Family Histories and Teen Pregnancy in the United States and Canada.

OBJECTIVE: This study took a long view of childhood experiences that can contribute to the risk of teen pregnancy in the U.S. and Canada, two countries with different norms and policies surrounding family life and inequality. BACKGROUND: Teenage pregnancy is a major life experience arising from life course trajectories unfolding over a young woman's childhood. Cross-national comparisons can elucidate family-based pathways while embedding youth within broader national contexts of the U.S. and Canada, which are similar in some respects yet different in others. METHOD: Longitudinal data from the U.S. NLSY79 Young Adult Survey (n = 3,122) and the Canadian NLSCY (n = 2,517) connected childhood histories to teenage pregnancy. Competing risk models estimated the risk of teenage pregnancy with family structure changes and episodes in poverty during childhood. RESULTS: Teenage pregnancy, family change, and poverty were more common in the U.S. In the U.S., only multiple experiences of instability and poverty were associated with greater risk of teenage pregnancy, but, in Canada, any experience of childhood disadvantage was associated with elevated risk. CONCLUSION: The risk of teen pregnancy was higher among both U.S. and Canadian adolescents from more unstable and economically insecure families, and that link between cumulative experiences of childhood disadvantage and adolescent pregnancy was stronger in Canada. IMPLICATIONS: Policies and interventions to reduce teen pregnancy must address childhood socioeconomic disadvantage.

I want to move, but cannot: characteristics of involuntary stayers and associations with health among Canadian seniors.

OBJECTIVES: The purpose of this study was to investigate characteristics of seniors in the Canadian population who are involuntary stayers and to assess associations with health. METHOD: Data come from the 1994 Canadian National Population Health Survey, with the sample restricted to those 65 and older (N = 2,551). RESULTS: Nearly 1 in 10 seniors identified as an involuntary stayer. Seniors with few socioeconomic resources, poor health, greater need for assistance, and low social involvement were more likely to identify as an involuntary stayer. Furthermore, seniors who were involuntary stayers report significantly more distress and greater odds of low self-rated health than other seniors. DISCUSSION: This study brings into visibility an understudied segment of the elderly population: seniors who are unable to move from their present location despite their desire to do so. Further research and policy responses assisting seniors to age in a setting of their own choosing are needed.

A life-course approach to studying transitions among Canadian seniors in couple-only households.

This study tracked the occurrence of death, widowhood, institutionalization, and coresidence with others between 1994 and 2002 for a nationally representative sample of 1,580 Canadian respondents who, at initial interview, were aged 55 and older and living in a couple-only household. Although the majority of seniors remained in a couple-only household throughout the duration of the survey, nearly one in four who experienced a first transition underwent one or more subsequent transitions. Age, economic resources, and health were significant predictors of a specific first transition and multiple transitions. More work is needed to understand the dynamics of the aging process.

Prevalence of methylphenidate use among Canadian children following parental divorce.

BACKGROUND: Evidence suggests that children living in single-parent or step-parent households are more likely than children in households with 2 biological parents to be prescribed methylphenidate. I conducted a study of prospective data to investigate parental divorce as a predictor of methylphenidate use. METHODS: I used data for children who participated in the National Longitudinal Survey of Children and Youth from 1994 to 2000. The sample was restricted to children who remained in the survey in 2000 and who, at initial interview, lived in a household with 2 biological parents (n = 4784). A generalized estimating equation model was used to compare the odds ratios of methylphenidate use among children whose parents obtained a divorce between 1994 and 2000 relative to children whose parents remained married during this period. RESULTS: Between 1994 and 2000, 633 children (13.2%) experienced the divorce of their parents. The proportion of children who received methylphenidate at any time between 1994 and 2000 was 3.3% among those whose parents remained married and 6.1% among those whose parents divorced during this period. After adjustment for age of the mother and sex and age of the child, I found that methylphenidate use was significantly higher among children whose parents subsequently divorced than among those whose parents remained married (odds ratio 1.82, 95% confidence interval 1.01-3.33). INTERPRETATION: The increased risk of children receiving a prescription for methylphenidate in the period following parental divorce raises questions about the causal links in this association. Future research is needed to replicate these findings and to investigate possible explanations.

Marital transitions and mental health: are there gender differences in the short-term effects of marital status change?

