Marital status and suicide risk: Temporal effect of marital breakdown and contextual difference by socioeconomic status

31 Background: GBM is associated with a poor prognosis and early death in elderly patients. Prior studies have demonstrated a high burden of hospitalization in this population. We sought to evaluate and examine trends in hospitalizations and EOL care in GBM survivors. Methods: Using SEER-Medicare linked data, we performed a retrospective observational cohort study of patients aged ≥ 65 years diagnosed with GBM from 2005-2017 who lived at least 6 months from the time of diagnosis. Aggressive EOL care was defined as: chemotherapy or radiotherapy within 14 days of death (DOD), surgery within 30 DOD, > 1 emergency department visit, ≥ 1 hospitalization or intensive care unit admission within 30 DOD; in-hospital death; or hospice enrollment ≤ 3 DOD. We evaluated age, race, ethnicity, marital status, gender, socioeconomic status, comorbidities, prior treatment and percentage of time hospitalized. Multivariable logistic regression was performed to determine factors associated with aggressive end of life care. Results: Of 5827 patients, 2269 (38.9%) survived at least 6 months. Among these, 1106 (48.7%) survived 6-12 months, 558 (24.6%) survived 12-18 months, and 605 (26.7%) survived > 18 months. Patients who survived 6-12 months had the highest burden of hospitalization and spent a median of 10.6% of their remaining life in the hospital compared to those surviving 12-18 months (5.4%) and > 18 months (3%) (P < 0.001). 10.1% of the cohort had claims for palliative care services; 49.8% of initial palliative care consults occurred in the last 30 days of life. Hospice claims existed in 83% with a median length of stay 33 days (IQR 12, 79 days). 30.1% of subjects received aggressive EOL care. Receiving chemo at any time (OR 1.510, 95% CI 1.221-1.867) and spending ≥ 20% of life in the hospital after diagnosis (OR 3.331, 95% CI 2.567-4.324) were associated with aggressive EOL care. Women (OR 0.759, 95% CI 0.624-0.922), patients with higher socioeconomic status (OR 0.533, 95% CI 0.342-0.829), and those diagnosed ≥ age 80 (OR 0.723, 95% CI 0.528-0.991) were less likely to receive aggressive EOL care. Race, ethnicity, marital status, and extent of initial resection were not associated with aggressive EOL care. Conclusions: A minority of elderly patients with GBM in the SEER-Medicare database survived ≥ 6 months; hospitalizations were common and patients spent a significant proportion of their remaining life hospitalized. Although hospice utilization was high in this cohort, 30% of patients received aggressive EOL care. Despite the aggressive nature of GBM, few patients had palliative care consults during their illness. Increased utilization of palliative care services may help reduce hospitalization burden and aggressive EOL care in this population.

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Adult Suicide Mortality in the United States: Marital Status, Family Size, Socioeconomic Status, and Differences by Sex

Social Science Quarterly ◽

10.1111/j.1540-6237.2009.00652.x ◽

2009 ◽

Vol 90 (5) ◽

pp. 1167-1185 ◽

Cited By ~ 77

Author(s):

Justin T. Denney ◽

Richard G. Rogers ◽

Patrick M. Krueger ◽

Tim Wadsworth

Keyword(s):

United States ◽

Socioeconomic Status ◽

Marital Status ◽

Family Size ◽

The United States ◽

Suicide Mortality

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Abstract P149: Retention of Participants in Longitudinal Research: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.137.suppl_1.p149 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Sandi Shrager

Keyword(s):

