Skip to main content
SpringerLink
Log in

Lone Motherhood and Risk for Cardiovascular Disease

The National Population Health Survey (NPHS), 1998–99

  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Purpose: To examine whether lone parenthood among Canadian women is associated with risk factors for cardiovascular disease (CVD).

Methods: The sample was from the National Population Health Survey (NPHS) and it included 2,184 mothers (women with dependent children < 18 years of age) of whom 478 were lone (22%) and 1,706 (78%) were partnered mothers. Descriptive statistics and multiple logistic regression were undertaken with weighted data.

Results: Compared to partnered mothers, lone mothers were significantly younger, and reported lower levels of education and income. Lone mothers reported significantly lower levels of health, less social support, and more distress and depression than partnered mothers. Further, lone mothers were significantly more likely to be smokers than partnered mothers. Odds ratios for being a lone mother and current smoker on social assistance in this analysis was 4.15 (95% CI 2.27–7.60), and for those reporting low or mid/high incomes respectively, were 2.99 (1.51–5.90) and 3.01 (1.93–4.70). There were no significant differences between the two groups for obesity or physical activity.

Conclusions: Smoking is a significant CVD lifestyle risk for lone mothers. Smoking occurred in the context of considerable life stress, depression, and distress pointing to links between health behaviour, psychosocial factors, and CVD health. These results suggest that lone mothers are a key target group for primary prevention in the CVD field. Programs and policies that support lone mothers in their goals of attaining healthier lifestyles have the potential to contribute to the prevention of cardiovascular disease in Canadian women.

Résumé

Objet: Déterminer si la monoparentalité chez les Canadiennes est associée aux facteurs de risque des maladies cardiovasculaires (MCV).

Méthode: Notre échantillon, tiré de l’Enquête nationale sur la santé de la population (ENSP), comprenait 2 184 mères (ayant des enfants à charge de moins de 18 ans); 478 étaient monoparentales (22 %), et 1 706 (78 %) avaient un partenaire. Nous avons procédé à l’aide de statistiques descriptives et d’une analyse de régression logistique multiple de données pondérées.

Résultats: Par rapport aux mères ayant un partenaire, les mères de familles monoparentales étaient significativement plus jeunes et déclaraient des niveaux de scolarité et de revenu inférieurs. Les mères de familles monoparentales déclaraient aussi de manière significative être en moins bonne santé, avoir un niveau de soutien social inférieur et vivre davantage de détresse et de dépression que les mères ayant un partenaire. De plus, les mères de familles monoparentales étaient de manière significative plus susceptibles d’être des fumeuses que les mères ayant un partenaire. Le risque relatif d’être mère de famille monoparentale, fumeuse actuelle et bénéficiaire de l’aide sociale, dans notre analyse, était de 4,15 (IC de 95 %=2,27–7,60); ce risque était de 2,99 (1,51–5,90) et de 3,01 (1,93–4,70), respectivement, pour celles ayant déclaré un faible niveau de revenu ou un revenu moyen/supérieur. Nous n’avons observé aucune différence significative entre les deux groupes pour ce qui est de l’obésité ou de l’activité physique.

Conclusions: Pour les mères de familles monoparentales, le tabagisme est une habitude de vie qui comporte un important facteur de risque de MCV. Le tabagisme est présent dans un contexte de stress quotidien, de dépression et de détresse considérables, ce qui laisse supposer l’existence de liens entre les habitudes de santé, les facteurs psychosociaux et la santé cardiovasculaire. Ces résultats donnent à penser que les mères de familles monoparentales sont un important groupe cible pour la prévention primaire dans le domaine des MCV. Les programmes et les politiques qui appuient les mères de familles monoparentales à la recherche d’un mode de vie plus sain pourraient éventuellement contribuer à prévenir les maladies cardiovasculaires chez les Canadiennes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Reference

  1. Manuel D, Leung M, Nguyen K, Tanuseputro P, Johansen H. Burden of cardiovascular disease in Canad. Can J Cardio. 2003;10(9):997–1004.

    Google Scholar 

  2. Levenson JW, Skerrett PJ, Gaziano JM. Reducing the global burden of cardiovascular disease: The role of risk factor. Prev Cardio. 2002;5:188–99.

    Article  Google Scholar 

  3. Mathers CD, Sadana R, Salomon JA, Murray CJ, Lopez AD. Healthy life expectancy in 191 countries, 199. Lances. 2001;357(9269):1685–91.

