The Association between General Health Status and Marital Status among Mothers of Reproductive Age (20-44) Living with Children under 14: A Secondary Analysis of the 2009 California Health Interview Survey 公开

Sahay, Kashika M. (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/br86b421t?locale=zh
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Abstract

Background: Motherhood is a transitional time when general health status may vary by social supports, operationalized in this study as marital status.

Hypothesis: Among mothers with young children living in California, those who are married or living with partners will have reduced odds of self-reported fair or poor health when compared to mothers who are not living with a partner.

Methods: We used the cross-sectional 2009 Adult California Health Interview Survey to obtain a sample of mothers ages 20-44 (N = 4228) who reported having children under age 14 living at home. We assessed our primary outcome using the five category general health status question at interview. We defined the primary exposure of interest of marital status at interview by a single question assessing if the individual is now married, living with a partner in a marriage-like relationship, or single. We examined the potential effect modifiers of the mother's country of birth, as well as her education, age and race. We identified potential confounders using a 10% difference rule between the crude (cOR) and adjusted odds ratios (aOR). We performed logistic regression in SUDAAN to account for jackknife replicate weights the complex survey design with married mothers as the reference group.

Results: The unadjusted odds ratio (cOR) for fair or poor health was significantly higher for single (cOR = 3.29, 95% CI: 1.99-5.45) and cohabiting (cOR 2.38, 95% CI: 1.54-3.69) mothers as compared to married mothers. Non-native born mothers comprised 46% of the sample (n=1935). Preliminary analyses found effect modification for country of origin. However, all women were included in the final model which adjusts for education and race. Compared to married mothers, adjusted odds ratio (aOR) for fair or poor health for single mothers was (aOR= 2.50, 95% CI 1.39-4.51); and for cohabiting mothers (aOR=1.45, 95% CI: 0.93-2.27).

Conclusion: Married women with young children are healthier than either single or cohabiting women. Cohabiting women are healthier than women rearing children alone. Owing to the cross-sectional nature of the survey, the data capture a moment in time rather than a longitudinal follow-up; therefore, causation cannot be established.

Table of Contents

Chapter 1: Background

1

Introduction

1

Literature Critique

8

Summary

12

References

14

Chapter 2: Manuscript

21

Abstract

21

Introduction

23

Methods

25

Results

29

Discussion

33

Strengths and Limitations

34

Summary

37

Tables

38

Figures

45

References

47

Chapter 3: Future Directions and Public Health Implications

52

Summary

52

Possible Future Directions for Research

53

Public Health Implications

56

Final Recommendation

57

References

58

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