Health and Union Dissolution among Parenting Couples: Differences by Gender and Marital Status

Neurological conditions and subsequent divorce risk in the Nordic countries: the importance of gender and both spouses' education

BACKGROUND

Prior studies suggest that poor physical health, accompanied by functional disability, is associated with increased divorce risk. However, this association may depend on gender, the socioeconomic resources of the couple, as well as the social policy and social (in)equality context in which the illness is experienced. This study focuses on neurological conditions, which often have substantial functional consequences.

METHODS

We used longitudinal population-wide register data from the years 2007-2016 (Denmark, Sweden) or 2008-2017 (Finland, Norway) to follow 2 809 209 married couples aged 30-64 for neurological conditions, identified using information on specialised healthcare for diseases of the nervous system and subsequent divorce. Cox regression models were estimated in each country, and meta-analysis used to calculate across-country estimates.

RESULTS

During the 10-year follow-up period, 22.2% of couples experienced neurological conditions and 12.0% of marriages ended in divorce. In all countries, divorce risk was elevated among couples where at least one spouse had a neurological condition, and especially so if both spouses were ill. The divorce risk was either larger or similar for husband's illness, compared with wife's illness, in all educational categories. For the countries pooled, the weighted average HR was 1.21 (95% CI 1.20 to 1.23) for wives' illness, 1.27 (95% CI 1.25 to 1.29) for husbands' illness and 1.38 (95% CI 1.34 to 1.42) for couples where both spouses were ill.

CONCLUSIONS

Despite some variation by educational resources and country context, the results suggest that the social consequences of illness are noticeable even in Nordic welfare states, with the husband's illness being at least as important as the wife's.

Partnership status and positive DNA methylation age acceleration across the adult lifespan in the UK

Although a significant body of research has shown that married people are healthier and live longer, empirical research on sex differences in the link between marital status and health suggests results are mixed. Moreover, the sex disparities in marital status and health relationships vary across adulthood. The literature on partnership status and measures of ageing is largely focused on older age groups and is limited in its view of early adulthood. Data from waves 2 and 3 (2010-2012) of Understanding Society: UKHLS were used to examine the association of current partnership status with epigenetic age acceleration (AA) assessed with DNA methylation (DNAm) algorithms 'Phenoage' and ' DunedinPACE ' in 3492 participants (aged 16-97). Regression models were estimated separately for men and women, and further stratified by age groups. Divorced/separated and widowed people showed positive age acceleration compared to the married/cohabiting people (reference group). Some sex differences were apparent, especially, among the single and divorced/separated groups. Age differences were also apparent, for example in men, being single was negatively associated with DNAmAA in the youngest group, but positively in the oldest group compared to partnered counterparts. These findings illustrate the importance of partnerships on the ageing process, in particular marital change through divorce and widowhood for positive age acceleration in adults. For single groups, observations were heterogenous by age and sex.

Health, Suicidal Thoughts, and the Life Course: How Worsening Health Emerges as a Determinant of Suicide Ideation in Early Adulthood

Poor physical health places adults at greater risk for suicide ideation. However, the linkage between health and suicidal thoughts may emerge and become established during early adulthood, concomitant with other social processes underlying suicidality. Using nationally representative survey data from Waves III through V of the National Longitudinal Study of Adolescent to Adult Health (n = 8,331), we examine the emergence of health as a predictor of suicide ideation across the early adult life course (ages 18-43). We find that worsening health does not significantly predict suicide ideation until young adults approach the transition into midlife. Our findings suggest this may be due to the increasing severity of health problems, reduced social network engagement, and disruption of social responsibilities later in early adulthood. Our findings underscore the need for social science research to examine the relationship between mental and physical health from a life course perspective.

Does social isolation affect physical and mental health? A test of the social causation hypothesis using dynamic panel models with fixed effects

OBJECTIVES

The widely acknowledged negative association between social isolation and physical and mental health is commonly interpreted in terms of social causation and has served as an important frame of reference for many interventions. However, evidence of social causation is likely biased because most studies cannot differentiate between social causation and health selection. The public attention given to this field of research indicates a need for analytical strategies that improve the understanding of the underlying link between social isolation and physical and mental health.

METHODS

Using data from the German Socio-Economic Panel (GSOEP) study (2004 to 2012) of 6740 men and 7189 women aged 50 and above, we estimated dynamic panel models with fixed effects that allow us to probe the social causation hypothesis while accounting for direct selection (reverse causality) and indirect selection (unobserved heterogeneity). All analyses were conducted for women and men separately.

RESULTS

We found that social isolation adversely affected mental health among older men and women to a degree that suggests practical relevance. However, we could not find a similar effect on physical health. A considerable part of the association between social isolation and both health outcomes was attributable to indirect selection, whereas direct selection led to underestimating the relevance of social isolation for mental health.

CONCLUSION

The results provide more convincing evidence that social isolation has adverse effects on mental health among older people. We conclude that effective interventions targeting social isolation might indeed be suitable for improving mental health among older people.

Evaluation of an Online Gottman's Psychoeducational Intervention to Improve Marital Communication among Iranian Couples

Amounting evidence indicates that insufficient knowledge of marital communication skills leads to destructive interactions and poor marital adjustments in couples, especially during stressful situations. Despite the high effectiveness of Gottman’s psychoeducational intervention, there is a lack of study on the online Gottman’s psychoeducation intervention (O-GPI) to improve marital communication and dyadic adjustments. The aim of this study was to evaluate the effectiveness of O-GPI on the improvement of marital communication patterns among Iranian couples. Method: The study followed a single-blind parallel group in a randomized controlled trial using an experimental longitudinal design, comprising 72 heterosexual couples living in Shiraz, Iran, with a 1–7-year marital age and no severe marital problems. The experimental group received eight consecutive O-GPIs via the Zoom platform, while the control group received information related to parenting skills via email. The outcome measures were the three patterns of communication: (i) constructive communication; (ii) demand–withdraw communication; and (iii) mutual avoidance communication—the screening measure was the dyadic adjustment scale. Results: The findings indicated that O-GPI could improve couples’ constructive communication significantly (45% for husbands and 40% wives) and decrease their total demand–withdrawal (51% for husbands and 65% wives) and mutual avoidance communication (60% for husbands and 62% wives). Limitations: Due to the homogenous nature of the sample, generalizations should be made with caution. Conclusions: This study demonstrates the feasibility and effectiveness of the online Gottman’s psychoeducational intervention to improve couples’ communication patterns.

Parenting in poor health: Examining associations between parental health, prescription drug use, and child maltreatment

RATIONALE

Child maltreatment and problematic parenting are related to negative outcomes for children. Poor parental health could be a risk factor for problematic parenting through several mechanisms: 1) inadequate emotional regulation and coping; 2) impairment of parental capacity; and, 3) impairment of the parent-child relationship.

OBJECTIVE

This study examines relationships between self-rated parental health, prescription drug use, and a broad array of negative parenting outcomes.

METHODS

A sample of general population parents of children aged ten and younger was recruited from 30 mid-sized cities in California (n = 681). Weighted mixed-effects negative binomial and logistic regression models were used to examine associations between poor parental health, prescription drug use and child maltreatment (physical abuse, supervisory neglect, and physical neglect), and problematic parenting (psychological aggression and corporal punishment).

RESULTS

Parents in poor health used physical abuse, corporal punishment, and psychological aggression more frequently and had higher odds of supervisory neglect. Parents who were taking more prescription medications had higher odds of physical neglect. Exploratory analyses suggested that prescriptions for certain medical conditions both increased and decreased the risk of problematic parenting.

CONCLUSIONS

Poor health and prescription drug use are not uncommon and present largely under-recognized risk factors for a spectrum of adverse parenting outcomes. Our study provides additional evidence that parents in poor health are at heightened risk of negative parenting, and need targeted intervention supports to support family well-being.

Chronic conditions, couple-level factors and union dissolution

This paper examines the association between chronic illness and union dissolution by examining rich, longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Using competing-risks discrete-time event-history models on longitudinal, dyadic data, we find the risk of union dissolution to be approximately 40 percent higher when either partner reports an illness than in the absence of an illness. We then examine whether the observed associations are mediated by variations in paid work, housework, financial stress and time stress. Financial stress is the factor that contributes most to the indirect associations between dissolution and partner's health condition, but overall these factors account for only 18.5 percent of the association between chronic illness and relationship dissolution. Our results provide further insight into the factors undermining relationship stability and highlight the importance of reducing financial stress associated with chronic illness.

Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study

INTRODUCTION

Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality.

AIM

The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups.

METHODS

We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used.

RESULTS

The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C.

RELEVANCE TO CLINICAL PRACTICE

In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.