Partnership, Parenthood,Employment and Mental Health Among Finnish Young Adults

Introduction

Individualsliving with a partner, who have children in the family and who are employedgenerally engage in healthier behaviors, enjoy better health, and have lowermortality than individuals without a partner, without children in the familyand without employment, respectively.^1-3 However, these differentdimensions of work-family life, i.e. partnership, parenthood and employment,may share similar pathways through which they potentially influence health. Forexample, an individual without employment may lack financial security, but someof this insecurity may be compensated by having an employed partner. Combiningemployment, marriage and parenthood may have a positive influence on anindividual’s health (role accumulation hypothesis) or a negativeinfluence (multiple role hypothesis).⁴

Weexamine whether partnership, parenthood, and employment among Finnish young menand women interact in their influence on mental health, using longitudinalregistry data linked to medication registries.

Dataand methods

An 11%random sample representative of the population permanently residing in Finlandat the end of any of the years 1995 to 2007 was used. This sample was linked,on an individual level, to data from other official registries; labor marketdata and medication records. The sample was restricted to men and women aged 25to 39 years in 1995.

Wefocused on purchases of prescribed psychotropic medication (antidepressants,antipsychotics, antimanic agents, and anxiolytic/sedative/hypnotic medication).Purchased psychotropic medication was considered as a binary variable; i.e.whether or not individuals purchased at least one prescription of psychotropicmedication in a calendar year.

Individualswere defined as being in a partnership when they were married or cohabiting andliving with their partner. Individuals not in a partnership included those notliving with another adult, those living with at least one adult other than apartner (e.g., a sibling or friend) and those with an unknown livingarrangement status. Parenthood status was based on whether an individual had atleast one child under the age of 18 years in the family. Employment was definedas being employed, whereas not being employed included unemployed individuals,students and pupils, pensioners, and others. Five-year age dummies wereincluded to allow for a non-linear relationship between age and psychotropicmedication purchases. Year dummies were included to allow for a possible timetrend in psychotropic medication purchases. Educational attainment wascategorized as: only compulsory education, upper secondary or less education,lower tertiary education, and higher tertiary or more education. All variableswere annually measured and treated as time-varying in our analysis.

Theassociation between partnership, parenthood, employment status and psychotropicmedication purchases was first estimated separately, and then for alldimensions together. Next, the binary measures of partnership, parenthood andemployment status were combined in eight work-family combinations and therelationship of these combinations with purchased psychotropic medication wasanalyzed. We used ordinary least squares (OLS) models and applied individualfixed effects (FE) models, to control for unobserved time-invariantconfounders. All models controlled for age, year and education and the analyseswere done separately for men and women.

Results

Theobserved distributions of employment, partnership, and parenthood, and theprevalence of psychotropic medication purchases are presented in Table 1.Results from the first OLS model indicated that men and women who were notpartnered, had no children in the family, and were not employed were morelikely to have purchased psychotropic medication than those with a partner(Table 2), with children in the family, and with employment, respectively. Whenpartnership, parenthood and employment were included in one model, their effectsizes were attenuated. This may indicate that these work-family dimensionsshare some of the same pathways. When psychotropic medication purchases of theeight work-family combinations were studied, we found that, compared to men andwomen with a partner, with children in the family and with employment, men andwomen with any of the other combinations were more likely to have purchasedpsychotropic medication. When controlling for time-invariant factors in theindividual FE models, we found similar patterns but with strongly attenuatedeffect sizes.

Conclusions

Descriptiveresults and the OLS model indicated that men and women who do not have apartner, no children in the family and who are not employed were more likely topurchase psychotropic medication. These differences became smaller in theindividual FE models, indicating that selection explains some but not all ofthis association.

References

1.Kiecolt-Glaser JK, Newton TL. Marriage and health: His and hers. PsycholBull. 2001;127(4):472-503.

2. HelbigS, Lampert T, Klose M, Jacobi F. Is parenthood associated with mental health?Findings from an epidemiological community survey. Soc Psychiatry PsychiatrEpidemiol. 2006;41(11):889-896.

3. RossCE, Mirowsky J. Does employment affect health? J Health Soc Behav.1995;36(3):230-243.

4. MartikainenP. Women’s employment, marriage, motherhood and mortality: A test of themultiple role and role accumulation hypotheses. Soc Sci Med.1995;40(2):199-212.