Physical Health and Mortality After a Parent Dies in Childhood: The Evidence

In the largest study so far, children in Denmark, Sweden and Finland whose parent died before they turned 18 had about one and a half times the death rate of other children, a raised risk that lasted into early adulthood. For specific illnesses the picture is mixed, and where health care is scarce a mother’s death can threaten a young child’s survival directly.

Most research on children whose parent has died concerns grief, mental health and school. Yet families and practitioners also ask physical questions: is a bereaved teenager more likely to become ill, or to die young? Across whole populations, the answer is that risks are somewhat higher while absolute numbers stay small. A raised rate in a register study describes thousands of children; it predicts nothing certain about any one of them. This study sets out what the strongest evidence, mostly from Nordic registers, shows, and where it is thin.

Across three Nordic countries, death rates were about half as high again

The strongest evidence comes from a 2014 study linking the national registers of Denmark, Sweden and Finland. It covered about 7.3 million people born in Denmark (1968–2008), Sweden (1973–2006) and Finland (1987–2007, an 89.3% sample), of whom 189,094 had a parent die before they were 18. People were followed for up to 42 years, without loss to follow-up^[1].

After adjustment, children whose parent had died had 1.50 times the death rate of other children (a mortality rate ratio, MRR, of 1.50). The raised rate held whatever age the child had been when the parent died, and it persisted into early adulthood. It was similar for boys and girls in relative terms (MRR 1.54 for boys, 1.43 for girls), even though the absolute death rate among bereaved boys, 87.2 per 100,000 person-years, was more than twice that among bereaved girls, 37.9^[1].

In absolute terms, death in childhood and early adulthood was rare in both groups: the crude rate was 63.3 deaths per 100,000 person-years among the bereaved and 29.4 among others (crude rates are not age-adjusted, so they overstate the gap)^[1]. The great majority of bereaved children did not die young.

The raised risk covers illness as well as injury

The excess was not confined to accidents and injuries. Deaths from natural causes (diseases and medical conditions) were raised by a similar amount to deaths from external causes: an MRR of 1.45 against 1.60, a difference that was not statistically significant^[1].

Rates were raised for most of the main cause groups. Deaths from diseases of the circulatory system had an MRR of 1.80, the digestive system 2.34 and the nervous system 1.71. Deaths from infections (MRR 1.40) and respiratory disease (MRR 1.02) were not significantly raised. Death by suicide had an MRR of 1.78^[1]. Suicide is never the result of a single cause, and it is not an expected outcome of bereavement. Suicidal feelings can pass, and help is available. See our study of mental health after a parent’s death.

Risks were highest when the child later died of the same broad cause as the parent: roughly sevenfold for nervous system and fivefold for digestive diseases, though these groups were small. The cause of the parent’s death also mattered. Where a parent died from an unnatural cause, such as an accident, their children’s death rate was 1.84 times that of other children; where a parent died from illness, it was 1.33 times^[1]. See also our study of children bereaved by suicide.

Shared genes are part of the explanation, but the authors judged that genetic susceptibility “most likely explains only a minor part of the observed association”, since the raised risk also appeared for causes unrelated to the parent’s death^[1]. They had no information on what happened after the death: the relationship with the surviving parent, lifestyle, or the shared home environment^[1].

The shadow reaches into middle and later life, through a chain of disadvantage

Other studies have followed people much further. In Stockholm, researchers traced 12,615 children born in 1953 through to 2016. About 3% had a parent die when they were aged 0 to 12. Between ages 38 and 63, 40 of 372 bereaved people died, against 895 of 12,210 others. After adjusting for family and social circumstances at birth, the bereaved group had 1.52 times the hazard of death (a hazard ratio, HR)^[2].

