G Ringbäck Weitoft1, B Haglund, M Rosén. 1. Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden. gunilla.ringback@sos.se
Abstract
BACKGROUND: An increasing number of lone mothers are experiencing financial and health disadvantages. Our aim was to assess mortality among lone mothers compared with mothers with partners. METHODS: In this population-based study, overall and cause-specific mortality, between 1991 and 1995, was estimated for 90,111 lone mothers and 622,368 mothers with partners from data collected in the Swedish Population and Housing Census 1990. We estimated relative risks by Poisson regression, adjusted for socioeconomic status, and, to handle health-selection effects, we adjusted for previous inpatient history from 1987 to 1990. FINDINGS: Lone mothers showed an almost 70% higher premature risk of death than mothers with partners. The excess risk remained significantly increased (relative risk 1.2 [95% CI 1.1-1.4]) after adjustments for socioeconomic status and previous severe somatic and psychiatric inpatient history. Increased mortality was especially pronounced for suicides (2.2 [1.5-3.1]), violence (3.0 [0.9-10.6]), and alcohol-related mortality (2.4 [1.4-4.1]) among mothers who were without a partner in 1985 and in 1990. INTERPRETATION: The increase of lone mothers in society shows financial, social, and health disadvantages. Nevertheless, the increased mortality risk of lone mothers seems to be partly independent of socioeconomic status and health selection into lone motherhood. For long-term lone mothers the risks may be underestimated when adjusting for selection bias by taking hospital discharge history into account, since these events may be part of the consequences of the stress of lone motherhood.
BACKGROUND: An increasing number of lone mothers are experiencing financial and health disadvantages. Our aim was to assess mortality among lone mothers compared with mothers with partners. METHODS: In this population-based study, overall and cause-specific mortality, between 1991 and 1995, was estimated for 90,111 lone mothers and 622,368 mothers with partners from data collected in the Swedish Population and Housing Census 1990. We estimated relative risks by Poisson regression, adjusted for socioeconomic status, and, to handle health-selection effects, we adjusted for previous inpatient history from 1987 to 1990. FINDINGS: Lone mothers showed an almost 70% higher premature risk of death than mothers with partners. The excess risk remained significantly increased (relative risk 1.2 [95% CI 1.1-1.4]) after adjustments for socioeconomic status and previous severe somatic and psychiatric inpatient history. Increased mortality was especially pronounced for suicides (2.2 [1.5-3.1]), violence (3.0 [0.9-10.6]), and alcohol-related mortality (2.4 [1.4-4.1]) among mothers who were without a partner in 1985 and in 1990. INTERPRETATION: The increase of lone mothers in society shows financial, social, and health disadvantages. Nevertheless, the increased mortality risk of lone mothers seems to be partly independent of socioeconomic status and health selection into lone motherhood. For long-term lone mothers the risks may be underestimated when adjusting for selection bias by taking hospital discharge history into account, since these events may be part of the consequences of the stress of lone motherhood.
Authors: Lisa F Berkman; Yuhui Zheng; M Maria Glymour; Mauricio Avendano; Axel Börsch-Supan; Erika L Sabbath Journal: J Epidemiol Community Health Date: 2015-05-14 Impact factor: 3.710