J Epidemiol Community Health 67:265-270 doi:10.1136/jech-2012-201311
  • Research reports

Changing associations between partnership history and risk of accidents, violence and suicides

  1. Pekka Martikainen
  1. Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
  1. Correspondence to Dr Karri Silventoinen, Population Research Unit, Department of Social Research, University of Helsinki, P.O. Box 18, Helsinki 00014, Finland; karri.silventoinen{at}
  1. Contributors KS and PM created the study design. KS conducted the analyses and wrote the paper. RP was in charge of data management and helped to write the data description. HM helped in statistical analyses. All authors have contributed to interpretation of the results and critically revising the manuscript.

  • Accepted 13 August 2012
  • Published Online First 29 September 2012


Background Lower mortality has been systematically found in married when compared with non-married, especially in men, but little is known about marital status differences in mortality from external causes. Furthermore, the role of cohabitation and partnership history in the formation of these differences and how they have been changed over time are poorly understood.

Methods The incidence of fatal and non-fatal cases of accidents, violence and suicides by partnership history was analysed during 1991–1997 and 2001–2007 in a representative sample of the Finnish population aged 26–59 years. HRs were calculated using Cox proportional hazards models.

Results Incidence rates in accidents, violence and suicides were generally lower in men and women living with a partner than those living alone. Current cohabitation and previous divorce increased the risk of all of these outcomes when compared with married without previous divorce. Higher incidence rates were found in men who had divorced 3 years ago or earlier when compared with those who had divorced later. Generally, these differences were larger in fatal than in non-fatal cases and significantly larger in men. There was little change in these differences between 1991–1997 and 2001–2007. These differences were partly explained by socioeconomic factors but remained statistically significant also after these adjustments.

Conclusions Currently living without a partner and cohabitation and previous divorce increased the risk of accidents, violence and suicides. This indicates that also other mechanisms than immediate support from a partner are important in the formation of marital status differences in mortality.


  • Funding This work was supported by the Academy of Finland grant numbers 1255388 and 1250569.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.