Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
Addiction. 2024 Feb;119(2):301-310. doi: 10.1111/add.16354. Epub 2023 Oct 5.
Fathers' parental leave has been associated with decreased risks of alcohol-related hospitalizations and mortality. Whether this is attributable to the health protections of parental leave itself (through stress reduction or behavioral changes) or to selection into leave uptake remains unclear, given that fathers are more likely to use leave if they are in better health. Using the quasi-experimental variation of a reform incentivizing fathers' leave uptake (the 1995 Father's quota reform), this study aimed to assess whether fathers' parental leave influences alcohol-related morbidity and mortality.
Quasi-experimental interrupted time series and instrumental variable analyses.
Sweden.
Fathers of singleton children born from January 1992 to December 1997 (n = 220 412).
Exposure was indicated by the child's birthdate before or after the reform and used to instrument fathers' 2- and 8-year parental leave uptake. Outcomes included fathers' hospitalization rates for acute alcohol-related (intoxication; mental and behavioral disorders) and chronic alcohol-related diagnoses (cardiovascular, stomach and other diseases; liver diseases), as well as alcohol-related mortality, up to 2, 8 and 18 years after the first child's birthdate.
In interrupted time series analyses, fathers of children born after the reform exhibited immediate decreases in alcohol-related hospitalization rates up to 2 (incidence rate ratio [IRR] = 0.66, 95% confidence interval [CI] = 0.51-0.87), 8 (IRR = 0.74, 95% CI = 0.57-0.96) and 18 years after birth (IRR = 0.72, 95% CI = 0.54-0.96), particularly in acute alcohol-related hospitalization rates, compared with those with children born before. No changes were found for alcohol-related mortality. Instrumental variable results suggest that alcohol-related hospitalization decreases were driven by fathers' parental leave uptake (e.g. 2-year hospitalizations: IRR = 0.16, 95% CI = 0.03-0.84).
In Sweden, a father's parental leave eligibility and uptake may protect against alcohol-related morbidity.
父亲休育儿假与降低与酒精相关的住院率和死亡率风险有关。这是否归因于育儿假本身的健康保护（通过减轻压力或行为改变），或者由于父亲健康状况较好而更有可能休育儿假而导致的选择性休假，目前尚不清楚。利用激励父亲休育儿假的改革的准实验性变化（1995 年父亲配额改革），本研究旨在评估父亲的育儿假是否会影响与酒精相关的发病率和死亡率。
准实验性中断时间序列和工具变量分析。
瑞典。
1992 年 1 月至 1997 年 12 月期间出生的单胎儿童的父亲（n=220412）。
暴露由孩子在改革前后的出生日期来表示，并用于为父亲 2 年和 8 年育儿假的参与度设置工具。结果包括父亲因急性酒精相关（中毒；精神和行为障碍）和慢性酒精相关诊断（心血管、胃和其他疾病；肝脏疾病）而住院的比率，以及酒精相关死亡率，直到孩子出生后的 2、8 和 18 年。
在中断时间序列分析中，与孩子出生在改革前的父亲相比，改革后出生的孩子的父亲在 2 年（发病率比[IRR]=0.66，95%置信区间[CI]=0.51-0.87）、8 年（IRR=0.74，95%CI=0.57-0.96）和 18 年（IRR=0.72，95%CI=0.54-0.96）后，与酒精相关的住院率立即下降，特别是急性酒精相关住院率，而与孩子出生前的父亲相比，没有发现与酒精相关的死亡率变化。工具变量结果表明，与酒精相关的住院率下降是由父亲休育儿假的参与度驱动的（例如 2 年住院率：IRR=0.16，95%CI=0.03-0.84）。
在瑞典，父亲休育儿假的资格和参与度可能有助于预防与酒精相关的发病。
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