There is evidence that the mortality disadvantage of widows and widowers relative to married men and women has been increasing over the last decades. At the same time, a rising life expectancy and heavy size fluctuations between birth cohorts have been reshaping the demographic characteristics of the widowed population, which may have implications for how to interpret the excess mortality of the widowed. This study uses Swedish register data to compare trends in the excess mortality of widows and widowers in younger and older age groups during the years 1970-2019, and link the trends to the demographic changes that occurred in the population in the same period. The results show that the excess mortality rose in all age groups during the period, with the strongest increase occurring in younger ages and among women. At the same time, the widowed population became significantly older, and the contribution from the groups aged 75 or younger to the overall excess mortality of the widowed declined. Further, the results show that widowhood overall became slightly less common among the old during the period, that the relative number of men entering widowhood rose and that the proportion who remarried after widowhood remained negligible throughout the period. The transition to widowhood also began to occur increasingly late in life while the average duration of widowhood before dying or remarrying fell, especially for women. The findings of the study suggest that while increasing selection into widowhood contributed to the rising excess mortality, other mechanisms were at work as well. Other potential explanations include an increasing overlap between widowhood and periods of sickness and disabilities, and a decline in access to formal care and assistance.

With few exceptions, greater disparities in mortality risk by socio-economic status (SES) have been found among men than among women. Most research has also shown that the higher mortality risk after widowhood (the widowhood effect) is greater for men. However, a different picture appears when examining these associations jointly. Based on Swedish register data, this study shows that widowhood weakens, or even reverses, the sex differences in socio-economic disparities in mortality. The overall findings also indicate that higher SES elevates the widowhood effect for men but diminishes it for women, and that the widowhood effect is greater for women than men in the lowest SES categories. These results imply that men with higher SES are more vulnerable after widowhood, perhaps because of their previous relatively privileged situation. The disadvantage of widows in lower SES categories may reflect exposure to financial strains after spousal loss and inequalities in the healthcare system.

Findings from several studies have showed that the rise in mortality risk after spousal loss (often called the widowhood effect) has become greater over the last decades. Previous research has also shown that the widowhood effect tends to be greater among individuals with higher education than among those with lower education. This paper explores both these trends further by comparing period trends in the widowhood effect for men and women, for different educational levels and for different durations of widowhood during the period 1990-2017, using Swedish register data. Further, it compares the importance of education and spousal education for the widowhood effect among men and women. The results show that the short-term widowhood effect (six months or less since the death of the spouse) has increased more over time than the widowhood effect for longer durations of widowhood. This may be related to widowhood on average occurring increasingly late in life, when people are less resilient. No significant difference in the increase in excess mortality was evident by neither by sex nor education. Finally, spousal education was more important than own education for the widowhood effect among men, while own education was more important among women, throughout the period. Thus, the positive association between the widowhood effect and education among men may have an explanation in that part of the health advantage of married men with higher education comes from having spouses with higher education, or other resources.