Co-resident Spouse Research Articles

Migration, Gender, and Families: The Effects of Spousal Migration on Women's Empowerment

Labor migration has a profound effect on families, but evidence documenting the impact of migration on women left behind is still lacking. Utilizing the Matlab Health and Socioeconomic Surveys, we examined the roles of migration and families in four domains of empowerment for women in Bangladesh. We found that women with international migrant spouses saw significant improvements in economic empowerment, mobility, and decision-making relative to women with coresident spouses (p < .0001). However, women who lived in multigenerational households with their parents or in-laws experienced significant reductions in empowerment across these three domains. Both having a migrant spouse and living in a multigenerational household had negative effects on beliefs about gender equivalence and reduced joint decision-making for women. Results, which were robust to migration selection controls (including propensity approaches), indicate that the benefits of migration for women left behind might be diluted by family structures that perpetuate unequal gender dynamics.

Does who you live with matter for your health? The influence of partners' socioeconomic characteristics on self-rated health in Norway.

Studies of the association between self-rated health and persons' income and education have almost invariably shown that people with higher education and incomes report better health. Less is known of the influence of household members' socioeconomic characteristics on individuals' health. This study thus aimed to assess the extent to which the socioeconomic characteristics of partners may contribute to explaining the variation in the respondents' self-rated health (SRH). Using an observational design, we analysed cross-sectional Norwegian survey data on SRH (2015 and 2019), linked to register data on education and income for respondents (N = 7082) and their opposite-sex coresident spouse or partner. We employed logistic regression models to assess the associations between respondents' SRH and the relative income and education of their partner. Average marginal effects were calculated to enable cross-model comparisons. Net of individual characteristics, having a higher-educated partner was positively associated with SRH for both male (OR = 1.56) and female (OR = 1.36) respondents. Having a partner with an above median income (by age and sex) was positively associated with SRH for female (OR = 1.29) respondents only. For education, the positive SRH associations were roughly similar for respondents and partners. For income, the associations were more pronounced for respondents than partners. Our findings suggest that health is affected by the resources (or lack thereof) in one's immediate networks. To reduce social inequalities in health, health personnel might customise interactions to account for household resources. Such knowledge could also be used in health-promoting activities to enhance participation and health competency.

"Living Well" Trajectories Among Family Caregivers of People With Mild-to-Moderate Dementia in the IDEAL Cohort.

ObjectivesUnderstanding whether and how caregivers’ capability to “live well” changes over time, and the factors associated with change, could help target effective caregiver support.MethodsWe analyzed 3 time points (12 months apart) of Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort data from coresident spouse caregivers of community-dwelling individuals who had mild-to-moderate dementia at baseline, using latent growth and growth mixture models. Capability to “live well” was derived from measures of quality of life, well-being, and satisfaction with life.ResultsData from 995 spouse caregivers at Time 1, 780 at Time 2, and 601 at Time 3 were included. The mean “living well” score decreased slightly over time. We identified 3 classes of caregivers: one with higher baseline scores declining slightly over time (Stable; 66.8%), one with low baseline scores remaining stable (Lower Stable; 26.0%), and one with higher baseline scores showing marked decline (Declining; 7.2%). Scores on baseline measures differentiated the Lower Stable, but not the Declining, from the Stable class. Longitudinally, the Declining class was associated with care recipient cognitive decline and increasing hours providing care, as well as caregiver stress and depression. Findings were similar when caregivers with other kin relationships were included.DiscussionThe findings indicate the importance of prompt identification of, and support for, caregivers at risk of the declining capability to “live well” and may assist in identifying those caregivers who could benefit most from targeted support.

Intergenerational Proximity to Aging Parents and Depression Among Married Persons in China.

Using data from China Health and Retirement Longitudinal Study (N = 3864), we examined the relationship between proximity to aging parents and depression among middle-aged (45-64years) married individuals in China. Our study depicted and explained the declining coresident rate and showed a majority of adult children live separately from their parents. Children living in different households had higher levels of depression than coresident children, including those living adjacently. Furthermore, having a coresident spouse increased the levels of depression of sons living in an adjacent dwelling and in the same city, and reduced the levels of depression of daughters living farther away. More intergenerational economic support increased the levels of depression of daughters living in an adjacent dwelling. These findings may offer a reference for married adult children to reconstruct intergenerational proximity and adjust intergenerational relations.

Prenatal Depression: Assessment and Outcomes among Medicaid Participants.

