Associations of Fatherhood and Race With Cardiovascular Health Among Men: Findings From the Coronary Artery Risk Development in Young Adults (CARDIA) Study, 1985‒2022, United States.

Objectives. To estimate associations of fatherhood with cardiovascular health (CVH), incident cardiovascular disease (CVD), and all-cause mortality. Methods. The Coronary Artery Risk Development in Young Adults (CARDIA) study is a US-based cohort that enrolled Black and White individuals aged 18 to 30 years at baseline (1985-1986). CVH was defined by Life's Essential 8 scores. Models included multivariable linear regression and Cox proportional hazards. Results. Among 1648 men with fatherhood data, there was a statistical interaction between age at fatherhood onset and race on CVH (P < .05) in adjusted models. Among Black men, fathers had lower death rates than nonfathers (hazard ratio [HR] = 0.5; 95% confidence interval [CI] = 0.3, 0.9). Black fathers who were younger than 25 years (HR = 4.2; 95% CI = 1.2, 14.6) and those aged 25 to 29 years (HR = 4.2; 95% CI = 1.2, 14.8) at fatherhood onset had higher death rates compared with Black fathers who were aged 30 years or older. White fathers who were younger than 25 years and those aged 25 to 29 years at fatherhood onset had worse total CVH compared with White fathers who were aged 30 years or older (69.2 and 69.9 vs 73.3 points; P < .05). Conclusions. Fatherhood may be a protective health factor for Black men and adverse influence for young fathers, offering insight for public health programming. (Am J Public Health. 2026;116(8):1146-1155. https://doi.org/10.2105/AJPH.2026.308439).