New report reveals hidden impact of fatherhood on heart health

Heart disease is the leading cause of death among men, and becoming a father may further increase the risk of poor heart health in older age, according to a new study by researchers at Northwestern University and the Ann & Robert H. Lurie Children's Hospital of Chicago.

The study, which included 2,814 men aged 45 to 84, found that fathers had worse cardiovascular health in older age compared to men who did not have children. Participants' heart health was assessed based on their diet, physical activity, smoking, weight, blood pressure, and blood lipid and glucose levels.

"The changes in heart health we found suggest that the added responsibility of child care and the stress associated with the transition to fatherhood may make it more difficult for men to maintain healthy lifestyle choices, such as eating healthy and exercising," said lead study author Dr. John James Parker, an internist, pediatrician, and associate professor of pediatrics and general internal medicine at Northwestern University Feinberg School of Medicine.

"We really need to study fathers as a unique population and track men's health as they become fathers. Cardiovascular health is especially important because all the factors that influence it are modifiable."

The study was published as a peer-reviewed preprint in the journal AJPM Focus and the final version will be published soon.

Fathers have worse heart health but lower mortality rates

Although the fathers in the study had worse heart health in old age, the study found that they actually had lower mortality rates than men who did not have children. Parker believes that this discrepancy may be due to the fact that fathers may have a more developed social support system, and social connectedness is associated with lower mortality.

“Fathers may be more likely to have someone who will care for them in the future (such as their children), helping them attend medical appointments and manage medications and treatments as they age,” Parker said. “We also found that fathers had fewer depressive symptoms than men without children, so mental health may contribute to the lower age-adjusted mortality rates among fathers.”

The study included men who identified as black, Chinese, Hispanic or white, and the age-adjusted mortality rate for all black fathers was lower than for black men without children, the only racial and ethnic subgroup with such an association.

“Becoming a father may be a protective factor for black men,” Parker said. “It may be that becoming a father helps black men lead healthier lives. Further study of this association could have important public health implications.”

Previous studies assessing fatherhood, cardiovascular health, cardiovascular disease, and mortality have not included racially and ethnically diverse populations or comprehensively assessed cardiovascular health. This study is novel because it included men from the Multi-Ethnic Study of Atherosclerosis (MESA).

This study also examined the impact of age at which men become fathers on heart health and disease outcomes. Interestingly, men who became fathers at younger ages (25 years and younger), particularly black and Hispanic men, had worse heart health and higher mortality rates and may require targeted clinical and public attention.

“If you’re under 25, you may be less financially stable, your brain may be less mature, and, especially for racial and ethnic minorities, you may have low-paying jobs with fewer benefits and limited leave,” Parker said. “All of that can make it difficult to focus on your health. There are a lot of public policies for new mothers, but no one has ever looked at new fathers in that way.”

"A father's health has a significant impact on his family"

Because most men in the United States are fathers, identifying some explanations for the relationship between health, disease and fatherhood could have important implications for the health of men, especially men of color, the researchers said.

“Often we focus on the health of mothers and children and don’t even think about fathers, but their health has a significant impact on their family,” Parker said, citing previous research that has shown higher rates of obesity among partners if their spouse is obese. “To improve the health of families, we need to consider the multidimensional relationships between mothers, fathers, other caregivers, and children.”

The study also found higher rates of smoking among fathers, which Parker said was surprising because other studies have shown that many fathers quit smoking when they have children.

"This study looked at older fathers, so it's possible that men quit smoking when they become fathers, but then maybe they get more stressed and start smoking again," Parker said. "Either way, we need to look at what's happening with smoking rates, because smoking is the leading cause of preventable death, and if a father smokes, it impacts his family as well."

The researchers determined the participants' cardiovascular health using the American Heart Association's 8 Essentials of Vital Factors scale (excluding sleep). The men were divided into fathers (82% of the participants) and childless men based on an interview in which the participants were asked to list the ages and medical conditions of their children. Men who did not report having children were classified as childless.