The Family Life Course and Health: Partnership, Fertility Histories, and Later-Life Physical Health Trajectories in Australia

Associations of parity and cognitive decline, depression, and chronic comorbidity in West China: Results from WCHAT study

OBJECTIVE

To investigate the associations between parity (the number of offspring a female has borne) and cognitive function, depression, and chronic comorbidity in Western China.

METHODS

A total of 846 women aged 50-55 years were included in the current analysis. Cognitive status was measured using a 10-item short portable mental status questionnaire (SPMSQ). Depressive symptoms were assessed using the 15-item geriatric depression scale (GDS-15). Other characteristics were self-reported. The associations between parity and cognitive decline, depression, and chronic comorbidity were analyzed using univariable and multivariable models. Multivariable models were adjusted for age, ethnic group, occupation, marital status, educational level, lifestyle factors, and sleeping time.

RESULTS

Among the enrolled women, 26.71% were either childless or had one child, 47.40% had two children, 18.32% had three children, and 7.57% had ≥4 children. Compared to women with low parity, women with two or more children exhibited a higher risk of cognitive decline. Moreover, having four or more children was significantly associated with depression and chronic comorbidity. After adjusting covariates, women with three or more children exhibited a higher risk of cognitive decline than those with low parity. However, high parity was not significantly associated with depression or chronic comorbidity after adjustment for covariates.

CONCLUSION

Our study showed that ≥3 children was associated with cognitive decline in women. Longitudinal studies are needed to evaluate this conclusion and to investigate the mechanisms involved. More importantly, families and societies should pay more attention to women's long-term health outcomes related to fertility.

Non-standard family histories and wellbeing at older ages

The life course approach emphasizes that health and wellbeing at older ages are influenced by experiences occurred in the previous stages of life. We contribute to the literature by focusing on the role of the non-standardness of family histories and argue that individuals who experienced non-standard trajectories have been exposed to social sanctions throughout their life course with negative long-term consequences on wellbeing. In our study, non-standardness of family histories is the extent an individual's family history differs from those of the others within reference groups, defined combining birth cohort, gender and country of residence. Family histories between age of 15 and 49 are analyzed using Sequence Analysis, thus accounting for events related to fertility and union formation (marriage and cohabitation) and dissolution, and their timing. Dissimilarities between family sequences are measured using optimal matching and are standardized within the reference groups. We use retrospective data from the seventh wave of the Survey of Health Ageing and Retirement in Europe (SHARE) and estimate linear regression models to assess the association between non-standardness of family histories and older people's life satisfaction. Quality of life and depressive symptoms are examined in additional analyses. A negative association is found between non-standardness of family histories and wellbeing, which is stronger for lower educated individuals and in Southern European countries. Results are consistent with the idea that uncommon family behaviors may have a long-term negative effect on wellbeing. Individual resources and a more tolerant societal context can reduce or eliminate the negative consequences of engaging in non-standard family behaviors.

Family Formation History and the Psychological Well-Being of Women from Diverse Racial-Ethnic Groups

Studying disparities in psychological well-being across diverse groups of women can illuminate the racialized health risks of gendered family life. Integrating life course and demand-reward perspectives, this study applied sequencing techniques to the National Longitudinal Study of Youth: 1979 to reveal seven trajectories of partnership and parenthood through women's 20s and 30s, including several in which parenthood followed partnership at different ages and with varying numbers of children and others characterized by nonmarital fertility or eschewing such roles altogether. These sequences differentiated positive and negative dimensions of women's well-being in their 50s. Women who inhabited any family role had greater life satisfaction and fewer depressive symptoms, although these general patterns differed by race-ethnicity. Family roles were more closely related to well-being than ill-being for White women, parenthood had more pronounced importance across outcomes for Black women, and the coupling of partnership and parenthood generally mattered more for Latinas.

