David J. Roelfs

Widowhood and Mortality: A Meta-Analysis and Meta-Regression

The study of spousal bereavement and mortality has long been a major topic of interest for social scientists, but much remains unknown with respect to important moderating factors, such as age, follow-up duration, and geographic region. The present study examines these factors using meta-analysis. Keyword searches were conducted in multiple electronic databases, supplemented by extensive iterative hand searches. We extracted 1,377 mortality risk estimates from 123 publications, providing data on more than 500 million persons. Compared with married people, widowers had a mean hazard ratio (HR) of 1.23 (95% confidence interval (CI), 1.19–1.28) among HRs adjusted for age and additional covariates and a high subjective quality score. The mean HR was higher for men (HR, 1.27; 95% CI, 1.19–1.35) than for women (HR, 1.15; 95% CI, 1.08–1.22). A significant interaction effect was found between gender and mean age, with HRs decreasing more rapidly for men than for women as age increased. Other significant predictors of HR magnitude included sample size, geographic region, level of statistical adjustment, and study quality.

Meta-analysis of marital dissolution and mortality: reevaluating the intersection of gender and age.

The study of marital dissolution (i.e. divorce and separation) and mortality has long been a major topic of interest for social scientists. We conducted meta-analyses and meta-regressions on 625 mortality risk estimates from 104 studies, published between 1955 and 2011, covering 24 countries, and providing data on more than 600 million persons. The mean hazard ratio (HR) for mortality in our meta-analysis was 1.30 (95% confidence interval [CI], 1.23-1.37) among HRs adjusted for age and additional covariates. The mean HR was higher for men (HR, 1.37; 95% CI, 1.27-1.49) than for women (HR, 1.22; 95% CI: 1.13-1.32), but the difference between men and women decreases as the mean age increases. Other significant moderators of HR magnitude included sample size; being from Western Europe, Israel, the United Kingdom and former Commonwealth nations; and statistical adjustment for general health status.

The strength of family ties: A meta-analysis and meta-regression of self-reported social support and mortality

Perceived social support has long been recognized as associated with better health and longevity. However, important factors that may moderate this relationship have not been sufficiently explored. The authors used meta-analyses and meta-regressions to examine 178 all-cause mortality risk estimates from 50 publications, providing data on more than 100,000 persons. The mean hazard ratio (HR) for mortality among those with lower levels of perceived social support was 1.11 (95% confidence interval [CI]: 1.05, 1.17) among multivariate-adjusted HRs. Metaregressions suggest that support from family members was more beneficial than support provided by friends, and that a moderate level of support may be enough to achieve positive results. The results also show that the HR increases with age, but no substantial difference was found between men and women in the magnitude of the risk.

The Rising Relative Risk of Mortality for Singles: Meta-Analysis and Meta-Regression

Never-married persons (singles) constitute a growing demographic group; yet, the magnitude of the all-cause relative mortality risk for nonelderly singles is not known and important moderating factors have not been explored. The authors used meta-analysis to examine 641 risk estimates from 95 publications that provided data on more than 500 million persons. The comparison group consisted of currently married individuals. The mean hazard ratio for mortality was 1.24 (95% confidence interval: 1.19, 1.30) among multivariate-adjusted hazard ratios with a high subjective quality rating. Meta-regressions showed that hazard ratios have been modestly increasing over time for both genders, but have done so somewhat more rapidly for women. The results also showed that the hazard ratio decreased with age and that study quality has an important relation to hazard ratio magnitude.

Social contact frequency and all-cause mortality: A meta-analysis and meta-regression

Social contact frequency is a well-defined and relatively objective measure of social relationships, which according to many studies is closely associated with health and longevity. However, no previous meta-analysis has isolated this measure; existing reviews instead aggregate social contact with other diverse measures of social support, leaving unexplored the unique contribution of social contact to mortality. Furthermore, no study has sufficiently explored the factors that may moderate the relationship between contact frequency and mortality. We conducted meta-analyses and meta-regressions to examine 187 all-cause mortality risk estimates from 91 publications, providing data on about 400,000 persons. The mean hazard ratio (HR) for mortality among those with lower levels of social contact frequency was 1.13 (p < 0.05) among multivariate-adjusted HRs. However, sub-group meta-analyses show that there is no significant relationship between contact and mortality for male individuals and that contact with family members does not have a significant effect. The moderate effect sizes and the lack of association for some subgroups suggest that mere social contact frequency may not be as beneficial to ones health as previously thought.

War-related stress exposure and mortality: a meta-analysis.