    Article  CAS  Google Scholar 

  4. Kaplan GA, Keil, JE. Socioeconomic factors and cardiovascular disease: A review of the literatur. Circulatio. 1993;88(4 Pt1):1973–98.

    Article  CAS  Google Scholar 

  5. Luoto R, Pekkanen J, Uutela A, Tuomilehto J. Cardiovascular risks and socioeconomic status: Differences between men and women in Finlan. J Epidemiol Community Healt. 1994;48(4):348–54.

    Article  CAS  Google Scholar 

  6. Cabrera C, Helgesson O, Wedel H, Bjorkelund C, Bengtsson C, Lissner L. Socioeconomic status and mortality in Swedish women: Opposing trends for cardiovascular disease and cance. Epidemiolog. 2001;12(5):532–36.

    Article  CAS  Google Scholar 

  7. Salonen JT. Socioeconomic status and risk of cancer, cerebral stroke, and death due to coronary heart disease and any disease: A longitudinal study in eastern Finlan. J Epidemiol Community Healt. 1982;36(4):294–97.

    Article  CAS  Google Scholar 

  8. Harrell JS, Gore SV. Cardiovascular risk factors and socioeconomic status in African American and Caucasian women. Res Nurs Healt. 1998;21(4):285–95.

    Article  CAS  Google Scholar 

  9. Myllykangas M, Pekkanen J, Rasi V, Haukkala A, Vahtera E, Salomaa V. Haemostatic and other cardiovascular risk factors, and socio-economic status among middle-aged Finnish men and women. Int J Epidemio. 1995;24(6):1110–16.

    Article  CAS  Google Scholar 

  10. Froelicher ES, Christopherson DJ, Miller NH, Martin K. Women’s initiative for nonsmoking (WINS) IV: Description of 277 women smokers hospitalized with cardiovascular diseas. Heart Lun. 2002;31(1):3–14.

    Article  Google Scholar 

  11. Washington Women’s Education Foundation. The health of Washington’s women. Olympia, Washington. August, 1997.

    Google Scholar 

  12. Lipman EL, Offord DR, Boyle MH. Single mothers in Ontarion: Sociodemographic, physical, and mental health characteristic. CMA. 1997;56(5):639–45.

    Google Scholar 

  13. Benzeval M. The self-reported health status of lone mother. Soc Sci Med. 1998;46(10):1337–353.

    Article  CAS  PubMed  Google Scholar 

  14. Cairney J, Thorpe C, Rietschlin J, Avison WR. 12-month prevalence of depression among single and married mothers in the 1994 National Population Health Survey. Can J Public Health. 1999;90(5):320–24.

    Article  CAS  PubMed  Google Scholar 

  15. Perez C, Beaudet MP. The health of lone mother. Health Report. 1999;11(2):21–32.

    CAS  Google Scholar 

  16. Cairney J, Boyle M, Offord D, Racine Y. Stress, social support, and depression in single and married mother. Soc Psychiatry Psychiatr Epidemio. 1999;38:442–49.

    Article  Google Scholar 

  17. Hunsley T. Lone Parent Incomes and Social Policy Outcomes: Canada in International Perspective. Kingston, ON: McGill/Queen’s University Press, 1997.

    Google Scholar 

  18. Statistics Canada. General Social Survey Cycle 15: Family history (Statistics Canada Catalogue 89–575-XIE). Ottawa, ON: Statistics Canada, 2002.

    Google Scholar 

  19. Sheilds M. Proxy reporting in the National Population Health survey. Health Report. 2000;12(1):21–39(Eng).

    Google Scholar 

  20. Swain L, Catlin G, Beaudet MP. The National Population Health Survey–Its longitudinal nature. Health Report. 1999;10:69–82.

    CAS  Google Scholar 

  21. Tambay JL, Catlin G. Sample design of the National Population Health survey. Health Report. 1995;7:29–38.

    CAS  Google Scholar 

  22. Marmot MG. Understanding social inequities in healt. Perspectives Biology Met. 2003;46(3):S9–S23.

    Article  Google Scholar 

  23. Baker D, Mead N, Campbell S. Inequalities in morbidity and consulting behaviour for socially vulnerable group. Br J Gen Pract. 2002;52(475):124–30.

    PubMed  PubMed Central  Google Scholar 

  24. Cairney J, Wade TJ. Single parent mothers and mental health care service us. Soc Psychiatry Psychiatr Epidemion. 2002;37(5):236–42.

