title: Is young fatherhood causally related to midlife mortality? A sibling fixed-effect study in Finland.
abstract: BACKGROUND
  Previous studies have shown that young fatherhood is associated with higher later-life mortality. It is unclear whether the association is credible, in the sense that mortality and young fatherhood appear to be associated because both are determined by family-related environmental, socioeconomic and genetic characteristics.
  
  
  METHODS
  We used a household-based 10% sample drawn from the 1950 Finnish census to estimate all-cause mortality of fathers born during 1940-1950. The fathers were followed from age 45 until death, or the end of age 54. We used a standard Cox model and a sibling fixed-effects Cox model to examine whether the effect of young fatherhood was independent of observed adulthood characteristics and unobserved early-life characteristics shared by brothers.
  
  
  RESULTS
  Men who had their first child before the age of 22 or at ages 22-24 had higher mortality as compared with their brothers who had their first child at the median or mean age of 25-26. Men who had their first child later at ages 30-44 had lower mortality than their brothers who had a first child before the age of 25. The pattern of results from a standard model was similar to that obtained from a fixed-effects sibling model.
  
  
  CONCLUSIONS
  The findings suggest a causal effect of young fatherhood on mortality and highlight the need to support young fathers in their family life to improve health behaviours and health.
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Einiö
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
authors.forename: Jessica
authors.initials: J
authors.lastname: Nisén
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
mesh_terms: D000328:Adult; D017677:Age Distribution; D002423:Cause of Death; D004522:Educational Status; D005191:Family Characteristics; D005220:Fathers / Q000706:statistics & numerical data*; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D061213:Mortality, Premature; D010331:Paternal Age; D016016:Proportional Hazards Models; D035781:Siblings; D055815:Young Adult
keywords: FERTILITY; MORTALITY; Social and life-course epidemiology