Living arrangements after family split-up, well-being and health of adolescents in French-speaking Belgium

Abstract

Introduction After a parental separation, different types of living arrangements exist for children and adolescents; joint physical custody (when children spend equal time with both parents), mostly with one parent and sole custody. Current findings on the effects of living arrangements on adolescents are not consistent. For some authors, joint physical custody is the most favourable living arrangement to health and well-being while for others, it is less favourable than other living arrangements. Finally, some authors argued there is no difference. In Belgium, about one fifth of the children below the age of eighteen experienced a parental separation. In 2006, joint physical custody was introduced in Belgian law as the default residential model. The objective of this study was to identify the most favourable living arrangement to adolescent health and well-being in French-speaking Belgium. Methods The Health Behaviour in School-aged Children (HBSC) study is a repeated cross-sectional survey, in which every four years, adolescents are questioned about their health, well-being and health behaviours along with their living conditions, among which family environment. This study is based on data from two waves of HBSC survey in French-speaking Belgium (2010 and 2014). In total, 18,683 10–18-year-old adolescents were included. Self-rated health, multiple health complaints and life satisfaction were used as outcomes variables. Living arrangements was used as the main independent variable and categorised into “joint physical custody”, “mostly with one parent” and “sole custody”. All analyses were weighted according to the sample size of each survey year. Logistic regressions were used. Firstly, analyses were adjusted for survey year (model 1). Thereafter, analyses were adjusted for age, gender, survey year and family wealth perception (model 2). The family wealth perception is based on the question “How well off do you think your family is?”. Results Over the two surveys, 18.3% of the adolescents were living with separated parents. Among them, 34.2% were living in joint physical custody, 41.8% were living mostly with one parent and 24.0% in sole custody. Globally, adolescents living with separated parents were more likely to report a poor self-rated health (OR = 1.30; 1.08–1.56), multiple health complaints (OR = 1.47; 1.36–1.60) and a poor life satisfaction (OR = 1.76; 1.58–1.96) than those living with both parents. In model 1, adolescents living mostly with one parent (OR = 2.06; 1.39–3.06) or in sole custody (OR = 2.46; 1.61–3.74) were more likely to report a poor self-rated health than those living in joint physical custody. This association was still significant after adjustment for sociodemographic characteristics in model 2. Adolescents living in sole custody were more likely to report multiple health complaints (OR = 1.42; 1.18–1.70) and a poor life satisfaction (OR = 1.48; 1.19–1.85) compared with those in joint physical custody. No differences were observed between adolescents living in joint physical custody and those living mostly with one parent. After adjustment for age, gender and wealth perception, both associations became non-statistically significant. Conclusion In terms of health and well-being, few differences were observed between post-separation living arrangements. Only the self-rated health significantly differed between living arrangements, in favour of adolescents living in joint physical custody. Health and well-being differences between living arrangements in the non-adjusted model can be partially explained by socioeconomic disparities. Living arrangements per se have few impacts on adolescent health and well-being. Further researches are needed to investigate the role of other living conditions (e.g. socioeconomic characteristic, parenting style) on the association between living arrangements and adolescent health and well-being.