Although there has been evidence to suggest that women exhibit more vulnerability to psychological distress than men when they lose a spouse or remarry, knowledge about the process by which men and women adjust to marital change remains fragmentary. This is due in part to the length of time between observations in longitudinal studies on marital change, with the result that mental health status is typically assessed long after a marital status transition has occurred. The purpose of the current study is to test for gender differences in the short-term mental health effects of a marital status transition using three waves of data collected at two year intervals in a Canadian population health survey (N=11,155). Growth curve analyses confirm the mental health advantage of marriage and reveal that the short-term effects of moving into and out of marriage on psychological distress are similar for men and women. We discuss the implications of these findings for resolving competing explanations regarding psychological adjustment to marital change.

Household income histories and child mental health trajectories.

Although it is widely accepted that low household income is associated with worse child mental health, less is known about whether income histories, often differentiated into stable and dynamic components, also matter. Using longitudinal data from the Child Supplement of the National Longitudinal Study of Youth, comprising the repeated measures of children ages 4 to 14 from 1986 to 1998 inclusive, I estimate generalized linear mixed models to evaluate the influence of household income histories on child depression and antisocial behavior over time. Results indicate that, at initial interview, low household income is associated with higher levels of depression and antisocial behavior; subsequent improvements in household income reduce child mental health problems. Further, the effect of initial household income on the rate of change in child depression attenuates as children grow older, whereas for antisocial behavior the effect of initial household income becomes stronger over time. These findings highlight the importance of understanding the ways in which children are influenced by their families' income histories.

Age and the gender gap in distress.

Women report more psychological distress than men and recent evidence suggests that this gap increases with age. It has been argued that the widening differential in distress reflects the progressive and cumulative nature of women's disadvantaged work and family roles. Drawing on the cumulative disadvantage hypothesis and social stress theory, we test: (1) whether exposure to chronic stress accounts for an increasingly larger proportion of the gender effect on distress with age; and (2) whether women are increasingly more vulnerable to the effects of chronic stress on distress with age. Data are from the 1994 wave of the Canadian National Population Health Survey, a national probability sample of women and men aged 20 and older (N = 13,798). Exposure to long-term stress helps us understand gender differences in distress for those in their pre-retirement years. However, contrary to the cumulative disadvantage hypothesis, the model became increasingly less likely to explain such differences with age. Gendered vulnerability to long-term stress was not evident in the sample. The implications of these findings are discussed with particular reference to our ongoing efforts to understand health in the context of social structure and subjectivity.

The influence of work, household structure, and social, personal and material resources on gender differences in health: an analysis of the 1994 Canadian National Population Health Survey.

Data from the 1994 Canadian National Population Health Survey (NPHS) do not confirm the widespread assumption that women experience considerably more ill health than men. The patterns vary by condition and age and at many ages, the health of women and men is more similar than is often assumed. However, we should not minimize the gender differences that do exist and in this paper we focus on three health problems which are more common among women: distress, migraine and arthritis/rheumatism. We consider to what extent work, household structure and social, personal and material resources explain these gender differences in health. Analysis of the distributions of paid work conditions, household circumstances and resources reveal mostly minor differences by gender and differences in exposure to these circumstances contribute little to understanding gender differences in health. There is also little evidence that greater vulnerability is a generalized health response of women to paid and household circumstances. We find limited evidence that social, personal and material resources are involved in pathways linking work and home circumstances to health in ways that differ between the sexes. In conclusion, we consider some reasons for the lack of support for our explanatory model: the measures available in the NPHS data set which contains little information on the household itself; the difficulty of separating 'gender' from the social and material conditions of men's and women's lives; and changes in women's and men's roles which may have led to a narrowing of differences in health.

Chronic stress and the social patterning of women's health in Canada.

Existing research on the social patterning of women's health draws attention to the significance of social roles and socioeconomic position. Although we know a great deal about health differences according to the occupancy of these positions, we know a lot less about why such patterns exist. This paper addresses this gap by examining the pathways through which social structure is linked to health using data from a 1994 Canadian national probability sample of women, aged 25-64 years. We begin by charting differences in women's self-rated ill-health, distress, and reports of long-standing health conditions by socioeconomic position and social role occupation. We then assess the extent to which these patterns can be understood in relation to the chronic stress arising from these social locations. Socioeconomic position, assessed by housing tenure, education, and household income, was positively related to health. Employment enhanced women's health, as did being currently married and a mother living with children. The ongoing stressors that distinguish the experiences of various structural locations accounted for some of the health effects of social structure, particularly for socioeconomic position. However, chronic stress was largely irrelevant to the pathways linking social roles to health. In fact, employed women and parents living with children enjoyed better health despite their greater stress.