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Association between marital status and mortality risk in rural areas: a mediation analysis of hypertension

cardiology
epidemiology
global-health
public-health
metabolic-sciences

Abstract

Background: Social health support is an important determinants of health. Several studies have revealed that married subjects can achieve greater health benefits in contrast with their unmarried counterparts. China has undergone rapid social and economic growth, resulting in shifts in family structures and marriage in recent decades. It is necessary to investigate the relations of marital status with mortality risk and the underlying mechanism. The aim of this study is to investigate the relations of marital status with mortality risk and examine whether hypertension play a mediating role.

Methods: An population-based cohort study conducted and 63 365 participants from 215 villages in rural areas were recruited in the study. Sociodemographic information, lifestyles, physical activity, medical history and physical measurements were collected. Marital status was obtained through questionnaire. Cause of death was obtained through linkage to China Center for Disease Control and Prevention’s death surveillance system.

Results: During a median of 11.3 years follow-up, a total of 5 878 all-cause deaths occurred, including 2611 CVD deaths, 2 033 cancer deaths. Compared to married individuals, unmarried individuals had a 21% higher risk for all-cause mortality, a 23% higher risk for CVD death, and 51% higher risk for respiratory death. The mediation analysis showed that hypertension mediated the associations, with the proportions of 8.12% total death and 14.60% for CVD death.

Conclusions: Our results demonstrated that maintaining in marriage may reduce the risk of mortality and unmarried participants have higher mortality rates which maybe affected by poor social determinants and unhealthy status. The results of this study indicate hypertension can partially mediated the association between marital status and health outcomes.

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