Losing a spouse forces people into what is often one of the most vulnerable parts of their lives. The negative health consequences of widowhood can stretch years down the line, but in some cases, they don’t get a chance to. The phenomenon in which both halves of a couple die in short succession is so common that it even has a name: the widowhood effect.
How at risk is any given person? That depends on many contributing factors, from their religion to race and even their spouse’s cause of death. But the widowhood effect is generally believed to be a problem primarily affecting closely bonded elderly couples.
However, a study published Mar. 22 in the journal PLOS One finds that younger people—especially men—are even more at risk. Researchers in Denmark, the U.K., and Singapore studied data from almost one million Danish citizens ages 65 and older and found that the younger people were when they lost their spouse, the more susceptible they were to dying within a year. Overall, the researchers also found that in the year after losing a spouse, men were 70% more likely to die than similarly aged men who did not lose a spouse, while women were 27% more likely to die compared to women who did not become widowed.
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Controlling for key variables can be difficult in this type of research, says Dawn Carr, co-director of the Aging Research on Contexts, Health and Inequalities program at Florida State University (who was not involved in the study but has researched geriatric health). Old age in general means a higher risk of death, and couples often share lifestyle habits and other behaviors that play a big role in health, like diet and exercise regimens. But because of the study’s large size and long follow-up period—up to six years—the researchers were able to peer into specific risk factors for the widowhood effect.
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Gender and age were two of the most influential risk factors for the widowhood effect. People in their 60s—the youngest group studied—were most likely to experience mortality linked to bereavement. “It’s a surprising finding to see those kinds of increased risks that you just really wouldn’t expect at such a young age,” says Carr.
For the most part, the study authors did not speculate on the reasons for the findings. But “it could be that bereavement at a younger age—since it’s more unusual to lose a spouse so young—creates added stress compared to later in life, when it may be more anticipated,” suggests Kara Dassel, assistant dean of the Gerontology Interdisciplinary Program at the University of Utah (who was not involved in the study but has researched the experiences of dementia caregivers).
Just as surprising was the finding that younger men in the study seemed to be hit harder than women by the loss of a spouse. Though it’s well known that elderly men—those around age 75 and above—suffer more from spousal loss than elderly women, such an outcome is unexpected in younger people, Carr says. Among these younger men, an increased risk of death lingered for up to three years after losing a spouse, rather than the one year seen in older age groups.
Dassel and Carr suggest that among men of all ages, increased mortality risk could be tied to the detrimental effects of loneliness in older age—one of the biggest risk factors for early death. “A lot of these older men grew up during a time when men had certain ideas about what was appropriate and not to be masculine,” says Carr. “Men tend to rely very heavily on their spouses, in heterosexual couples, for their social needs to be met.” Carr expects that this could change gradually as younger generations grow older.
The effects of loneliness, which can impact older adults’ physical health as well as their mental health, could also help to explain another finding from the study. Although the researchers found that across all participants, mortality risk increased during the first year after a spouse’s death, it actually decreased for a few weeks immediately following their loss. This could indicate the helpful effects of immediate social support from family and friends, and might suggest that seniors need longer, more intensive support after the loss of a spouse than many of them receive. Umair Majid, a PhD student focusing on health services research at the University of Toronto (who was not involved in the study but has researched the widowhood effect), says that this finding may also reflect some of the lingering effects of waiting for a loved one to die after a long and painful decline. In those situations, a loved one’s death may close the stressful, emotional, and often physically difficult chapter of caregiving. Other studies looking at health of caretakers before their loved one dies have found that “mortality actually starts to decrease in situations where spousal loss is imminent, in situations where there’s a sort of anticipation, like in palliative care,” Majid says.
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The study also included data on people’s health care expenses before and after losing a spouse, which the researchers use as proxies for both health status and attention to personal care during times of caregiving and grief. This metric allowed the researchers to draw some interesting connections, including that the increased risk of death among younger grieving spouses doesn’t come with an increase in health care spending as frequently as it does for older grieving spouses—further indicating that shock, rather than frailty, might be the key hazard for younger people, the study authors suggest.
Experts also note that patterns like those found in the paper aren’t guaranteed to apply to all people. It’s easy to imagine, for instance, that in areas of the world with more collectivist cultures than Denmark, increased social support following spousal loss, or even different outlooks on the meaning of death, could affect these outcomes. It’s also not known whether these findings would apply to non-heterosexual relationships, or even close relationships between unmarried people, a category that will likely grow as marriage rates continue to decrease.
As researchers continue to learn more about how loss can change us, says Carr, the main takeaway from this study “should be a big warning. This goes in and above other factors”—like old age—”that we would expect to cause increased risk of death following the loss of a partner.”