It is well known that raising children as a single parent is not optimal for either parent or child(ren). But just how bad is it? Researchers in Sweden, relying on data gleaned from nine years of mortality, severe morbidity, and hospital inpatient records of nearly a million Swedish children included in the Swedish national registers, set out to determine just how being raised by a single parent affects the health and welfare of children. It is worth noting at the outset, as the authors do, that “In 1999, a quarter of all Swedish 17-year-olds had experienced their parents’ separation.”

The researchers investigated 65,085 children living with the same single parent in both 1985 and 1990, and compared their findings with 921,257 children living with two parents in both years. The authors found that children of single parents had increased risks of psychiatric disease, suicide or suicide attempt, injury, and addiction.

Even after adjusting for a number of factors, including the parent’s mental health, addiction, or socioeconomic status, children of single parents still faced much tougher odds than children raised in two-parent homes: “...girls with single parents were more than twice as likely to commit suicide and more than three times as likely to die from an addiction to drugs or alcohol than were girls with two parents. Boys of single parents were more than five times more likely to die from an addiction to drugs or alcohol, more than three times as likely to die from a fall or poisoning, and four times more likely to die from external violence….”

Even using the most stringent statistical model, girls were twice as likely and boys were two-and-a-half times as likely to develop psychiatric disease (relative risk for girls 2.1 [95% CI 1.9-2.3] and boys 2.5 [2.3-2.8]). Both boys and girls were more likely to attempt suicide (girls 2.0 [1.9-2.2], boys 2.3 [2.1-2.6]) and to develop alcohol-related disease (girls 2.4 [2.2-2.7], boys 2.2 [2.0-2.4]). Boys raised by a single parent were four times as likely to develop narcotics-related disease, and girls were more than three times as likely (girls 3.2 [2.7-3.7], boys 4.0 [3.5-4.5]). Moreover, boys raised in a single-parent home experienced a much higher likelihood of “all-cause mortality,” that is, of dying from any cause: “After adjustment for age, the risk of dying was more than 50% greater in boys in single-parent families than in those boys living with both parents.”

The researchers conclude, after four iterations of adjusting the results, that, in the end, the effects of having just one parent cannot be explained by socioeconomics, parental status or health, or even addiction: “…even when a wide range of demographic and socioeconomic circumstances are included in multivariate models, children of single parents still have increased risks of mortality, severe morbidity, and injury,” and “…for all outcomes, significant increases in risk remained unaccounted for even in the fully adjusted model.”

No amount of massaging the figures or of adjusting for confounding variables will ever be able to explain away the reality that children need both parents at home.

(Source: Gunilla Ringbäck Weitoft, Anders Hjern, Bengt Haglund, and Måns Rosén, “Mortality, severe morbidity, and injury in children living with single parents in Sweden: A population-based study,” The Lancet, Vol. 361, No. 9354 [25 January 2003]: 289-295; and Margaret Whitehead and Paula Holland, “What puts children of lone parents at a health disadvantage?” The Lancet, Vol. 361, No. 9354 [25 January 2003]: 271.)

Among a treasure trove of findings concerning those who entered four-year institutions of higher education in 2002 are some mixed messages. Researchers at the University of California, Los Angeles (UCLA), in their report, “The American Freshman: National Norms for Fall 2002,” detail study and internet habits, continuing grade inflation, and some intriguing social and political attitudes.

Based on the survey responses of 282,549 students at 437 colleges and universities offering four-year degrees and representing almost 24% of the nation’s 1.2 million 2002 freshmen, this report finds that while entering freshmen seem to be growing a bit more politically conservative, their stance on some key family and social issues continues to shift left.

In general, political interest is on the rise, with nearly a third (32.0%) of the incoming freshmen stating that political awareness is a “‘very important’ or ‘essential’ life goal, compared with 31.4 percent last year and an all-time low of 28.1 percent in 2000.” Nonetheless, this remains far below the all-time high of 60.3 percent reported in 1966.

