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Ageing and Health


Thu 27. 8.  14:00 - 15:30
room FA 203

Reproductive histories and deprivation inequalities in Europe: Long-term health consequences for gendered cohorts


Loter, Katharina
Martin Luther University Halle-Wittenberg (MLU), Germany

Gender and cohort specific biosocial mechanisms are supposed to play a substantial role in shaping the fertility-health nexus at older ages. However, previous evidence from national studies is mixed, and little is known about the influence of reproductive histories on health when contextual variation is controlled for. Do reproductive life course influences or rather societal inequalities prevail after reaching the age of 50? What kind of similarities and differences arise for gendered cohorts? This study aims at answering these two questions and has three objectives. The first objective is to explore the long-term impact of reproductive histories on physical and mental later life health, controlling for past and contemporary individual characteristics. The second one is to address the lack of cross-national research and test whether and to what extent contemporary context – using the example of material deprivation inequalities – is supposed to contribute to the observed differentials within the nexus. Finally, the third one is to provide findings across gender and age cohorts, separately for men and women at pre-retirement (50-64) and post-retirement (65+) age. I apply the integrated life course approach. This framework – though it “still lacks the status of a systematic theory” (Huinink and Kohli 2014: 1316) – is indispensable for understanding how biological, behavioural and social dynamics that unfold over time and across generations (Kuh et al. 2003), “act independently, cumulatively and interactively to influence health” (Mishra et al. 2010: 93). This study is based on a general theoretical assumption that cumulative risk exposures throughout life may cause gradual, long-term damage to health. This corresponds to accumulation of risk models (Kuh et al. 2003) and is similar to the stress-related concept of allostatic load (McEwen and Stellar 1993; Ben-Shlomo and Kuh 2002; see also Grundy and Read 2015). Accordingly, unequal incidence, severity, and duration of reproductive exposures may lead to health inequalities at older ages. I use data from the Survey of Health, Ageing and Retirement in Europe (Börsch-Supan et al. 2011, 2013; Schröder 2011). The initial sample for this study is based on the third wave of SHARE – the retrospective SHARELIFE survey (Schröder 2011) – which provides detailed individual health, work, fertility, and partnership life courses for respondents who participated either in the first or in the second wave. SHARELIFE was conducted from 2008 to 2009 in 13 European countries: Switzerland, Germany, Austria, Belgium, the Netherlands, Sweden, Denmark, France, Spain, Greece, Italy, Poland, and Czech Republic. The final sample consists of 10,821 men and 13,460 women who are representative of the non-institutionalized populations over 50 years of age and who were divided into pre-retirement (aged 50-64) and post-retirement (aged 65+) cohorts. I conduct multilevel logistic analyses, separately for each cohort by gender, controlling for demographics, socio-economic status, particular aspects of the intergenerational transmission of health risks, and the percentage of severely materially deprived men and women at country-level. Random intercept and fixed slopes models for binary outcomes are estimated (Guo and Zhao 2000; Gelman and Hill 2007). The results indicate that neither men’s nor women’s health seems to be affected by childlessness at age 50+. For pre-retirement fathers, high parity and parenthood before 24 years of age are linked with physical limitations, whereas for pre-retirement mothers, only adolescent parenthood turns out to be an important risk factor for multiple health impairments. Deprivation inequalities do not seem to play a significant role in explaining health at age 50-64. However, findings change fundamentally for post-retirement cohorts: At age 65+, except for the impact of contact with biological children on physical health, reproductive life course influences are no longer persistent. At this age, it is the societal context and later life socio-economic status that matter. References: Ben-Shlomo, Y. and D. Kuh. 2002. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges, and interdisciplinary perspectives, International Journal of Epidemiology, 31(2): 285-293. Börsch-Supan, A., Brandt M., Hank K. and M. Schröder (eds). 2011. The individual and the welfare state. Life histories in Europe. Heidelberg: Springer. Börsch-Supan, A., Brandt, M., Hunkler, C., Kneip, T., Korb-macher, J., Malter, F., Schaan, B., Stuck, S. and S. Zuber. 2013. Data Resource Profile: The Survey of Health, Ageing and Retirement in Europe (SHARE). International Journal of Epidemiology, 42(4): 992-1001. Gelman, A. and J. Hill. 2007. Data analysis using regression and multilevel/hierarchical models. Cambridge: Cambridge University Press. Grundy, E. 2009. Women’s fertility and mortality in late mid life: a comparison of three contemporary populations, American Journal of Human Biology, 21(4): 541-547. Grundy, E. and S. Read. 2015. Pathways from fertility history to later life health: Results from analyses of the English Longitudinal Study of Ageing, Demographic Research, 32(4): 107-146. Guo, G. and H. Zhao. 2000. Multilevel modeling for binary data, Annual Review of Sociology, 26: 441-462. Hank, K. 2010. Childbearing history, later-life health and mortality in Germany, Population Studies, 64(3): 275-291. Huinink, J. and M. Kohli. 2014. A life-course approach to fertility, Demographic Research, 30: 1293-1326. Kuh, D, Ben-Shlomo, Y., Lynch, J., Hallqvist, J. and C. Power. 2003. Life course epidemiology, Journal of Epidemiology and Community Health, 57(10):778–83. McEwen, B. S. and E. Stellar. 1993. Stress and the individual ‒ mechanisms leading to disease, Archives of Internal Medicine, 153: 2093-2101. Mishra, G. D., Cooper R., Kuh D. 2010. A life course approach to reproductive health: Theory and methods. Matu-ritas, 65: 92-97. Schröder, M. 2011. Retrospective data collection in the Survey of Health, Ageing and Retirement in Europe. SHARELIFE methodology. Mannheim: Mannheim Research Institute for the Economics of Aging (MEA).