Work and Family Pathways and Their Associations with Health for Young Women in Korea

The aim of this study is two-fold: to discern patterns in pathways of work and family transitions among young women (aged 24-39 years) whose decisions and behaviors toward labor force participation, marriage, and parenthood are considerably shaped by social constraints and gender norms; and to examine whether and to what extent work and family pathways are associated with later health. Using data from a longitudinal survey based on a large sample of adult women in Korea (N = 2418), we identified eight dominant pathways of employment, marriage, and parenthood among young women and found that educational attainment and family values are strong predictors of these work-family pathways. We also found that the timing and sequencing of work-family pathways appears to be associated with later health outcomes. In particular, unemployed women who are not married and do not have children seem to be vulnerable to health problems, compared to those with other pathways. We discuss the implications of our findings regarding the occurrence of work and/or family transitions, as well as their timing and sequencing for women's health in later life.

Number of Births and Later-Life Depression in Older Adults: Evidence from China

Previous studies on the number of births and the health of the elderly have been highly focused on physical health and used samples from developed countries. Therefore, this study aimed to explore the effect of the lifetime number of births on depression in Chinese older adults. We used panel data for men and women aged 50 and over from the 2013-2018 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed through a short form of the Center for Epidemiologic Studies Depression Scale. We found that depression levels in women were significantly higher than in men, with a mean difference of 2.44 (p < 0.001). The model estimation results indicated that the number of births affected depression in older adults, and its increase could exacerbate depression in older adults. The number of births significantly impacted depression among the elderly aged 50-69. Furthermore, there was a negative relationship between the proportion of sons and older adults' depression, which was significant in older males; the number of abortions may exacerbate depression in older adults, especially in females.

Sequence analysis: Its past, present, and future

This article marks the occasion of Social Science Research's 50th anniversary by reflecting on the progress of sequence analysis (SA) since its introduction into the social sciences four decades ago, with focuses on the developments of SA thus far in the social sciences and on its potential future directions. The application of SA in the social sciences, especially in life course research, has mushroomed in the last decade and a half. Using a life course analogy, we examined the birth of SA in the social sciences and its childhood (the first wave), its adolescence and young adulthood (the second wave), and its future mature adulthood in the paper. The paper provides a summary of (1) the important SA research and the historical contexts in which SA was developed by Andrew Abbott, (2) a thorough review of the many methodological developments in visualization, complexity measures, dissimilarity measures, group analysis of dissimilarities, cluster analysis of dissimilarities, multidomain/multichannel SA, dyadic/polyadic SA, Markov chain SA, sequence life course analysis, sequence network analysis, SA in other social science research, and software for SA, and (3) reflections on some future directions of SA including how SA can benefit and inform theory-making in the social sciences, the methods currently being developed, and some remaining challenges facing SA for which we do not yet have any solutions. It is our hope that the reader will take up the challenges and help us improve and grow SA into maturity.

The Role of Fertility and Partnership History in Later-life Cognition

Cognitive ageing continues to be a significant burden for society and a primary contributor to individuals’ diminishing independence and quality of life. Therefore, improving our understanding of life-course influences on cognitive function is a necessity for public health. Parenthood and marriage are two such influences that may affect cognition in old age. Using the Health and Retirement Study, the relationship between family histories and cognitive functioning in adults in the ‘older’ age group in the United States is investigated through a sequence-analysis approach. The results show that most of the relationship between fertility and partnership history and cognition later in life is explained by childhood health and socioeconomic conditions, and current sociodemographic characteristics. However, those individuals who have never been married, and in particular those who have never been married and have had no children, report a significantly lower level of cognitive functioning in older age, especially women.