Political identification is also changing, as the report describes: “Following five consecutive years in which students gravitated toward more liberal political labels, 2002 signals a modest shift back towards more moderate and conservative political orientations.” Only 27.8 percent of freshmen now identify themselves as “liberal” or “far left,” down from 29.9 percent in 2001, and those taking the “conservative” moniker constituted 20.0 percent of the freshmen population, up from 19.1 percent in 2001.

This political conservatism seems to be worked out in a new appreciation of the military: 45.0 percent of students agreed “somewhat” or “strongly” that military spending should be increased, doubling the percentage that agreed with this sentiment in 1993 (21.4 %). In addition, there was a full 3 percent decrease in the number of freshmen who believed that there is a need for more handgun control, down from 80.8 percent in 2001 to 77.8 percent in 2002.

This slight move to the right is tempered by the continued leftward tilt on social issues, most notably in the acceptance of homosexuality on campus: “Support for gay rights reached new heights, with 59.3 percent of freshmen agreeing that ‘Same-sex couples should have the right to legal marital status,’ compared with 57.9 percent last year and 50.9 percent when this question was first introduced on the survey in 1997.” The acceptance of homosexual practice is further highlighted by the finding that only 24.8 percent of incoming freshmen agree that “It is important to have laws prohibiting homosexual relationships,” compared with 50.4 percent in 1987.

Another indicator of the moral and political schizophrenia exhibited by these new freshmen is the recent increase in support for the legalization of marijuana, now at 39.7 percent, the highest level in 23 years, while cigarette smoking is at a fifteen-year low of 7.4 percent. Moreover, while pot is OK and cigarettes are bad, drinking and “partying” are also on the decline: “An all-time low 46.5 percent report drinking beer ‘frequently’ or ‘occasionally’ during the past year, down from 47.1 percent last year and a high of 73.7 percent in 1982.”

While the decline of smoking, drinking, and partying is no doubt a positive turn of events, more serious transgressions are taking their place: the growing acceptance of marijuana and homosexuality describe a continuing turn against the family and morality and toward self. Given researchers’ assertion that these seemingly contradictory findings point to the events of September 11, 2001, as being the cause of the slight conservative movement, the conclusion seems simple. What American young adults seem to want is the safety and security afforded by a strong defense, so that they can continue to practice the prurience of their desires.

(Source: Shaena Engle, “College Freshmen Spend Less Time Studying and More Time Surfing the Net, UCLA Survey Reveals,” Higher Education Research Institute, University of California, Los Angeles, January 27, 2003; a summary report of L. J. Sax, J. A. Lindholm, A. W. Astin, W. S. Korn, and K. M. Mahoney, “The American Freshman: National Norms for Fall 2002,” 2001.)

“A recent CNN/USA Today/Gallup poll finds four in 10 Americans indicating they have a limited amount of time to relax, including 14% who say they ‘never have time to relax.’”

Not surprisingly, those who were raising small children occupied the end of the continuum having the least amount of relaxation time, “in fact, the seven groups with the least amount of time to relax all have young children.” Working mothers were the most likely to say they have little time to relax and to be the most stressed: “Just 9% of this group say they have much time to relax…while roughly two-thirds, 65%, report having limited time.”

Also predictable is the finding that unmarried Americans with children rank second highest in stress in this poll, with 61% reporting having little or no time to relax.

Yet another rationale for marriage and for avoiding the day care trap: less stress.

(Source: Jeffrey M. Jones, “Parents of Young Children Are Most Stressed Americans,” Gallop Poll Analyses, November 8, 2002.)

American pediatricians well understand that the day care center makes their job much harder by spreading various diseases among young children and by incubating tougher antibiotic-resistant germs as the carriers of those diseases. They also well understand that despite these very real medical problems, American mothers are not likely to reduce their reliance on day care as a surrogate parent any time soon.

To see both pediatricians’ deep concern about how day care spreads disease and their pessimistic resignation to a future dominated by day care, readers need only turn to a recent special issue of Pediatric Annals devoted to acute otitis media (AOM), an ear infection that has become alarmingly common among young children in the day-care era.

