Less is (Often) More: Number of Children and Health Among Older Adults in 24 Countries.

OBJECTIVES: Previous evidence about the impact of parenthood on health for older adults is mixed, perhaps due to variation in number of children and context. Higher numbers of children could lead to support or strain, depending on individual and country contexts. Yet, no studies currently exist that examine associations between number of children and several health indicators among older adults across multiple global regions.

METHODS: We analyze cross-sectional data (1992-2017) of 166,739 adults aged 50+ across 24 countries from the Health and Retirement Study family of surveys to document associations between number of children, treated as a categorical variable, and five health outcomes (self-rated health, ADL limitations, IADL limitations, chronic conditions, depression). We perform multivariable analyses by estimating logistic regression models for each country and each outcome.

RESULTS: Multiple comparisons between categories of number of children revealed at least one significant difference in each country, and a majority of significant differences indicated those with more children had poorer health. The risk of poorer health for parents of multiple children was observed in 15 countries, but in some countries fewer children predict poorer health. The greatest number of differences were identified for depression and chronic conditions, and very few for functional limitations.

DISCUSSION: We observe a greater probability that more children is associated with poorer health in later life, especially for chronic conditions and depression. However, a universal global or regional pattern could not be identified. These findings raise new questions about how country contexts shape fertility and health.