Health after union dissolution(s): Cumulative and temporal dynamics

The number of individuals experiencing one or multiple union dissolutions in their lifetime is increasing. The literature has shown significant interactions with health disorders, in response to the crisis situation that affects the spouses. However, processes are still unclear, in particular regarding the timing of the affection. This study explored whether different health disorders are observed shortly after dissolution or are delayed, and whether they are short- or long-lasting. We used data from the two waves (2006 and 2010) of the French Health and Professional Lives Survey (SIP) among 8349 individuals aged 25-64 years. Based on three health disorders, we studied 1) their levels in relation to the retrospective histories of union dissolutions; 2) health changes associated with a dissolution occurring between the two waves. We found that individuals who experienced one or multiple union dissolutions had worse self-rated health, more depressive symptoms and sleep disorders. The two latter were more related with a recent dissolution than with distant ones, suggesting an immediate association, yet long-lasting. Self-rated health was related with distant dissolutions only, suggesting a lagged, however also long-lasting association. Experiencing union dissolution between the two waves was linked to a higher probability of the onset of sleep disorders and depressive mood, and of deterioration of self-rated health if it was not the first dissolution. Our study shows that union dissolutions are highly correlated with different poor health measures, in the short and the long run, depending on the health disorder, with cumulative and durable effects.

Childbearing Biographies and Midlife Women's Health

OBJECTIVES

We introduce a "childbearing biography" approach to show how multiple childbearing characteristics cluster in ways significant for midlife health.

METHODS

We analyze the National Longitudinal Survey of Youth 1979 (NLSY79; N = 3992) using mixed-mode Latent Class Analysis with eight childbearing variables (e.g., age at first birth, parity, birth spacing, and mistimed births) to identify how childbearing biographies are associated with midlife health, adjusting for key covariates-including socioeconomic status (SES) and relationship history.

RESULTS

We identify six childbearing biographies: (1) early compressed, (2) staggered, (3) extended high parity, (4) later, (5) married planned, and (6) childfree. Childbearing biographies are strongly associated with physical health but not mental health, with differences primarily explained by SES.

DISCUSSION

Different childbearing biographies are related to physical health inequalities above what is demonstrated by the typical use of one or two childbearing measures, providing a new perspective into the growing health gap among aging midlife women.

Childhood hearing impairment and fertility in Norway

There is a lack of studies assessing how hearing impairment relates to reproductive outcomes. We examined whether childhood hearing impairment (HI) affects reproductive patterns based on longitudinal Norwegian population level data for birth cohorts 1940-1980. We used Poisson regression to estimate the association between the number of children ever born and HI. The association with childlessness is estimated by a logit model. As a robustness check, we also estimated family fixed effects Poisson and logit models. Hearing was assessed at ages 7, 10 and 13, and reproduction was observed at adult ages until 2014. Air conduction hearing threshold levels were obtained by pure-tone audiometry at eight frequencies from 0.25 to 8 kHz. Fertility data were collected from Norwegian administrative registers. The combined dataset size was N = 50,022. Our analyses reveal that HI in childhood is associated with lower fertility in adulthood, especially for men. The proportion of childless individuals among those with childhood HI was almost twice as large as that of individuals with normal childhood hearing (20.8% vs. 10.7%). The negative association is robust to the inclusion of family fixed effects in the model that allow to control for the unobserved heterogeneity that are shared between siblings, including factors related to the upbringing and parent characteristics. Less family support in later life could add to the health challenges faced by those with HI. More attention should be given to how fertility relates to HI.

Multiple social roles in early adulthood and later mental health in different labour market contexts

Work and family roles entail divergent responsibilities, which can be a source of conflict especially in young adulthood - the so-called "rush-hour" of life. Combining these multiple social roles can result in an accumulation of stress but also be a valuable resource for mental health. The aim of this study is to investigate combined employment, parenthood and partnership trajectories of men and women during early adulthood, and to analyse the relationship of these multiple roles with depressive symptoms at older age. We used harmonised data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) with retrospective information on employment, partnerships and parenthood histories between age 25 and 40 for 18,816 men and 24,686 women (n = 43,502). We applied sequence analysis and clustering to group trajectories into four clusters for women and three clusters for men. We then used multilevel models to analyse the links between combined employment and family roles and later mental health in different historical labour market contexts (indicated by female employment rates). Women and men who did not combine work and family roles between age 25 and 40 report higher levels of depression than those who combined work and family. Results differ by gender and labour market context, with stronger differences between women in countries with higher female employment rates. Overall, combining multiple roles in early adulthood is associated with decreased rather than increased risk for depressive symptoms in older Europeans.

