The effects of family type on child mortality - elaboration of the association in Finland 1990-2004

Hanna Remes, University of Helsinki
Pekka Martikainen, University of Helsinki
Tapani Valkonen, University of Helsinki

Social inequalities in health in childhood are still evident in many developed countries. A growing number of children live with only one parent, which seems to be associated with negative effects on a child's wellbeing. Less is known about children in cohabiting two-parent families that are also increasingly common, and more susceptible to family break-up than married two-parent families. We examined how, and in what measure does family type affect child mortality, and whether the association can be explained by socioeconomic factors such as parental education, household income, or housing tenure. Using annually updated longitudinal register data that includes a representative 11% sample of the whole Finnish population with an over-sample of 80% of all deaths, we followed mortality of children between the ages 1-14 for a 15-year period from 1990 to 2004. The relative effect of family characteristics on the risk of death was estimated using Cox regression models. Children in one-parent families carried an excess risk in mortality that was connected to the child’s age at death; the effect ranged from a hazard ratio of 1.71 (95% CI 1.38-2.13) among 1–4-year-olds to absence of differentials in the age group 10–14. In accidental and violent causes of death, the differentials were even stronger. Controlling for parental education and level of household income made the negative effect of single parenthood disappear. In contrast, children in families with cohabiting parents had a somewhat lower level of mortality than children in married-parent families, and adjusting for socioeconomic factors rendered this difference statistically significant.