Osteoporosis International

, Volume 26, Issue 3, pp 931–942 | Cite as

Adult bone strength of children from single-parent families: the Midlife in the United States Study

  • C. J. Crandall
  • A. S. Karlamangla
  • S. S. Merkin
  • N. Binkley
  • D. Carr
  • G. A. Greendale
  • T. E. Seeman
Original Article



Bone health may be negatively impacted by childhood socio-environmental circumstances. We examined the independent associations of single-parent childhood and parental death or divorce in childhood with adult bone strength indices. Longer exposure to a single-parent household in childhood was associated with lower bone strength in adulthood.


Because peak bone mass is acquired during childhood, bone health may be negatively impacted by childhood socio-environmental disadvantage. The goal of this study was to determine whether being raised in a single-parent household is associated with lower bone strength in adulthood.


Using dual-energy X-ray absorptiometry data from 708 participants (mean age 57 years) in the Midlife in the United States Biomarker Project, we examined the independent associations of composite indices of femoral neck bone strength relative to load (in three failure modes: compression, bending, and impact) in adulthood with the experience of single-parent childhood and parental death or divorce in childhood.


After adjustment for gender, race, menopause transition stage, age, and body mass index, each additional year of single-parent childhood was associated with 0.02 to 0.03 SD lower indices of adult femoral neck strength. In those with 9–16 years of single-parent childhood, the compression strength index was 0.41 SD lower, bending strength index was 0.31 SD lower, and impact strength index was 0.25 SD lower (all p values < 0.05). In contrast, parental death or divorce during childhood was not by itself independently associated with adult bone strength indices. The magnitudes of these associations were unaltered by additional adjustment for lifestyle factors and socioeconomic status in childhood and adulthood.


Independent of parental death or divorce, growing up in a single-parent household is associated with lower femoral neck bone strength in adulthood, and this association is not entirely explained by childhood or adult socioeconomic conditions or lifestyle choices.


Bone strength Composite strength indices Parental death Parental divorce Single-parent childhood Strength relative to load 



This research was supported by National Institutes of Health grant numbers 1R01AG033067, R01-AG-032271, and P01-AG-020166. The UCLA GCRC helped support this study (UCLA GCRC grant no. M01-RR000865). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Dr. Crandall received support from the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles.

Conflicts of interest

Carolyn J. Crandall, Arun S. Karlamangla, Sharon Stein Merkin, Deborah Carr, Gail A. Greendale, and Teresa E. Seeman declare that they have no conflicts of interest. Neil Binkley has received research grants from Lilly, Merck, and Amgen and consulting fees from Lilly and Merck.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2014

Authors and Affiliations

  • C. J. Crandall
    • 1
  • A. S. Karlamangla
    • 2
  • S. S. Merkin
    • 2
  • N. Binkley
    • 3
  • D. Carr
    • 4
  • G. A. Greendale
    • 2
  • T. E. Seeman
    • 2
  1. 1.Department of Medicine, David Geffen School of Medicine, Los AngelesUniversity of California, Los AngelesLos AngelesUSA
  2. 2.Division of Geriatrics, Department of Medicine, David Geffen School of MedicineUniversity of California, Los AngelesLos AngelesUSA
  3. 3.Osteoporosis Clinical Center and Research ProgramUniversity of WisconsinMadisonUSA
  4. 4.Department of SociologyRutgers UniversityNew BrunswickUSA

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