Testing the Anniversary Reaction: Causal Effects of Bereavement in a Nationwide Follow-Up Study from Sweden

Jan M. Saarela, University of Helsinki and Åbo Akademi University
Mikael Rostila, Stockholm University
Anders Hjern, Centre for Health Equity Studies

By observing parental mortality around the death date and birth date of children one can examine whether there is an excess risk of death in mothers and fathers around these critical dates. This quasi-experimental approach can be considered a test for whether there is a true bereavement effect in terms of a causal effect of the death of a child on parental mortality. Our aim was to study parental mortality following the death of a minor child around the anniversary since the loss and birth of a deceased child, using inter-generational linked data from nationwide Swedish registers.We found evidence of such an anniversary effect, but only for mothers and primarily related to the anniversary of death. On the death date of a minor child, bereaved mothers had twice the mortality rate as would be expected if deaths were equally distributed over the calendar year.