Spouse's Illness Can Be Deadly to You
Caretakers of Ill Spouses Have Greater Risk of Death
Disabling Outweighs Deadly continued...
There's another factor that makes it hard on spouses: poverty.
"If you are living at the margin, economically or in terms of age or being sicker, you are more vulnerable to your spouse being sick," Christakis says. "If I am richer or younger, it is not as big a shock."
Poorer elderly people in the U.S. have limited access to health care, notes Suzanne Salamon, MD, associate chief for clinical geriatrics at Beth Israel Deaconess Medical Center in Boston. Salamon was not involved in the Christakis study but participated in the Harvard news conference.
"What I have noted with poor people is there are more of the things that affect your health negatively," Salamon says. "You often have more health problems in poor people because of obesity-related issues -- high blood pressure, diabetes, small strokes -- and because of less access to health care."
Spouse Illness: Early Risk and Later Risk
Why does a spouse's illness boost a partner's risk of death? There are two danger periods, Christakis says.
In the first weeks or months there's a stress effect. This may lead to an increase in harmful behaviors -- drinking, for example, or eating an unhealthy diet. And the stress may also lead to illnesses and accidents.
"Initially the partner is at increased risk from heart attack, suicide, and accidents," Christakis says. "I am shocked my wife is sick and I stop paying attention when driving. And there is an increase in infections."
Eventually, these stress effects diminish. But then the partner faces a new set of health risks from waning social support.
"At first there are a lot of people around and there is a lot of support," Salamon says. "But as time goes by, people don't come by, people don't bring food. And over time the loneliness sets in."
Your Health, My Health Connected
Christakis hopes that one result of the study will be that health care providers and insurers will realize that they can save future costs by giving more attention to the health of caretakers.
"What our work does is shed light on particular vulnerabilities to elderly people, and show there are time windows to target interventions," he says. "Seeing people as interconnected might change the way we see the costs of health care. Taking care of both spouses while one is dying increases the health benefits for the surviving partner."
What about other relationships?
"Because people are interconnected, we think this phenomenon we studied in elderly married couples applies more generally," Christakis says. "We are looking at broader connections -- between parent and child, brother and sister, neighbors, and friends."