Lisa Strohschein

Chronic stress and the social patterning of women's health in Canada

Existing research on the social patterning of womens health draws attention to the significance of social roles and socioeconomic position. Although we know a great deal about health differences according to the occupancy of these positions, we know a lot less about why such patterns exist. This paper addresses this gap by examining the pathways through which social structure is linked to health using data from a 1994 Canadian national probability sample of women, aged 25-64 years. We begin by charting differences in womens self-rated ill-health, distress, and reports of long-standing health conditions by socioeconomic position and social role occupation. We then assess the extent to which these patterns can be understood in relation to the chronic stress arising from these social locations. Socioeconomic position, assessed by housing tenure, education, and household income, was positively related to health. Employment enhanced womens health, as did being currently married and a mother living with children. The ongoing stressors that distinguish the experiences of various structural locations accounted for some of the health effects of social structure, particularly for socioeconomic position. However, chronic stress was largely irrelevant to the pathways linking social roles to health. In fact, employed women and parents living with children enjoyed better health despite their greater stress.

Age and the gender gap in distress.

ABSTRACT Women report more psychological distress than men and recent evidence suggests that this gap increases with age. It has been argued that the widening differential in distress reflects the progressive and cumulative nature of womens disadvantaged work and family roles. Drawing on the cumulative disadvantage hypothesis and social stress theory, we test: (1) whether exposure to chronic stress accounts for an increasingly larger proportion of the gender effect on distress with age; and (2) whether women are increasingly more vulnerable to the effects of chronic stress on distress with age. Data are from the 1994 wave of the Canadian National Population Health Survey, a national probability sample of women and men aged 20 and older (N = 13,798). Exposure to long-term stress helps us understand gender differences in distress for those in their pre-retirement years. However, contrary to the cumulative disadvantage hypothesis, the model became increasingly less likely to explain such differences with age. Gendered vulnerability to long-term stress was not evident in the sample. The implications of these findings are discussed with particular reference to our ongoing efforts to understand health in the context of social structure and subjectivity.

Gender Socialization: Differences between Male and Female Youth in India and Associations with Mental Health

This paper describes patterns of gender socialization among youth in India and evaluates how these patterns are associated with their mental health. Data come from the Youth in India: Situation and Needs Study (), a subnationally representative survey conducted during 2006–2008. Descriptive results underscored the gendered nature of socialization experiences, showing that male and female youth inhabit different social worlds. Female youth expressed more gender-egalitarian attitudes than male youth but reported greater restrictions to their independence than male youth. Male youth recognized more gender-discriminatory practices within their households than did the female youth. Poisson models revealed that female youth experienced more mental health problems when their households engaged in practices that favoured males over females, even as these same practices were associated with fewer mental health problems among male youth. Family violence and restrictions to independence were associated with mental health problems for both male and female youth. When males and females engaged in behaviours contravening sex-specific gender norms, there were corresponding increases in mental health problems for both sexes. Together, these findings suggest that gender inequality permeates family life in India, with corresponding consequences for the mental well-being of male and female youth.

Family Structure Differences in Family Functioning Interactive Effects of Social Capital and Family Structure

This study investigated family structure differences in family functioning, evaluated whether extra-familial social capital accounted for any observed differences, and tested whether the influence of extra-familial social capital on family functioning varied by family structure. Using the first wave of the Canadian National Longitudinal Survey of Children and Youth (n = 6,223), analysis revealed significantly lower family functioning levels within stable cohabiting two-biological-parent households and stable single-biological-mother households relative to stable married two-biological-parent households, even after sociodemographic controls. Higher levels of social involvement and neighborhoodcohesion were associated with increased family functioning, but did not mediate family structure differences in family functioning. The effect of neighborhood cohesion on family functioning depended on family type such that the benefits of neighborhood cohesion for family functioning were magnified at high levels of neighborhood cohesion for both married and cohabiting households but had much less influence on family functioning within single-mother households.

Parental Divorce and Child Mental Health: Accounting for Predisruption Differences

Although evidence shows that the effects of divorce can be observed in advance of the actual event, there remains ambiguity over which aspects of child mental health are affected and why. This study analyzed two waves of data from a national survey of Canadian children (N = 4,474) to compare depression, antisocial behavior, and hyperactivity at initial interview between children whose parents subsequently divorced and children whose parents remain married. Results confirmed significantly worse mental health problems among children whose parents later divorced. Differences were mostly attributable to greater socioeconomic disadvantage and more dysfunctional family processes among eventually divorcing households.

