Fertility History and Physical and Mental Health Changes in European Older Adults

Abstract

Previous studies have shown that aspects of reproductive history, such as earlier parenthood and high parity, are associated with poorer health in mid and later life. However, it is unclear which dimensions of health are most affected by reproductive history, and whether the pattern of associations varies for measures of physical, psychological and cognitive health. Such variation might provide more insight into possible underlying mechanisms. We use longitudinal data for men and women aged 50-79 years in ten European countries from the Survey of Health, Ageing and Retirement in Europe to analyse associations between completed fertility history and self-reported and observed health indicators measured 2-3 years apart (functional limitations, chronic diseases, grip strength, depression and cognition), adjusting for socio-demographic, and health factors at baseline. Using multiple imputation and pattern mixture modelling, we tested the robustness of estimates to missing data mechanisms. The results are partly consistent with previous studies and show that women who became mothers before age 20 had worse functional health at baseline and were more likely to suffer functional health declines. Parents of 4 or more children had worse physical, psychological and cognitive health at baseline and were more likely to develop circulatory disease over the follow-up period. Men who delayed fatherhood until age 35 or later had better health at baseline but did not experience significantly different health declines. This 123Eur J Population https://doi.org/10.1007/s10680-018-9489-x study improves our understanding of linkages between fertility histories and later life health and possible implications of changes in fertility patterns for population health. However, research ideally using prospective life course data is needed to further elucidate possible mechanisms, considering interactions with partnership histories, health behaviour patterns and socio-economic trajectories.

Fertility History and Biomarkers Using Prospective Data: Evidence From the 1958 National Child Development Study

“…Other research has focused on associations between fertility and health outcomes, rather than mortality, both in midlife and at older ages (Buber and Engelhardt 2008;Grundy and Holt 2000;Grundy and Tomassini 2005;Gunes 2016;Hank 2010;Hanson et al 2015;Henretta 2007;O'Flaherty et al 2016;Pirkle et al 2014;Williams et al 2011). Outcomes investigated include self-reported health, disability, presence of limiting long-term illness, chronic diseases, allostatic load, grip strength, psychological well-being, and mental health (Grundy and Read 2015;Henretta et al 2008;Keenan and Grundy 2018;Spence 2008). Findings are similar to those reported for mortality, with early parenthood, childlessness, and high parity associated with poorer health outcomes.…”

The Role of Fertility in the Demography of Grandparenthood: Evidence from Italy

“…Respondents were asked a number of questions about their fertility histories, based on which we distinguished between respondents with one, two, and three or more children. Following Keenan and Grundy (2018), we then considered age of parenthood by including a trichotomous variable, indicating whether the respondent became a parent before the age of 21, between 22 and 29, or at 30 or older.…”

The More the Merrier? The Causal Effect of High Fertility on Later-Life Loneliness in Eastern Europe

“…Although the above mentioned mechanisms are particularly salient for women, adverse effects of high fertility have also been reported for men (e.g., Grundy and Tomassini 2006). Keenan and Grundy (2018) argued that the cumulative stress and financial strain associated with raising many children may partly explain the finding that both mothers and fathers of four or more children had poorer physical and psychological health than their counterparts with two children (cf. Read et al 2011).…”