By Aaron E. Carroll

"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 percent 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 Pediatricsfollowed 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 follow-up, these children were more than 70 percent 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."

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