Cardiovascular Disease ◽

Socioeconomic Status ◽

African American ◽

Health Insurance ◽

Health Status ◽

Marital Status ◽

Ethnic Minority ◽

Ethnic Groups ◽

Longitudinal Research ◽

Minority Participants

Background: Retention of participants is a critical component of ensuring the scientific goals of longitudinal research studies. Differential rates of attrition for ethnic minority participants can be particularly problematic in the fields of health and cardiovascular research, where ethnic minorities are shown to have disproportionately higher rates of both cardiovascular disease and risk factors for heart disease such as diabetes, hypertension, and obesity. The ability to explore the underlying causes of these differences is adversely affected when attrition in a study occurs at a higher rate among the ethnic minority subject participants. Understanding and preventing the causes of subject drop-out to improve retention among all ethnic groups is therefore a vital endeavor of any longitudinal research or cohort study. Methods: We analyzed data on ten-year retention rates of Caucasian, Chinese, Hispanic, and African-American participants in the Multi-Ethnic Study of Atherosclerosis (MESA). 6814 participants were recruited into the study in 2000, and 5,865 participants were still alive for the fifth in-person examination ten years later. Of these, 4651 participants returned for this examination. Logistic regression was used to examine the association between retention in the study, race/ethnicity and various baseline demographic characteristics, including age, gender, marital status, income, employment, education, language, place of birth, health insurance status and overall health status as measured by a 10-year predicted cardiovascular disease rate. Results: Racial differences in retention were observed, with Chinese, African-American, and Hispanic participants having 30-40% lower odds of being retained than Caucasian participants. However, after adjusting for demographic variables, these differences were primarily explained by indicators of socioeconomic status. Higher income, higher education, employment status, availability of health insurance and health status were significantly associated with ten-year retention in the study across all racial/ethnic groups. Marital status, gender, age, and birthplace (US vs non-US) were not associated with retention. Conclusions: Although minority participants were retained at lower rates in MESA, this can be primarily explained by differences in socioeconomic status and health status. Individuals with higher SES indicators may have life circumstances making participation in an examination taking much of a full day more plausible. Future studies should consider how these findings may inform developing support services or incentives which make follow-up participation in clinical research more persuasive for these individuals.

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P03-309 - Suicide risk and marital status

European Psychiatry ◽

10.1016/s0924-9338(10)71363-8 ◽

2010 ◽

Vol 25 ◽

pp. 1377

Author(s):

S. Roskar ◽

A. Podlesek ◽

M. Kuzmanic ◽

L. Demsar ◽

M. Zaletel ◽

...

Keyword(s):

Marital Status ◽

Suicide Risk

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Tourist Activity of Senior Citizens (60+) Residing in Urban and Rural Areas

Physical Culture and Sport Studies and Research ◽

10.1515/pcssr-2016-0028 ◽

2016 ◽

Vol 72 (1) ◽

pp. 51-65 ◽

Cited By ~ 3

Author(s):

Aneta Omelan ◽

Robert Podstawski ◽

Marek Raczkowski

Keyword(s):

Socioeconomic Status ◽

Educational Attainment ◽

Marital Status ◽

Rural Areas ◽

Urban Areas ◽

Senior Citizens ◽

Professional Activity ◽

Rural Residents ◽

Financial Status ◽

Permanent Residence

AbstractThe objective of this study was to analyze the influence of place of permanent residence (urban or rural) on the tourist activity of senior citizens (60+) of different socioeconomic statuses. The study involved 380 senior citizens (305 female and 75 male) aged 60 years and older who were permanent residents of the region of Warmia and Mazury, Poland. In this group, 244 subjects resided in urban areas and 136 participants were rural dwellers. The respondents were asked to complete a questionnaire regarding their socioeconomic status (place of permanent residence, age, gender, educational attainment, financial status, membership in senior organizations, marital status, and professional activity) and tourist activity. A significance test of two structure coefficients (α=0.05) was applied. Factors such as gender, professional activity, and marital status were not related with the travel propensity of seniors from different groups (urban and rural), but were significant when rural residents were compared with urban dwellers. Seniors residing in urban areas of Warmia and Mazury, Poland, were significantly more likely to travel for leisure than those residing in rural areas. The tourist activity of seniors decreased significantly (p<0.05) with the age (60-74 years) and financial status of rural residents. The travel propensity of elderly people increased significantly (p<0.05) with educational attainment and membership in senior organizations. The study revealed considerable differences in the socioeconomic status and social characteristics of seniors residing in rural and urban areas, and those variations significantly influenced their propensity for travel: urban residents traveled more frequently than rural residents. It can be concluded that place of residence was a crucial factor determining the tourist behavior of senior citizens, and urban dwellers were more likely to travel.

