Racial Differences in Marital Instability and Risks for Stroke in U.S. Older Adults

Matthew E. Dupre, Duke University
Alicia Nelson, Duke University

Stroke is among the leading causes of disability and death in the United States and racial differences are greater for stroke than for all other major chronic diseases. This study examines whether black-white differences in marital instability play a role in the large racial inequalities in stroke. Using longitudinal data from the Health and Retirement Study, results show that non-Hispanic (NH) blacks have significantly greater numbers of health-risk factors, higher rates of marital instability, and greater risks for stroke compared with NH whites. Contrary to expectations, risks for stroke were significantly higher in NH whites who were currently divorced, remarried, and widowed, including those with a history of dissolution, compared with NH whites who were continuously married. In NH blacks, risks for stroke were only elevated in those who never married or were widowed—with no significant risks attributable to divorce. The mechanisms underlying the associations are assessed.