Arthur S. Kraus

Some epidemiologic aspects of the high mortality rate in the young widowed group

Abstract The relationship between marital status and mortality appearing in statistical data published by the National Office of Vital Statistics on deaths and death rates in 1949–1951 by marital status, age, color, and sex was reviewed. The main feature was the lower death rate in the married group than in the single, widowed, or divorced, at every age. The outstanding excess risk of mortality among the young widowed was noted. This excess risk in the widowed under age 35, compared to the married, was greater than tenfold for at least one of the specific age-sex groups involved for several leading causes of death, including arteriosclerotic heart disease and vascular lesions of the central nervous system. Possible explanatory hypotheses were discussed. It seems unlikely that the several possible artificial factors mentioned, including the “selection” factor, could have accounted for more than a small part of the great excess risk noted in the young widowed for these several causes of death. Three biologic hypotheses were suggested in explanation of what appears to be a genuine association between young widowhood and subsequent mortality. These were called the 1. (1) “mutual selection of poor-risk mates,” 2. (2) “joint unfavorable environment,” and 3. (3) “effects of widowhood” hypotheses. Further studies, of both the retrospective and prospective types, were suggested to assess these hypotheses.

Sexual factors in the epidemiology of cancer of the prostate.

Abstract Attention is drawn to the importance of prostate cancer in terms of morbidity and mortality among males in Canada and elsewhere. A resume is presented of some of the more notable epidemiologic factors found to be associated with the disease. A retrospective study of histologically confirmed prostate cancer in 39 patients hospitalized is described. Each patient was matched with another patient having a non-genito-urological, non-cancerous condition. A second group of patients with benign hyperplasia of the prostate was also used for comparative purposes. Among the major areas covered in the study are social and demographic factors, personal and family history of illness and sexual habits. The most striking findings relate to sexuality and in particular extra-marital activity; the engagement in sexual relationships with multiple partners ; greater sexual drive and the greater frequency of venereal disease among the cancer group of patients. Reference is made to certain similarities between the epidemiology of cancer of the Sexual Factors in the Epidemiology of Cancer of the Prostate 37 cervix and cancer of the prostate, as described, with regard to sexuality. The possibility of a sexually transmitted virus infection being the aetiological factor in the production of cancer of the prostate is considered. Recommendations are made for further study with particular reference to the exploration of a viral-venereal or hormonal aetiology.

The Increase in the Usual Life Span in North America

An assumed fixed maximum life span was involved in a much publicized prediction of a compression of morbidity in late life. The maximum life span has major weaknesses as a measure. The “usual life span“, or age to which 1.0% of a birth cohort survives, is suggested as a more useful measure. Statistics were derived from recent United States and Canadian censuses on the age above which 1.0% of the population is contained, from recent United States and Canadian mortality data on the age above which 1.0% of the deaths were reported, and from recent Canadian life tables on the age to which 1.0% of a cohort would survive. These statistics suggest that the usual life span increased at least 2 years in the 1960–1980 period in North America.