Intergenerational persistence of family formation trajectories among teenage-mothers and -fathers in Sweden

In this paper, we address the questions of whether early family trajectories of parents are reflected in childbearing teenagers, and how socio-economic and family background factors impact these intergenerational correlations. We use within-dyad sequence analysis to examine combined marital and childbearing trajectories, up to age 30, of two generations of a representative sample of childbearing teenagers born between 1975 and 1985 and their progenitors, drawn from the Swedish population register data. We find evidence for within-family persistence of early family trajectories, with better matches across family state sequences for dyads composed of childbearing teenagers and their parents, than for dyads composed of childbearing teenagers and parents of random birth cohort peers. Regression analysis shows that these intergenerational associations are stronger and occur among later-born siblings from non-traditional family backgrounds, and among families with lower socio-economic backgrounds. This study fills gaps in the knowledge of intergenerational family life course dynamics beyond the early parenthood event.

Family embeddedness and older adult mortality in the United States

Do different operationalizations of family structure offer different understandings of the links between family structure and older adult mortality? Using the American Health and Retirement Study (N = 29,665), we examine mortality risks by three measures of family structure: whether respondents have different family statuses (e.g. married vs. unmarried), volume of family members available (e.g. having one vs. two living immediate family members), and family embeddedness (e.g. having neither spouse nor child vs. having spouse but no child). We focus on three kin types: partner/spouse, children, and siblings. We find that differences in empirical estimates across measures of family structure are not dramatic, but that family embeddedness can show some additional heterogeneity in mortality patterns over family status variables or the volume of ties. This paper tests different ways of operationalizing family structure to study mortality outcomes and advances our understanding of how family functions as a key social determinant of health.

Fertility History and Biomarkers Using Prospective Data: Evidence From the 1958 National Child Development Study

Research on the later-life health implications of fertility history has predominantly considered associations with mortality or self-reported indicators of health. Most of this previous research has either not been able to account for selection factors related to both early-life and later-life health or has had to rely on retrospectively reported accounts of childhood circumstances. Using the 1958 National Child Development Study, and in particular the biomedical survey conducted in 2002-2003, we investigate associations between fertility histories (number of children and age at first and at last birth) and biomarkers for cardiometabolic risk and respiratory function in midlife among both men and women. Results from models that adjusted for a very wide range of childhood factors, including early-life socioeconomic position, cognitive ability, and mental health, showed weak associations between parity and biomarkers. However, we found an inverse association between age at first birth and biomarkers indicative of worse cardiometabolic health, with poorer outcomes for those with very young ages at entry to parenthood and increasingly better outcomes for those becoming parents at older ages. A very young age at last birth was also associated with less favorable biomarker levels, especially among women. Results highlight the value of prospectively collected data and the availability of biomarkers in studies of life course determinants of health in midlife and later.

Divorce, Repartnering, and Stepfamilies: A Decade in Review

This article reviews key developments in the past decade of research on divorce, repartnering, and stepfamilies. Divorce rates are declining overall, but they remain high and have risen among people older than age 50. Remarriage rates have declined, but the overall proportion of marriages that are remarriages is rising. Transitions in parents' relationships continue to be associated with reduced child well-being, but shifting patterns of divorce and repartnering during the past decade have also reshaped the family lives of older adults. We review research on the predictors and consequences of these trends and consider what they reveal about the changing significance of marriage as an institution. Overall, recent research on divorce, repartnering, and stepfamilies points to the persistence of marriage as a stratified and stratifying institution and indicates that the demographic complexity of family life is here to stay.

