Increased health risks of children with single mothers: the impact of socio-economic and environmental factors.
BACKGROUND
Adverse effects of single parenthood on children's health have been reported before. Socio-economic difficulties are discussed as mediating factors. As child health also depends on environmental conditions, we investigated the impact of environmental exposures and socio-economic factors on differences in health outcomes of children with single mothers vs. couple families.


METHODS
Data on 17,218 pre-school children (47% female) from three cross-sectional surveys conducted during 2004-07 in Germany were analysed. Health and exposure assessment were primarily based on parental report. Effects of socio-economic indicators (maternal education, household income) and environmental factors (traffic load at the place of residence, perceived environmental quality) on associations of four health outcomes (parent-reported health status, asthma, overweight, psychological problems) with single parenthood were determined by logistic regression analyses.


RESULTS
Children with single mothers showed an increased risk regarding parent-reported poor health status [boys: odds ratio (OR) 1.39 (95% confidence interval (CI): 1.06-1.82), girls: 1.73 (1.28-2.33)], psychological problems [boys: 1.90 (1.38-2.61), girls: 1.58 (1.03-2.42)], overweight [only boys: OR 1.23 (1.01-1.50) and asthma [only girls: OR 1.90 (1.15-3.15)]. Adjusting for socio-economic factors attenuated the strength of the association of family type with child health. Although environmental factors were associated with most health outcomes investigated and children of single mothers were more often exposed, these environmental factors did not alter the differences between children with single mothers and couple families.


CONCLUSIONS
The increased health risks of children from single-mother families vs. couple families are partly explained by socio-economic factors, but not by the environmental exposures studied.
Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany.
Marion
M
Scharte
Gabriele
G
Bolte
D001249:Asthma / Q000453:epidemiology; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000193:education / Q000706:statistics & numerical data; D050177:Overweight / Q000453:epidemiology; D012111:Residence Characteristics; D012307:Risk Factors; D015406:Single Parent / Q000523:psychology / Q000706:statistics & numerical data*; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires