Partnership trajectories and cardiovascular health in late life of older adults in England and Germany

Objectives: Previous studies have shown marital status differences in incidence and prevalence of cardiovascular disease and cardiovascular mortality. This study examines the consequences of partnership on biomarkers related to cardiovascular health of older men and women in Germany and England (C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol). Methods: Data used is from older adults (60 +) from the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership trajectory. OLS for C-reactive protein, logistic regressions for systolic and diastolic blood pressure, and multinomial logistic regressions for cholesterol are used to investigate the associations between life course partnership characteristics and biomarkers, accounting for early age socioeconomic and health conditions. Results: Timing of first partnership is associated with poor cardiovascular health in England, number of partnership transitions with poor health in Germany, and partnership trajectories are associated with cardiovascular health both in Germany and England. Men in trajectories with multiple marriages have higher CRP, and are more likely to have elevated systolic and diastolic BP. Trajectories containing single marital disruption for men and women are no longer associated with poor health after accounting for selection effects of childhood conditions. Respondents in widowed partnership trajectories have poorer cardiovascular health compared to those in intact committed relationships, whereas cohabitation trajectories do not differ in the associations with biomarkers from those in intact marriage. Conclusion: The results offer better understanding of the pathways through which family events and processes are linked to health and support the hypothesis that adversity related to partnerships over the life course accumulates and contributes to worse cardiovascular health in later life measured by objective health measures.