The Association between Single-parent Family Background and Physical Morbidity, Mortality, and Criminal Behaviour in Adulthood

The proportion of single-parent families has increased in the last few decades world-wide, mostly due to high divorce rates. Also in Finland growing numbers of children spend part of their childhood in single-parent families. The aim of this study was to investigate in a longitudinal perspective, the possible long-term effects of the childhood family structure on psychological, physical and criminal outcomes of an offspring during adulthood. A large, prospectively collected general population birth cohort (n= 11 017), the Northern Finland 1966 Birth Cohort, was used as a study population. This database provided the information on childhood family structure of cohort members with additional information of sociodemographic factors of the family and of the child. Information concerning physical and psychiatric illnesses were gathered from the Finnish Hospital Discharge Register (FHDR). Death certificates and the information from national crime registers were also obtained. Females with a single-parent family background were more commonly hospital-treated (61.3 % vs. 56.7 %) for any physical condition than females with a two-parent family background. For males such difference in overall physical illness was not found. Both females and males from single-parent families had more commonly been hospital-treated for some diagnoses in the ICD-category of "injury and poisoning" than had other cohort members. Furthermore, females from single-parent families had also more commonly been treated due to pregnancy-related conditions such as induced abortions. During the follow-up time (16 to 28 years of age) 117 (90 males, 27 females) cohort members had died. Males with single-parent family background exhibited an increased mortality risk, especially due to suicides (OR=2.5, 95% CI 1.1-5.8, adjusted for psychiatric hospital diagnosis, parental social class). Criminality was more common among both males and females from single-parent families compared with other cohort members. The results showed that the risk of violent offending and recidivism was increased up to 8-fold if the cohort male member had been born and raised in a singlemother family over most of his childhood. Parental divorce also doubled the risk for both violent and recidivistic offending. Non-violent offences among males were associated only with parental death and divorce. Furthermore, drunk driving was more common among both males and females with single-parent background. Males who were born into single-mother families were at the highest risk of drunk driving offences in adulthood (OR=2.4, 95% CI 1.4-4.2, adjusted for maternal age, psychiatric hospital diagnosis, parental social class). In this study it was shown that young adults with single-parent families in childhood experienced a more stressful pathway from late adolescence to adulthood. However, most of the offspring of single-parent families did well during the follow-up time. Strategies to promote the well-being of children and adolescents in single-parent families are of prime importance for preventive health care.