Urban/rural variation in the influence of widowhood on mortality risk

Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect), although the mechanisms driving the effect are poorly understood. After acute stress and grief have dissipated, mortality risk may be increased by loss of emotional and instrumental support for daily living and so we investigated whether social support at both the household and community levels moderated the influence of spousal bereavement on mortality risk.

We assembled death records from the Northern Ireland Mortality Study spanning almost nine years for a prospective cohort of 296,125 married couples enumerated in the 2001 Census. Presence of other adults within the household and urban/rural residence were used as measures of support at the household and community levels, with informal social support perceived to be strongest in rural areas. We used Cox proportional hazards models to estimate the effects of widowhood, sex, household composition and urban/intermediate/rural residence on all-cause mortality.

Elevated mortality risk during the first six months of widowhood was found in all areas and for both sexes (range of hazard ratios 1.24, 1.57). After more than six months the effect among men was attenuated in rural but not urban areas (HRs and 95%CIs 1.09 [0.99, 1.21] and 1.35 [1.26, 1.44] respectively). Among women the effect was attenuated in both rural and urban areas (HRs 1.06 [0.96, 1.17] and 1.09 [1.01, 1.17]). Mortality risk post bereavement was not associated with presence of other adults in the household.

We found some support for the hypothesis that informal social support is beneficial for reducing the impacts of spousal loss. Rural residence had a positive effect especially among men but presence of other adults in the household had no effect. The reasons for this discrepancy require further investigation and we identify men in urban areas as being at greatest risk in the long term.

Agriculture, settlement and society in Early Medieval Ireland

During the early medieval period, Ireland was politically organised into a large number of very small kingdoms. Unlike much of Western Europe, it had not been incorporated into the Roman Empire, and as a consequence, settlement remained exclusively rural in character until the Viking period. Extensive documentary, archaeological, zooarchaeological and macro-plant evidence provides a detailed reconstruction of the livestock and arable economy of the period. Cattle ownership formed the basis of wealth as well as being an indicator of status in society, and this is reflected in its clear dominance of the livestock economy during this period. From the eighth century onwards, however, cereal production appears to grow in importance as subsistence farming gave way to the production of agricultural surplus. This is reflected in cereal diversification and in the construction of watermills and more efficient grain-drying kilns. At the same time, settlement underwent significant changes and the relative importance of cattle in some areas began to decline.