BACKGROUND Domestic and international wars continue to be pervasive in the 21st century. This study summarizes the effects of war-related stress on all-cause mortality using meta-analyses and meta-regressions. METHODS A keyword search was performed, supplemented by extensive iterative hand-searches for observational studies of war-related stress and mortality. Two hundred and twenty mortality risk estimates from 30 studies were extracted, providing data on more than 9 million persons. RESULTS The mean hazard ratio (HR) was 1.05 [95% confidence interval (CI) 0.98-1.13] among HRs adjusted for age and additional covariates. The mean effect for men was 1.14 (CI 1.00-1.31), and for women it was 0.92 (CI 0.66-1.28). No differences were found for various follow-up durations or for various types of war stress. Neither civilians nor military personnel had an elevated mortality risk. Those exposed to a combat zone during the Vietnam War had a slightly higher chance of death (HR 1.11; 95% CI 1.00-1.23). CONCLUSIONS The results show that, over all, exposure to war-stress did not increase the risk of death when studies were well controlled. Effects were small when found. This lack of substantial effect may be the result of selection processes, developed resiliency and/or institutional support.

The “Hispanic mortality paradox” revisited: Meta-analysis and meta-regression of life-course differentials in Latin American and Caribbean immigrants' mortality

The literature on immigrant health has repeatedly reported the paradoxical finding, where immigrants from Latin American countries to OECD countries appear to enjoy better health and greater longevity, compared with the local population in the host country. However, no previous meta-analysis has examined this effect focusing specifically on immigrants from Latin America (rather than Hispanic ethnicity) and we still do not know enough about the factors that may moderate the relationship between immigration and mortality. We conducted meta-analyses and meta-regressions to examine 123 all-cause mortality risk estimates and 54 cardiovascular mortality risk estimates from 28 publications, providing data on almost 800 million people. The overall results showed that the mean rate ratio (RR) for immigrants vs. controls was 0.92 (95% CI, 0.84-1.01) for all-cause mortality and 0.73 (CI, 0.67-0.80) for cardiovascular mortality. While the overall results suggest no immigrant mortality advantage, studies that used only native born persons as controls did find a significant all-cause mortality advantage (RR, 0.86; 95% CI, 0.76-0.97). Furthermore, we found that the relative risk of mortality largely depends on life course stages. While the mortality advantage is apparent for working-age immigrants, it is not significant for older-age immigrants and the effect is reversed for children and adolescents.

Meta-Analysis for Sociology – A Measure-Driven Approach

Meta-analytic methods are becoming increasingly important in sociological research. In this article we present an approach for meta-analysis which is especially helpful for sociologists. Conventional approaches to meta-analysis often prioritize “concept-driven” literature searches. However, in disciplines with high theoretical diversity, such as sociology, this search approach might constrain the researcher’s ability to fully exploit the entire body of relevant work. We explicate a “measure-driven” approach, in which iterative searches and new computerized search techniques are used to increase the range of publications found (and thus the range of possible analyses) and to traverse time and disciplinary boundaries. We demonstrate this measure-driven search approach with two meta-analytic projects, examining the effects of various social variables on all-cause mortality.

Misery loves company? A meta-regression examining aggregate unemployment rates and the unemployment-mortality association.

PURPOSE Individual-level unemployment has been consistently linked to poor health and higher mortality, but some scholars have suggested that the negative effect of job loss may be lower during times and in places where aggregate unemployment rates are high. We review three logics associated with this moderation hypothesis: health selection, social isolation, and unemployment stigma. We then test whether aggregate unemployment rates moderate the individual-level association between unemployment and all-cause mortality. METHODS We use six meta-regression models (each using a different measure of the aggregate unemployment rate) based on 62 relative all-cause mortality risk estimates from 36 studies (from 15 nations). RESULTS We find that the magnitude of the individual-level unemployment-mortality association is approximately the same during periods of high and low aggregate-level unemployment. Model coefficients (exponentiated) were 1.01 for the crude unemployment rate (P = .27), 0.94 for the change in unemployment rate from the previous year (P = .46), 1.01 for the deviation of the unemployment rate from the 5-year running average (P = .87), 1.01 for the deviation of the unemployment rate from the 10-year running average (P = .73), 1.01 for the deviation of the unemployment rate from the overall average (measured as a continuous variable; P = .61), and showed no variation across unemployment levels when the deviation of the unemployment rate from the overall average was measured categorically. Heterogeneity between studies was significant (P < .001), supporting the use of the random effects model. CONCLUSIONS We found no strong evidence to suggest that unemployment experiences change when macroeconomic conditions change. Efforts to ameliorate the negative social and economic consequences of unemployment should continue to focus on the individual and should be maintained regardless of periodic changes in macroeconomic conditions.

Meta-Analysis, History of

Meta-analysis is a type of systematic literature review through which a researcher can combine the results of existing studies to produce an overall estimate of the magnitude of a statistic such as a mean, correlation, or odds ratio. Meta-analyses are often coupled with meta-regressions, which are multivariate analyses of the effect of between-study differences on the magnitude of the statistic of interest. Developments to meta-analytic and meta-regression methodology are ongoing, with a trend emerging toward using the techniques to examine causal pathways.