Date of Award


Degree Type


Degree Name

Doctor of Philosophy


From widely reported cross-sectional data analyses, widowed and divorced men 25 to 44 years have a risk of death approximately four times that of married men their age. Relative risks of death are less for women, and decrease with age. Cohort studies of widowed persons indicate that the relative risks may be lower.;Three reasons why there might be an increased risk after the loss of a spouse are: stress of losing a spouse, loss of a protective effect of marriage, and selection into spousal status on the basis of health. A case-control study was carried out to provide empirical data for assessing the relative merits of these constructs.;Cases are all persons 25 to 44 years, and a 25% sample of persons 45 to 64 years, who died in 1981, according to the Alberta Health Care (AHC) registration file. Controls were a 1 in 600 two stage systematic sample of persons who were alive in 1981 according the AHC registration file. The spousal history of the cases and controls was determined retrospectively for a maximum of twelve years.;Overall, the study data closely approximate 1981 Alberta census and vital statistics data. For the hypothesis testing, there were: 2279 married, 344 no longer married (widowed and divorced) and 98 remarried persons. The data were analysed using Mantel-Haenszel methods and multiple logistic regression.;There was support for selection into remarriage on the basis of good health, which was greatest for men 25 to 44 years. Selection into loss of spouse on the basis of ill health appeared to be greatest for women 25 to 44 years.;Further research, using longitudinal data, is required to ascertain what, if any, increase in risk of death after the loss of a spouse can be attributed to stress of losing a spouse and loss of a protective effect of marriage. Possible peak of excess mortality approximately two to four years after the loss of a spouse for persons 45 to 64 years should be investigated.



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