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Intimate Partner Violence, Depression, and Quality of Life among Women Living with HIV/AIDS in a Coastal City of South India

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325957417691137 ◽

2017 ◽

Vol 16 (5) ◽

pp. 455-459 ◽

Cited By ~ 4

Author(s):

Basavaprabhu Achchappa ◽

Mahak Bhandary ◽

Bhaskaran Unnikrishnan ◽

John T. Ramapuram ◽

Vaman Kulkarni ◽

...

Keyword(s):

Quality Of Life ◽

Socioeconomic Status ◽

Intimate Partner Violence ◽

Marital Status ◽

Partner Violence ◽

Intimate Partner ◽

Cd4 Counts ◽

Women Living With Hiv ◽

Living With Hiv

Background: Intimate partner violence (IPV) is a severe form of abuse prevalent in urban and rural areas of India with its effects on mental and physical health of the person receiving it, leading to a poorer quality of life. Methods: A cross-sectional study was conducted among 99 women living with HIV, and information was collected using abuse assessment scale. The data were entered and analyzed using SPSS version 17.0. Results: The IPV was reported by 19.2% of the respondents, of which psychological (14.1%) was most common followed by physical (4.1%) and sexual abuse (1.0%). The experience of IPV was significantly associated with socioeconomic status, number of children, marital status, and CD4 counts of the participants. Conclusion: The prevalence of IPV in our study was found to be less compared to previous studies, however, there were significant association among factors such as socioeconomic status, CD4 counts, and marital status of the participants.

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Marital Status and Risk of Dementia: Does Race Matter?

Innovation in Aging ◽

10.1093/geroni/igaa057.2683 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 745-746

Author(s):

Zhenmei Zhang ◽

Hui Liu ◽

Seung-won Choi

Keyword(s):

Socioeconomic Status ◽

Longitudinal Study ◽

Marital Status ◽

Interest Group ◽

Discrete Time ◽

Preliminary Analysis ◽

Event History ◽

Never Married ◽

Disease Research ◽

Social Engagements

Abstract Previous research has shown that unmarried individuals (i.e., divorced, widowed, and never married) had a higher risk of dementia than their married counterparts. However, few studies examined whether the link between marital status and dementia varies by race. To fill the gap, we used data from the Health and Retirement Longitudinal Study (2000-2014) and analyzed 15,379 respondents (13,278 non-Hispanic whites and 2,101 non-Hispanic blacks) ages 50 and older in 2000 who had no dementia. Discrete-time event history models were estimated. Our preliminary analysis showed that marital status was significantly associated with the odds of dementia for both whites and blacks. Furthermore, the associations between unmarried status (i.e., cohabiting, widowed, and never married) and dementia were stronger among blacks than whites. The effect of divorce on odds of dementia did not differ by race. The results were robust after controlling for socioeconomic status, health and lifestyle factors, and social engagements. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.

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Physical activity and socio-economic status of single and married urban adults: a cross-sectional study

PeerJ ◽

10.7717/peerj.12466 ◽

2021 ◽

Vol 9 ◽

pp. e12466

Author(s):

Daniel Puciato ◽

Michał Rozpara

Keyword(s):