Work–family lifecourses and later-life health in the United Kingdom

Socio-economic inequalities in physical and mental health persist at older ages and previous studies have shown that partnership and parenthood histories are also associated with differentials in later-life health. These domains of adult life interact, and both may be influenced by earlier life circumstances, indicating a need for a holistic approach to understanding lifecourse influences on health at older ages. In this paper, we identify classes of lifecourse types for a United Kingdom (UK) cohort born 1933–1945 and investigate differences between the latent classes identified in physical and mental health, and changes in health over a five-year follow-up period. Data were drawn from Waves 1–5 (2009–2013) of the nationally representative UK Household Longitudinal Study. Multi-level models were used to analyse associations with summary indicators of physical and mental health measured using the SF-12, and changes in health, controlling for childhood circumstances and taking account of support from family and friends in later life. Lifecourses characterised by lower socio-economic position, early parenthood and large family size were associated with worse physical and mental health in later life, with respondents who had combined a high socio-economic position and two children being the most advantaged. The study indicates that socio-economic disparities in later-life health vary depending on the way in which individuals combine work and family life.

Fertility histories and chronic conditions later in life in Europe

Understanding the association between fertility histories and health later in life is necessary in the context of ageing societies. Past literature has generally found a U-shaped relationship between parity, age at first birth, and several health-related outcomes. However, these findings differed to some extent depending on the country under analysis and on the measures of health considered. As such, using wave 3 (2008-2009) and 5 (2013) of the Survey of Health, Ageing and Retirement in Europe (SHARE), this work aimed to answer the question: "Are fertility histories associated with the presence of chronic conditions later in life in Europe?" The analysis included 11 European countries and compared results using two different measures of chronic conditions: self-reported chronic or long-term illness and chronic diseases diagnosed by a doctor. Results showed that age at first birth is more relevant than parity for health outcomes at older ages. Moreover, in socio-democratic and continental countries, the association between fertility and chronic conditions-in particular between age at first birth and long-term illnesses-is statistically significant among women, but not among men. Finally, the association between fertility history and health was similar when using self-reported measures and chronic diseases diagnosed by a doctor.

Childlessness and union histories: evidence from Finnish population register data

From an evolutionary perspective, childlessness may be considered a failure, as it implies that there will be no direct transmission of one's genetic material to later generations. It is also a pressing social issue, because in many contemporary advanced societies, levels of childlessness have increased, and particularly so among men. The absence of a partner is naturally a fundamental determinant of childlessness. Empirical evidence on how childlessness relates to individuals' partnership histories is nevertheless limited. This issue was analysed with Finnish population register data, which allow the complete cohabitation and marriage histories of individuals from age 18 years to be observed. For women and men born between 1969 and 1971, logistic regression models were estimated for childlessness at age 40 by partnership histories in terms of various stages in the process of union formation and dissolution, and accounting for several socioeconomic variables. A strong link between union histories and childlessness was found, with short partnership spells raising the risk of not becoming a parent. Later age when leaving the parental home raised female childlessness, while a short first-union duration related more strongly to male childlessness. These findings may be considered as providing insights into how specific life-history strategies affect reproductive outcomes, and highlight the need to develop new approaches to understand this feature of social inequality.

Swimming Against the Stream: Non-normative Family Transitions and Loneliness in Later Life Across 12 Nations

Background and Objectives

Relatively little research investigated whether experiences during young adulthood have long-lasting consequences for older age loneliness. This article examines whether deviations from culturally based scripts regarding family transitions represent risk factors for later-life loneliness. Moreover, it analyzes whether and in which conditions long-term associations between family transitions and loneliness differ across nations.

Research Design and Methods

The analyses use micro-level data from the Generations and Gender Survey Wave 1 for 12 European countries. The sample comprises 61,082 individuals aged 50–85. The research questions are addressed using a step-wise approach based on linear regression analyses, meta-analyses, and meta-regressions.

