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Lancet

Single dads at higher risk of premature death than single mothers or couples - study

Single fathers ate fewer fruit and vegetables, and were more likely to binge drink than single mothers and partnered parents, the study found.

SINGLE FATHERS HAVE a higher risk of premature death than single mothers and partnered parents, according to an observational study that tracked more than 40,000 people in Canada for 11 years, published in The Lancet this evening.

While the study could not identify specific causes of death, single fathers were more likely to lead to eat more healthily, binge drink, and visit the doctor less, which may explain the increased risk.

The study’s authors said that the research could encourage healthcare professionals to target this group’s needs and reduce that mortality rate.

“Our research highlights that single fathers have higher mortality, and demonstrates a need for public health policies to help identify and support these men,” says lead author Dr Maria Chiu, Institute for Clinical Evaluative Sciences and University of Toronto, Canada.
Behind the results
At baseline, single fathers were older, had a higher prevalence of cancer, and were more likely to have cardiovascular disease than single and partnered mothers. Single fathers were also more likely than partnered fathers to have had an emergency medical visit or hospital admission in the past year.

While the leading cause of death for single fathers remained unclear (deaths were most likely classified as “other causes”), single fathers were more likely to lead unhealthy lifestyles.

For example, they ate fewer fruit and vegetables, and were more likely to binge drink than single mothers and partnered parents.

The authors note that social differences could also play a role in the increased risk for single fathers, potentially leading to increased stress and fewer coping mechanisms.

Single fathers were more likely to be separated, divorced, or widowed than single mothers.

After adjusting the findings to consider differences in age, lifestyle, health and sociodemographic characteristics, single fathers’ mortality risk over the 11 years of the study was more than two times higher than other parents’.

Analysis

Single-parent families are becoming increasingly common around the world due to growing rates of divorce, separations, and couples having children outside of marriage.

In 2011, more than 2.6 million families in the US and 330,000 families in Canada were headed by single fathers, while 2016 estimates in the UK suggest that 10% of the three million single-parent families were headed by single fathers.

Despite this, previous research on single parents has largely focused on single mothers, and no study to date has compared single fathers and mothers. There is only one similar study from Sweden, which compared single and partnered fathers only, and found that single fathers had a 30% greater risk of mortality than partnered fathers.

shutterstock_298167551 Shutterstock / Kichigin Shutterstock / Kichigin / Kichigin

Methodology

The study included 40,490 people who took part in the Canadian Community Health Survey, including 871 single fathers, 4,590 single mothers, 16,341 partnered fathers, and 18,688 partnered mothers (average age 41-46 years).

Single parents included people who were living at home with one or more biological or adopted children under the age of 25, and who were divorced, separated, widowed, single, never married, and not living with a partner.

The participants completed questionnaires to give details of their lifestyle and sociodemographic status, including their fruit and vegetable intake, physical activity, and binge drinking.

This was linked to their administrative health records to identify medical conditions, how often they used health services, whether they died, and cause of death.

After a median of 11 years follow-up, 693 people had died.

Single fathers were more likely to die over this period (5.8 deaths per 1,000 person years, 35/871 died), compared to partnered fathers (1.9 deaths per 1,000 person years, 345/16,341 died), and single mothers (1.7 deaths per 1000 person years, 85/4,590 died).

Partnered mothers were least likely to die over the follow-up period (1.2 deaths per 1,000 person years, 228/18,688 died).

Social interaction and doctors

While the study found no differences between single fathers’ and other parents’ sense of belonging to their local community, the authors suggest that social support may also be an issue for single fathers who may be less likely to have social networks, social assistance and child support.

However, the study did find that single fathers were more likely to engage with the health service than partnered fathers, which could offer an opportunity for doctors to intervene.

“Doctors’ appointments could be an opportunity for doctors to engage with single fathers to help them to improve their health,”  says Dr Chiu.

Research has shown that these conversations can help to motivate patients to adhere to treatment plans, make better decisions about their health, and influence their behaviour and recovery.

The authors note some limitations, including that the study does not account for how long a person has been a single parent for, or whether their sociodemographic or lifestyle factors changed over time. Further work is needed to understand the causes of death behind the increased mortality in single fathers and initiatives that might help reduce their risk.

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