Fathers Die Preventably in First Years of Child’s Life, Study Finds

Key facts

• Study examined all 130,267 babies born in Georgia in 2017 and tracked fathers for five years.
• 796 fathers died within five years; 60% of deaths were from preventable causes: homicide (143), accidental injury (142), suicide (102), overdose (93).
• Fatherhood was associated with lower death rates: among 30-34 year olds, 120 deaths per 100,000 fathers vs. 231 per 100,000 non-fathers.
• Study published in JAMA Pediatrics, first in a major medical journal to examine paternal mortality post-birth.
• Lead author Dr. Craig Garfield developed PRAMS for dads, a survey mirroring maternal health monitoring, now in 10 states.
• Medicaid-paid births and unmarried status linked to higher homicide risk; higher education and Hispanic ethnicity associated with fewer deaths.

A Blind Spot in Public Health

In the five years following the birth of a child, nearly 800 fathers in Georgia died — and more than 60% of those deaths were from causes that could have been prevented. That is the central finding of a new study published Monday in JAMA Pediatrics, which researchers say exposes a glaring gap in how the United States tracks and addresses mortality among new parents. “Our data show that fathers die frequently in the first years of their child’s life, and we have no systems in place to understand how we might prevent it,” said Dr. Craig Garfield, a professor of pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine and the study’s corresponding author. “That’s a huge blind spot.” While maternal mortality review committees have long scrutinized deaths of mothers in the first year after childbirth, no equivalent mechanism exists for fathers. The study is, to the authors’ knowledge, the first published in a major medical journal to examine paternal mortality in the years immediately following a child’s birth.

The Georgia Pilot Study

Researchers linked birth certificates for all 130,267 babies born in Georgia in 2017 to death records for fathers listed on those certificates, tracking mortality through 2022. Of the 796 fathers who died within five years, 296 succumbed to natural causes. The remaining 500 died from homicide (143), accidental injury (142), suicide (102), or overdose (93) — all classified as preventable. “It’s been more common in my experience that there’s a dad who has died during the course of the mom’s either pregnancy or in the postnatal period,” Garfield said in an interview, reflecting on his work as a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago. He recalled many instances in the neonatal intensive care unit where mothers were coping with the sudden death of a partner from a shooting or car accident. The study also found that non-natural deaths occurred more frequently among younger fathers. Fathers who died were more likely to be older, non-Hispanic Black, unmarried, living in rural areas, and to have had Medicaid-paid births. Conversely, higher education, Hispanic ethnicity, and Tricare-paid births were associated with fewer deaths.

Fatherhood as a Protective Factor

Despite the high number of preventable deaths, the study yielded a surprising counterpoint: fatherhood itself appears to be protective. After age 20, the death rate for fathers was consistently lower than for men who were not fathers. For example, among men aged 30 to 34, fathers died at a rate of 120 per 100,000, compared to 231 per 100,000 for non-fathers. “Being a father appears to be protective in this particular group of men,” Garfield said. “We were surprised to see reduced mortality among men who are fathers. Whether that is due to changes in lifestyle or a new purpose or new roles and responsibilities, we don’t know, but it is certainly worth further study.” This pattern contrasts sharply with maternal mortality, where pregnancy and childbirth increase a woman’s risk of death. The study’s authors emphasize that the preventable deaths of fathers represent a family and public health crisis, not just a male health issue.

Building on PRAMS for Dads

Garfield has long researched the role of fathers in child well-being and the impact of fatherhood on men’s health. In 2018, he developed the Pregnancy Risk Assessment System (PRAMS) for dads, a mirror survey to the PRAMS for mothers that was created in 1987 to monitor maternal and infant health. The survey launched in Georgia and has since expanded to nine other states. “We’ve developed PRAMS for dads because we realized that there’s a huge gap in understanding dad’s perinatal health,” Garfield said. The new mortality study is a natural extension of that work, aiming to bring the same level of scrutiny to fathers’ deaths as has long been applied to mothers. Neel Shah, an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School and chief medical officer of Maven, called the study groundbreaking. “The authors are breaking ground by framing preventable paternal death as a family health issue,” he said. “The well-being of fathers absolutely requires more attention and research and solutioning in the broader context of family health.”

Calls for a National Surveillance System

The study’s authors argue that the findings underscore the need for a national system to monitor and investigate paternal deaths, similar to the maternal mortality review committees that operate in most states. Without such a system, they say, preventable deaths will continue to go unaddressed. “It took the better part of a century for maternal mortality to be recognized, forgotten and finally recognized again as an urgent public health crisis in the United States,” the researchers note. They hope that paternal mortality will not suffer a similar fate. Some public health experts, however, caution against framing paternal mortality as a crisis on par with maternal mortality, given that fatherhood appears to reduce overall death risk. Still, most agree that the deaths of nearly 800 fathers in a single state over five years — the majority from preventable causes — warrant attention and action.

What Comes Next

The study is a pilot, limited to Georgia and to births in a single year. Garfield and his team plan to expand the analysis to other states and to examine longer-term outcomes. They also hope to explore the mechanisms behind the protective effect of fatherhood and to identify interventions that could reduce preventable deaths. “We have no systems in place to understand how we might prevent it,” Garfield said. The question now is whether policymakers and public health officials will move to create them.

The bottom line

• More than 60% of fathers who died within five years of a child’s birth in Georgia died from preventable causes: homicide, accident, suicide, or overdose.
• Fatherhood is associated with lower mortality rates compared to non-fathers, a protective effect that warrants further study.
• No national surveillance system exists for paternal mortality, unlike maternal mortality review committees.
• The study is the first of its kind published in a major medical journal, highlighting a significant gap in perinatal health research.
• Medicaid-paid births and unmarried status were linked to higher risk of homicide among fathers.
• Researchers call for a system to monitor and prevent paternal deaths, emphasizing the impact on families and public health.