This study used bivariate and regression-adjusted analyses of participant-level survey and medical data to investigate prevalence of depression among pregnant Medicaid participants, correlates of depression, and the relationship between depression and pregnancy outcomes. The sample included Medicaid participants with a single gestation and valid depression data who were enrolled in Strong Start for Mothers and Newborns 2, a national preterm birth prevention program, from 2013 to 2017 (N= 37,287; 85% of total enrollment). Depression rates in Strong Start were high (27.5%). Depression was associated with being black; having other children, an unplanned pregnancy, or challenges accessing prenatal care; not having a co-resident spouse or partner; and experiencing intimate partner violence. After these and other risk factors were controlled for, depression remained associated with higher rates of preterm birth. Systematic screening and holistic approaches to prenatal care that address depression and associated risks could help reduce rates of preterm birth and other poor pregnancy outcomes.

Effects of Individual, Spousal, and Offspring Socioeconomic Status on Mortality Among Elderly People in China.

BackgroundThe relationship between socio-economic status and health among elderly people has been well studied, but less is known about how spousal or offspring’s education affects mortality, especially in non-Western countries. We investigated these associations using a large sample of Chinese elderly.MethodsThe data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from the years 2005 to 2011 (n = 15 355, aged 65–105 years at baseline; 5046 died in 2008, and 2224 died in 2011). Educational attainment, occupational status, and household income per capita were used as indicators of socio-economic status. Spousal and offspring’s education were added into the final models. The Cox proportional hazards model was used to study mortality risk by gender.ResultsAdjusted for age, highly educated males and females had, on average, 29% and 37% lower mortality risk, respectively, than those with a lower education. Particularly among men, this effect was observed among those whose children had intermediate education only. A higher household income was also associated with lower mortality risk among the elderly. Male elderly living with a well-educated spouse (HR 0.79; 95% CI, 0.64–0.99) had a lower mortality risk than those living with a low-educated spouse.ConclusionsBoth the socio-economic status of the individual and the educational level of a co-resident spouse or child are associated with mortality risk in elderly people. The socio-economic position of family members plays an important role in producing health inequality among elderly people.

Sample design, sample augmentation, and estimation for Wave 2 of the NSHAP.

The sample for the second wave (2010) of National Social Life, Health, and Aging Project (NSHAP) was designed to increase the scientific value of the Wave 1 (2005) data set by revisiting sample members 5 years after their initial interviews and augmenting this sample where possible. There were 2 important innovations. First, the scope of the study was expanded by collecting data from coresident spouses or romantic partners. Second, to maximize the representativeness of the Wave 2 data, nonrespondents from Wave 1 were again approached for interview in the Wave 2 sample. The overall unconditional response rate for the Wave 2 panel was 74%; the conditional response rate of Wave 1 respondents was 89%; the conditional response rate of partners was 84%; and the conversion rate for Wave 1 nonrespondents was 26%. The inclusion of coresident partners enhanced the study by allowing the examination of how intimate, household relationships are related to health trajectories and by augmenting the size of the NSHAP sample size for this and future waves. The uncommon strategy of returning to Wave 1 nonrespondents reduced potential bias by ensuring that to the extent possible the whole of the original sample forms the basis for the field effort. NSHAP Wave 2 achieved its field objectives of consolidating the panel, recruiting their resident spouses or romantic partners, and converting a significant proportion of Wave 1 nonrespondents.

Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study

Objectives To evaluate whether happiness can spread from person to person and whether niches of happiness form within social networks.Design Longitudinal social network analysis.Setting Framingham Heart Study social network.Participants 4739...

Major depression among medically ill elders contributes to sustained poor mental health in their informal caregivers

No longitudinal studies have addressed the effect of late life depression on the physical and mental health status of their informal caregivers. To examine whether a diagnosis of depression in older medical inpatients is associated with the physical and mental health status of their informal caregivers after 6 months, independent of the physical health of the care recipient. Longitudinal observational study with 6-month follow-up. Two Montreal acute-care hospitals. A sample of 97 cognitively intact medical inpatients aged 65 and over and their informal caregivers, with oversampling of patients with a diagnosis of major or minor depression. Patient data included depression (current diagnosis, duration of current diagnosis, severity of symptoms, and history of depression), physical health (severity of illness, comorbidity, premorbid disability), and cognitive impairment. Caregiver data included relationship to patient, co-residence, and the physical and mental health status subscales of the SF-36. Multivariate linear regression analyses were conducted to determine the relationship between patient depression and caregiver 6 month SF-36 physical and mental scores, adjusting for baseline values, patient comorbidity, disability, and other patient and caregiver variables. Patient characteristics included: mean age 79.3, 62% female, 46% major depression, 18% minor depression, 36% no depression. Caregiver characteristics included: 73% female, 35% co-resident spouse, 15% other co-resident relation, 50% not residing with the patient. Results of the multivariate analyses showed that in comparison with caregivers of patients without a current diagnosis of depression, caregivers of those with major depression had a lower mental health score at follow-up (-9.54, 95% CI -16.66, -2.43), even though their physical health was slightly better (5.42 95% CI 0.04, 10.81). A diagnosis of major depression in older medical inpatients is independently associated with poor mental health in their informal caregivers 6 months later.

