Marital partner and mortality: the effects of the social positions of both spouses.

BACKGROUND Dimensions of the individual socioeconomic position-education, social class, social status and income-are associated with mortality. Inequalities in death also related to the social position of the household. It is, however, less clear how the socioeconomic position of one marital/cohabiting partner influences the mortality of the other partner. We examine the independent effect on mortality of own and partner's positions regarding these four socioeconomic factors. METHODS Register data on education, social class, social status and income of both marital/cohabiting partners were collected from the 1990 Census of the employed Swedish population aged 30-59 (N = 1,502,148). Data on all-cause mortality and deaths from cancer and circulatory disease for the subsequent period 1991-2003 were collected from the Cause of Death Register. Relative mortality risks for different socioeconomic groups were estimated by Cox regression. RESULTS All-cause mortality of both men and women differs by women's education and status and by men's social class and income. For men, the wife's education is more important for the mortality risk than his own education when the man's social class is included in the model. For women, the husband's social class yields larger mortality differences than own occupational measures. Women's education and men's social class and income are particularly important for women's deaths from circulatory diseases. CONCLUSION The partner's social position has a clear independent association with individual mortality, and women's education and men's social class seem to be particularly important. Suggested explanations of health inequality are not always compatible with the observed relationship between partners' social and economic resources and mortality.