Physical Activity ◽

Socioeconomic Status ◽

Marital Status ◽

Short Form ◽

Occupational Status ◽

Cross Sectional Study ◽

Activity Levels ◽

Sectional Study ◽

Cross Sectional ◽

Urban Adults

Background Changing family models have resulted in a large increase in the number of single-person households. This phenomenon has certain implications for society and the economy as single people often exhibit different behaviours, including their engagement in health-related physical activity, than those who are married and living with partners. However, the results of studies on determinants of physical activity in people of different marital status have been inconclusive. The aim of this study was to identify associations between physical activity and socioeconomic status in single and married urban adults. Methods The study material consisted of 4,460 persons (1,828 single and 2,632 married and living with partners). A cross-sectional study was conducted in Wroclaw (Poland). A diagnostic survey-direct interview method was used. Two research tools were applied: the International Physical Activity Questionnaire Short Form (IPAQ-SF) and the Socioeconomic Status Questionnaire (S-ESQ). The level of respondents’ physical activity was assessed following WHO recommendations. The descriptive statistics included the number and frequency of categories of dependent and independent variables as well as measures of association between them, i.e., crude and adjusted odds ratios. Results The odds ratio of meeting the WHO physical activity recommendations was almost 70% higher in single than in married respondents (OR = 1.67; CI [1.46–2.19]), and slightly more than 40% higher after adjusting for sex, age and education (aOR = 1.42; CI [1.21–1.67]). In both groups socioeconomic the respondents’ status revealed a significant and slightly different association with their levels of physical activity. Occupational status and financial savings significantly affected the level of physical activity in single respondents, while net disposable income was a significant modifier of physical activity levels in respondents who were married or lived with their partners. Conclusions Assessment of the levels and determinants of physical activity among people of different marital status should be continued and extended to other subpopulations. This will allow effective preventive and therapeutic measures to be taken for groups most at risk of hypokinesia. Programs aimed at improving physical activity accounting for the socioeconomic status and marital status of their beneficiaries are particularly important.

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Social aspects of patients with carcinoma breast presented to Sir Ganga Ram Hospital Lahore

Annals of King Edward Medical University ◽

10.21649/akemu.v10i2.1180 ◽

2016 ◽

Vol 10 (2) ◽

Author(s):

Andleeb Khanam ◽

Aamer Zaman Khan ◽

Absar Nazir ◽

Muhammad Saleem ◽

Amer Riaz Bhutta ◽

...

Keyword(s):

Socioeconomic Status ◽

Family History ◽

Marital Status ◽

Rural Areas ◽

Social Aspects ◽

Carcinoma Breast ◽

Number Of Children ◽

Average Size ◽

Breast Fed ◽

Lower Group

This study was carried out in Sir Ganga Ram Hospital from January 2001 to December 2003. 525 patients with carcinoma breast were selected and a detailed demographic record was maintained. It was seen that the largest no. of cases were between 30-39 years i.e., 37.33% Socioeconomic status showed that 47.24 % belong to lower group 80.38% were house wives Marital status showed 97.14% were married 66.67% patients belong to rural areas. Age at the time of first pregnancy was between 22-27 years i.e., 75% of cases. Average number of children was 5 seen in 52.78% cases. Lactation status showed 41.67% had breast fed their children for 18 months. Family history was positive in 2.7% patients.. Average size of the lump was 6-10cm i.e 55.6%. It was T3 tumor in 47.22% of cases.

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Suicide Risk and Its Relationship to Change in Marital Status

Crisis ◽

10.1027/0227-5910/a000054 ◽

2011 ◽

Vol 32 (1) ◽

pp. 24-30 ◽

Cited By ~ 19

Author(s):

Saška Roškar ◽

Anja Podlesek ◽

Marja Kuzmanić ◽

Lucija Omejc Demšar ◽

Metka Zaletel ◽

...

Keyword(s):

Older People ◽

Marital Status ◽

Suicidal Behavior ◽

Suicide Risk ◽

Control Group ◽

First Year ◽

Suicidal Risk ◽

Status Change ◽

Different Types ◽

Different Levels

Background: Different types of marital status are associated with different levels of suicidal risk. Aims: To study marital status change and the effect of its recency in relation to suicidal behavior. Methods: Suicide victims (1614) in Slovenia and matched controls (4617) were compared for incidence and recency of marital status change during the last 5 years of their lives. Results: A higher percentage of suicide victims (10.7%) had a marital status change in the last 5 years compared with the controls (5.6%). All types of marital status changes (becoming widowed, getting divorced, getting married) proved to be risk factors for suicidal behavior. Almost half of all marital status changes in suicide victims occurred in the year prior to suicide, whereas marital status changes in the control group were equally distributed over the last 5 years. For recently married and divorced people, the increase in suicide risk depended on age: The risk was higher in older people. Conclusions: Marital status change represents a risk factor for suicidal behavior. The first year after the change is critical for elevated suicidal risk, in particular for older people.

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