and employment status on the association between marital transition and stroke risk.
Methods—
We examined sex-specific associations between marital transition and stroke risk using data from Japan Public Health Center–based Prospective Study. We included 24 162 men and 25 626 women who were married at prebaseline (5 years before baseline). Marital transition was determined by marital status at baseline. Weighted hazard ratios of stroke risk were estimated by Cox proportional regression analysis with inverse probability of weighting using a propensity score.
Results—
An increased risk of stroke, particularly hemorrhagic stroke, was observed among men and women with marital transition (ie, married to unmarried); weighted hazard ratios (95% confidence interval [CI]) for men and women were 1.26 (1.13–1.41) and 1.26 (1.09–1.45), respectively. Participants with marital transition and lived with children had increased stroke risk. Living with parents buffered the increased stroke risk owing to marital transition among men; however, no such effect was identified among women. Elevated stroke risk owing to marital transition was magnified among women if they were unemployed; weighted hazard ratio=2.98 (95% CI, 1.66–5.33).
Conclusions—
Living arrangement and employment status modified the positive associations between marital transition and stroke risk, which differed by sex.
Introduction
Marital status is viewed as an important determinant of health.1 Married people have been consistently reported to be healthier than unmarried people, with more profound effects among men.2–7 These associations can be attributed to both marital selection (ie, healthier people are more likely to be married) and marital protection (refers to the benefits of marital ties on health).8–11
Consistent findings have been reported from research investigating marital transition (ie, a change in marital status during a given time period).5 Men and women who experience marital transition by death or divorce have prospectively increased risk of associated onset and progression of cardiovascular disease.12–14 The hypothesized mechanisms underlying the association between marital transition and cardiovascular risk include preexisting health conditions,5 change to unhealthy profiles of health behavior,15–17 poorer psychological state2 stemming from the loss of financial stability,18,19 and reduced social support and social networks11,20 owing to loss of the spouse. However, few studies have been conducted to address stroke risk,17,21 particularly stroke subtypes,22 in this population. In addition, no such studies have been conducted in Asia.
Sociocultural differences could be a potential moderator for the health effect of marital transition.5 A prospective study of middle-aged men and women in Japan showed that marital dissolution significantly increased the risk of cardiovascular mortality among men, but no such impact was identified among women.6 Another prospective study of Japanese elderly adults showed no evidence of increased all-cause mortality risk among widowed men and women; in fact, decreased mortality risk was found among widowed women.7 These inconsistent results could be because the social roles of men and women in Japanese society are different, with strong gender role norms (ie, the male breadwinner model). Under such social norms, women are generally more likely to adopt the role of providing emotional support to their spouse. Therefore, widowed women might feel relieved of their duty to care for their spouse emotionally, which might in turn lower their mortality risk.
Marital transition often changes people’s living arrangement and economic situation. Living alone is a well-known health risk factor.23–26 In addition, a previous study conducted in Japan showed that who people live with was important for increased risk of coronary heart disease incidence and mortality.26 Thus, the magnitude of stroke risk could vary by living arrangement.
In the same way that marital transition affects economic status (ie, through loss of the breadwinner or reduced sources of household income), the impact on employment status must also be considered. However, to our knowledge, no studies have examined the moderating effect of living arrangement and employment status on the association between marital transition and stroke risk.
In this study, we sought to examine the sex-specific associations between marital transition and incidence of total stroke and stroke subtypes, as well as modification of the identified associations, according to living arrangement and employment status, in a large prospective cohort in Japan.
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