, Volume 52, Issue 2, pp 613–639 | Cite as

Birth Order and Mortality: A Population-Based Cohort Study

  • Kieron BarclayEmail author
  • Martin Kolk


This study uses Swedish population register data to investigate the relationship between birth order and mortality at ages 30 to 69 for Swedish cohorts born between 1938 and 1960, using a within-family comparison. The main analyses are conducted with discrete-time survival analysis using a within-family comparison, and the estimates are adjusted for age, mother’s age at the time of birth, and cohort. Focusing on sibships ranging in size from two to six, we find that mortality risk in adulthood increases with later birth order. The results show that the relative effect of birth order is greater among women than among men. This pattern is consistent for all the major causes of death but is particularly pronounced for mortality attributable to cancers of the respiratory system and to external causes. Further analyses in which we adjust for adult socioeconomic status and adult educational attainment suggest that social pathways only mediate the relationship between birth order and mortality risk in adulthood to a limited degree.


Birth order Mortality Fixed effects Population register data Sweden 

Supplementary material

13524_2015_377_MOESM1_ESM.pdf (42 kb)
ESM 1 (PDF 41 kb)


  1. Altieri, A., & Hemminki, K. (2007). Number of siblings and the risk of solid tumours: A nationwide study. British Journal of Cancer, 96, 1755–1759.CrossRefGoogle Scholar
  2. Amirian, E., Scheurer, M. E., & Bondy, M. L. (2010). The association between birth order, sibship size and glioma development in adulthood. International Journal of Cancer, 126, 2752–2756.Google Scholar
  3. Andersson, G., & Kolk, M. (2011). Trends in childbearing and nuptiality in Sweden: An update with data up to 2007. Finnish Yearbook of Population Research, 46, 21–29.Google Scholar
  4. Andersson, G., Ronsen, M., Knudsen, L. B., Lappedgård, T., Neyer, G., Skrede, K., . . . Vikat, A. (2009). Cohort fertility patterns in the Nordic countries. Demographic Research, 20(article 14), 313–352. doi:  10.4054/DemRes.2009.20.14
  5. Barclay, K. J. (2015a). A within-family analysis of birth order and intelligence using population conscription data on Swedish men. Intelligence, 49, 134–143.CrossRefGoogle Scholar
  6. Barclay, K. J. (2015b). Birth order and educational attainment: Evidence from fully adopted sibling groups. Intelligence, 48, 109–122.CrossRefGoogle Scholar
  7. Bard, D. E., & Rodgers, J. L. (2003). Sibling influence on smoking behavior: A within-family look at explanations for a birth-order effect. Journal of Applied Social Psychology, 33, 1773–1795.CrossRefGoogle Scholar
  8. Batty, G. D., Deary, I. J., & Gottfredson, L. S. (2007). Premorbid (early life) IQ and later mortality risk: Systematic review. Annals of Epidemiology, 17, 278–288.CrossRefGoogle Scholar
  9. Bengtsson, T., & Broström, G. (2009). Do conditions in early life affect old-age mortality directly or indirectly? Evidence from 19th-century rural Sweden. Social Science & Medicine, 68, 1583–1590.CrossRefGoogle Scholar
  10. Bengtsson, T., & Mineau, G. P. (2009). Early-life effects on socio-economic performance and mortality in later life: A full life-course approach using contemporary and historical sources. Social Science & Medicine, 68, 1561–1564.CrossRefGoogle Scholar
  11. Bevier, M., Weires, M., Thomsen, H., Sundquist, J., & Hemminki, K. (2011). Influence of family size and birth order on risk of cancer: A population-based study. BMC Cancer, 11. doi: 10.1186/1471-2407-11-163
  12. Bjerkedal, T., Kristensen, P., Skjeret, G. A., & Brevik, J. I. (2007). Intelligence test scores and birth order among young Norwegian men (conscripts) analyzed within and between families. Intelligence, 35, 503–514.CrossRefGoogle Scholar
  13. Black, S. E., Devereux, P. J., & Salvanes, K. G. (2005). The more the merrier? The effect of family size and birth order on children’s education. Quarterly Journal of Economics, 120, 669–700.Google Scholar
  14. Black, S. E., Devereux, P. J., & Salvanes, K. G. (2007). From the cradle to the labor market? The effect of birth weight on adult outcomes. Quarterly Journal of Economics, 122, 409–439.CrossRefGoogle Scholar
  15. Black, S. E., Devereux, P. J., & Salvanes, K. G. (2011). Older and wiser? Birth order and IQ of young men. CESifo Economic Studies, 57, 103–120.CrossRefGoogle Scholar
