Impact of loss of a spouse on self-rated health among middle-aged and elderly populations in China / 预防医学

ABSTRACT

Objective@#To evaluate the impact of loss of a spouse on self-rated health among middle-aged and elderly populations in China, so as to provide insights into health promotion among middle-aged and elderly populations with loss of a spouse. @*Methods@#Based the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, married and separated individuals or individuals with loss of a spouse at ages of 45 years and older and with monthly household consumption of no less than 100 yuan were enrolled. Subjects' age, gender, educational levels, marital status, monthly household consumption, number of chronic diseases and self-rated health were collected. Subjects were classified according to loss of a spouse, and the impact of loss of a spouse on self-rated health was evaluated among middle-aged and elderly populations using propensity score matching (PSM). In addition, heterogeneity test was performed to evaluate the gender- and educational level-stratified impacts.@*Results@#Totally 3 272 valid subjects were enrolled, including 1 618 men (49.45%) and 1 654 women (50.55%), and there were 512 subjects with loss of a spouse (15.65%). There were 656 subjects with very good self-rated health (20.05%), 622 with good health (19.01%), 1 534 with fair health (46.88%), 376 with poor health (11.49%) and 84 with very poor health (2.57%). There were 3 152 couples with successful nearest neighbor matching, and there was no significant difference between the subjects with and without loss of a spouse after adjustment for variables (P>0.05), while the overall fitting degree of the model was good following matching. PSM showed that the self-rated health became poor following loss of a spouse among middle-aged and elderly populations, with average treatment effect (ATT) of 0.055 to 0.061, and a remarkably negative effect of loss of a spouse on self-rated health was seen in women, with ATT of 0.192 to 0.223, while no remarkable effect was seen in men. Loss of a spouse showed a remarkably negative effect on self-rated health among individuals receiving junior and senior high educations, with ATT of 0.048 to 0.057, but presented no remarkable effect on self-rated health among individuals receiving primary educations. @*Conclusions @#Loss of a spouse presents a negative effect on self-rated health among middle-aged and elderly populations, and remarkably negative effects are seen among women and individuals receiving high educational levels.