In one of the feature articles, Stan L. Block, professor of pediatrics at the University of Louisville, points out that “rates of AOM in younger children have nearly doubled since the 1970s; AOM thus accounts for nearly 25 million antibiotic prescriptions annually.” The problem with such a high number of antibiotic prescriptions, Block worries, is that it “exacerbates the growing rates of antibiotic-resistant bacterial strains.” Indeed, in a complementary article, Elizabeth D. Barnett of the Boston Medical Center reports that a growing number of strains of Streptococcus pneumoniae — the bacteria most commonly identified as the cause of AOM — have grown resistant to penicillin and other antibiotics: “The proportion of [Streptococcus pneumoniae] isolates that are nonsusceptible to penicillin…has been increasing steadily worldwide in the last 2 decades. …[B]y the late 1990s up to 50% of isolates in some regions were no longer susceptible to penicillin.”

This special issue of Pediatric Annals naturally surveys new strategies for diagnosing and treating AOM. However, Jerome O. Klein—the guest editor—predicts that “during the next few years, otitis media will continue to be a major complication of respiratory infections of children.” This almost fatalistic prediction reflects, in large part, Klein’s assessment of how day care spreads — and will continue to spread — AOM. “Attendance in group child daycare,” Klein stresses, “is one of the most important risk factors for otitis media,” adding that “the number of American children who receive some form of daycare is large.” “The more children in the daycare group,” Klein reasons, “the more exposure to respiratory pathogens and the higher the rate of respiratory tract infections, including otitis media.” Unfortunately, Klein sees little likelihood of any social change that will soon break the links in this pathogenic chain: “There is,” he writes, “no reason to believe that daycare attendance will diminish in the near future.” “Use of group day care,” he even ventures, “is unlikely to change in spite of [any] family leave initiative.”

(Sources: Stan L. Block, “Therapeutic Nihilists: Lend Me Your Ears, or the Witches Cauldron of Acute Otitis Media,” Pediatric Annals 31(2002): 784-791; Elizabeth D. Barnett, “Antibiotic Resistance and Choice of Antimicrobial Agents for Acute Otitis Media,” Pediatric Annals 31(2002): 794-799; Jerome O. Klein, “What’s New in the Diagnosis and Management of Otitis Media?” and “Changes in Management of Otitis Media: 2003 and Beyond,” Pediatric Annals 31(2002): 777-778 and 824-826.)

The complementarity of the sexes stirs a deep sense of reverence in bioethicist Leon R. Kass of the University of Chicago. In a recently published philosophical commentary on the ancient biblical text of Genesis (Adam and Eve started it all), Kass speaks of “the mystery of sexual complementarity and its peculiarly human self-conscious and imaginative embodiment.” In this complementarity, Kass glimpses “an opening to the truly transcendent and eternal,” an opening that inspires “awe in the face of life and sex and love and other great powers not of our making.” This mystery also inspires in him a profound “gratitude for the unmerited gift of creative powers exercisable through procreative handing down of our living humanity to the next generation.”

Still, these feelings of awe and gratitude do not blind Kass to the way the “nonidentical desires and interests” of the male and the female “threaten divorce.” “The tensions [between male and female] are almost guaranteed to cause trouble,” Kass concedes, “both for thought and for action.” After all, sexual relations always entail “rivalry and risk of inequality.” Consequently, although he acknowledges that the various elements of sexual relationships can be “clothed by culture, and altered by customs, rituals, beliefs, and diverse institutional arrangements,” Kass insists that “the elements themselves are none of them cultural constructions, nor is there likely to be any conceivable cultural arrangement that can harmonize to anyone’s satisfaction all their discordant tendencies. On the contrary, political and cultural efforts to rationally solve the problem of man and woman — and we are, to be frank, in the midst of such utopian spasms — will almost certainly be harmful, even dehumanizing, to man, to woman, and especially to children, not least because such matters are so delicate and private, and their deeper meanings inexpressible.”

(Source: Leon R. Kass, The Beginning of Wisdom: Reading Genesis [New York: Free Press, 2003], 119-121.)

Epidemiologists have known for some time that married people live longer than unmarried peers. Now a research team from the University of Texas-Austin and the University of Colorado-Colorado informs us that simply living in a neighborhood made up of a preponderance of married people boosts life expectancy.

