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Honkaniemi H, Katikireddi SV, Rostila M, Juárez SP. Psychiatric consequences of a father's leave policy by nativity: a quasi-experimental study in Sweden. J Epidemiol Community Health 2022; 76:367-373. [PMID: 34635548 PMCID: PMC8921563 DOI: 10.1136/jech-2021-217980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parental leave use has been found to promote maternal and child health, with limited evidence of mental health impacts on fathers. How these effects vary for minority populations with poorer mental health and lower leave uptake, such as migrants, remains under-investigated. This study assessed the effects of a Swedish policy to encourage fathers' leave, the 1995 Father's quota, on Swedish-born and migrant fathers' psychiatric hospitalisations. METHODS We conducted an interrupted time series analysis using Swedish total population register data for first-time fathers of children born before (1992-1994) and after (1995-1997) the reform (n=198 589). Swedish-born and migrant fathers' 3-year psychiatric hospitalisation rates were modelled using segmented negative binomial regression, adjusting for seasonality and autocorrelation, with stratified analyses by region of origin, duration of residence, and partners' nativity. RESULTS From immediately pre-reform to post-reform, the proportion of fathers using parental leave increased from 63.6% to 86.4% of native-born and 37.1% to 51.2% of migrants. Swedish-born fathers exhibited no changes in psychiatric hospitalisation rates post-reform, whereas migrants showed 36% decreased rates (incidence rate ratio (IRR) 0.64, 95% CI 0.47 to 0.86). Migrants from regions not predominantly consisting of Organisation for Economic Cooperation and Development countries (IRR 0.50, 95% CI 0.19 to 1.33), and those with migrant partners (IRR 0.23, 95% CI 0.14 to 0.38), experienced the greatest decreases in psychiatric hospitalisation rates. CONCLUSION The findings of this study suggest that policies oriented towards promoting father's use of parental leave may help to reduce native-migrant health inequalities, with broader benefits for family well-being and child development.
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Affiliation(s)
- Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | | | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Sol P Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Juárez SP, Honkaniemi H, Heshmati AF, Debiasi E, Dunlavy A, Hjern A, Rostila M, Mussino E, Katikireddi SV, Duvander AZ. Unintended health consequences of Swedish parental leave policy (ParLeHealth): protocol for a quasi-experimental study. BMJ Open 2021; 11:e049682. [PMID: 34108172 PMCID: PMC8191630 DOI: 10.1136/bmjopen-2021-049682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Sweden has long been praised for a generous parental leave policy oriented towards facilitating a gender-equitable approach to work and parenting. Yet certain aspects of Swedish parental leave could also be responsible for the maintenance of (or even the increase in) health inequalities. Using a 'Health in All Policies' lens, this research project aims to assess the unintended health consequences of various components of Sweden's parental leave policy, including eligibility for and uptake of earnings based benefits. METHODS AND ANALYSIS We will use individual-level data from multiple Swedish registers. Sociodemographic information, including parental leave use, will be retrieved from the total population register, Longitudinal Integration Database for Health Insurance and Labour Market Studies and Social Insurance Agency registers. Health information for parents and children will be retrieved from the patient, prescribed drug, cause of death, medical birth and children's health registers. We will evaluate parents' mental, mothers' reproductive and children's general health outcomes in relation to several policy reforms aiming to protect parental leave benefits in short birth spacing (the speed premium) and to promote father's uptake (the father's quota) and sharing of parental leave days (the double days reform). We will also examine effects of increases in basic parental leave benefit levels. Using quasi-experimental designs, we will compare health outcomes across these reforms and eligibility thresholds with interrupted time series, difference-in-difference and regression discontinuity approaches to reduce the risk of health selection and assess causality in the link between parental leave use and health. ETHICS AND DISSEMINATION This project has been granted all necessary ethical permissions from the Stockholm Regional Ethical Review Board (Dnr 2019-04913) for accessing and analysing deidentified data. The final outputs will primarily be disseminated as scientific articles published in open-access, high-impact peer-reviewed international journals, as well as press releases and policy briefs.
