Marriage, bereavement and mortality: The role of health care utilization

There is ample evidence that bereavement is associated with heightened mortality. Regardless of whether this strong association is truly causal, little is known about the factors contributing to it. This study begins to unpack the black box of the bereavement-mortality puzzle by investigating the extent to which heath behaviors and health care utilization patterns vary among chronically ill elderly males living with a spouse and those who are widowed, and by asking whether these differences contribute to the well-documented correlation between widowhood and health deterioration. In order to separate the effect of health care utilization from other potential channels it uses a unique dataset of doctor-patient encounters that allows in-depth analysis of the organization and effectiveness of medical care. Changes in health care utilization attributable to bereavement have a negative effect on survival but account for a small part of the overall negative effect of widowhood on longevity. (C) 2012 Elsevier B.V. All rights reserved.