Abstract
BACKGROUND AND AIMS: Marital and parental role characteristics are important factors in both men and women's health. Most studies to date have either focused on disease specific outcomes or summary measures of self-reported health rather than using functional tests of performance. The goal of this study is to investigate the extent to which marital and parental role characteristics are associated with midlife physical function. METHODS: A prospective birth cohort study was carried out with reference to births that took place in England, Scotland, and Wales during one week in March of 1946. Regular assessment of 1353 men and 1411 women were made from six weeks after birth throughout childhood and adulthood. Handgrip strength, timed chair rising, and standing balance tests at age 53 years were used to calculate an aggregate physical performance score that ranged from 0 (poorest score) to 2.81. RESULTS: The mean physical performance score was 1.42 (SD 0.42) for men and 1.30 (SD 0.37) for women. By age 53 years, 11% of men and 8% of women had married but remained childless; 6% of men and 4% of women had never married. Never married (x- 1.15; 95% CI 1.06, 1.24) and childless married men (x- 1.36; 95% CI 1.30, 1.42) had significantly poorer physical performance scores than married men with children (x - 1.46; 95% CI 1.43, 1.48). These relationships remained after adjustment for adult social class and employment status, own educational attainment and body mass index at 53 years (beta=-0.18, 95% CI -0.27, -0.09 for never married and beta=-0.09, 95% CI -0.16, -0.03 for childless married, compared with married men with children). Of those men who had never married, 28% reported they were not working due to long-term health problems compared to 5% in both childless married men and married men with children. There were no marked differences in functional outcomes among women. CONCLUSIONS: In this representative middle-aged population, unmarried and childless men faced greater risk of poor midlife physical function, even after adjustment for confounders. These findings suggest that for men, marriage and parenthood protect against functional decline in midlife. Alternatively, physical performance may be a marker of poorer health in earlier life, which affects the chance of marriage and parenthood.