Mortality of Bereavement

Abstract

A survey was made in a semirural area (pop. 5,184) to determine whether bereavement produced an increased mortality among bereaved close relatives-these being defined as a spouse, a child, a parent, or a sibling. During a six-year survey period 488 residents died; 371 of these people had close relatives living in the survey area, and the subsequent mortality of their 903 close relatives was compared with that of a control group; this control group was composed of the 878 close relatives of 371 people matched by age, sex, and marital state with the people who had originally died. It was found that 4.76% of bereaved close relatives died within one year of bereavement compared with 0.68 % in the control group. This sevenfold increase in risk between the bereaved and control group was significant at the 0.001%0 level, and indicates that bereavement carries a considerably increased risk of mortality. This risk was found to be greater for male than for female relatives: 6.4 % of the 391 male relatives at risk died, compared with 3.5 % of 512 female relatives. This difference in risk between the sexes was significant at the 5 % level. The increase in risk was particularly great for widowed people and least for female children. During the first year of bereavement 12.2% of widowed people died, compared with 1.2% in the control group. This increase in risk for widowed people was significant at the 0.01% level. Of the remaining close relatives in the survey group, 3.21% died during the first year of bereavement, compared with 0.56% in the control group. This increase in risk for bereaved close relatives, excluding the widowed, was significant at the 0.1 % level. There is a relation between the place at which a person dies and the subsequent mortality of bereaved relatives. The risk of close relatives dying during the first year of bereavement is doubled when the primary death causing bereavement occurs in a hospital compared with at home. This difference in risk was significant at the 5% level. If the primary death occurs at some site-for example, a road or field-other than at home or hospital, the risk of a close relative dying during the first year of bereavement is five times the risk carried by the close relatives of people who die at home. This difference in risk was significant at the 0.01% level, though the small size of the sample reduces the significance that can be attributed to the result. People who die following a bereavement are on average slightly younger than the relatives who predeceased them, and they die at an earlier age than is usual for the community in which they live. © 1967, British Medical Journal Publishing Group. All rights reserved.