Family Structure and Early Life Mortality in the United States

Objective This study investigates the association between family structure and early life mortality (1-24 years of age) in the United States. Background Few studies have examined this association. Method We employed the restricted-use 1999-2015 National Health Interview Survey-Linked Mortality Files to reveal all-cause and cause-specific mortality disparities by family structure, as captured at the time of entry into the study, including married-parent, single-parent, and extended family structures. Results Family structure disparities in early life mortality were sizable. Compared to children living in married-parent families, children living with single fathers experienced 47% higher risk of death, and children living with one or more parents and one or more grandparents experienced 54% higher risk of death during the 17-year follow-up period, net of all covariates. Such risks were also high for specific causes of death, particularly external causes. The elevated all-cause and cause-specific mortality risks for children and youth living in single-parent and other nonmarital family structures was attenuated but persisted with controls for socioeconomic status, as well as for poor health and disability among children and other family members. Conclusion Family structure disparities in U.S. early life mortality are wide and most likely amenable to policy changes. Our results provide an evidence base for mortality disparities related to family structure and suggest further examination of family structure in reducing early life mortality.