I Want to Move, But Cannot: Characteristics of Involuntary Stayers and Associations With Health Among Canadian Seniors

Objectives: The purpose of this study was to investigate characteristics of seniors in the Canadian population who are involuntary stayers and to assess associations with health. Method: Data come from the 1994 Canadian National Population Health Survey, with the sample restricted to those 65 and older (N = 2,551). Results: Nearly 1 in 10 seniors identified as an involuntary stayer. Seniors with few socioeconomic resources, poor health, greater need for assistance, and low social involvement were more likely to identify as an involuntary stayer. Furthermore, seniors who were involuntary stayers report significantly more distress and greater odds of low self-rated health than other seniors. Discussion: This study brings into visibility an understudied segment of the elderly population: seniors who are unable to move from their present location despite their desire to do so. Further research and policy responses assisting seniors to age in a setting of their own choosing are needed.

Spousal Bereavement as a Triggering Mechanism for a Loss of Residential Independence Among Canadian Seniors

Although it is well recognized that unmarried seniors are more likely to experience instability in their living arrangements than their married counterparts, few studies have tested whether spousal bereavement in and of itself operates as a triggering mechanism for a subsequent loss of residential independence. The purpose of this study was to investigate whether Canadian seniors are at greatest risk for institutionalization and coresidence with others in the period immediately following spousal bereavement and whether this risk declines as acute responses to the crisis of bereavement become tempered with time. Data come from six waves of the Canadian National Population Health Survey (1994-2004), with the sample restricted to married or cohabiting adults who, at initial interview, were 65 years of age or older and living in a couple-only household (n = 1,082). Results from a competing risks analysis for time to first event, where first event was either moving into an institution or sharing a residence with others, confirm the time-dependent consequences of spousal bereavement. Relative to seniors whose spouse was still living 10 years later, respondents who experienced the death of a spouse or partner between 1994 and 2004 were at significantly greater risk for both institutionalization and coresidence in the period immediately following bereavement, with risk attenuating over time.

Prevalence of methylphenidate use among Canadian children following parental divorce

Background: Evidence suggests that children living in single-parent or step-parent households are more likely than children in households with 2 biological parents to be prescribed methylphenidate. I conducted a study of prospective data to investigate parental divorce as a predictor of methylphenidate use. Methods: I used data for children who participated in the National Longitudinal Survey of Children and Youth from 1994 to 2000. The sample was restricted to children who remained in the survey in 2000 and who, at initial interview, lived in a household with 2 biological parents (n = 4784). A generalized estimating equation model was used to compare the odds ratios of methylphenidate use among children whose parents obtained a divorce between 1994 and 2000 relative to children whose parents remained married during this period. Results: Between 1994 and 2000, 633 children (13.2%) experienced the divorce of their parents. The proportion of children who received methylphenidate at any time between 1994 and 2000 was 3.3% among those whose parents remained married and 6.1% among those whose parents divorced during this period. After adjustment for age of the mother and sex and age of the child, I found that methylphenidate use was significantly higher among children whose parents subsequently divorced than among those whose parents remained married (odds ratio 1.82, 95% confidence interval 1.01–3.33). Interpretation: The increased risk of children receiving a prescription for methylphenidate in the period following parental divorce raises questions about the causal links in this association. Future research is needed to replicate these findings and to investigate possible explanations.

Why are some Children Left Out?Factors Barring Canadian Children from Participating in Extracurricular Activities

Using three waves of data from the Canadian National Longitudinal Survey of Children and Youth, this study examines the impact of child, family and community level characteristics on children’s participation in extracurricular activities between the ages of 4 and 9 (n=2,289). Results show a large positive effect of family income on children’s participation in structured activities. Living in a poor neighbourhood constitutes an extra disadvantage for childrens participation in organized sport activities. Our study also identifies a positive association between parent’s education and children’s participation in most activities, and a negative association between family size and some structured activities. Furthermore, children of immigrants, as well as children of visible minority and aboriginal children were found to be disadvantaged in their participation in some activities.

Poverty Dynamics, Parenting, and Child Mental Health in Canada:

Although the detrimental effects of poverty on child mental health are well established, questions remain as to which aspects of poverty matter most and which mechanisms account for the association. This study tested the relative influence of depth of current poverty and poverty duration on child anxiety/depression and antisocial behavior, then evaluated whether parenting practices mediated observed associations. Data come from four waves of the Canadian National Longitudinal Survey of Children and Youth (1994–2000), with analysis restricted to children who were aged 2 to 5 at initial interview and lived with both biological parents throughout (n = 1,901). Depth of current poverty was associated with child anxiety/depression, whereas persistent poverty was associated with child antisocial behavior. Parenting behaviors were significant predictors but did not mediate the association between poverty dynamics and child mental health. The research and policy implications of these findings are discussed.