Childlessness and health in middle age and older adulthood: Evidence from Singapore

Health and well-being in mature adulthood are important concerns given the prevalence of individuals aging without children. We exploit two new instruments for childlessness—infertility and the number of childless siblings—and condition our analyses on a rich set of covariates including childhood health and financial status, to investigate the causal relationship between childlessness and health in middle age and older adulthood. Using a nationwide dataset of 1500 Singaporeans aged 50 and above, we show that OLS underestimates the negative effects of childlessness on health. We find that childlessness leads to higher likelihood of poorer self-reported health and mental distress. The results are robust to a battery of sensitivity analyses, including bounding the effects by relaxing the exclusion restrictions.

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Publication Details

Journal
European Economic Review
Published
2026-02-04
DOI
https://doi.org/10.1016/j.euroecorev.2026.105279
Primary Topic
Family Dynamics and Relationships
Type
article
Field-Weighted Citation Impact
0.00
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article

Childlessness and health in middle age and older adulthood: Evidence from Singapore

Bussarawan Teerawichitchainan, Rohan Ray, Dahye Kim, Christine Ho
European Economic Review
Family Dynamics and Relationships
article

Childlessness and health in middle age and older adulthood: Evidence from Singapore

Bussarawan Teerawichitchainan, Rohan Ray, Dahye Kim, Christine Ho
article en

Abstract

Health and well-being in mature adulthood are important concerns given the prevalence of individuals aging without children. We exploit two new instruments for childlessness—infertility and the number of childless siblings—and condition our analyses on a rich set of covariates including childhood health and financial status, to investigate the causal relationship between childlessness and health in middle age and older adulthood. Using a nationwide dataset of 1500 Singaporeans aged 50 and above, we show that OLS underestimates the negative effects of childlessness on health. We find that childlessness leads to higher likelihood of poorer self-reported health and mental distress. The results are robust to a battery of sensitivity analyses, including bounding the effects by relaxing the exclusion restrictions.

European Economic ReviewVol. 184
Hong Kong Baptist University (HK), National University of Singapore (SG), Oxford Policy Management (GB), Singapore Management University (SG), London School of Economics and Political Science (GB)
Reduced inequalities
Openalex Percentile: Top 73%
Family Dynamics and Relationships
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Childlessness and health in middle age and older adulthood: Evidence from Singapore — Bussarawan Teerawichitchainan, Rohan Ray, et al. · European Economic Review (2026) | TGRS Research Map | TGRS