Parsing nationally representative health and mortality data from 1986 to 1997, the Texas and Colorado scholars first document a clear mortality advantage for married over the unmarried. Their statistical models reveal that “those who have never been married have almost twice the mortality risk of those who are married” (Hazard Ratio of 1.96). Similarly, those who are divorced or separated run a mortality risk more than half-again as high as do those who are married (Hazard Ratio of 1.52). Indeed, when moving from a statistical model that does not take marital status into account to one that does, the researchers noted a marked narrowing of “the black-white mortality gap, most likely because blacks are much more likely to be in the non-married category than whites.”

But marital status affects mortality risk not only for the individual, but for the neighborhood. The Texas and Colorado researchers calculate that “residents of neighborhoods where more than 21 percent of the residents ages 18-64 have never been married have higher levels of mortality compared to those neighborhoods where only 9 percent or fewer of the residents have never been married.” These researchers suggest, in other words, that when it comes to marital status (and other characteristics scrutinized in this study), Americans of all racial and ethnic groups “risk death not only through their own socioeconomic characteristics, but also through the characteristics of their neighborhoods.”

(Source: Stephanie A. Bond Huie, Robert A. Hummer, and Richard G. Rogers, “Individual and Contextual Risks of Death among Race and Ethnic Groups in the United States,” Journal of Health and Social Behavior 43[2002]: 359-381.)

Among apologists for the nation’s culture of casual divorce, few words roll off the lips more easily than resilience. After all, it is because of their remarkable resilience that the children of divorced parents quickly connect with the school and community supports that enable them to rebound from the effects of their changed family circumstances. Soon these resilient young people move on to productive and successful lives. So the reassuring story goes. The trouble is that the latest research undermines rather than supports this edifying tale of doughty youth.

In a study recently published in the Journal of Marriage and Family, researchers from Washington State University examine the strength of “resiliency factors” among adolescents whose parents have divorced. The Washington State scholars use survey data collected from 2,144 teens in grades seven, nine, and eleven to test the hypothesis that “the presence of supports outside a family will buffer adolescents from low levels of parental support or low levels of parental monitoring,” especially in single-parent or stepparent homes.

Contrary to what the researchers expected, the data lend only “limited support for the buffering resiliency model” which had predicted that “nonfamilial support systems” could compensate for family failure.

Whether looking at symptoms for “externalizing behavior” (binge drinking, smoking marijuana, carrying a weapon, fighting, etc.) or at those for “internalizing” (depression, suicidal thoughts, low self-esteem), the pattern is the same: compared to peers in intact families, adolescents whose parents had divorced were significantly more likely to be in trouble — regardless of whether their divorced custodial parent had re-married (p < .001 for externalizing behaviors among offspring of all divorced-parent families; p < .01 for internalizing among children of divorced single parents, p < .001 for internalizing among children of remarried divorced parents).

Generally, the researchers admit, “nonfamily factors were not particularly important as buffers against low parental support.” “Neighbor support,” for instance, was for the teens in this study “not a support against the effect of low parental support.” Likewise, “school attachment did not buffer adolescents from the effect of low parental monitoring on externalizing, nor did it buffer adolescents from the effect of low parental support on internalizing.” Indeed, much to the astonishment of the researchers, “low parental monitoring and a high attachment to school was related to higher internalizing symptoms.” That is, “when parental monitoring is low, having an attachment to school may exacerbate internalizing, rather than serving as a source of support.” Perhaps, the researchers conjecture, when adolescents who suffer from the psychological distress of internalizing are not monitored closely by their parents, they “seek out connections with teachers or peers at school to help them cope [apparently not very successfully] with their feelings of depression or low self-esteem.”

The researchers’ final conclusion is that — after all their hypothesizing to the contrary — “parents are of primary importance to the well-being of children.”

(Source: Kathleen Boyce Rodgers and Hilary A. Rose, “Risk and Resiliency Factors Among Adolescents Who Experience Marital Transitions,” Journal of Marriage and the Family 64[2002]: 1024-1037, emphasis added.)