In children, sibling’s death tied to health risks
Of all the possible tragedies of childhood, losing a sister or brother to early death is almost too awful to contemplate. Yet it is startlingly common. In the United States, 5 to 8 per cent of children with siblings experience such a loss.
The immediate effects of a sibling’s death, and the grief that follows, are obvious to all. But the consequences are more than emotional and can last for decades. They are even associated with an increased risk of death in those who remain.
A recent study in JAMA Pediatrics followed all children in Denmark and Sweden from 1973 through 2013. More than 55,000 of these children experienced the death of a sibling before they turned 18. In the 37 years of followup, these children were more than 70 per cent more likely to die as well. Although the overall risk of death remained low throughout these years, it was highest in the first year after a sibling’s death. During that period, children who lost a sibling have a mortality rate two and a half times that of other children.
Why are children who lose siblings more likely to die, even decades later? One of the reasons is probably genetic. In the study, many of the children who died later, even those who died within a year of each other, died of the same disease as their sibling.
Another factor could be the emotional impact and its effects on mental health, especially in the short term. Children who lose their parents are more likely to engage in alcohol and substance abuse not long after, often because of greater functional impairment, or to experience depression or post-traumatic stress disorder.
That emotional damage can linger. A study of young adults who lost siblings to cancer found that most still had not worked through their grief, even nine years later.
A case control study of children in Scandinavia found that children who experience the death of a parent had twice the chance of committing suicide. That increased risk lasted at least 25 years.
The risk of suicide in children who had lost a parent was four in1,000 for boys and two in 1,000 for girls.
Emotional damage can have a physical impact as well. In 2013, researchers published work in PLoS One that showed that both men and women who had lost a sibling in adulthood had an elevated risk of death from stroke, potentially stress related, in the 18 months after the sibling’s death. For women, that increased risk got worse over time, still increasing 18 years later.
Families who lose a child are more likely to show problems that already existed, such as evidence of social deprivation and poor health. Health-care professionals may want to consider that the death of a child can exacerbate problems and signify long-term social, behavioural and environmental risks for the survivors.
It may be time for us to pay more attention to the longterm effects of a child’s death. We can take hope from research showing that most children do thrive and overcome adversity, even after such a loss. Too many do not, though. We ought to monitor those who lost siblings as children for possible health consequences for many years to come.