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Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study

Katherine Bristowe Orcid Logo, Peter May, Alexandra Pitman Orcid Logo, Jingjing Jiang, Liadh Timmins Orcid Logo, Michael King, Debbie Braybrook Orcid Logo, Steve Marshall Orcid Logo, Elizabeth Day, Paul Clift, Ruth Rose, Katherine Johnson, Kathryn Almack, Richard Harding Orcid Logo

Palliative Medicine, Volume: 39, Issue: 9, Pages: 977 - 986

Swansea University Author: Liadh Timmins Orcid Logo

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DOI (Published version): 10.1177/02692163251355796

Abstract

Background: Recent research has demonstrated higher levels of psychological distress for bereaved same-gender partners compared to different-gender partners. Economic outcomes have not yet been examined. Aim: To examine whether there are differences between same- and different-gender civil partners...

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Published in: Palliative Medicine
ISSN: 0269-2163 1477-030X
Published: SAGE Publications 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70579
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Aim: To examine whether there are differences between same- and different-gender civil partners or spouses (hereafter &#x2018;partners&#x2019;) in the amount of unpaid care provided in the 3&#x2009;months pre-bereavement, and time taken off work and formal healthcare used in the 3&#x2009;months pre- or post-bereavement. Design: A population-based cross-sectional survey of bereaved partners from England/Wales was conducted including three economic outcomes of interest: unpaid care, time taken off work, and formal healthcare used. We estimated formal healthcare costs using reference costs. We balanced groups on sociodemographic characteristics using propensity score weights and estimated average marginal difference in outcomes between groups using multivariable regressions. Setting/participants: There were 542 complete cases for primary analysis (220 same-gender partners, 322 different-gender partners). Results: Same- and different-gender partners provided very high levels of unpaid care pre-bereavement (mean 122&#x2009;h/week). Of those in paid employment, 85% missed some work pre- and post-bereavement. Same-gender partners had higher formal healthcare costs post-bereavement (+&#xA3;79, 95% CI: +2&#x2009;to&#x2009;+156). There were no other significant differences between groups. Conclusion: The economic burdens of bereavement are substantial. Same-gender partners were associated with more formal healthcare use than different-gender partners post-bereavement, possibly connected to higher levels of psychological distress. 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spelling 2025-12-16T10:28:43.0282279 v2 70579 2025-10-06 Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study 7f227f6f0fc0400bae2893d252d2f5ec 0000-0001-7984-4748 Liadh Timmins Liadh Timmins true false 2025-10-06 PSYS Background: Recent research has demonstrated higher levels of psychological distress for bereaved same-gender partners compared to different-gender partners. Economic outcomes have not yet been examined. Aim: To examine whether there are differences between same- and different-gender civil partners or spouses (hereafter ‘partners’) in the amount of unpaid care provided in the 3 months pre-bereavement, and time taken off work and formal healthcare used in the 3 months pre- or post-bereavement. Design: A population-based cross-sectional survey of bereaved partners from England/Wales was conducted including three economic outcomes of interest: unpaid care, time taken off work, and formal healthcare used. We estimated formal healthcare costs using reference costs. We balanced groups on sociodemographic characteristics using propensity score weights and estimated average marginal difference in outcomes between groups using multivariable regressions. Setting/participants: There were 542 complete cases for primary analysis (220 same-gender partners, 322 different-gender partners). Results: Same- and different-gender partners provided very high levels of unpaid care pre-bereavement (mean 122 h/week). Of those in paid employment, 85% missed some work pre- and post-bereavement. Same-gender partners had higher formal healthcare costs post-bereavement (+£79, 95% CI: +2 to +156). There were no other significant differences between groups. Conclusion: The economic burdens of bereavement are substantial. Same-gender partners were associated with more formal healthcare use than different-gender partners post-bereavement, possibly connected to higher levels of psychological