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Felix Elwert, PhD and Nicholas A. Christakis, MD, PhD, MPH

Felix Elwert is with the Department of Sociology and the Center for Demography and Ecology, University of Wisconsin, Madison. Nicholas A. Christakis is with the Department of Sociology, Harvard University, Cambridge, MA, and the Department of Health Care Policy, Harvard Medical School, Boston, MA.

Correspondence: Requests for reprints should be sent to Felix Elwert, PhD, Department of Sociology, University of Wisconsin, Madison, 1180 Observatory Dr, Madison, WI 53706 (e-mail: felwert{at}ssc.wisc.edu).

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.

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