The University of Southampton
University of Southampton Institutional Repository

A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001–2011

A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001–2011
A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001–2011
Background

Mortality risk is lower in married than in unmarried men and women. However, little is known about the association between mortality and relationship status in South Africa where marriage rates are low, migration is common, many couples are not co-resident and HIV prevalence is high.

Method

Using demographic surveillance data collected from 2001 to 2011, relationship status was categorised as conjugal (partners belong to the same household), non-conjugal (partners do not belong to the same household) or not partnered. Rates of relationship formation and dissolution were calculated by age and sex. Controlling for antiretroviral treatment (ART) introduction in 2005 as well as education, sex-specific and age-specific Cox proportional hazards models were used to investigate the association between relationship status and (1) all-cause mortality and (2) non-AIDS mortality.

Results

Before 2005, individuals in conjugal relationships had a lower hazard of all-cause mortality in all age groups than not partnered men and women. Non-conjugal relationships lowered the risk of dying compared with not partnered men and women in fewer age groups. After ART introduction, the protective association of conjugal relationships was weaker but remained generally significant for men and women but not in non-conjugal relationships. In the later period, the association is reversed in young men (20–29?years) with mortality higher in conjugal and non-conjugal relationships compared with men not partnered. The analysis of non-AIDS deaths provided similar results.

Conclusions

The higher degree of social connections within a shared household environment that characterises conjugal relationships affords men and women greater protection against mortality.
hiv, marital status status, mortality
0143-005X
1-9
Channon, Melanie
9fbd1bc5-7454-415a-8539-c1468a2d60da
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Channon, Melanie
9fbd1bc5-7454-415a-8539-c1468a2d60da
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961

Channon, Melanie, Hosegood, Victoria and McGrath, Nuala (2015) A longitudinal population-based analysis of relationship status and mortality in KwaZulu-Natal, South Africa 2001–2011. Journal of Epidemiology & Community Health, 1-9. (doi:10.1136/jech-2014-205408). (PMID:26254290)

Record type: Article

Abstract

Background

Mortality risk is lower in married than in unmarried men and women. However, little is known about the association between mortality and relationship status in South Africa where marriage rates are low, migration is common, many couples are not co-resident and HIV prevalence is high.

Method

Using demographic surveillance data collected from 2001 to 2011, relationship status was categorised as conjugal (partners belong to the same household), non-conjugal (partners do not belong to the same household) or not partnered. Rates of relationship formation and dissolution were calculated by age and sex. Controlling for antiretroviral treatment (ART) introduction in 2005 as well as education, sex-specific and age-specific Cox proportional hazards models were used to investigate the association between relationship status and (1) all-cause mortality and (2) non-AIDS mortality.

Results

Before 2005, individuals in conjugal relationships had a lower hazard of all-cause mortality in all age groups than not partnered men and women. Non-conjugal relationships lowered the risk of dying compared with not partnered men and women in fewer age groups. After ART introduction, the protective association of conjugal relationships was weaker but remained generally significant for men and women but not in non-conjugal relationships. In the later period, the association is reversed in young men (20–29?years) with mortality higher in conjugal and non-conjugal relationships compared with men not partnered. The analysis of non-AIDS deaths provided similar results.

Conclusions

The higher degree of social connections within a shared household environment that characterises conjugal relationships affords men and women greater protection against mortality.

PDF
jech-2014-205408.full.pdf - Version of Record
Available under License Creative Commons Attribution.
Download (448kB)

More information

Accepted/In Press date: 24 July 2015
Published date: 7 August 2015
Keywords: hiv, marital status status, mortality
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 380250
URI: https://eprints.soton.ac.uk/id/eprint/380250
ISSN: 0143-005X
PURE UUID: 37c00d36-892e-4d35-b1cd-fd77e1e0484c
ORCID for Victoria Hosegood: ORCID iD orcid.org/0000-0002-2244-2518

Catalogue record

Date deposited: 10 Aug 2015 15:43
Last modified: 06 Jun 2018 12:32

Export record

Altmetrics

Contributors

Author: Melanie Channon
Author: Nuala McGrath

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×