Fatherhood and Cardiovascular Health, Disease, and Mortality: Associations From the Multi-Ethnic Study of Atherosclerosis
John James F. Parker, MD, MS,
Craig F. Garfield, MD, MAPP,
Clarissa D. Simon, PhD, MPH,
Laura A. Colangelo, MS,
Michael P. Bancks, PhD, MPH,
Norrina B. Allen, PhD, MPH
Affiliations
John James F. Parker, MD, MS
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Family and Child Health Innovations Program, Smith Child Health Outcomes, Research and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Address correspondence to: John James Parker, MD, MS, Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 162, Chicago IL 60611.
Craig F. Garfield, MD, MAPP
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Family and Child Health Innovations Program, Smith Child Health Outcomes, Research and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Clarissa D. Simon, PhD, MPH
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Family and Child Health Innovations Program, Smith Child Health Outcomes, Research and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Laura A. Colangelo, MS
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Michael P. Bancks, PhD, MPH
Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Norrina B. Allen, PhD, MPH
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Introduction: Emerging literature links fatherhood to men's health but lacks comprehensive assessment of health outcomes, especially among multiethnic populations. This study's objective was to evaluate the associations of fatherhood (age at onset and status) with cardiovascular health scores, incident cardiovascular disease, cardiovascular disease death, and all-cause mortality, examining differences by race/ethnicity. Methods: The study sample included men from Multi-Ethnic Study of Atherosclerosis, prospective cohort study that enrolled adults aged 45–84 years without known cardiovascular disease at baseline. Cardiovascular health was defined using the American Heart Association's Life's Essential 8 scores (0–100), excluding sleep (cardiovascular health score). Results: In this sample of 2,814 men, mean age at cardiovascular health assessment was 62.2 years, 82% were fathers, 24% self-identified as Black, 13% self-identified Chinese, 22% self-identified Hispanic, and 41% self-identified White. Fathers who were aged 35 years (adjusted mean score of 61.1 vs 64.7 [p=0.01] and 61.0 vs 64.7 [p<0.001], respectively). Fathers had worse overall cardiovascular health (adjusted mean score of 63.2 vs 64.7, p=0.03) and more nicotine exposure (63.1 vs 66.6, p=0.04) than nonfathers. In age-adjusted models, fathers overall (hazard ratio=0.82; 95% CI=0.69, 0.98) and Black fathers (hazard ratio=0.73; 95% CI=0.53, 0.999) had a lower rate of all-cause mortality rate than nonfathers, but these associations were no longer significant in fully adjusted models. Conclusions: Fatherhood is a social determinant of health, and understanding its influence may provide opportunities to improve men's health, particularly among men of color.
