J Epidemiol Community Health 66:927-933 doi:10.1136/jech-2011-200339
  • Miscellaneous

Mortality in parents following the death of a child: a nationwide follow-up study from Sweden

  1. Ichiro Kawachi3
  1. 1Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
  2. 2Åbo Akademi University, Vasa, Finland
  3. 3Harvard School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Mikael Rostila, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sveavägen 160, SE-106 91 Stockholm, Sweden; mikael.rostila{at}
  1. Contributors MR and JS planned the study and the research design. They also analysed data, interpreted the results and wrote the draft version of the paper. IK contributed to writing, interpretation of data and critical reviews. All authors corrected and approved the final version of the manuscript.

  • Accepted 12 October 2011
  • Published Online First 1 November 2011


Background The death of a young child is so devastating that it can increase the risk of mortality in the grieving parent. Little is known about the impact of an adult child's death on the health of parents.

Methods The authors conducted a follow-up study between 1980 and 2002 based on a linked-registers database that contains the total Swedish population. The authors examined mortality from all causes, natural causes and unnatural causes among parents following the death of children aged 10–49 years.

Results An increased mortality risk (RR 1.31, 95% CI 1.02 to 1.68) in mothers following the death of a minor child (10–17 years) was found and especially following unnatural deaths (primarily accidents and suicides). Mothers also experienced elevated mortality following the death of an adult child aged 18–25 years (RR 1.15, 95% CI 1.03 to 1.29). Bereavement effects among fathers were more attenuated and chiefly found after >8 years of follow-up. From a short-term perspective (1–3 years), the death of an adult child (>25 years) was somewhat protective for parents. However, over longer follow-up periods, it approached (4–8 years) and exceeded (>8 years) the death risk of the general population.

Conclusions These findings corroborate and extend earlier findings suggesting elevated mortality risks also following the death of an adult child.


  • Funding This work was supported by the Swedish Council for Working Life and Social Research (grant number 2009-0547) and the Swedish Research Council (grant number 2008-1677).

  • Competing interests None.

  • Ethics approval The data used in this study was approved by the Regional Ethical Review board of Karolinska Institutet in 2002-11-11 (decision no. 02-481).

  • Provenance and peer review Commissioned; internally peer reviewed.