Death of an adult son increases depressive symptoms in mothers, but not fathers (Social Science and Medicine)

Posted on by Catherine Zandonella
Sad mother picture
A study by researchers at Princeton and Georgetown Universities found that Taiwanese mothers – but not fathers – experience depressive symptoms after an adult son’s death, while the death of a daughter had no such effect on either parent.

By B. Rose Huber, Woodrow Wilson School of Public and International Affairs

Mothers – but not fathers – exhibited symptoms of depression and experienced declines in overall health after the death of an adult son, while the death of a daughter had no such effect on either parent, according to one of the first studies to examine the impacts of the death of an adult child on parents aged 65 and older.

In East Asian cultures, an adult son’s role in the family is crucial to the wellbeing and financial stability of his parents, the researchers suggest. Therefore, a traumatic event, like the death of a son, could place quite a strain on elderly parents living in these cultures – particularly women, especially if the deceased son is the eldest or only son.

The researchers, from the Office of Population Research in Princeton University’s Woodrow Wilson School, published their findings in the journal Social Science & Medicine based on data from the Taiwanese Longitudinal Study of Aging, a nationally representative survey designed to assess the health of older people in Taiwan.

“In East Asian cultures like Taiwan, sons hold the primary responsibility for providing financial and instrumental assistance to their elderly parents,” said lead author Chioun Lee, a Princeton postdoctoral research associate. “Older women who have had particularly few educational and occupational opportunities are more likely to rely on their sons for support. Therefore, a traumatic event, like a son’s death, could place quite a strain on a mother’s health.”

Along with study coauthor Noreen Goldman, the Hughes-Rogers Professor of Demography and Public Affairs at WWS, and researchers from Georgetown University, Lee used data collected for the Taiwanese Longitudinal Study of Aging from 1996 to 2007, which included approximately 4,200 participants.

To evaluate parental wellbeing, they used two self-reported measures: one for overall health and another for depressive symptoms. Each respondent’s health was assessed based on the following question: “Regarding your current state of health, do you feel it is excellent, good, average, not so good, or poor?” The items were coded on a one-to-five-point scale with higher scores indicating better health. Past studies have indicated that this measure is a strong predictor of mortality.

Depressive symptoms were measured with an eight-item subset of the Center for Epidemiological Studies Depression Scale, which asks participants to report how often they’ve experienced various situations or feelings in the past week. Possible answers range from “0,” which means rarely or none of the time, to “3,” which is most or all of the time. Higher scores for the eight items indicate more frequent depressive symptoms.

The researchers controlled for parental wellbeing prior to the death of a child and analyzed the data in two stages. First, they tested the extent to which a child’s death affected a parent’s health and then whether that varied by the parent’s sex. Finally, they determined the influence of a deceased child’s sex on parental wellbeing.

They found that women who lost a son scored, on average, 2.4 points higher on levels of depressive symptoms than those who did not lose a child. For men, there were no significant differences. There was no evidence to suggest that either mothers or fathers were significantly affected by depressive symptoms or declines in reports of overall health following the death of a daughter. Lee explains that while finances are a concern, there may be other factors at play.

“I also think that various attributes of deceased children, such as birth order, affective bonds with their parents or cause of death, might influence parental wellbeing,” said Lee, who is a native of Korea and observed son preference and gender inequality throughout her childhood.

According to Goldman, these findings underscore the continued gender inequality in Taiwan.

“Despite large advances in women’s labor market participation and educational attainment in recent years – for example, women in Taiwan are now more likely than men to hold a higher education degree – son preference persists, affecting various aspects of women’s well-being,” Goldman said.

Read the abstract.

Lee, C., et al., Death of a child and parental wellbeing in old age: Evidence from Taiwan, Social Science & Medicine (2013), http://dx.doi.org/10.1016/jsocscimed.2013.08.007

The work was funded by the Demography and Epidemiology Unit of the Division of Behavioral and Social Research at the National Institute on Aging and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

More or less equal? How men factor into the reproductive equation (Gender & Society)

Posted on by Catherine Zandonella
A new study calls attention to the role of men’s behavior and health in reproductive outcomes, such as fetal health, birth defects and childhood diseases. (Image credit: CDC/Amanda Mills)
A new study calls attention to the role of men’s behavior and health in reproductive outcomes, such as fetal health, birth defects and childhood diseases. (Image credit: CDC/Amanda Mills)

By Bess Connolly Martell, Office of Public Affairs and Communications, Yale University

Researchers know a lot about how women’s bodily health affects their fertility, but less is known about how men’s health affects reproductive outcomes. Yale University researcher Rene Almeling and co-author Miranda Waggoner of Princeton University address this discrepancy in an article published Tuesday, Dec. 3, in the journal Gender & Society.

In the period before conception, family health history and current health behaviors matter for women and men alike, say the researchers, adding that more clinical research needs to be done on how men’s bodily health affects their sperm, and in turn, reproductive health outcomes.

“The lack of attention to men in research on reproduction leaves open many important questions, including how men’s reproductive contributions are understood,” say Almeling, an assistant professor of sociology at Yale, and Waggoner, a postdoctoral researcher in the Office of Population Research in the Woodrow Wilson School of Public and International Affairs at Princeton.

The vast majority of medical and social science research on reproduction focuses on women. It wasn’t until recently that scientists began studying the role that men’s behavior and men’s health play in reproductive outcomes, such as fetal health, birth defects and childhood diseases.

The stereotypical association of women with family and men with work has led to a focus on women’s bodies in reproduction, leaving the question of how men’s health contributes to reproduction unanswered.

“What kinds of advice, if any, do men receive about preparing their bodies for reproduction?” ask the researchers. “Men should be empowered with information about how their age, health history and unhealthy behaviors can affect pregnancy outcomes.”

The sperm bank is one of the few places where men’s reproductive health takes center stage, the researchers note. At sperm banks, men are counseled on healthy eating, avoiding stress and reducing alcohol consumption. Not adhering to this advice can and does lead to lower sperm counts, suggesting that this kind of guidance might be more broadly useful for men trying to conceive children with their partners.

There are also associated policy implications. The Affordable Care Act stipulates that women with private insurance are no longer required to pay for preconception health appointments, but excluding men from such coverage continues to obscure their role in reproduction, say Almeling and Waggoner. “Paying attention to how reproductive equations influence policy can suggest new and different avenues for improving public health,” say the sociologists. They add, “Recent public health initiatives devoted to preconception care offer at least the possibility that men’s reproductive contributions will be considered alongside women’s.”

Read the abstract.

Almeling, Rene and Miranda R. Waggoner. More and Less than Equal: How Men Factor in the Reproductive Equation. Gender & Society December 2013 27: 821-842, first published on April 25, 2013 doi:10.1177/0891243213484510.

Both authors received funding from the National Science Foundation (Almeling grant #0602871 and Waggoner grant #1029087), and Miranda Waggoner also received support from the National Institutes of Health (T32 HD007163).