Cause-specific mortality by partnership status in England and Wales 2001-2011: a competing risk approach

Sebastian Franke, University of Liverpool
Hill Kulu, University of Liverpool

This paper extends previous analysis on overall mortality to cause-specific mortality by partnership status using a competing risk approach. Scholars have shown that married men and women in developed countries have lower mortality rates than their unmarried counterparts. In a previous study, we could show that those differences still exist in 21st century England and Wales as well as how important it is to control for cohabitation. Using data from the ONS Longitudinal Study between 2001 and 2011, we conduct an analysis on cause-specific mortality for about 330,000 men and women in the age groups 30–49 years (76,368 men and 79,408 women); 50-64 years (47,665 men and 49,076 women); and 65-85 years (34,028 men and 43,222 women). By using Cox proportional hazard models in a competing risk approach each individual is at risk of multiple causes of death. Thus, the estimates of our control variables, like ethnicity, education or socio-economic status, are similar to those from the over-all cause analysis. This enables us to show not only how the risk of a given cause for a specific marital status relates to the risk of the other marital statuses of this cause, but also to any marital status of another cause. We find that mortality rates are lower for married men and women of all age-groups for circulatory, respiratory, alcohol-related and other-digestive diseases, as well as for accident. Those differences decline with age as well as with respect to the circulatory disease risk of married people. The majority of higher digestive disease risk at younger ages is due to alcohol consumption. We could not find a higher cancer mortality risk for not married persons, with exception of divorced. The nervous system disease risk is highest for single men and women as well as divorced women, but disappears at old age.