Abstract
A substantial body of research investigates potentially-modifiable individual risk factors for cardiovascular (CVD) diseases including tobacco use, physical inactivity, and clustered metabolic risk factors. In older adults, however, many of these “modifiable” factors are conditioned by exposure to a lifetime of socially- and culturally-established determinants. Some of the most intractable are tied to gender norms, which strongly influence reproductive timing and frequency and are among the most life-altering events in the human experience, both physiologically (women) and socially. To date, numerous studies investigate female lifetime parity and CVD, as well as adolescent childbirth and all-cause mortality. Many observe robust associations and attribute the findings to the physiological consequences of pregnancy. Almost all of this research takes place in high-income settings and few interrogate the complex constellation of influences on reproduction and its long-term health consequences. Very few look at male populations. In this symposium, we present findings from middle and high-income populations investigating age at first childbirth (AFB) and number of children on cardiometabolic diseases. We begin with results of a systematic review investigating associations between AFB and CVD. It highlights conceptual and methodological gaps in previous approaches to the topic. The next two studies present results from an international cohort of community-dwelling older adults with sites in Canada and middle-income countries, each characterized by divergent gender norms and human develop indices. Finally, we present results on lifetime number of children in men and women in the United States and associations with heart disease and stroke.