Influence of Obesity and Unemployment on Fertility Rates: A Multinational Analysis of 30 Countries from 1976 to 2014

Background: The rationale of a postulated decrease in fertility rate development is still being debated. Among the multiple influencing factors, socioeconomic variables and their complex influence are of particular interest. Methods: Data on socioeconomic and health variables from 1976-2014 of 30 countries within the OECD region were analysed for their respective influence on fertility rates by using mixed-effect regression models. Results: A significant negative influence of the increase in unemployment rate on the following year's changes in fertility rate in Western (-0.00256; p < 0.001) as well as Eastern European (-0.0034; p < 0.001) countries was revealed. The effect of being overweight was significant for Western European (-0.00256; p < 0.001) countries only. When analysing the whole OECD region, an increase in unemployment retained its significant negative influence on the fertility rate (-0.0028; p < 0.001), while being overweight did not. Interestingly, divergent influences of time were revealed and fertility rates increased with time in Eastern Europe while they decreased in Western Europe. Conclusion: Importantly, a significant negative influence of increase in unemployment on the fertility rate was revealed-irrespective of the region and time analysed. Furthermore, an adverse effect of being overweight on the fertility rate in Western European countries was revealed. Interestingly, time was associated with a decreasing fertility rate in Western but not in Eastern Europe.