This randomized controlled trial was designed to evaluate the 2-year costs and effects of a proactive, public health nursing case management approach compared with a self-directed approach for 129 single parents (98% were mothers) on social assistance in a Canadian setting. A total of 43% of these parents had a major depressive disorder and 38% had two or three other health conditions at baseline.
Study participants were recruited over a 12 month period and randomized into two groups: one receiving proactive public health nursing and one which did not.
At 2 years, 69 single parents with 123 children receiving proactive public health nursing (compared with 60 parents with 91 children who did not receive public health nursing services) showed a slightly greater reduction in dysthymia and slightly higher social adjustment. There was no difference between the public health and control groups in total per parent annual cost of health and support services. However, costs were averted due to a 12% difference in non-use of social assistance in the previous 12 months for parents in the public health nursing group. This translates into an annual cost saving of 240,000 dollars (Canadian) of costs averted within 1 year for every 100 parents.
In the context of a system of national health and social insurance, this study supports the fact that it is no more costly to proactively service this population of parents on social assistance.
While a number of studies have documented higher period prevalence rates of depression among single as compared to married mothers, all of the data have been based upon community surveys of mental illness. In Canada, all of the published work comes from Ontario. As a result, we do not know whether these results hold true for other regions of the country. Using a nationally representative sample, we find, consistent with previous work, that single mothers have almost double the 12-month prevalence rates of married mothers (15.4% versus 6.8%). As well, there are no significant differences in rates of depression between single and married mothers by region/province of the country. Our findings are compared with other epidemiologic data on the mental health of single mothers from Ontario.
This article explores the possible relationships between allostatic load (AL) and stress-related health issues in the low-income single-parent population, using both a population health perspective (PHP) and a biological framework. A PHP identifies associations among such factors as gender, income, employment, and social support and their potential effect on health outcomes. A PHP also recognizes physiological and pathological manifestations of the body such as stress (mental or somatic) and individual biological parameters (for example, glucose levels) as health determinants. AL uses an aggregate score of individual biological parameters as a health measure that is exacerbated through repetitive movement of physiologic systems under stress. The social work profession should incorporate knowledge of both PHP and AL into its theory and practice domains for effective care of vulnerable populations such as single-parent families.
To investigate those ante- and perinatal circumstances preceding suicide attempts and suicides, which have so far not been studied intensively.
Examination of the Northern Finland Birth Cohort 1966 (n = 10,742), originally based on antenatal questionnaire data and now followed up from mid-pregnancy to age 39, to ascertain psychiatric disorders in the parents and offspring and suicides or attempted suicides in the offspring using nationwide registers.
A total of 121 suicide attempts (57 males) and 69 suicides (56 males) had occurred. Previously unstudied antenatal factors (maternal depressed mood and smoking, unwanted pregnancy) were not related to these after adjustment. Psychiatric disorders in the parents and offspring were the risk factors in both genders. When adjusted for these, the statistically significant risk factors among males were a single-parent family for suicide attempts (OR 3.71, 95% CI 1.62-8.50) and grand multiparity for suicides (OR 2.67, 95% CI 1.15-6.18). When a psychiatric disorder in females was included among possible risk factors for suicide attempts, it alone remained significant (OR 15.55, 8.78-27.53).
A single-parent family was a risk factor for attempted suicides and grand multiparity for suicides in male offspring even after adjusting for other ante- and perinatal circumstances and mental disorders in the parents and offspring. Mothers' antenatal depressed mood and smoking and unwanted pregnancy did not increase the risk of suicide, which is a novel finding.
OBJECTIVE: The aim was to study whether early weaning from breastfeeding may be associated with increased risk of schizophrenia. METHOD: The current sample comprises 6841 individuals from the Copenhagen Perinatal Cohort of whom 1671 (24%) had been breastfed for 2 weeks or less (early weaning) and 5170 (76%) had been breastfed longer. Maternal schizophrenia, parental social status, single mother status and gender were included as covariates in a multiple regression analysis of the effect of early weaning on the risk of hospitalization with schizophrenia. RESULTS: The sample comprised 93 cases of schizophrenia (1.4%). Maternal schizophrenia was the strongest risk factor and a significant association between single mother status and elevated offspring risk of schizophrenia was also observed. Early weaning was significantly related to later schizophrenia in both unadjusted and adjusted analyses (adjusted odds ratio 1.73 with 95% CI: 1.13-2.67). CONCLUSION: No or
This study explored how single working mothers perceive and deal with concerns about their children's health. "Grounded theory" analysis of data from interviews with single mothers in a wide variety of circumstances suggested that contextual factors including the mother's work situation, child care and social network are important to understanding the health and illness behaviour of these families. Children's use of health services appeared to reflect the single mother's attempts to manage her roles as mother (nurturer) and worker (provider), and her sense of role flexibility. A sense of flexibility appeared to mitigate role conflict and to interact with other known influences of health services utilization including the quality of the client/practitioner relationship. The mother's sense of flexibility appeared to vary with her income, child care arrangement, work situation (e.g., emphathetic supervisor), access to tangible support (e.g., child care) and social network (i.e., proximity to her family of origin).
