Health in early adulthood and fertility: A study based on the 1958 British cohort.

Health is rarely used as an explanatory variable in fertility studies in high-income contexts, unlike in low-income settings. Using the 1958 National Child Development Study, we explore how self-rated health (SRH) and body mass index (BMI) at age 23 relate to achievement of fertility goals by age 46. We find that worse SRH and a BMI outside the healthy range at age 23 are strongly associated with lower fertility and underachieving fertility goals. While poor SRH is associated with lower fertility mostly among men, BMI outside the healthy range at 23 is more significant for women. Additional analyses indicate that employment and union history partly mediate the effect of health on fertility, but health retains a substantive direct effect. Our findings suggest that health in early adulthood is an important determinant, whether direct or indirect, of family life-course trajectories. This paper endorses the inclusion of health as an explanatory variable in studies of fertility in high-income contexts.