Fritzell Sara, Burström Bo
Department of Public Health Sciences, Division of Social Medicine, Norrbacka, 171 76 Stockholm, Sweden.
Health Policy. 2006 Dec;79(2-3):253-64. doi: 10.1016/j.healthpol.2006.01.004. Epub 2006 Feb 13.
Changes on the labour market and in Swedish welfare policy during the 1990s may have affected lone mothers. This study analysed economic strain and self-rated health (SRH) among lone and couple mothers in Sweden in the 1980s and the 1990s.
22,308, mothers, 19,122 couple and 3186 lone mothers, who responded to the Swedish Survey of Living Conditions in the years 1979-1998.
Exposure for economic strain was defined as having had difficulties to make ends meet in the last year, the outcome measure was less than good SRH. Prevalence rates were calculated and logistic regression analysis was used in the analysis. Adjustments were made for type of mother, age, time period, socio-economic group, income, born in Sweden/foreign born and employment.
Prevalence rates of economic strain and less than good SRH increased during the 1990s compared to the 1980s among lone and couple mothers. A polarisation in SRH was noted among lone mothers, with worsening health in poorer groups and improved health among better off groups. Economic strain had a substantial explanatory value for the excess risk of less than good SRH throughout the period studied. The association between economic strain and SRH did not change between lone and couple mothers between the 1980s and the 1990s or in different income groups.
The increased prevalence of less than good SRH among sub-groups of lone mothers may in part be due to an increase of financial problems among these groups in Sweden. Economic strain was an important explanatory factor.
20世纪90年代劳动力市场和瑞典福利政策的变化可能对单身母亲产生了影响。本研究分析了20世纪80年代和90年代瑞典单身母亲和已婚母亲的经济压力和自评健康状况(SRH)。
22308名母亲,其中19122名已婚母亲和3186名单身母亲,她们对1979 - 1998年瑞典生活条件调查做出了回应。
经济压力暴露被定义为在过去一年中难以维持收支平衡,结果指标为SRH状况不佳。计算患病率并在分析中使用逻辑回归分析。对母亲类型、年龄、时间段、社会经济群体、收入、在瑞典出生/外国出生以及就业情况进行了调整。
与20世纪80年代相比,20世纪90年代单身母亲和已婚母亲中经济压力和SRH状况不佳的患病率有所上升。在单身母亲中发现了SRH的两极分化,较贫困群体的健康状况恶化,较富裕群体的健康状况改善。在整个研究期间,经济压力对SRH状况不佳的额外风险具有很大的解释价值。20世纪80年代至90年代,单身母亲和已婚母亲之间以及不同收入群体中,经济压力与SRH之间的关联没有变化。
单身母亲亚组中SRH状况不佳的患病率增加,部分原因可能是瑞典这些群体中财务问题的增加。经济压力是一个重要的解释因素。