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Войти в исследования The Lancet. Public health · 2026
Association between parental death during childhood and health and wellbeing in adulthood in 22 countries and regions: a retrospective, outcome-wide analysis.
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Denckla Christy A, Cowden Richard G, Wilkinson Renae, Padgett R Noah, Sung Meekang, Johnson Byron R, VanderWeele Tyler J
Аннотация
BACKGROUND: Clinical and epidemiological evidence suggests that adults who have experienced the death of a parent or caregiver in childhood are at elevated risk for adverse health outcomes. The aim of this study was to examine cross-national variation in indicators of health and wellbeing among adults who experienced the death of a parent by age 12 years.
METHODS: In this retrospective, outcome-wide analysis, we analysed data from Wave 1 of the Global Flourishing Study, a 5-year pre-registered longitudinal panel study (2024-28) of nationally representative adult participants (N=202 898) aged 18 years and older using probability-sampling across 22 geographically and culturally diverse countries and regions (ie, Argentina, Australia, Brazil, Egypt, Germany, Hong Kong, India, Indonesia, Israel, Japan, Kenya, Mexico, Nigeria, the Philippines, Poland, South Africa, Spain, Sweden, Tanzania, Türkiye, the UK, and the USA) to examine associations between retrospectively recalled parental death during childhood (yes or no) and current health and wellbeing. We conducted a series of country and region-specific weighted multivariable regression using an outcome-wide design. Random effects meta-analyses were used to pool country and region-specific effect estimates for 69 wellbeing outcomes.
FINDINGS: Meta-analysed associations across 22 countries and regions suggested that participants who experienced the death of a parent by age 12 years, relative to those who did not, reported more age-normalised health impairments (risk ratio [RR] 1·14 [95% CI 1·04 to 1·25]), more anxiety and depression symptoms (RR 1·09 [1·01 to 1·17] and RR 1·08 [1·01 to 1·15], respectively), more loneliness (standardised effect estimate [B] 0·06 [95% CI 0·01 to 0·10]), reduced sense of meaning (B -0·05 [-0·08 to -0·01], and reduced wellbeing (for example a lower sense of being at peace [RR 0·96 (95% CI 0·92 to 0·99)]). Country-specific effect estimates varied in magnitude.
INTERPRETATION: Parental bereavement in childhood can affect health and wellbeing in adulthood, with some cross-national variation in the magnitude of adverse effects. Parental death during childhood is an important determinant of health across the lifespan and as such public health policies are needed to support a population-wide approach to bereavement care that spans health, social, and economic domains.
FUNDING: John Templeton Foundation, Templeton Religion Trust, Templeton World Charity Foundation, Fetzer Institute, Paul Foster Family Foundation, Wellbeing for Planet Earth Foundation, Well Being Trust, and the David and Carol Myers Foundation.
METHODS: In this retrospective, outcome-wide analysis, we analysed data from Wave 1 of the Global Flourishing Study, a 5-year pre-registered longitudinal panel study (2024-28) of nationally representative adult participants (N=202 898) aged 18 years and older using probability-sampling across 22 geographically and culturally diverse countries and regions (ie, Argentina, Australia, Brazil, Egypt, Germany, Hong Kong, India, Indonesia, Israel, Japan, Kenya, Mexico, Nigeria, the Philippines, Poland, South Africa, Spain, Sweden, Tanzania, Türkiye, the UK, and the USA) to examine associations between retrospectively recalled parental death during childhood (yes or no) and current health and wellbeing. We conducted a series of country and region-specific weighted multivariable regression using an outcome-wide design. Random effects meta-analyses were used to pool country and region-specific effect estimates for 69 wellbeing outcomes.
FINDINGS: Meta-analysed associations across 22 countries and regions suggested that participants who experienced the death of a parent by age 12 years, relative to those who did not, reported more age-normalised health impairments (risk ratio [RR] 1·14 [95% CI 1·04 to 1·25]), more anxiety and depression symptoms (RR 1·09 [1·01 to 1·17] and RR 1·08 [1·01 to 1·15], respectively), more loneliness (standardised effect estimate [B] 0·06 [95% CI 0·01 to 0·10]), reduced sense of meaning (B -0·05 [-0·08 to -0·01], and reduced wellbeing (for example a lower sense of being at peace [RR 0·96 (95% CI 0·92 to 0·99)]). Country-specific effect estimates varied in magnitude.
INTERPRETATION: Parental bereavement in childhood can affect health and wellbeing in adulthood, with some cross-national variation in the magnitude of adverse effects. Parental death during childhood is an important determinant of health across the lifespan and as such public health policies are needed to support a population-wide approach to bereavement care that spans health, social, and economic domains.
FUNDING: John Templeton Foundation, Templeton Religion Trust, Templeton World Charity Foundation, Fetzer Institute, Paul Foster Family Foundation, Wellbeing for Planet Earth Foundation, Well Being Trust, and the David and Carol Myers Foundation.