Grandparental support and maternal depression: Do grandparents' characteristics matter more for separating mothers?

Grandparental support may protect mothers from depression, particularly mothers who separate and enter single parenthood. Using longitudinal Finnish register data on 116,917 separating and 371,703 non-separating mothers with young children, we examined differences in mothers' antidepressant purchases by grandparental characteristics related to provision of support. Grandparents' younger age (<70 years), employment, and lack of severe health problems predicted a lower probability of maternal depression. Depression was also less common if grandparents lived close to the mother and if the maternal grandparents' union was intact. Differences in maternal depression by grandparental characteristics were larger among separating than among non-separating mothers, particularly during the years before separation. Overall, maternal grandmothers' characteristics appeared to matter most, while the role of paternal grandparents was smaller. The findings suggest that grandparental characteristics associated with increased potential for providing support and decreased need of receiving support predict a lower likelihood of maternal depression, particularly among separating mothers.

Analyzing the Impact of Family Structure Changes on Children's Stress Levels Using a Stress Biomarker.

Changes in family structure (e.g., parental separation or stepfamily formation) are associated with a deterioration in children's well-being. Most researchers have focused on the impact of such changes on children's educational and psychosocial outcomes, whereas the effects on children's biological processes have been studied less often. We analyze the effects of changes in family structure on children's stress levels using data from the German Health Interview and Examination Survey for Children and Adolescents study (2003-2006 and 2014-2017). Our outcome variable is the biomarker c-reactive protein (CRP), which correlates with psychological distress and is collected from blood samples. Calculating first-difference estimators, we analyze whether children have higher CRP levels after changing to (1) single-parent families (n = 117) or (2) stepfamilies (n = 80). Our findings suggest that changing to a single-parent family significantly increases children's stress, whereas changing to a stepfamily does not. These observations are important because increased stress in childhood can negatively affect well-being later in life.

Maternal health, well-being, and employment transitions: A longitudinal comparison of partnered and single mothers in Germany.

Balancing parenthood and employment can be challenging and distressing, particularly for single mothers. At the same time, transitioning to employment can improve the financial situations of single mothers and provide them with access to social networks, which can have beneficial effects on their health and well-being. Currently, however, it is not well understood whether the overall impact of employment on single mothers is positive or negative, and to what extent it differs from the impact of employment on partnered mothers. Building on the literature on work-family conflict, we investigate the differential effects of employment transitions on the health and well-being of single mothers and partnered mothers. Using longitudinal data from the German Socio-Economic Panel (1992-2016), we apply panel regression techniques that address the potential endogeneity of maternal employment, as well as the dynamic nature of the relationship between employment transitions and maternal health and well-being. We find that employment has a positive impact on single mothers, and that single mothers benefit from employment significantly more than partnered mothers. Surprisingly, income does not appear to be an important driver of these results. Overall, our findings suggest that employment plays a key role in the well-being of single mothers.

Does parental separation moderate the heritability of health risk behavior among adolescents?

Social influences on adolescents' health risk behavior are well documented, but little is known about the interaction of parental separation with genetic sensitivities. Using data from a German sample of 1762 twins, this study examines whether family living arrangements moderate the influence of genetic predispositions on health risk behavior. Derived from variance decomposition moderator models, three key findings emerge. Firstly, genetic contributions to drug use are significantly higher in single-mother families, indicating an amplified heritability potentially resulting from triggered genetic sensitivities or challenges in preventing genetic risks from unfolding. Secondly, unique environmental factors have a greater impact on drug use in single-mother families. Lastly, no heritability differences are found in smoking and excessive alcohol consumption between family types. These findings provide novel evidence of increased importance of genetic influences on drug use in single-mother families, shedding light on gene-environment interactions, and informing policy interventions that support vulnerable family arrangements.

Pathways into single motherhood, re-partnering, and trajectories of antidepressant medication purchases.

Single motherhood is known to be distressing, and to be associated with poor mental health. However, less is known about the pathways into and out of single motherhood, or about the mental health trajectories of single mothers. We used total population registry data on Finnish women who experienced the life events of separation (616,762), widowhood (43,355), or child birth (515,756) during the 1995-2018 period while between the ages of 15-64. Single mothers were compared with women who experienced the same life event, but without becoming a single mother. The results for women who separated showed that among single mothers, there was a substantial increase in antidepressant use at the time of separation, and only a moderate decline after separation. Among women who experienced widowhood, those who had underage children initially had lower antidepressant use than women without children, but this gap narrowed in the post-widowhood period. In addition, single women experienced more unfavorable mental health trajectories than partnered women around the time they gave birth. Re-partnering was associated with more favorable mental health among all groups of single mothers. Given the growing prevalence of single-parent households, our results underscore the need for context-specific interventions to support single mothers' mental health.

Mental Health before and during the COVID-19 Pandemic: The Role of Partnership and Parenthood Status in Growing Disparities between Types of Families.

This study investigates mental health inequalities by family type and gender during the COVID-19 pandemic in Germany. Using data from the German Family Panel, we compared three dimensions of mental health (i.e., self-reported stress, exhaustion, and loneliness) one year before the pandemic and in spring 2020. First, two-parent families emerged as a vulnerable group, as the levels of stress and exhaustion they reported during the pandemic converged with those experienced by single parents. Second, a gender gap emerged during this global health crisis, with women, and particularly mothers, reporting significantly worse mental health compared to men in the same family type. Our findings underline the substantive value of studying mental health inequality from a multidimensional perspective and over time. Based on these findings, we urge policy makers to consider more seriously the disproportionate burdens that families, and women in particular, have been carrying due to the pandemic both directly and indirectly.

