Health and healthcare utilization among single mothers and single fathers in Sweden

Abstract

Aims: To analyse self-rated health and healthcare utilization with regard to whether the respondents were single or couple parents, mothers or fathers. Methods: A postal questionnaire was distributed nationwide to 4,000 randomly chosen individuals 20—64 years of age, with a response rate of 66%. A total of 1,041 respondents had legal custody of a child (150 were single parents and 891 were couple parents), and thus met the definition of a parent used for this study. Analyses of self-rated health and health care utilization were performed according to sex, age, sociodemographic, and socioeconomic characteristics. Three different statistical methods were applied: Spearman correlation analyses, chi-square analyses and multivariate logistic regression. Results: Both single fathers and single mothers reported worse health than their couple counterparts. However, single fathers had contact with a physician more frequently (OR 1.84) than couple fathers, whereas single mothers did not. Furthermore, single mothers refrained from seeing a physician despite a medical need much more often (OR 2.07) than couple mothers. Conclusions: An uneven distribution of sociodemographic and socioeconomic characteristics might help us to understand why single parents, both mothers and fathers, have worse health than parents who live together. Previously recognized gender differences with regard to healthcare utilization were present in our study as well, and it is possible that these differences are related to the unequal distribution of sociodemographic and socioeconomic assets between single fathers and single mothers found here.

Keywords

Equity health healthcare single parent socioeconomic factors

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References

Benzeval M. The self-reported health status of lone parents . Soc Sci Med 1998;46:1337—53.

Whitehead M. , Burström B. , Diderichsen F. Social policies and the pathways to inequalities in health: A comparative analysis of lone mothers in Britain and Sweden. Soc Sci Med 2000;50:255—70.

Burström B. , et al. Lone mothers in Sweden: Trends in health and socioeconomic circumstances, 1979—1995. J Epidemiol Community Health 1999;53:750—6.

Ringbäck Weitoft G , Haglund B. , Rosén M. Mortality among lone mothers in Sweden. Lancet 2000;355:1215—19.

Popay J. , Jones G. Patterns of health and illness amongst lone parents. J Soc Pol 1990;19:499—534.

Ringbäck Weitoft G. Lone parenting, socioeconomic conditions and severe ill-health. Soc Sci Med. 2004 Oct;59(7):1449—59 Ringbäck Weitoft G. , Burström B. , Rosén M. Premature mortality among lone fathers and childless men. Soc Sci Med 2004;59:1449—59.

Föräldrabalken [The Children and Parents Act] SFS 1995:974, amended in SFS 1998:319.

Justitiedepartementet [Ministry of Justice]. Family Law — Information on the Rules. Stockholm; 2000.

Statistiska centralbyrån, SCB. Mammor och pappor. Demografiska rapporter 2002:7. [Statistics Sweden. Mothers and fathers. Demographic reports 2002:7] Örebro : Statistics Sweden; 2002 [in Swedish].

10.

Statistiska centralbyrån, SCB. Barn och deras familjer 2001. Demografiska rapporter 2003:1.2. [Statistics Sweden. Children and their Families 2001. Demographic reports 2003:1.2]. Örebro, Statistics Sweden; 2003 [in Swedish].

11.

Idler E.L. , Benyamini, Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav 1997;38:21—37.

12.

Manderbacka K. , et al. The effect of point of reference on the association between self-rated health and mortality. Soc Sci Med 2003;56:1447—52.

13.

Benyamini Y. , et al. Gender differences in processing information for making self-assessments of health. Psychosom Med 2000;62:354—64.

14.

Westin M. , et al. A large proportion of Swedish citizens refrain from seeking medical care — lack of confidence in the medical services a plausible explanation? Health Policy 2004;68:333—44.

15.

Haglund B. , Rosén M. The welfare wall is cracked: Low-educated people are not favoured by health services. Läkartidningen 1996;93:3672—3677 [in Swedish].

16.

Hjern A. , et al. Is there equity in access to health services for ethnic minorities in Sweden? Eur J Public Health 2001;11: 147—52.

17.

Elofsson S. , Undén A-L. , Krakau I. Patient charges — a hindrance to financially and psycho-socially disadvantage groups seeking care. Soc Sci Med 1998;46:1375—80.

18.

Burström B.

Increasing inequalities in health care utilisation across income groups in Sweden during the 1990s?

Health Policy 2002;62:117—29.

19.

Feinstein J.S. The relationship between socioeconomic status and health: a review of the literature. Milbank Q 1993;71:279—322.

20.

Hemingway H. , et al. The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: The Whitehall II study. Am J Public Health 1997;87: 1484—90.

21.

Iglesias E. , et al. Women, international migration and self-reported health. Soc Sci Med 2003;56:111—24.

22.

Sundquist J. , Johansson SE Long term illness among indigenous and foreign-born people in Sweden. Soc Sci Med 1997;44:189—98.

23.

Axén E. , Lindström M.

Ethnic differences in self-reported lack of access to a regular doctor: a population-based study. Ethn

Health 2002;7:195—207.

24.

Sundquist J. , Johansson SE Self reported poor health and low educational level predictors for mortality: A population based follow up study of 39,156 people in Sweden. J Epidemiol Community Health 1997;51:35—40.

25.

Hope S. , Power C. , Rodgers B.

Does financial hardship account for elevated psychological distress in lone mothers?

Soc Sci Med 1999;49:1637—49.

26.

Wyke S. , Ford G. Competing explanations for associations between marital status and health . Soc Sci Med 1992;34: 523—32.

27.

Hallqvist J. , et al. Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Soc Sci Med 1998;46: 1405—15.

28.

Lundberg O. The impact of childhood living conditions on illness and mortality in adulthood. Soc Sci Med 1993;36: 1047—52.

29.

Clark , et al. The influence of domestic position on health status. Soc Sci Med 1987;24:501—6.

30.

Al-Windi A. , et al. The influence of socio-demographic characteristics on well-being and symptoms in a Swedish community. Scand J Prim Health Care 1999;17: 201—9.