distress. Future research should consider longer-term impacts of partner bereavement on health outcomes, explore whether care services are experienced as inclusive, and target ethnically diverse and gender diverse communities. Journal Article Palliative Medicine 39 9 977 986 SAGE Publications 0269-2163 1477-030X Bereavement, sexual minority, sexual orientation, health service utilisation, health care costs, labour force, informal care 1 10 2025 2025-10-01 10.1177/02692163251355796 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University Another institution paid the OA fee This work was supported by the Marie Curie Research Grants Scheme grant reference MCRGS–07–16–45. MCRGS–07–16–45 2025-12-16T10:28:43.0282279 2025-10-06T11:03:44.6239424 Faculty of Medicine, Health and Life Sciences School of Psychology Katherine Bristowe 0000-0003-1809-217x 1 Peter May 2 Alexandra Pitman 0000-0002-9742-1359 3 Jingjing Jiang 4 Liadh Timmins 0000-0001-7984-4748 5 Michael King 6 Debbie Braybrook 0000-0001-9253-4955 7 Steve Marshall 0000-0002-3728-7389 8 Elizabeth Day 9 Paul Clift 10 Ruth Rose 11 Katherine Johnson 12 Kathryn Almack 13 Richard Harding 0000-0001-9653-8689 14 70579__35833__b0cc3be1e1e9408e8e831ae6ec11cdea.pdf 70579.VOR.pdf 2025-12-16T10:26:32.5266824 Output 478300 application/pdf Version of Record true © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License. true eng https://creativecommons.org/licenses/by/4.0/
title Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
spellingShingle Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
Liadh Timmins
title_short Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
title_full Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
title_fullStr Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
title_full_unstemmed Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
title_sort Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study
author_id_str_mv 7f227f6f0fc0400bae2893d252d2f5ec
author_id_fullname_str_mv 7f227f6f0fc0400bae2893d252d2f5ec_***_Liadh Timmins
author Liadh Timmins
author2 Katherine Bristowe
Peter May
Alexandra Pitman
Jingjing Jiang
Liadh Timmins
Michael King
Debbie Braybrook
Steve Marshall
Elizabeth Day
Paul Clift
Ruth Rose
Katherine Johnson
Kathryn Almack
Richard Harding
format Journal article
container_title Palliative Medicine
container_volume 39
container_issue 9
container_start_page 977
publishDate 2025
institution Swansea University
issn 0269-2163
1477-030X
doi_str_mv 10.1177/02692163251355796
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
document_store_str 1
active_str 0
description Background: Recent research has demonstrated higher levels of psychological distress for bereaved same-gender partners compared to different-gender partners. Economic outcomes have not yet been examined. Aim: To examine whether there are differences between same- and different-gender civil partners or spouses (hereafter ‘partners’) in the amount of unpaid care provided in the 3 months pre-bereavement, and time taken off work and formal healthcare used in the 3 months pre- or post-bereavement. Design: A population-based cross-sectional survey of bereaved partners from England/Wales was conducted including three economic outcomes of interest: unpaid care, time taken off work, and formal healthcare used. We estimated formal healthcare costs using reference costs. We balanced groups on sociodemographic characteristics using propensity score weights and estimated average marginal difference in outcomes between groups using multivariable regressions. Setting/participants: There were 542 complete cases for primary analysis (220 same-gender partners, 322 different-gender partners). Results: Same- and different-gender partners provided very high levels of unpaid care pre-bereavement (mean 122 h/week). Of those in paid employment, 85% missed some work pre- and post-bereavement. Same-gender partners had higher formal healthcare costs post-bereavement (+£79, 95% CI: +2 to +156). There were no other significant differences between groups. Conclusion: The economic burdens of bereavement are substantial. Same-gender partners were associated with more formal healthcare use than different-gender partners post-bereavement, possibly connected to higher levels of psychological distress. Future research should consider longer-term impacts of partner bereavement on health outcomes, explore whether care services are experienced as inclusive, and target ethnically diverse and gender diverse communities.
published_date 2025-10-01T05:33:02Z
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score 11.096295

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