Race/ethnicity, completed parity, and women’s later-life health in the Health and Retirement Study

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ID: 330887
2026
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Ranked #111 of 124 articles by views in the journals of gerontology series b, psychological sciences and social sciences

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Abstract
OBJECTIVES: This study examines associations between completed parity, including childlessness (zero parity), and a range of medical conditions (individually and cumulatively) and self-rated health, including differences associated with race/ethnicity-related factors. METHODS: We conduct correlational and multivariable regression analyses using a historical HRS/AHEAD sample of ever-married, non-Hispanic Black and White women born between 1920 and 1941. Multivariable models adjust for early-life-course social determinants of health, including contextual birthplace exposure to Jim Crow-era structural racial inequalities. We focus on childlessness/zero parity by using zero-inflated count regression methods that statistically identify women with zero probability of having had a live birth (a latent "always-zero" group). RESULTS: Black women had three times the odds of "always-zero" group membership and, if not in that group, an expected parity 11% higher than White women. In correlational analyses, the predicted probability of "always-zero" group membership (Predicted Infecundity Probability or PIP)-rather than reported childlessness status-and high parity were associated with high-fatality medical conditions and self-rated fair/poor health. In multivariable models, PIP and high parity were positively associated with number of conditions, while PIP and number of conditions were positively associated with self-rated fair/poor health. Net of parity, consistent with weathering, younger Black women had a higher-than-expected number of medical conditions relative to all women. DISCUSSION: In the context of historical structural racial inequality, race/ethnicity-related differences in childlessness and high parity were strongly associated with later-life, post-reproductive health disparities. Women's number of births was associated with the accumulation of medical conditions in a U-shaped pattern.
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openalex_W7218873713 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Cheryl Elman, Andrew S. London, Angela M. O’Rand
Journal the journals of gerontology series b, psychological sciences and social sciences
Year 2026
DOI
10.1093/geronb/gbag202
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