a Institute of Health and Welfare Policy and Research Center for Health and Welfare Policy, College of Medicine, National Yang-Ming University , Taipei , Taiwan.
Soc Work Public Health. 2014;29(1):42-53. doi: 10.1080/19371918.2011.619465.
Although a large body of literature exists on how different types of child care arrangements affect a child's subsequent health and sociocognitive development, little is known about the relationship between birth health and subsequent decisions regarding type of nonparental child care as well as how this relationship might be influenced by maternal employment. This study used data from the Los Angeles Families and Neighborhoods Survey (L.A.FANS). Mothers of 864 children (ages 0-5) provided information regarding birth weight, maternal evaluation of a child's birth health, child's current health, maternal employment, type of child care arrangement chosen, and a variety of socioeconomic variables. Child care options included parental care, relative care, nonrelative care, and daycare center. Multivariate analyses found that birth weight and subjective rating of birth health had similar effects on child care arrangement. After controlling for a child's age and current health condition, multinomial logit analyses found that mothers with children with poorer birth health are more likely to use nonrelative and daycare centers than parental care when compared to mothers with children with better birth health. The magnitude of these relationships diminished when adjusting for maternal employment. Working mothers were significantly more likely to use nonparental child care than nonemployed mothers. Results suggest that a child's health early in life is significantly but indirectly related to subsequent decisions regarding child care arrangements, and this association is influenced by maternal employment. Development of social policy aimed at improving child care service should take maternal and family backgrounds into consideration.
尽管有大量文献探讨了不同类型的儿童保育安排如何影响儿童随后的健康和社会认知发展，但对于出生健康与随后选择非父母照顾儿童的类型之间的关系以及这种关系如何受到母亲就业的影响知之甚少。本研究使用了洛杉矶家庭和社区调查（L.A.FANS）的数据。864 名儿童（0-5 岁）的母亲提供了有关出生体重、母亲对孩子出生健康的评估、孩子目前的健康状况、母亲就业状况、选择的儿童保育安排类型以及各种社会经济变量的信息。儿童保育选择包括父母照顾、亲戚照顾、非亲戚照顾和日托中心。多变量分析发现，出生体重和主观出生健康评估对儿童保育安排有相似的影响。在控制孩子的年龄和当前健康状况后，多项逻辑回归分析发现，与出生健康状况较好的孩子的母亲相比，出生健康状况较差的孩子的母亲更有可能使用非亲属和日托中心，而不是父母照顾。当调整母亲就业状况时，这些关系的幅度减小。与未就业母亲相比，就业母亲更有可能使用非父母照顾的儿童保育。研究结果表明，儿童生命早期的健康状况与其随后选择儿童保育安排的决策显著相关，但这种关联受到母亲就业的影响。制定旨在改善儿童保育服务的社会政策时，应考虑到母亲和家庭背景。
