Bereavement is an old-fashioned term, harking back to an era when family members who lost a loved one dressed in black, literally wearing their grief for all to see.

Today, mourning a death has few rules, traditions or identifiers. But research indicates that a significant loss is deadly serious, putting the grieving at higher risk for serious health problems, and even their own premature death.

For more than 10 years, Dr. Toni Miles has studied the impact of bereavement. A physician with a Ph.D. in public health, Miles is a professor of epidemiology at the University of Georgia and director of its Institute of Gerontology.

As the boomer population ages and more individuals live with grief, Miles believes the time is right to look at bereavement care as a public health issue that can buffer the negative impact of loss. Her research also identifies effective strategies to support the bereaved.

In this interview, Miles explains how bereavement affects people’s health and mortality and what we can do to better help those who are grieving.

Dr. Toni Miles: Critical losses are destabilizing and accumulate over time. The death of a significant loved one — by that I mean a parent, spouse, sibling or child — increases your own risk of dying.

I’m not talking about the anecdotal story of an older couple that dies within twenty-four hours of each other. I’m using a large data set of people fifty and older, studying people who report they’ve lost someone close in the last twenty-four months. At a population level, those people are two times more likely to die over the course of a lifetime than someone without that loss.

The rates for premature death are highest in the first two years after the loss. The research also shows that the younger you are when you lose someone important to you, the worse it is for your health. The elevated mortality risk for children who lose a parent goes up fivefold. In our models, losing a child, even an adult child, statistically carries a high risk of morbidity.

That’s true. The risk never goes away; it does not return to the expected level of the general population that has not experienced such a loss. Even when you adjust for age, the risk stays higher. When we measure this at a population level, we believe that five percent of the deaths that happen in a year are attributable to a loss; by that I mean, they might not have died if they didn’t have this loss in their background.

Bereavement is this feeling of profound loss; it’s having a giant hole in your soul. You are living with this feeling that you didn’t have before this event. Your physiology is perturbed. People gain or lose weight, their sleep is disturbed. They take up smoking again. Grief sends people to the doctor and the hospital.

If people started turning purple with each loss, we would be able to see it in front of us. Some people are lavender, others are like an eggplant. After studying the risks and outcomes of elevated mortality from a public health perspective, I say we are in the midst of a hidden epidemic.