  16. Blake, J. (1981). Family size and the quality of children. Demography, 18, 421–442.CrossRefGoogle Scholar
  17. Blane, H. T., & Barry, H. (1973). Birth order and alcoholism: A review. Quarterly Journal of Studies on Alcohol, 34, 837–852.Google Scholar
  18. Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic status and child development. Annual Review of Psychology, 53, 371–399.CrossRefGoogle Scholar
  19. Buckles, K., & Kolka, S. (2014). Prenatal investments, breastfeeding, and birth order. Social Science & Medicine, 118, 66–70.CrossRefGoogle Scholar
  20. Campbell, F., Conti, G., Heckman, J., Moon, S. H., Pinto, R., Pungello, E., & Pan, Y. (2014). Early childhood investments substantially boost adult health. Science, 343, 1478–1485.CrossRefGoogle Scholar
  21. Chen, J., & Millar, W. J. (1998). Age of smoking initiation: Implications for quitting. Health Reports, 9(4), 39–46.Google Scholar
  22. Christakis, N. A., & Fowler, J. H. (2008). The collective dynamics of smoking in a large social network. New England Journal of Medicine, 358, 2249–2258.CrossRefGoogle Scholar
  23. Elliott, B. A. (1992). Birth order and health: Major issues. Social Science & Medicine, 35, 443–452.CrossRefGoogle Scholar
  24. Erikson, R., & Goldthorpe, J. H. (1992). The constant flux: A study of class mobility in industrial societies. Oxford, UK: Clarendon Press.Google Scholar
  25. Erikson, R., Goldthorpe, J. H., & Portocarero, L. (1979). Intergenerational class mobility in three Western European societies: England, France and Sweden. British Journal of Sociology, 30, 415–441.CrossRefGoogle Scholar
  26. Gluckman, P. D., Hanson, M. A., Cooper, C., & Thornburg, K. L. (2008). Effect of in utero and early-life conditions on adult health and disease. New England Journal of Medicine, 359, 61–73.CrossRefGoogle Scholar
  27. Greene, W. H. (2012). Econometric analysis (7th ed.). Upper Saddle River, NJ: Prentice Hall.Google Scholar
  28. Gualtieri, T., & Hicks, R. E. (1985). An immunoreactive theory of selective male affliction. Behavioral and Brain Sciences, 8, 427–441.CrossRefGoogle Scholar
  29. Hagestad, G. O. (1986). The family: Women and grandparents as kin-keepers. In A. J. Pifer & L. Bronte (Eds.), Our aging society: Paradox and promise (pp. 141–160). New York, NY: W.W. Norton.Google Scholar
  30. Hamil-Luker, J., & O’Rand, A. M. (2007). Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood. Demography, 44, 137–158.CrossRefGoogle Scholar
  31. Harakeha, Z., Engelsa, R. C. M. E., Vermulsta, A. A., De Vriesb, H., & Scholtea, R. H. J. (2007). The influence of best friends and siblings on adolescent smoking: A longitudinal study. Psychology and Health, 22, 269–289.CrossRefGoogle Scholar
  32. Härkönen, J. (2014). Birth order effects on educational attainment and educational transitions in West Germany. European Sociological Review, 30, 166–179.CrossRefGoogle Scholar
  33. Hayward, M. D., & Gorman, B. K. (2004). The long arm of childhood: The influence of early-life social conditions on men’s mortality. Demography, 41, 87–107.CrossRefGoogle Scholar
  34. Heckman, J. (2006). Skill formation and the economics of investing in disadvantaged children. Science, 312, 1900–1902.CrossRefGoogle Scholar
  35. Heckman, J. J., Moon, S. H., Pinto, R., Savelyev, P. A., & Yavitz, A. (2010). The rate of return to the High/Scope Perry Preschool Program. Journal of Public Economics, 94, 114–128.CrossRefGoogle Scholar
  36. Hemminki, K., & Mutanen, P. (2001). Birth order, family size, and the risk of cancer in young and middle-aged adults. British Journal of Cancer, 84, 1466–1471.CrossRefGoogle Scholar
  37. Hertwig, R., Davis, J. N., & Sulloway, F. J. (2002). Parental investment: How an equity motive can produce inequality. Psychological Bulletin, 128, 728–745.CrossRefGoogle Scholar
  38. Holman, R. C., Shay, D. K., Curns, A. T., Lingappa, J. R., & Anderson, L. J. (2003). Risk factors for bronchiolitis-associated deaths among infants in the United States. Paediatric Infectious Disease Journal, 22, 483–489.Google Scholar
  39. Hosmer, D. W., Jr., Lemeshow, S. A., & Sturdivant, R. X. (2013). Applied logistic regression (3rd ed.). Hoboken, NJ: Wiley.CrossRefGoogle Scholar
