Parity and mortality in Finnish men and women: do living conditions in childhood and adulthood explain the association?

Elina Einiö, University of Helsinki
Jessica Nisén, University of Helsinki
Pekka Martikainen, University of Helsinki

Objective: This study examined whether the number of children ever born was associated with mortality in the post reproductive period among Finnish men and women, and whether the association could be explained by living conditions in childhood and adulthood. Methods: This study was based on a 10% household sample drawn from the 1950 Finnish census with a mortality follow-up from 1970 to 2007 and almost complete records on reproductive history. The childhood sample was linked with quinquennial censuses from 1970 to 1995 providing information from adulthood. Cox regression models were used. Results: The nulliparous men and women had the highest mortality followed by those with only one child, independent of education and marital status. Mothers and fathers of two or three children had the lowest mortality. Fathers of at least four children had excess mortality compared to those with two children, while respectively mortality of high parity mothers was not significantly elevated. The role of childhood living conditions in explaining mortality differences was modest, especially in women, while material living conditions in adulthood and early retirement had a larger role. In men, only the excess mortality of the nulliparous was significant net of all living conditions, while respectively in women also the excess mortality of those with only one child remained significant. Cause-specific analyses indicated that the excess mortality of childless men was largely related to circulatory and alcohol-related diseases. Conclusions: The modest contribution of childhood living conditions suggested that higher mortality of the childless, parents of only one child, and fathers of at least four children related more strongly to their material living conditions in adulthood than to those in childhood. The contribution of very early retirement suggests that also health selection is likely to have a major importance in understanding the elevated mortality of childless men and women.