Results

Results show that never having lived with a partner and childlessness are most strongly related to later-life loneliness. Whereas early transitions are unrelated to later-life loneliness, the postponement of partnership, and parenthood are associated with higher levels of loneliness compared to having experienced these transitions “on-time”. Childlessness is more strongly associated with later-life loneliness in more traditionalist countries than in less traditionalist ones.

Discussion and Implications

This study reveals that individuals with non-normative family transitions are more exposed to loneliness in old age, and that this exposure is related to societal context. In traditionalist contexts, where people rely on families for support, older adults who have experienced non-normative family behavior, and childlessness in particular, may be particularly at risk of loneliness.

Partnership trajectories and cardiovascular health in late life of older adults in England and Germany

Objectives

Previous studies have shown marital status differences in incidence and prevalence of cardiovascular disease and cardiovascular mortality. This study examines the consequences of partnership on biomarkers related to cardiovascular health of older men and women in Germany and England (C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol).

Methods

Data used is from older adults (60 +) from the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership trajectory. OLS for C-reactive protein, logistic regressions for systolic and diastolic blood pressure, and multinomial logistic regressions for cholesterol are used to investigate the associations between life course partnership characteristics and biomarkers, accounting for early age socioeconomic and health conditions.

Results

Timing of first partnership is associated with poor cardiovascular health in England, number of partnership transitions with poor health in Germany, and partnership trajectories are associated with cardiovascular health both in Germany and England. Men in trajectories with multiple marriages have higher CRP, and are more likely to have elevated systolic and diastolic BP. Trajectories containing single marital disruption for men and women are no longer associated with poor health after accounting for selection effects of childhood conditions. Respondents in widowed partnership trajectories have poorer cardiovascular health compared to those in intact committed relationships, whereas cohabitation trajectories do not differ in the associations with biomarkers from those in intact marriage.

Conclusion

The results offer better understanding of the pathways through which family events and processes are linked to health and support the hypothesis that adversity related to partnerships over the life course accumulates and contributes to worse cardiovascular health in later life measured by objective health measures.

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This study investigates the longitudinal accumulated effects of partnership on cardiovascular health using haemostatic and inflammatory biomarkers in later-life, C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol.

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Based on life course theory of cumulative disadvantage, the study finds support that the benefits and risks of marital status accumulate over the life-course. The effects are visible on biomarkers of older adults in both Germany and England in models that account for conditions in early life, health behaviors in adult life and sociodemographic factors.

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Data used is from older adults (60 +) form the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership sequence type.

Early-life conditions and health at older ages: The mediating role of educational attainment, family and employment trajectories

Objectives

We examine to what extent the effect of early-life conditions (health and socioeconomic status) on health in later life is mediated by educational attainment and life-course trajectories (fertility, partnership, employment).

Methods

Using data from the Survey of Health, Ageing and Retirement in Europe (N = 12,034), we apply, separately by gender, multichannel sequence analysis and cluster analysis to obtain groups of similar family and employment histories. The KHB method is used to disentangle direct and indirect effects of early-life conditions on health.

Results

Early-life-conditions indirectly impact on health in later life as result of their influence on education and family and employment trajectories. For example, between 22% and 42% of the effect of low parental socio-economic status at childhood on the three considered health outcomes at older age is explained by educational attainment for women. Even higher percentages are found for men (35% - 57%). On the contrary, the positive effect of poor health at childhood on poor health at older ages is not significantly mediated by education and life-course trajectories. Education captures most of the mediating effect of parental socio-economic status. More specifically, between 66% and 75% of the indirect effect of low parental socio-economic status at childhood on the three considered health outcomes at older age is explained by educational attainment for women. Again, higher percentages are found for men (86% - 93%). Early-life conditions, especially socioeconomic status, influence family and employment trajectories indirectly through their impact on education. We also find a persistent direct impact of early-life conditions on health at older ages.

Conclusions

Our findings demonstrate that early-life experiences influence education and life-course trajectories and health in later life, suggesting that public investments in children are expected to produce long lasting effects on people’s lives throughout the different phases of their life-course.