Widowhood, depression and blood pressure: A U.S.-England comparison

Objectives This study queried associations of older adults’ widowhood with their systolic and diastolic blood pressure (BP), and mediation of these linkages by depression. Methods Data were from the 2008 and 2012 waves of two surveys: the U.S. Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). Analyses used lagged dependent variable models to examine widowhood effects, and a counterfactual approach to test mediation. Results Positive widowhood-BP linkages were found only among HRS women. Associations were negative for HRS men’s systolic BP, and absent in ELSA. These sex- and societal differences seemed driven not by linkages of widowhood with depression—which remained constant across all subgroups—but by that of depression with BP. For both outcomes, the latter was positive for HRS women, negative for HRS men, and absent in ELSA. Accordingly, depression mediated over a third of HRS women’s widowhood effects. A substantial proportion of this influence also seemed to bypass this psychological state. Discussion Results indicate a need for more sex-specific basic research into depression’s physiological impact, and on non-distress mechanisms linking life events to physiology. They also suggest that single-country studies may lead to flawed conclusions on the biological implications of life course factors.