Gender differences in health in Havana versus in Mexico City and in the US Hispanic population.

Health progress in the 1960s and 1970s placed Cuba at the vanguard of longevity in Latin America and the Caribbean. This success has often been attributed to equity of access to the health care system and its cost-effectiveness in the country. Cuba also has a small gender gap in life expectancy. In this study, we examined how this pattern is reflected in the gender differences in health among the population aged 60+ in Havana. We compared gender differences in health in samples drawn from Havana, Mexico City, and the US Hispanic population: three geographic settings with very different political, health care, and social systems. The data come from the Survey on Health, Well-Being, and Aging in Latin America and the Caribbean and the 2000 Health and Retirement Study. Age-adjusted prevalence and logistic regressions were estimated for poor self-rated health, limitations on activities of daily living, depression, and mobility limitations. While an absolute female disadvantage in health was apparent in all three populations, the relative gender differences were inconsistent across all four health domains. Gender differences were most pronounced in Havana, even after adjusting for age, socio-economic status, family characteristics, and smoking behaviour. Despite having higher overall life expectancy and more equitable and universal access to primary care and preventive medicine, women in Havana appear to have a larger burden of ill health than women in less equitable societies. The study provides indirect evidence that Cuba faces challenges in combating the health threats posed by chronic diseases and other diseases and conditions common among the population aged 60+.

Immigration Background and the Widowhood Effect on Mortality.

OBJECTIVES: Widowhood is a stressful life event with one of the most profound negative effects on health and longevity. Immigrant populations are growing and aging throughout Western nations, and marginalization and cultural differences may make some immigrants especially vulnerable to the stressors of widowhood. However, studies have yet to systematically explore whether the widowhood effect differs between immigrant and native-born individuals. METHODS: Using Danish population register data from 1980 to 2014, this study assesses whether the relationship between widowhood and mortality differs between immigrants from 10 countries and native-born Danes aged 50 and older at 0-2, 3-5, and 6 and more years post-widowhood. RESULTS: We find that immigrant men are at higher risk of dying in the first 2 years after experiencing widowhood than Danish-born men, but these mortality differences dissipate over longer periods. Immigrant women have a higher risk of having died 3 and more years after a spouse's death than Danish women. Patterns vary further by country of origin. DISCUSSION: The results suggest that some immigrants may suffer more from widowhood than native-born individuals, giving insight into how immigration background may influence the health effects of negative life events. They also underscore the potential vulnerabilities of aging immigrant populations to stressors encountered in older age.

Stillbirths in Germany: On the rise, but no additional increases during the first COVID-19 lockdown.

OBJECTIVE: To examine possible changes in the rate of stillbirths in Germany during the first COVID-19 lockdown. METHODS: Population-level data of live births and stillbirths occurring between January 1995 and July 2020 were used and negative binomial regression was applied to estimate the rate of stillbirths in this period. The actual rate was compared to the expected figure for 2020. RESULTS: A steady increase in stillbirths was detected in Germany since 2013. The stillbirth rate for January to July 2020 (4.148) was slightly lower than that of the same period in 2019 (4.242). Furthermore, all monthly rates of stillbirths during the first half of 2020 lie inside the 95% prediction interval of expected stillbirth rates for this period. CONCLUSION: A growing body of studies on the indirect effect of the COVID-19 pandemic on stillbirths shows mixed and context-dependent evidence. In contrast to other European countries, stillbirth rates have been on the rise in Germany in the last decade. However, stillbirth rates during the first half of 2020 were not higher than expected. The results suggest that stillbirth rates have not changed during the first-wave COVID-19 lockdown in this high-income setting. However, further studies on the causes of the increasing trend in stillbirths in Germany are needed.

Trends in gender differences in health at working ages among West and East Germans.

Before 1990, Germany was divided for more than 40 years. While divided, significant mortality disparities between the populations of East and West Germany emerged. In the years following reunification, East German mortality improved considerably, eventually converging with West German levels. In this study, we explore changes in the gender differences in health at ages 20-59 across the eastern and western regions of Germany using data from the German Socio-Economic Panel (SOEP) for the 1990-2013 period. We apply random-effects linear regressions to the SOEP data to identify trends in health, measured as self-assessed health satisfaction, after German reunification. The findings indicate that women were substantially less satisfied with their health than men in both West and East Germany, but that the gender gap was larger in East Germany than in West Germany. Furthermore, the results show that respondents' satisfaction with their health decreased over time, and that the decline was steeper among men - and particularly among East German men - than among women. Thus, the initial male advantage in health in East and West Germany in the years immediately after reunification diminished over time, and even reversed to become a female advantage in East Germany. One interpretation of this finding is that stress-inducing post-reunification changes in the political and social landscape of East Germany had lasting damaging consequences for men's health. Ongoing risky health behaviors and high levels of economic insecurity due to unemployment could have had long-lasting effects on the health of the working-aged population. A partial explanation for our finding that health declined more sharply among East German men than among their female counterparts could be that women have better compensatory mechanisms than men for dealing with psychosocial stress.