    Article  Google Scholar 

  25. Antonovsky A. Unraveling the Mysteries of Health: How People Manage Stress and Stay Well. San Francisco, CA: Jossey-Bass Publishers, 1987.

    Google Scholar 

  26. Rao JNK, Wu CFJ, Yue K. Some recent work on resampling methods for complex survey. Survey Methodolog. (Statistics Canada, Catalogue 12–001) 1992;18:209–17.

    Google Scholar 

  27. Rust KF, Rao JNK. Variance estimation for complex surveys using replication technique. Statistical Methods in Medical Researc. 1996;5:283–310.

    Article  CAS  Google Scholar 

  28. Whitehead M, Burstron B, Diderichsen F. Social policies and the pathways to inequalities in health: A comparative analysis of lone mothers in Britain and Swede. Soc Sci Met. 2000;50;255–70.

    CAS  Google Scholar 

  29. Lahelma E, Arber A, Kiveal K, Roos E. Multiple roles and health among British and Finnish women: The influence of socio-economic circumstance. Soc Sci Med. 2002;54:727–40.

    Article  PubMed  Google Scholar 

  30. Siahpush M, Borland R, Scollo M. Prevalence and socio-economic correlates of smoking among lone mothers in Australia. Aust N Z J Public Health. 2002;26(2):132–35.

    Article  PubMed  Google Scholar 

  31. Dorsett R, Marsh A. The health trap: Poverty, smoking and lone parenthood. Policy Studies Institute, London, 1998. (PSI Report No. 855.

    Google Scholar 

  32. Young L, Cunningham S, Buist D. Lone mothers are at higher risk for cardiovascular disease compared to partnered mothers. Data from the US National Health and Nutrition Examination Survey III (NHANES III). Lances. (Submitted for review).

  33. Choinière R, Lafontaine P, Edwards AC. Distribution of cardiovascular disease risk factors by socioeconomic status among Canadian adult. CMA. 2000;162(9 Suppl):S13–S24.

    Google Scholar 

  34. Diez Roux AV, Merkin SS, Hannan P, Jacobs DR, Kiefe CI. Area characteristics, individual-level socioeconomic indicators, and smoking in young adults: The coronary artery disease risk development in young adults stud. Am J Epidemiol. 2003;157(4):315–26.

    Article  CAS  PubMed  Google Scholar 

  35. Plotnikoff RC, Hugo K, Cousineau N. Heart disease risk factor prevalence and profiles in a randomized community sample of Canadian women. Can J Public Healt. 2001;92(2):121–26.

    Article  CAS  Google Scholar 

  36. Bancroft A, Wiltshire S, Parry O, Amos A. “It’s like an addiction first thing…afterwards it’s like a habit”: Daily smoking behavior among people living in areas of deprivatio. Soc Sci Med. 2003;56(6):1261–67.

    Article  PubMed  Google Scholar 

  37. McLeod JD, Kessler RC. Socioeconomic status and differences in vulnerability to undesireable life event. J Health Soc Behav. 1990;31:162–72.

    Article  CAS  PubMed  Google Scholar 

  38. Dunn CL, Ririe PL, Lando HA. Attitudes and perceptions related to smoking among pregnant and postpartum women in a low-income, multiethnic settin. Am J Health Proc. 1998;12(4):267–74.

    Article  CAS  Google Scholar 

  39. Beech BM, Scarinci IC. Smoking attitudes and practices among low-income African-Americans: Qualitative assessment of contributing factor. Am J Health Proc. 2003;17(4):240–48.

    Article  Google Scholar 

  40. Stewart MJ, Brosky G, Gillis A, Jackson S, Johnston G, Kirkland S, et al. Disadvantaged women and smokin. Can J Public Healt. 1996;87:257–60.

    CAS  Google Scholar 

  41. Mason R. Stacking the deck: The relationship between reliable child care and lone mothers’ attachment to the labour force. http://www.childcarecanada.org/research/comlete/stackdeck.html200.

  42. Kawachi I, Colditz GA, Stampfer MJ, Willet WC, Manson JE, Rosner B, et al. Smoking cessation in relation to total mortality rates in women: A prospective stud. Ann Intern Med. 1993;119(10):992–1000.

    Article  CAS  PubMed  Google Scholar 

  43. Tunstall-Pedoe H, Kuulasmaa K, Mahonen M, Tolonen H, Ruokokoski E, Amouyel P. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular diseas. Lancet. 1999;353(9164):1547–57.