  40. Janssen, F., & Kunst, A. E. (2004). ICD coding changes and discontinuities in trends in cause-specific mortality in six European countries, 1950–99. Bulletin of the World Health Organization, 82, 904–913.Google Scholar
  41. Janssen, F., & Kunst, A. E. (2005). Cohort patterns in mortality trends among the elderly in seven European countries, 1950–99. International Journal of Epidemiology, 34, 1149–1159.CrossRefGoogle Scholar
  42. Khlat, M., Jusot, F., & Ville, I. (2009). Social origins, early hardship and obesity: A strong association in women, but not in men? Social Science & Medicine, 68, 1692–1699.CrossRefGoogle Scholar
  43. Khuder, S. A., Dayal, H. H., & Mutgi, A. B. (1999). Age at smoking onset and its effect on smoking cessation. Addictive Behaviors, 24, 673–677.CrossRefGoogle Scholar
  44. Knudsen, E. I., Heckman, J. J., Cameron, J. L., & Shonkoff, J. P. (2006). Economic, neurobiological, and behavioral perspectives on building America’s future workforce. Proceedings of the National Academy of Sciences, 103, 10155–10162.CrossRefGoogle Scholar
  45. Kristensen, P., & Bjerkedal, T. (2007). Explaining the relation between birth order and intelligence. Science, 316, 1717.CrossRefGoogle Scholar
  46. Kristensen, P., & Bjerkedal, T. (2010). Educational attainment of 25 year old Norwegians according to birth order and gender. Intelligence, 38, 123–136.CrossRefGoogle Scholar
  47. Lager, A. C. J., & Torssander, J. (2012). Causal effect of education on mortality in a quasi-experiment on 1.2 million Swedes. Proceedings of the National Academy of Sciences, 109, 8461–8466.CrossRefGoogle Scholar
  48. Leonardi-Bee, J., Jere, M. L., & Britton, J. (2011). Exposure to parental and sibling smoking and the risk of smoking uptake in childhood and adolescence: A systematic review and meta-analysis. Thorax, 66, 847–855.CrossRefGoogle Scholar
  49. Mackenbach, J. P., Kunst, A. E., Cavelaars, A. E. J. M., Groenhof, F., & Geurts, J. J. M. (1997). Socioeconomic inequalities in morbidity and mortality in Western Europe. Lancet, 349, 1655–1659.CrossRefGoogle Scholar
  50. Magnus, P., Berg, K., & Bjerkedal, T. (1985). The association of parity and birth weight: Testing the sensitization hypothesis. Early Human Development, 12, 49–54.CrossRefGoogle Scholar
  51. Marmot, M. (2004). The status syndrome: How social standing directly affects our health and longevity. London, UK: Bloomsbury.Google Scholar
  52. Maty, S. C., Lynch, J. W., Raghunathan, T. E., & Kaplan, G. A. (2008). Childhood socioeconomic position, gender, adult body mass index, and incidence of type 2 diabetes mellitus over 34 years in the Alameda County Study. American Journal of Public Health, 98, 1486–1494.CrossRefGoogle Scholar
  53. Modin, B. (2002). Birth order and mortality: A life-long follow-up of 14,200 boys and girls born in early 20th century Sweden. Social Science & Medicine, 54, 1051–1064.CrossRefGoogle Scholar
  54. Myrskylä, M., & Fenelon, A. (2012). Maternal age and offspring adult health: Evidence from the Health and Retirement Study. Demography, 49, 1231–1257.CrossRefGoogle Scholar
  55. Myrskylä, M., Silventoinen, K., Jelenkovic, A., Tynelius, P., & Rasmussen, F. (2013). The association between height and birth order: Evidence from 652 518 Swedish men. Journal of Epidemiology and Community Health, 67, 571–577.CrossRefGoogle Scholar
  56. O’Leary, S. R., Wingard, D. L., Edelstein, S. L., Criqui, M. H., Tucker, J. S., & Friedman, H. S. (1996). Is birth order associated with adult mortality? Annals of Epidemiology, 6, 34–40.CrossRefGoogle Scholar
  57. Price, J. (2008). Parent-child quality time: Does birth order matter? Journal of Human Resources, 43, 240–265.CrossRefGoogle Scholar
  58. Primo, D. M., Jacobsmeier, M. L., & Milyo, J. (2007). The practical researcher: Estimating the impact of state policies and institutions with mixed-level data. State Politics and Policy Quarterly, 7, 446–459.CrossRefGoogle Scholar
  59. Read, J. G., & Gorman, B. K. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371–386.CrossRefGoogle Scholar
  60. Richards, S. J., Kirkby, J. G., & Currie, I. D. (2006). The importance of year of birth in two-dimensional mortality data. British Actuarial Journal, 12, 5–61.CrossRefGoogle Scholar
  61. Richiardi, L., Akre, O., Lambe, M., Granath, F., Montgomery, S. M., & Ekbom, A. (2004). Birth order, sibship size, and risk for germ-cell testicular cancer. Epidemiology, 15, 323–329.CrossRefGoogle Scholar
