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How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand

OBJECTIVE: To examine the relationship between baseline union status (ie, including marriage and cohabitation) and mortality, paying attention to gender differentials, through an 11-year follow-up of a large cohort in Thailand. DESIGN: Cohort data from Thai Cohort Study (TCS) were linked official de...

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Autores principales: Zhao, Jiaying, Law, Chi Kin, Kelly, Matthew, Yiengprugsawan, Vasoontara, Seubsman, Sam-Ang, Sleigh, Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486337/
https://www.ncbi.nlm.nih.gov/pubmed/36123057
http://dx.doi.org/10.1136/bmjopen-2022-062811
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author Zhao, Jiaying
Law, Chi Kin
Kelly, Matthew
Yiengprugsawan, Vasoontara
Seubsman, Sam-Ang
Sleigh, Adrian
author_facet Zhao, Jiaying
Law, Chi Kin
Kelly, Matthew
Yiengprugsawan, Vasoontara
Seubsman, Sam-Ang
Sleigh, Adrian
author_sort Zhao, Jiaying
collection PubMed
description OBJECTIVE: To examine the relationship between baseline union status (ie, including marriage and cohabitation) and mortality, paying attention to gender differentials, through an 11-year follow-up of a large cohort in Thailand. DESIGN: Cohort data from Thai Cohort Study (TCS) were linked official death records over an 11-year follow-up period. SETTING: Community-based adults in Thailand. PARTICIPANTS: 87 151 Thai adults participated in TCS cohort. METHOD: Cox regression models measured longitudinal associations between union status and 11-year mortality. RESULTS: From 2005 (baseline) to 2016, persons who cohabited and lived with a partner, married persons but not living with a partner and separated/divorced/widowed people were more likely to die compared with those married and living together with a partner. Those who did not have good family support had a higher death risk than those having good family support. Single or cohabiting women had higher risks of mortality than women who were married and living together with a partner throughout follow-up, while separated/divorced/widowed men had higher risks of mortality than counterpart males. CONCLUSIONS: Our study reveals the protective effect of marriage and living together on mortality in Thailand, an understudied setting where institutionalisation of cohabitation is low leading to a limited mortality protection. Public policies for moderating mortality should thus be gender nuanced, culturally and institutionally specific. Also, we demonstrate that in settings such as Thailand, where marital status is not always defined in the same way as in western cultures, the need to measure cohabitation in locally relevant terms is important.
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spelling pubmed-94863372022-09-21 How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand Zhao, Jiaying Law, Chi Kin Kelly, Matthew Yiengprugsawan, Vasoontara Seubsman, Sam-Ang Sleigh, Adrian BMJ Open Epidemiology OBJECTIVE: To examine the relationship between baseline union status (ie, including marriage and cohabitation) and mortality, paying attention to gender differentials, through an 11-year follow-up of a large cohort in Thailand. DESIGN: Cohort data from Thai Cohort Study (TCS) were linked official death records over an 11-year follow-up period. SETTING: Community-based adults in Thailand. PARTICIPANTS: 87 151 Thai adults participated in TCS cohort. METHOD: Cox regression models measured longitudinal associations between union status and 11-year mortality. RESULTS: From 2005 (baseline) to 2016, persons who cohabited and lived with a partner, married persons but not living with a partner and separated/divorced/widowed people were more likely to die compared with those married and living together with a partner. Those who did not have good family support had a higher death risk than those having good family support. Single or cohabiting women had higher risks of mortality than women who were married and living together with a partner throughout follow-up, while separated/divorced/widowed men had higher risks of mortality than counterpart males. CONCLUSIONS: Our study reveals the protective effect of marriage and living together on mortality in Thailand, an understudied setting where institutionalisation of cohabitation is low leading to a limited mortality protection. Public policies for moderating mortality should thus be gender nuanced, culturally and institutionally specific. Also, we demonstrate that in settings such as Thailand, where marital status is not always defined in the same way as in western cultures, the need to measure cohabitation in locally relevant terms is important. BMJ Publishing Group 2022-09-19 /pmc/articles/PMC9486337/ /pubmed/36123057 http://dx.doi.org/10.1136/bmjopen-2022-062811 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Epidemiology
Zhao, Jiaying
Law, Chi Kin
Kelly, Matthew
Yiengprugsawan, Vasoontara
Seubsman, Sam-Ang
Sleigh, Adrian
How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
title How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
title_full How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
title_fullStr How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
title_full_unstemmed How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
title_short How do cohabitation and marital status affect mortality risk? Results from a cohort study in Thailand
title_sort how do cohabitation and marital status affect mortality risk? results from a cohort study in thailand
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486337/
https://www.ncbi.nlm.nih.gov/pubmed/36123057
http://dx.doi.org/10.1136/bmjopen-2022-062811
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