    Article  CAS  PubMed  Google Scholar 

  44. McKenna H, Slater P, McCance T, Bunting B, Spiers A, McElwee G. Qualified nurses’ smoking prevalence: Their reasons for smoking and desire to quit. J Adv Nur. 2001;35(5):769–75.

    Article  CAS  Google Scholar 

  45. Boughton BJ. Compulsory health and safety in a free societ. J Med Ethic. 1984;10(4):186–90.

    Article  CAS  Google Scholar 

  46. Harvey HD, Fleming P, Patterson M. Ethical dilemmas and human rights considerations arising from the evaluation of a smoking policy in a health promoting settin. Int J Environ Health Res. 2002;12(3):269–75.

    Article  PubMed  Google Scholar 

  47. Gettleman L, Winkleby MA. Using focus groups to develop a heart disease prevention program for ethnically diverse, low-income women. J Community Health. 2000;25(6):439–53.

    Article  CAS  PubMed  Google Scholar 

  48. Reitsma-Street M. Processes of community action research: Putting poverty on the policy agenda of a rich region. Can Rev Soc Pol. 2002;49–50:69–78.

    Google Scholar 

  49. Raphael D. Inequality is Bad for Our Hearts: Why Low Income and Social Exclusion are Major Causes of Heart Disease in Canada. Toronto: North York Heart Health Network. http://depts.washington.edu/eqhlth/paperA15.html200.

  50. United States Department of Health and Human Services. Physical activity and health: A report of the Surgeon General. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.

    Google Scholar 

  51. Statistics Canada. National Population Health Survey. http://www.hc-sc.gc.ca/pphb-dgspsp/.ccdpc-spcmc/cancer/publications/nphs_physical_e.html199.

  52. Rabkin SW, Chen Y, Leiter L, Liu L, Reeder BA. Risk factor correlates of body mass index. CMA. 1997;157(Suppl 1):S26–S31.

    Google Scholar 

  53. Cairney J, Wade TJ. Correlates of body weight in the 1994 National Population Health survey. Int J Obes Relat Metab Disor. 1998;22(6):584–91.

    Article  CAS  Google Scholar 

  54. Gilmore J. Body mass index and healt. Health Report. 1999;11(1):31–43(Eng); 33–47(Fre).

    CAS  Google Scholar 

  55. Bray GA, Bouchard C, James WPT. Definitions and proposed current classification of obesity. In: Bray GA, Bouchard C, James WPT (Eds.). Handbook of Obesity. New York, NY: Marcel Dekker, 1998;31–40.

    Google Scholar 

  56. Bray GA. An approach to the classification and evaluation of obesity. In: Bjorntorp P, Brodoff BN (Eds.). Obesity. Hagerstown, MD: JB Lippincott Company, 1992;294–308.

    Google Scholar 

  57. Roberts RJ. Can self-reported data accurately describe the prevalence of overweigh. Public Healt. 1995;109(4):275–84.

    Article  CAS  Google Scholar 

  58. Hill A, Roberts J. Body mass index: A comparison between self-reported and measured height and weigh. J Public Health Med. 1998;20(2):206–10.

    Article  CAS  PubMed  Google Scholar 

  59. Cooper R, Cutler J, Desvigne-Nickens P, Fortmann SP, Friedman L, Havlik R, et al. Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: Findings of the national conference on cardiovascular disease preventio. Circulatio. 2000;102:3137–47.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Langara College, University of Victoria School of Nursing, Lower Mainland Campus, 5th Floor Library Building, 100 West 49th Avenue, Vancouver, BC, V5Y 2Z6, Canada

    Lynne E. Young PhD

  2. Population and Public Health Branch, Cardiovascular Diseases Division, Health Canada, Ottawa, ON, Canada

    Alison D. James MSc

  3. School of Nursing, University of Washington, Washington, DC, USA

    Susanna L. Cunningham PhD

Authors
  1. Lynne E. Young PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alison D. James MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Susanna L. Cunningham PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lynne E. Young PhD.

Additional information

Acknowledgements: The authors thank Dr.Gregory Taylor, Ms. Caren Uhlik, and Ms. Marie DesMeules. This study was supported by the Heart & Stroke Foundation of Canada, and Health Canada.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Young, L.E., James, A.D. & Cunningham, S.L. Lone Motherhood and Risk for Cardiovascular Disease. Can J Public Health 95, 329–335 (2004). https://doi.org/10.1007/BF03405140

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03405140

Search

Navigation