Pathways from fertility history to later life health: Results from analyses of the English Longitudinal Study of Ageing

Abstract

BACKGROUNDPrevious research shows associations between fertility histories and later life health. The childless, those with large families, and those with a young age at entry to parenthood generally have higher mortality and worse health than parents of two or three children. These associations are hypothesised to reflect a range of biosocial influences, but underlying mechanisms are poorly understood. OBJECTIVESTo identify pathways from fertility histories to later life health by examining mediation through health-related behaviours, social support and strain, and wealth. Additionally to examine mediation through allostatic load -an indicator of multisystem physical dysregulation, hypothesised to be an outcome of chronic stress. METHODSAssociations between fertility histories, mediators, and outcomes were analysed using path models. Data were drawn from the English Longitudinal Study of Ageing. Outcomes studied were a measure of allostatic load based on 9 biomarkers and selfreported long-term illness which limited activities. RESULTSEarly parenthood (<20 for women, <23 for men) was positively associated with higher (worse) allostatic load and long-term illness. These associations were partly mediated through wealth, smoking, and physical activity. Wealth, smoking, physical activity, and social strain also mediated associations between larger family size, itself associated with early parenthood, and health outcomes. We found no significant associations between childlessness and allostatic load or long-term illness, except for an association

Fertility History and Cognition in Later Life.

“…Although a considerable amount of covariance was explained by socioeconomic factors, some of the associations remained even after adjusting for a number of factors related to health, depression, control, activities, social contacts, and isolation. Our results from models adjusted only for age showed a U-shaped association between parity and poorer cognitive functioning (Model 1 in Table 3) which is similar to associations between parity and physical health reported in previous studies (Grundy & Read, 2015;Grundy & Tomassini, 2005). In the case of high parity, the association with poorer functioning was largely due to a lower socioeconomic position among parents with large families and adding further controls for social interaction, depression, and lack of sense of control had trivial effects.…”

“…Other studies on early parenthood and various other health outcomes also point to a strong role of socioeconomic factors (Grundy & Read, 2015;Spence, 2008). We found no association between late fatherhood and cognitive functioning, to our knowledge, this has not been studied before.…”

“…Improving understanding of life-course influences on cognitive function is therefore important. Previous studies have shown that socioeconomic factors, social interaction, and health are all associated with cognitive function (Agrigoroaei & Lachman, 2011;Brunner, 2005) and a separate body of research has identified links between these domains and fertility history and between fertility histories and later life health (Grundy & Read, 2015). However, the limited previous research into associations between fertility histories and later life cognitive function has paid little attention to the possible social pathways which may link them (Heys et al, 2011).…”

“…The timing of parenthood, and to some extent number of children, is socially patterned and strongly associated with levels of education. However, even taking account of this, previous studies suggest that early parenthood and high parity, as well as childlessness, are associated with poorer physical health in later life (Grundy & Read, 2015;Read, Grundy & Wolf, 2011). Lower socioeconomic position, poorer physical health, depression, and lack of control are all associated with poorer cognitive functioning (Agrigoroaei & Lachman, 2011;Brunner, 2005).…”

“…The timing of parenthood and number of children born have important implications for activities, roles, social and economic resources, and lifestyles throughout adulthood (Knoester & Eggebeen, 2006;Nomaguchi & Milkie, 2003;Wenger, Dykstra, Melkas, & Knipscheer, 2007)-all domains which may directly or indirectly affect cognitive reserve and later life cognitive functioning (Agrigoroaei & Lachman, 2011;Brunner, 2005). Moreover, previous research has identified links between fertility histories and later life physical health (Grundy & Read, 2015), which itself associated with cognitive function (Brunner, 2005). We use nationally representative longitudinal data from England to investigate the association between fertility history and later life cognitive functioning in women and men.…”