One Parent,Two Parents and Child Well-Being

The structure of the family in the United States and other countries is changing. 

This change has occurred over a relatively brief period of time. Data noted in the study I am reviewing today shows that between 1970 and 2013 in the U.S.:

• Percentage of children living with two parents dropped 24%
• Percentage of children living with a single mother increased to 23.7%
• Percentage of children living with a single father quadrupled to 4.1%
• Percentage of children living with a grandparent doubled to 6.2%

It is important to understand how these changes in the structure of family effects children across a variety of domains.

This topic is the focus of an important manuscript published in Population Health Metrics. Patrick Krueger along with four colleagues summarized data related to parental structure and child well-being using the National Health Interview Survey.

They grouped parental structure into nine parental groups. Using married couples (comprising 67% of the sample) as a reference parental unit other structural units in the study included: cohabiting non-married couples, single mother, single father, extended married couple, extended cohabiting couple, extended single mother, extended single mother and skipped generation (care by grandparent). Extended modifiers were added to parental structure when at least one grandparent was available and provided direct care activity to the child.

Children with the various parental structures were compared across multiple variables. The findings that stood out to me included the following:

• Children of married couples generally show higher markers of well-being. However, this effect is reduced but not eliminated when controlling for socioeconomic status
• Children living with a single father fared better than children living with a single mother--fewer ER visits, fewer missed school days, better global health status
• The presence of an extended grandparent did not appear to significantly buffer the effect of single parent on health well-being and other well-being measures
• Learning disabilities and child ADHD rates were highest in children of single mothers and children being raised by grandparents
• Children of single mothers were more likely to be reported as having several medical problems including headaches, ear infections, asthma and anemia 

The findings from this study are important. The most important implication from my perspective is the need to identify at-risk children across all family structure groups. Targeting assessment and intervention assistance in children of single mother and grandparents may produce the highest improvement in well-being and outcome.

The additional services required to address changes in parental structure are evident. Improving access to child medical and mental health care seems to be a key first step. Providing additional financial assistance, assistance with transportation and regular day care support is needed. Expanding early childhood education programs and integrating medical and mental health services with school services may also benefit those most at risk.

There is a load of data in this important paper that readers may want to review in more detail. The free full-text manuscript can be accessed by clicking on the PMID link in the citation below.

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Krueger PM, Jutte DP, Franzini L, Elo I, & Hayward MD (2015). Family structure and multiple domains of child well-being in the United States: a cross-sectional study. Population health metrics, 13 PMID: 25729332