Children from single-mother families are at increased risk of psychosocial morbidity. This article examines the strength of association between single-mother family status and child outcome, both alone and controlling for other sociodemographic and personal (maternal/family) variables.
Data from the Canadian National Longitudinal Survey of Children and Youth Cycle 1 (1994-1995) were used. Children aged 6 to 11 years in single-mother and two-parent families were included (n = 9,398). Child functioning measures included social impairment, psychiatric problems, and math score.
Single-mother family status on its own is a significant predictor of all child difficulties, but the explained variance is limited and the effect size decreases when other variables known to influence child functioning are included. Household income, a sociodemographic variable, is inversely associated with social impairment and positively associated with math score. Hostile parenting and maternal depression are the personal variables most strongly associated with social impairment and psychiatric problems. Children in single-mother families where there is hostile parenting are at significantly increased risk of psychiatric problems.
The results suggest that children from single-mother families develop difficulties for the same reasons as children from two-parent families. Specific interventions for single-mother families may be warranted in the areas of parenting and other areas of concentrated risk.
Collective kitchens represent a relatively new social and community practice in the province of Quebec. They provide support that goes far beyond the food they supply, affecting the participants' life conditions and personal development. This qualitative study aimed to evaluate the effects that collective kitchens have on participants. We carried out semistructured interviews with a stratified sample of 25 people between the ages of 20 and 60, a majority of whom were single parents. These 20 women and 5 men were involved in 13 different groups for an average of 1 to 2 years. The results showed that the main reasons for participating in these groups were economic, nutritional, and psychosocial in nature. Prominent among the psychosocial reasons was a desire to overcome a feeling of isolation, which a majority of respondents perceived as one of the most disturbing features of their lives before they were involved in the collective kitchens. We identified 3 types of factors that influence the effects of the respondents' participation in collective kitchens: (a) factors related to the internal dynamics of each collective kitchen (their modes of functioning and organizational structure), (b) factors related to the personal situation of the participants and (c) factors related to the use of other services or to the participants' social involvement. The various effects differ not only in character (psychosocial, economic, nutritional, etc.) but also in the time they appeared in the participation process and in their direct or indirect links with participation in collective kitchens. It would be interesting in future research to evaluate whether the benefits of participation in collective kitchens identified in this study have a long-term impact on the lives of the people in these groups.
Parental depression was assessed using the Beck Depression Inventory (BDI) in 216 families with children with autism and/or intellectual disability (ID), and in 214 control families. Mothers with children with autism had higher depression scores (mean = 11.8) than mothers of children with ID without autism (mean = 9.2), who in turn, had higher depression scores than fathers of children with autism (mean = 6.2), fathers of children with ID without autism (mean = 5.0), and control mothers (mean = 5.0) and fathers (mean = 4.1). Forty-five per cent of mothers with children with ID without autism and 50% of mothers with children with autism had elevated depression scores (BDI > 9), compared to 15-21% in the other groups. Single mothers of children with disabilities were found to be more vulnerable to severe depression than mothers living with a partner.
The prevalence of teenage smoking in a cohort of 12,058 subjects born in northern Finland in 1966 is discussed in terms of its social and family determinants, especially in "non-standard" families (with one or more of the parents absent for at least part of the child's upbringing). The prevalence of experimental or daily smoking was 67.4%, the rate being 65.5% in the standard, two-parent families and 75.5% in the non-standard families, the difference being statistically significant (p less than 0.001). The corresponding prevalence of daily smoking was 6.4%, but the rate was 5.1% in standard families and 12.1% in non-standard families (p less than 0.001). An elevated risk of smoking existed among adolescents who had experienced death of their father or divorce of their parents and among girls who had experienced death of their mother. Maternal smoking during pregnancy and maternal age under 20 years at the time of delivery increased the risk, while being the first-born child reduced it. Among family factors existing in 1980, paternal smoking increased the risk for both sexes, while more than three siblings, mother's unemployment or gainful employment (i.e. not a housewife) were associated with smoking by the boys as was urban living, and for the girls migration by the family to a town. The results suggest that juvenile smoking may be a kind of indicator of possible problems experienced by the parents and/or the adolescents themselves with respect to parenthood and family development.