Dads are dying after their kids are born, and almost no one is tracking it

Research has shown that fathers, especially men in their 20s through early 40s, are disproportionately affected by preventable causes of death including suicide, overdose, homicide and accidental injury. Yet researchers have rarely studied these deaths specifically in the context of becoming a parent.

Scientists at Northwestern University are working to bring more attention to that gap.

Most Deaths Among Fathers Were Preventable

In a new study, Northwestern researchers examined all 130,267 babies born in Georgia in 2017 and followed their fathers for the next five years, through 2022. During that period, 796 fathers died.

Of those fathers who died within five years (796), 60% died from causes considered preventable, a finding the researchers described as a “huge, missed opportunity.”

The deaths included homicide (143), accidental injury (142), suicide (102) and overdose (93). Another 296 fathers died from natural causes.

The study was published in JAMA Pediatrics.

While maternal mortality review committees closely examine the deaths of mothers during the first year of a child’s life, the researchers say paternal mortality has received little comparable attention. To their knowledge, this is the first study published in a major medical journal to examine the deaths of fathers during the years following the birth of a child.

“Our data show that fathers die frequently in the first years of their child’s life, and we have no systems in place to understand how we might prevent it,” said corresponding author Dr. Craig Garfield, professor of pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine. “That’s a huge blind spot.”

The results resemble a pattern already documented in maternal mortality research. Deaths surrounding the transition to parenthood often have more to do with social vulnerability than biology, and many of them can be prevented. Yet deaths among fathers remain largely uncounted and unaddressed.

Previous research has also connected a father’s involvement with better health outcomes for children and families. The absence of a father, meanwhile, has been associated with a variety of negative outcomes for children.

Fatherhood Itself May Be Protective

Although many fathers in the study died from preventable causes, researchers also uncovered a seemingly contradictory finding. Being a father was associated with lower overall death rates among men in Georgia between 2017 and 2022.

Among men older than 20, fathers consistently had lower mortality rates than men who were not fathers.

For example, among those aged 30 to 34, the death rate for Georgia fathers was 120 deaths per 100,000 men compared with 231 deaths per 100,000 among Georgia men who were not fathers.

“Being a father appears to be protective in this particular group of men,” Garfield said. “We were surprised to see reduced mortality among men who are fathers. Whether that is due to changes in lifestyle or a new purpose or new roles and responsibilities, we don’t know, but it is certainly worth further study.”

Who Faced the Greatest Risks?

For the analysis, scientists examined births throughout Georgia between 2017 and 2022 and connected those records with death records for fathers named on birth certificates. They investigated causes of death, overall mortality rates and whether becoming a father appeared to influence a man’s risk of dying.

Deaths from non-natural causes were more common among younger fathers.

Births paid for by Medicaid and unmarried status were associated with a greater risk of homicide. Fathers who died were also more likely to have been older, non-Hispanic Black, unmarried, living in rural areas and connected with Medicaid-paid births.

Higher levels of education, Hispanic ethnicity and Tricare-paid births were associated with fewer deaths.

Hospital Experiences Inspired the Research

Garfield, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago, said his experiences with families in the neonatal intensive care unit helped motivate the research.

He has encountered numerous mothers coping with the sudden death of their partner from causes such as shootings, car accidents and other unexpected events.

“In my experience, that happens more often than mothers dying,” Garfield said. “The death of any parent has enormous consequences for a child, and as a pediatrician, I care most about how a parent’s death impacts the child, especially in the early years.”

Garfield has published dozens of studies examining fathers’ physical and mental health. Even so, he said he found very little research focused specifically on fathers who die during the first several years after the birth of a child.

Why Researchers Focused on Georgia

A similar nationwide analysis of paternal mortality is not currently possible because of limitations in how birth and death data are handled.

States collect detailed birth and death records, but when those records are compiled nationally, personally identifiable information is removed. That makes it impossible to connect individual fathers with specific causes of death and other important information needed for this type of analysis.

Garfield and his colleagues were able to study Georgia because they already had access to the state’s data through an existing project called the Pregnancy Risk Assessment Monitoring System for Dads (PRAMS for Dads survey), which the team developed and first piloted in Georgia in 2018.

Garfield hopes other states will conduct similar analyses of their own records. Combining those efforts could eventually help researchers better understand paternal mortality across the United States and develop a system for tracking the problem nationally.

“If we don’t measure it, we can’t change it,” Garfield said. “That affects thousands of children.”

Other Northwestern co-authors include Clarissa D. Simon and Katy Bedjeti.