Background Literature assessing the effect of marital status on mortality has underrepresented, or altogether omitted Hispanics and the potential moderating effect of Hispanic ethnicity on these relationships. Given cultural and network dynamics, marital advantages in older Hispanic women may be greater than other groups given their family-focused, collectivist orientation. Purpose The purpose of this study was to understand whether older Hispanic women exhibited a more pronounced marital advantage as compared with non-Hispanic Whites. Methods We used longitudinal data from the Women’s Health Initiative (WHI) Observational Study and Clinical Trials (N = 161,808) collected initially from 1993 to 1998 and followed until 2018. Our sample excluded those respondents indicating “other” as their race-ethnicity and those missing marital status and race-ethnicity variables (N = 158,814). We used Cox-proportional hazards models to assess the association between race-ethnicity, marital status, and the interactive effect of race-ethnicity and marital status on survival. Results After controlling for socioeconomic status (SES) and health controls, we found a Hispanic survival advantage when compared with non-Hispanic Whites and all other racial-ethnic groups with the exception of Asian/Pacific Islander women (all significant HRs < 0.78, all ps ≤ 0.001). Hispanics had a higher rate of divorce when compared with non-Hispanic Whites. The interactive effect of race-ethnicity and marital status was not significant. Conclusions U.S. Hispanic, postmenopausal women exhibit a mortality advantage over and above marital status despite their high rates of divorce. Implications and potential explanations are discussed. Clinical Trial Registration NCT00000611.

中文翻译：

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在妇女健康倡议中，西班牙裔死亡率优势是否因绝经后妇女的婚姻状况而异？

背景文献评估婚姻状况对死亡率的影响的代表性不足或完全忽略了西班牙裔以及西班牙裔对这些关系的潜在调节作用。鉴于文化和网络动态，考虑到以家庭为中心的集体主义取向，老年西班牙裔女性的婚姻优势可能比其他群体更大。目的 本研究的目的是了解与非西班牙裔白人相比，老年西班牙裔女性是否表现出更明显的婚姻优势。方法 我们使用了女性健康倡议 (WHI) 观察性研究和临床试验 (N = 161,808) 的纵向数据，该数据最初从 1993 年到 1998 年收集，一直持续到 2018 年。我们的样本排除了那些将“其他”作为他们的种族种族的受访者以及那些缺少婚姻状况和种族种族变量的受访者（N = 158,814）。我们使用 Cox 比例风险模型来评估种族-民族、婚姻状况以及种族-民族和婚姻状况对生存的交互影响之间的关联。结果 在控制了社会经济地位 (SES) 和健康控制后，我们发现与非西班牙裔白人和除亚洲/太平洋岛民女性之外的所有其他种族群体相比，西班牙裔的生存优势（所有显着的 HR 均 < 0.78，所有 ps ≤ 0.001)。与非西班牙裔白人相比，西班牙裔的离婚率更高。种族-民族与婚姻状况的交互作用不显着。结论美国西班牙裔，尽管离婚率很高，但绝经后妇女的死亡率高于婚姻状况。讨论了影响和潜在的解释。临床试验注册 NCT00000611。