The Stockholm study also asked why. Psychiatric or alcohol problems in the surviving parent made little difference to the association^[2]. What did contribute were two links in a chain: being recorded for delinquent behaviour in adolescence (an indirect HR of 1.03) and having a lower income in early adulthood (HR 1.04). Once these paths were accounted for, the remaining direct association fell to HR 1.35 and was no longer statistically significant^[2]. The authors conclude that the raised mortality was “mediated through a chain of disadvantages over the life course”^[2].

In the United States, a study linking the Utah Population Database to Medicare records found that people whose parent died when they were children, and especially when they were adolescents or young adults, had “modest but significant mortality risks after age 65”^[3]. A 2025 Swedish register study of 948,483 people, designed around those with out-of-home care experience, likewise found a raised risk of death between ages 20 and 47 among those whose parent died before they were 20^[4].

Heart disease: a raised risk in Swedish men, a less consistent picture elsewhere

The clearest evidence on heart disease again comes from Sweden. A study of 48,992 men born in 1949 to 1951, examined at military conscription in 1969–70, followed them for 39 years. Men whose parent had died during their childhood had 1.30 times the hazard of ischaemic heart disease (narrowed arteries supplying the heart), after adjustment. There was no raised risk of stroke (HR 0.87, not significant)^[5].

The pattern varied with the cause of the parent’s death. Where a mother had died from cardiovascular disease, the HR for the son’s heart disease was 2.04, and where she had died from an unnatural cause it was 2.50. Where a father had died, a raised risk was seen only when he had died from cardiovascular disease (HR 1.82)^[5]. The link with a mother’s unnatural death is unlikely to reflect inherited heart disease alone. The study covered men only^[5].

In the United States, the National Longitudinal Study of Adolescent to Adult Health (4,193 people) found that a parent’s death before 18 was associated with higher cardiovascular risk in early to mid-adulthood for Black Americans; a parent’s death from age 28 onwards was linked to poorer cardiovascular health for both Black and White Americans. Black Americans experience the death of a parent much earlier in life on average, so this is also a question of unequal exposure^[6]. In southern China, a study of 28,771 adults aged 50 and over found early parental death was not associated with blood pressure, fasting glucose or cholesterol. The authors suggest that some associations seen in Western populations “may be socially rather than biologically based or may be population specific”^[7].

Cancer, asthma, diabetes and weight: mostly small differences, or none

For other conditions, large studies often find little or nothing.

• Cancer. A Swedish register study of 4,219,691 people followed from birth to age 40 found that a parent’s death was not associated with overall cancer risk. A parent’s death in childhood was linked to a higher risk of cancers related to human papillomavirus (HPV) infection (relative risk 1.4) and of pancreatic cancer (RR 2.6)^[8]. In a US cohort of 9,169 daughters, a 4.69-fold hazard of breast cancer among women both of whose parents had died rests on few cases (confidence interval 1.68 to 13.04)^[9].
• Asthma. Among 5,202,576 children in Denmark and Sweden, those bereaved of a parent or sibling had 1.10 times the hazard of a first hospital admission for asthma. The raised risk was seen only for deaths at age 14 to 17 (HR 1.54), and bereaved children were slightly less likely to start asthma medication (HR 0.87)^[10].
• Type 1 diabetes. A 2025 study of 3,598,159 children born in Sweden found no overall association between the death of a parent or sibling and type 1 diabetes (HR 1.04, not significant)^[11]. An earlier Danish study of the death of a parent or sibling found a raised rate only when the death happened after age 11 (incidence rate ratio 1.28)^[12].
• Weight. Among 46,401 Copenhagen schoolchildren, the 492 whose parent died in their first six years had no difference in body mass index or overweight at ages 7 to 13^[13].

In the Netherlands, a study of 177 adults whose parent died in childhood, compared with 2,463 who had not been bereaved, found “no overall association” with physical health measures, such as metabolic syndrome, or with health behaviour^[14]. These studies do not support a picture of bereaved children as generally in poor health; they point to specific, modest and sometimes age-dependent risks.

