Behavioral and psychological outcomes of marital status and transition among aging adults in rural South Africa: A longitudinal analysis

The study aimed to evaluate behavioral and psychological outcomes of marital status and transition among aging adults in rural South Africa. The analysis utilized data from the South African 7-year longitudinal Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (analytic sample: n = 3,707, aged 40 years and older). Behavioral outcomes assessed included substance use, dietary intake, and body mass index, and psychological outcomes included depressive symptoms, life satisfaction, loneliness, sleep quality, posttraumatic stress, and cognitive functioning. Results indicate that non-marital status increased the odds of current and/or incident tobacco use. Among men, being divorced or remaining unmarried increased the odds of current and/or incident heavy alcohol use and (incident) low fruit and vegetables intake. Among women and/or men, non-marital status was positively associated with (incident) underweight, while being widowed, single, or divorced increased the odds of obesity. Among women and/or men, widowed, single or divorced was associated with poor life satisfaction, loneliness, depressive symptoms, and cognitive impairment, remaining unmarried and/or transitioning to divorced or widowed increased the odds of incident poor life satisfaction, incident poor sleep quality, incident PTSD, incident loneliness and incident impaired cognition. With the exception of obesity, different categories of being unmarried were associated with several behavioral and psychological outcomes.