  62. Rodgers, J. L. (2001). What causes birth order-intelligence patterns? The admixture hypothesis, revived. American Psychologist, 56, 505–510.CrossRefGoogle Scholar
  63. Rodgers, J. L., Cleveland, H. H., van den Oord, E., & Rowe, D. C. (2000). Resolving the debate over birth order, family size, and intelligence. American Psychologist, 55, 599–612.CrossRefGoogle Scholar
  64. Rodgers, J. L., & Rowe, D. C. (1988). Influence of siblings on adolescent sexual behavior. Developmental Psychology, 24, 722–728.CrossRefGoogle Scholar
  65. Rosenquist, J. N., Murabito, J., Fowler, J. H., & Christakis, N. A. (2010). The spread of alcohol consumption behavior in a large social network. Annals of Internal Medicine, 152, 426–433.CrossRefGoogle Scholar
  66. Rossi, A. S., & Rossi, P. H. (1990). Of human bonding: Parent-child relations across the life course. New York, NY: Aldine de Gruyter.Google Scholar
  67. SCB. (2011). Multi-generation register 2010: A description of contents and quality. Stockholm: Statistics Sweden.Google Scholar
  68. Schmidt, C. O., & Kohlmann, T. (2008). When to use the odds ratio or the relative risk? International Journal of Public Health, 53, 165–167.CrossRefGoogle Scholar
  69. Sénéchal, M., & LeFevre, J.-A. (2002). Parental involvement in the development of children’s reading skill: A five-year longitudinal study. Child Development, 73, 445–460.CrossRefGoogle Scholar
  70. Sénéchal, M., Lefevre, J.-A., Thomas, E. M., & Daley, K. E. (1998). Differential effects of home literacy experiences on the development of oral and written language. Reading Research Quarterly, 33, 96–116.CrossRefGoogle Scholar
  71. Smith, K. R., Mineau, G. P., Garibotti, G., & Kerber, R. (2009). Effects of childhood and middle-adulthood family conditions on later-life mortality: Evidence from the Utah Population Database, 1850–2002. Social Science & Medicine, 68, 1649–1658.CrossRefGoogle Scholar
  72. Socialstyrelsen. (2010). Dödsorsaker 2010 [Causes of death 2010]. Stockholm, Sweden: Socialstyrelsen.Google Scholar
  73. Strachan, D. P. (1989). Hay fever, hygiene, and household size. British Medical Journal, 299, 1259–1260.CrossRefGoogle Scholar
  74. Sulloway, F. J. (1996). Born to rebel: Birth order, family dynamics, and creative lives. London, UK: Little, Brown and Company.Google Scholar
  75. Sulloway, F. J., & Zweigenhaft, R. L. (2010). Birth order and risk taking in athletics: A meta-analysis and study of major league baseball. Personality and Social Psychology Review, 14, 402–416.CrossRefGoogle Scholar
  76. Sundström, M., & Duvander, A.-Z. E. (2002). Gender division of childcare and the sharing of parental leave among new parents in Sweden. European Sociological Review, 18, 433–447.CrossRefGoogle Scholar
  77. Torssander, J., & Erikson, R. (2010). Stratification and mortality—A comparison of education, class, status, and income. European Sociological Review, 26, 465–474.CrossRefGoogle Scholar
  78. United Nations, Department of Economic and Social Affairs, Population Division. (2013). World Mortality Report 2013. New York, NY: United Nations.Google Scholar
  79. Willson, A. E., Shuey, K. M., & Elder, G. H., Jr. (2007). Cumulative advantage processes as mechanisms of inequality in life course health. American Journal of Sociology, 112, 1886–1924.CrossRefGoogle Scholar
  80. Young, M., & Willmott, P. (1957). Family and kinship in East London. Glencoe, IL: Free Press.Google Scholar
  81. Zajonc, R. B. (1976). Family configuration and intelligence. Science, 192, 227–236.CrossRefGoogle Scholar
  82. Zajonc, R. B., & Markus, G. B. (1975). Birth order and intellectual development. Psychological Review, 82, 74–88.CrossRefGoogle Scholar
  83. Zhang, J., & Kai, F. Y. (1998). What’s the relative risk? Journal of the American Medical Association, 280, 1690–1691.CrossRefGoogle Scholar
  84. Zweigenhaft, R. L., & Von Ammon, J. (2000). Birth order and civil disobedience: A test of Sulloway’s “born to rebel” hypothesis. Journal of Social Psychology, 140, 624–627.CrossRefGoogle Scholar

Copyright information

© Population Association of America 2015

Authors and Affiliations

  1. 1.Department of Social PolicyLondon School of Economics and Political ScienceLondonUK
  2. 2.Department of SociologyStockholm UniversityStockholmSweden

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