Where health care is scarce, a mother’s death can threaten a young child’s survival

Elsewhere the question is starker: whether a young child survives at all after their mother dies. Here the evidence comes from surveillance sites that record every birth and death in a defined rural area.

In Farafenni, in rural Gambia, 25 years of surveillance (1989 to 2014) found a death rate of 25.89 per 1,000 child-years among children up to age ten whose mother had died, against 14.44 among children whose mother was alive. In the study’s adjusted model (a hazard ratio), children were 4.66 times as likely to die if their mother had died^[15]. In two rural Tanzanian sites (1996 to 2012), 46.28% of children whose mother died during or near their birth also died before their tenth birthday, against 7.88% of children whose mothers survived^[16]. In Butajira, Ethiopia, 81% of the infants whose mothers died within 42 days of childbirth also died, though this rests on small numbers^[17].

These figures describe newborns and very young children where health services are far weaker, and are not comparable with the Nordic ones.

What the evidence asks of us

The evidence does not say bereaved children are destined for poor health. It shows a modest but persistent rise in the risk of dying young, much of it running through circumstances that can be changed.

• Treat bereavement as a long-term health matter, not only an emotional one. The authors of the Stockholm study write that “Professionals working with bereaved children should take the higher mortality risk in bereaved offspring into account and consider its lifelong consequences”^[2].
• Support adolescents and young adults, not just young children. In Sweden, the paths that explained the raised mortality ran through adolescence and early working life: delinquency and lower income^[2]. A systematic review of ten studies of 15- to 25-year-olds whose parent died of a terminal illness highlights “their need for age-appropriate psychosocial support and clear information during parental illness, death and bereavement”^[18]. See our study of what helps bereaved children.
• Protect economic security. If lower income in early adulthood links bereavement to later mortality, financial support for bereaved families and help into education and work are health measures too.
• Prevent maternal deaths, and care for the children when a mother dies. Where maternal deaths are still common, the Gambian researchers call for a continuum of care for mother and child through pregnancy and childbirth and “beyond 6 weeks post-partum”^[15]. Health systems should count the children left behind when they count maternal deaths.
• Fill the gaps. The heart disease evidence comes largely from Swedish men born around 1950^[5]; there is far less on women, recent generations, or low- and middle-income countries. Funders should support studies that test whether support changes bereaved children’s physical health.

More studies on bereaved children are collected in our research library on children bereaved of a parent.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. Where it discusses suicide, it follows the Samaritans’ media guidelines.

Why we're publishing this

Bereavement services for children are often framed, and funded, as emotional support. The research on physical health and mortality shows that the stakes are wider. Childhood bereavement organisations already know that a parent’s death can shape a life for decades; the register evidence gives them population-scale figures to make that case to commissioners and funders. We present them carefully, because bereaved families deserve accurate information rather than alarm.

How to read this data

Most figures here come from national population registers in Denmark, Sweden and Finland, which link every resident’s records and so capture virtually all deaths and hospital admissions. These are counts, not estimates, but they describe high-income countries and particular birth decades. The US, Dutch and Chinese studies are cohort studies of selected groups, some of them small; the African figures come from surveillance sites covering defined rural areas, not whole countries.

The studies use different measures. A mortality rate ratio or incidence rate ratio compares rates; a hazard ratio compares the instantaneous risk over follow-up; a relative risk compares risks. All are relative: a ratio of 1.5 on a rare outcome still means a small absolute risk. Crude rates are not age-adjusted.

All of these studies are observational. They adjust for some confounders (typically birth characteristics and parents’ social position) but not all, and cannot fully separate the effect of the death from the illness, hardship or family history before it. Some studies also count a sibling’s death, as noted. Findings from different studies, countries and generations are not directly comparable and should not be read as a trend.

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, schools, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This study summarises published research about groups of people for general information. It is not medical advice or bereavement support, and it cannot describe or predict anything about an individual child or family. If you are worried about a child or about yourself, please speak to a GP or another qualified professional.

Sources

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