Former first lady Barbara Bush died Tuesday at the age of 92, a spokesman announced in a statement.
"A former First Lady of the United States of America and relentless proponent of family literacy, Barbara Pierce Bush passed away Tuesday, April 17, 2018 at the age of 92," the statement from the office of her husband, former President George H.W. Bush, said.
Bush is survived by her husband, five children — including former President George W. Bush — and her brother Scott Pierce, as well as 17 grandchildren and seven great-grandchildren.
She had been hospitalized multiple times throughout the year due to complications involving chronic obstructive pulmonary disease and congestive heart failure.
In her final days, she had decided against seeking additional medical treatment and instead chose to focus on comfort care while living in her home in Houston.
Barbara Bush was born in 1925 to Pauline and Marvin Pierce in New York City and was raised in the suburban town of Rye, N.Y.
She met her future husband when she was 16, and they became engaged a year and a half later.
After her husband graduated from Yale, the two moved to Texas where George worked in the oil industry. They had six children, including George W. Bush and Jeb Bush, who would become governor of Florida and mount an unsuccessful presidential campaign during the 2016 race.
Barbara Bush sometimes sparked controversy for views that did not align with the Republican Party’s platform, including her support of the Equal Rights Amendment during her husband’s failed 1980 presidential bid.
She also caused a stir in 1992, when her husband was president, after she referred to homosexuality as a “personal choice” and called on the party to drop its opposition to abortion.
As first lady, Barbara Bush made the promotion of literacy her special cause, calling it the “most important issue we have.”
She also founded the nonprofit Barbara Bush Foundation for Family Literacy.
Barbara Bush had said that if more people knew how to read and write, “we could be much closer to solving so many other problems that our country faces.”
She participated in other causes as well, including those involving the homeless, AIDS, the elderly and school volunteer programs.
The former first lady has said that people tended to like her because they know, “I’m fair and I like children, and I adore my husband.”