Does One Have to Be Healthy to Opt to Have Children in Norway?

Astri Syse , Norwegian Institute of Public Health
Lars Dommermuth, Statistics Norway
Rannveig K. Hart, Statistics Norway and University of Oslo

Extensively analyzed fertility determinants such as income and education influence fertility because they structure the time and money available, and to some extent also proxy preferences. Health is a comparable resource: Poor health may constrain women’s capacity for active leisure, including family life and childrearing, for earning money in the labor market, but also potentially affect preferences. Still, health remains remarkably understudied. We explore the association between health and fertility, using uptake of doctor-certified sick leaves and long-term health-related benefits as proxies for health. We examine whether compositional changes in health distributions and/or changes in the health-fertility association have contributed to the distinct fall in TFR in Norway since 2009. Lastly, we investigate if health-related associations differ across socio-demographic characteristics, and thus influence fertility differently in various groups. We use nationwide registry data on women aged 16-45 from 2004-2018. We analyze first, second and third births separately, and use annual observations with lagged time-varying covariates for education, income, employment and health. Long-term benefits are negatively associated with fertility, but such uptake is relatively rare. The use of sickness absence, positively associated with fertility, is common but decreases over time. If this indicates a stronger labor market preference and attachment among women in fertile ages, it might help explain parts of the observed decline. Trends are similar across parities and health status over time, with an initial increase, followed by a slow decline until 2013, and thereafter a sharper drop for healthy women. Health as a fertility determinant warrants further research.

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 Presented in Session 5. Health, Wellbeing and Morbidity