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

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

New study examines paternal mortality data in Georgia, finds 60% of deaths were preventable

• Majority of deaths resulted from potentially preventable causes like homicide, accidental injury, suicide
• While maternal deaths are closely tracked, paternal mortality is rarely examined
• Study includes Georgia data only
• Studying these trends nationally is difficult because of how data is collected and de-identified

CHICAGO - It took the better part of a century for maternal mortality to be recognized, forgotten and finally recognized again as an urgent public health crisis in the United States. In contrast, research shows fathers - particularly men in their 20s through early 40s - die disproportionately from preventable causes such as suicide, overdose, homicide and accidental injury. Yet paternal mortality is rarely examined in connection to the transition to parenthood.

Northwestern University scientists are trying to change that.

A new Northwestern study examined all 130,267 babies born in Georgia in 2017 and tracked whether their fathers died at any point during the following five years, through 2022. Of those fathers who died within five years (796), 60% of the deaths were preventable, which the study authors call a "huge, missed opportunity." These deaths resulted from homicide (143), accidental injury (142), suicide (102) or overdose (93), while 296 fathers died of natural causes.

The study was published May 4 in JAMA Pediatrics.

While maternal mortality review committees focus specifically and in depth on deaths of mothers in the first year of a child's life, this is, to the researchers' knowledge, the first study published in a major medical journal to examine paternal mortality in the years following a child's birth.

"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 findings echo what maternal mortality research has long shown: Deaths around the transition to parenthood are shaped less by biology than by social vulnerability, and many are preventable - even as paternal deaths remain largely uncounted and unaddressed. Prior research has shown that paternal involvement is linked to better child and family health outcomes, while paternal absence is associated with a range of adverse outcomes for children.

Still, fatherhood appears to be protective

Despite fathers in the study dying disproportionately from preventable causes, the scientists found being a father was associated with lower death rates among all men in Georgia between 2017 and 2022.

After age 20, the death rate for fathers is consistently lower compared to men who are not fathers. For example, among those aged 30 to 34, the death rate for Georgia fathers was 120 deaths per 100,000 men compared to Georgia non-fathers, whose death rate was 231 deaths per 100,000 men.

"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."

More about the study

The scientists examined all births in Georgia between 2017 and 2022 and linked them to death records for fathers listed on birth certificates. They analyzed causes of death, overall mortality rates and whether fatherhood, itself, appeared to affect men's risk of death.

Non-natural deaths occurred more frequently among younger fathers. Medicaid-paid births and unmarried status were linked to higher homicide risk. Fathers who died were more likely to have been older, non-Hispanic Black, unmarried, living in rural areas and to have had Medicaid-paid births. Higher education, Hispanic ethnicity and Tricare-paid births were associated with fewer deaths.

Experiences in the hospital inspired the work

As a pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago, Garfield said he has encountered many situations in which mothers in the neonatal intensive care unit were coping with the death of their partner - whether from a shooting, a car accident or another sudden cause.

"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."

Despite publishing dozens of papers on fathers' mental and physical health, Garfield said he could find little research examining fathers' deaths in the years immediately following a child's birth.

Why Georgia?

Examining paternal mortality at a national level is currently not possible. While birth and death data are collected at the state level, when that data is collected at the national level, personally identifiable information is removed and there is no way to determine individual cause of death, among many other important factors. Garfield and team had access to Georgia's data through an existing project - the Pregnancy Risk Assessment Monitoring System for Dads (PRAMS for Dads survey) - which they created and first piloted in the state in 2018.

He hopes the findings will prompt other states to analyze their own data to better understand paternal mortality at a state level and work collectively to create a system to analyze this important national trend.

"If we don't measure it, we can't change it," Garfield said. "That affects thousands of children."

The study is titled "Paternal Mortality During Early Childhood." Other Northwestern co-authors include Clarissa D. Simon and Katy Bedjeti.