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Payback time? Influence of having children on mortality in old age
  1. K Modig1,
  2. M Talbäck1,
  3. J Torssander2,
  4. A Ahlbom1
  1. 1Epidemiology unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
  1. Correspondence Dr Karin Modig, Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210 Stockholm SE-171 76, Sweden; karin.modig{at}


Background It is known that parents have lower mortality than childless individuals. Support from adult children to ageing parents may be of importance for parental health and longevity. The aim of this study was to estimate the association between having a child and the risk of death, and to examine whether the association increased at older ages when health starts to deteriorate and the need of support from a family member increases.

Methods In this nationwide study, all men and women (born between 1911 and 1925 and residing in Sweden), as well as their children, were identified in population registers and followed over time. Age-specific death risks were calculated for each calendar year for individuals having at least one child and for individuals without children. Adjusted risk differences and risk ratios were estimated.

Results Men and women having at least one child experienced lower death risks than childless men and women. At 60 years of age, the difference in life expectancy was 2 years for men and 1.5 years for women. The absolute differences in death risks increased with parents' age and were somewhat larger for men than for women. The association persisted when the potential confounding effect of having a partner was taken into account. The gender of the child did not matter for the association between parenthood and mortality.

Conclusions Having children is associated with increased longevity, particularly in an absolute sense in old age. That the association increased with parents' age and was somewhat stronger for the non-married may suggest that social support is a possible explanation.

  • Life course epidemiology

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  • Contributors KM proposed the research question. MT performed the statistical analyses. All authors contributed to the interpretation of the results. KM drafted the first manuscript to which all authors contributed. All authors have approved the final version of this manuscript. MT had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None declared.

  • Ethics approval Regional Ethics Committee, Karolinska Institutet, Stockholm, Sweden, Dnr 2011/136-31/5 and Dnr 2015/1917-32.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data underlying this study are sensitive individual-level data protected by the personal data act. Data can only be shared after ethical approval from the Regional Ethics Committee, Karolinska Institutet, Stockholm, Sweden, and after consent from the principal investigator.

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