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Affiliation(s)
- Sol Pia Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Amy F Heshmati
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Enrico Debiasi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Andrea Dunlavy
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Anders Hjern
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Eleonora Mussino
- Stockholm University Demography Unit (SUDA), Stockholm University, Stockholm, Sweden
| | - Srinivasa Vittal Katikireddi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ann-Zofie Duvander
- Stockholm University Demography Unit (SUDA), Stockholm University, Stockholm, Sweden
- Department of Sociology, Mid University, Östersund, Sweden
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Social support, parental role competence and satisfaction among Chinese mothers and fathers in the early postpartum period: A cross-sectional study. Women Birth 2019; 33:e280-e285. [PMID: 31235276 DOI: 10.1016/j.wombi.2019.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/07/2019] [Accepted: 06/11/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND A sense of parental competence and satisfaction during the transition to parenthood can have a tremendous impact on the quality of parenting behaviors, with social support being an important facilitator. AIM To examine parental role competence and satisfaction of Chinese mothers and fathers in the early postpartum period with regard to social support. METHODS A cross-sectional study was conducted in a regional teaching hospital in Guangzhou, China. The study was conducted between June 5 and November 16, 2015. One hundred and eighty parental pairs at 6-8 weeks after birth completed the Parenting Sense of Competence Scale, Perceived Social Support Scale, and socio-demographic questionnaires. RESULTS Parental role competence and satisfaction of Chinese mothers and fathers were at a moderate level, affected each other and there were no significant differences between the mothers and the fathers. The Competence Scale scores had a significant positive correlation with social support. Multiple regression analysis revealed two variables that predicted maternal Competence Scale scores: maternal social support and the paternal Competence Scale scores. Paternal social support and maternal Competence Scale scores contributed significantly to paternal Competence Scale scores. CONCLUSION Parental role competence and satisfaction of mothers and fathers were at a moderate level and affected by the parenting partner. To improve parental role competence and satisfaction, health care professionals should develop strategies that impact the whole family and not just a single individual. Supportive parenting programs should be implemented for both mothers and fathers.
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King TL, Kavanagh A, Scovelle AJ, Milner A. Associations between gender equality and health: a systematic review. Health Promot Int 2018:5233434. [PMID: 30534989 DOI: 10.1093/yel/day093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This systematic review sought to evaluate the impact of gender equality on the health of both women and men in high-income countries. A range of health outcomes arose across the 48 studies included. Gender equality was measured in various ways, including employment characteristics, political representation, access to services, and with standard indicators (such as the Global Gender Gap Index and the Gender Empowerment Measure). The effects of gender equality varied depending on the health outcome examined, and the context in which gender equality was examined (i.e. employment or domestic domain). Overall, evidence suggests that greater gender equality has a mostly positive effect on the health of males and females. We found utility in the convergence model, which postulates that gender equality will be associated with a convergence in the health outcomes of men and women, but unless there is encouragement and support for men to assume more non-traditional roles, further health gains will be stymied.
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Affiliation(s)
- Tania L King
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anne Kavanagh
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anna J Scovelle
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
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D'Inverno AS, Reidy DE, Kearns MC. Preventing intimate partner violence through paid parental leave policies. Prev Med 2018; 114:18-23. [PMID: 29857023 PMCID: PMC6369689 DOI: 10.1016/j.ypmed.2018.05.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 11/25/2022]
Abstract
Paid parental leave policies have the potential to strengthen economic supports, reduce family discord, and provide opportunities to empower women (Basile et al., 2016; Niolon et al., 2017). In this article, we present a theory of change and evidence to suggest how paid parental leave may impact intimate partner violence (IPV). In doing so, we present three mechanisms of change (i.e., reduction in financial stress, increase in egalitarian parenting practices, and promotion of child/parent bonding) through which paid parental leave could reduce rates of IPV. We also describe limitations of the current state of knowledge in this area, as well as opportunities for future research. Ultimately, our goal is to facilitate the identification and implementation of approaches that have the potential to reduce violence at the population level. Paid parental leave embodies the potential of policies to change societal-level factors and serve as an important prevention strategy for IPV.
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Affiliation(s)
| | - Dennis E Reidy
- Centers for Disease Control and Prevention, Division of Violence Prevention, United States
| | - Megan C Kearns
- Centers for Disease Control and Prevention, Division of Violence Prevention, United States
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