Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
J Epidemiol Community Health. 2022 Apr;76(4):367-373. doi: 10.1136/jech-2021-217980. Epub 2021 Oct 11.
Parental leave use has been found to promote maternal and child health, with limited evidence of mental health impacts on fathers. How these effects vary for minority populations with poorer mental health and lower leave uptake, such as migrants, remains under-investigated. This study assessed the effects of a Swedish policy to encourage fathers' leave, the 1995 , on Swedish-born and migrant fathers' psychiatric hospitalisations.
We conducted an interrupted time series analysis using Swedish total population register data for first-time fathers of children born before (1992-1994) and after (1995-1997) the reform (n=198 589). Swedish-born and migrant fathers' 3-year psychiatric hospitalisation rates were modelled using segmented negative binomial regression, adjusting for seasonality and autocorrelation, with stratified analyses by region of origin, duration of residence, and partners' nativity.
From immediately pre-reform to post-reform, the proportion of fathers using parental leave increased from 63.6% to 86.4% of native-born and 37.1% to 51.2% of migrants. Swedish-born fathers exhibited no changes in psychiatric hospitalisation rates post-reform, whereas migrants showed 36% decreased rates (incidence rate ratio (IRR) 0.64, 95% CI 0.47 to 0.86). Migrants from regions not predominantly consisting of Organisation for Economic Cooperation and Development countries (IRR 0.50, 95% CI 0.19 to 1.33), and those with migrant partners (IRR 0.23, 95% CI 0.14 to 0.38), experienced the greatest decreases in psychiatric hospitalisation rates.
The findings of this study suggest that policies oriented towards promoting father's use of parental leave may help to reduce native-migrant health inequalities, with broader benefits for family well-being and child development.
已有研究发现，父母产假的使用有利于母婴健康，但对父亲心理健康的影响证据有限。对于心理健康状况较差、产假利用率较低的少数群体（如移民），这些影响因何而异，目前研究还不够充分。本研究评估了瑞典鼓励父亲休产假的政策（1995 年）对瑞典出生和移民父亲精神科住院治疗的影响。
我们利用瑞典总人口登记数据，对 1992-1994 年和 1995-1997 年期间生育第一胎的瑞典出生和移民父亲进行了一项中断时间序列分析（n=198589）。采用分段负二项回归模型，对瑞典出生和移民父亲的 3 年精神科住院率进行建模，调整了季节性和自相关性，按原籍地区、居住时间和伴侣的出生地进行分层分析。
从改革前立即到改革后，瑞典出生父亲使用育儿假的比例从 63.6%增加到 86.4%，而移民父亲的这一比例从 37.1%增加到 51.2%。改革后，瑞典出生父亲的精神科住院率没有变化，而移民父亲的住院率则下降了 36%（发病率比（IRR）0.64，95%CI 0.47 至 0.86）。来自经济合作与发展组织国家以外地区的移民（IRR 0.50，95%CI 0.19 至 1.33）和移民伴侣的移民（IRR 0.23，95%CI 0.14 至 0.38）精神科住院率下降幅度最大。
本研究结果表明，旨在促进父亲休育儿假的政策可能有助于减少本地移民的健康不平等，为家庭幸福和儿童发展带来更广泛的益处。
