Living Arrangement, health status and mortality risk

Health status and mortality risks differ by type of living arrangement. Living as a married couple has a protective effect, whereas living alone is often associated with poorer health and higher mortality. Mortality is higher still for those living in institutions. However, given that those living in institutions are generally in poorer health than those living independently, it is unclear whether this higher mortality risk among the institutionalized population results from their poorer health, or from other causes. We use an exhaustive Belgian data set of 1.7 million persons aged 65 and above from the 2001 census, and model their survival during year 2002 using logistic regression and controlling for age, sex and education. The results confirm that living with a spouse is associated to the lowest mortality risk but survival for both is improved when the husband is older than the wife. Other types of family-household living arrangements are less favourable, while living alone is better for women than it is for men. Those living in institutions have a higher risk of mortality than those living in private households, irrespective of their health status. However this disadvantage declines with age, and effectively disappears after age 90.