The effect of widowhood on mortality by the causes of death of both spouses.

OBJECTIVES We investigated the effect of spousal bereavement on mortality to document cause-specific bereavement effects by the causes of death of both the predecedent spouse and the bereaved partner. METHODS We obtained data from a nationally representative cohort of 373 189 elderly married couples in the United States who were followed from 1993 to 2002. We used competing risk and Cox models in our analyses. RESULTS For both men and women, the death of a predecedent spouse from almost all causes, including various cancers, infections, and cardiovascular diseases, increased the all-cause mortality of the bereaved partner to varying degrees. Moreover, the death of a predecedent spouse from any cause increased the survivor's cause-specific mortality for almost all causes, including cancers, infections, and cardiovascular diseases, to varying degrees. CONCLUSIONS The effect of widowhood on mortality varies substantially by the causes of death of both spouses, suggesting that the widowhood effect is not restricted to one aspect of human biology. Future research should examine the specific mechanisms of the widowhood effect and identify opportunities for health interventions.