Fatherhood History and Later Life Health and Mortality in England and Wales: A Record Linkage Study

ABSTRACT: Fatherhood is an important domain of the lives of most men but, in contrast to extensive research into associations between marriage and health, possible effects of paternity on later life health and mortality have attracted relatively little attention. Of those studies that have been undertaken, many relate to historical or less developed country populations with high levels of fertility and much less is known about associations in contemporary developed societies. In this paper we use data from a large nationally representative record linkage study of men in England and Wales to analyse associations between aspects of paternity history and subsequent mortality and health in a sample of 20,260 mature men in long-term first marriages. At entry to the study in 1981 sample members had a mean age of 63 and a mean duration of marriage of 38 years. Mortality was observed for a twenty three year period (1981-2004) and indicators of health status measured ten (in 1991) and twenty years (in 2001) after entry into the analysis. Paternity Characteristics investigated included number of children born and, among men who were fathers, early or late paternity; experience of a particularly short or long interval between marriage and first birth; and experience of one or more short intervals between births. Socioeconomic characteristics included in the analysis were based on measures relating to educational attainment, occupational social class and housing tenure, in the latter two cases observed at more than one point of time. Contrary to our hypotheses, results showed no later life disadvantages of childlessness in this sample of men who had experienced long term first marriages. However, aspects of paternity history were associated with later life health and mortality. Most notably men who had had a child before the age of 23 had higher mortality and higher odds of poor health in 1991 and 2001 than other fathers, while men who had a child at ages 40 or over had lower mortality and lower risks of long term illness in 1991. Men who had had four or more children also appeared to have worse later life health in some of the health indicators used in this study. Limitations of the data include absence of information on contacts with children or on health related behaviours hypothesised to be associated with fatherhood. Results nevertheless suggest long-term consequences of particular paternity pathways.