The association between child loss and health decline from circulatory diseases among bereaved parents: a survival analysis
Date
2026-06-08
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Abstract
This study examines the association between child loss and the timing of health decline among older parents in the Philippines. Using data from the Longitudinal Study of Ageing and Health in the Philippines (LSAHP), the analysis applies a Cox proportional hazards model to estimate how parental bereavement is associated with the risk of developing circulatory diseases over time. We explore the timing of adverse health outcomes of bereavement by modeling loss of a child as a time-varying covariate. Health decline is measured by the onset of circulatory diseases, including heart disease, cerebrovascular disease, and high blood pressure. Results indicate that parental bereavement is significantly associated with earlier health decline. The hazard of circulatory disease onset was 55% higher (HR=1.55) among bereaved parents than non-bereaved parents. Kaplan-Meier estimates show that differences in health trajectories begin to emerge at around age 50 and increase with age. Stratified analyses also show that the effect exists within subgroups, and stronger associations are observed among mothers, urban residents, and parents who initially reported good health. This study contributes to the literature by providing evidence from a context of a developing country and focusing on the timing of health decline rather than solely on mortality outcomes. The findings highlight the need to consider bereaved parents as a vulnerable population and point toward the need for targeted public health policies for mitigating long-term effects of child loss.
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Keywords
Parental bereavement, Health decline, Circulatory disease, Cox proportional hazards model, Survival analysis, Philippines, Ageing, Time-to-event analysis