Homogamia educacional en México y Brasil, 1970-2000: Pautas y tendencias

En un contexto historico de expansion educativa, mejora de los rendimientos de la educacion y aumento de la participacion de la mujer en la actividad economica, este articulo examina y compara las pautas y tendencias en homogamia educativa en Mexico y Brasil entre 1970 y 2000. Concretamente, tratamos en perspectiva temporal y comparada las siguientes cuestiones: grado y alcance de la homogamia educativa y simetria en las relaciones de genero. Para ello utilizamos las muestras armonizadas de microdatos de los censos de Mexico 1970, 1990 y 2000, y de Brasil 1970, 1980, 1991 y 2000, puestas a disposicion por el proyecto IPUMS-International. Los resultados muestran un aumento de la homogamia entre las capas mas instruidas y una disminucion de la hipergamia femenina en ambos paises. Comparativamente, la homogamia educativa es mayor en Brasil que en Mexico, reflejo de una mayor desigualdad social, mientras que las diferencias de genero son mayores en Mexico. Educational homogamy (marriage between individuals of the same level of educational attainment) in Mexico and Brazil is declining significantly with the revolution in school attainment. In Mexico, over a mere three decades, the proportions finishing primary school doubled, rising from 40 percent for the 1931–40 birth cohort to 80 percent for those born 1961–70. In Brazil, where primary school consists of only four grades (compared to Mexico's six), the completion rate rose even more dramatically from 33 to 73 percent. Nevertheless these figures also show that in both countries sizeable fractions of the youngest generation did not complete primary schooling (one-fifth in Mexico and one-fourth in Brazil). Substantial inequalities of access to schooling persist. At the upper end of the educational spectrum, for these same cohorts the percentage of Mexican husbands with some university studies increased even more dramatically, from 5.1 to 13.2 percent and, for wives, from 1.1 to 8.3 percent. In Brazil the comparable figures are 2.2 to 5.8 percent and 0.6 to 5.7 percent, respectively. Marriage choice in both countries is strongly associated with levels of schooling completed—such as graduation from primary school, completion of basic or upper secondary, and attendance at or graduation from university. Years of schooling completed is not as salient. Thus, this research focuses on culturally significant categories rather than arbitrary number of years of schooling to compare patterns of marriage by educational attainment in the two countries. We analyze three successive ten-year birth cohorts, beginning with the 1931–40 generation, and take into consideration all marital unions, consensual as well as official. All coresident spouses in which either the husband or the wife was born between 1931 and 1970 are considered. The number of Mexican couples analyzed is 2,396,320 and Brazilian, 1,546,365. Our sources are high density integrated, anonymized census microdata samples obtained from https://www.ipums.org/international/index.html for the period 1970–2000. A series of nine log-linear models control for the unequal frequencies of various levels of educational attainment to reveal striking changes in the propensities of marriage within and between these groups. Log-odds ratios show universally positive homogamy for both countries, all censuses, and all levels of educational attainment except for one—where either the husband or the wife began but did not complete the secondary grades. (For this group, heterogamy was the rule in both countries and increased over time.) At the higher levels of educational attainment, homogamy is most extreme and is increasing in intensity over the generations, while at the lowest levels, homogamy is lower and declining slightly. Homogamy levels are much higher in Brazil than in Mexico, a finding which demonstrates the greater social inequalities in Brazil, and the fact that for Brazilians social mobility by means of education is more difficult than for Mexicans. These findings are suggestive rather than conclusive, and call for further research taking into account variables that influence educational attainment.

Caregiver strain in spouses of stroke patients.

To test the ability of a previously generated logistic regression model to predict caregiver strain from carer mood, negative affectivity and perceived patient functional ability. Postal prospective survey. Spouses of community-residing patients identified from hospital stroke registers. Spouses were assessed at three and six months after stroke. A previously derived equation was used to make predictions at three months of their level of strain at six months, which were compared with observed outcomes. Spouses were asked to complete the Caregiver Strain Index (CSI), the General Health Questionnaire (GHQ-12), the Positive and Negative Affectivity Schedule (PANAS) and to assess patients' independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). Of 409 stroke patients, 276 had an identifiable co-resident spouse and 116 (42%) completed the measures. At three months after stroke, 39 carers (34%) were under significant strain with 40 (35%) under strain at six months. The predictive model using the GHQ-12, PANAS and EADL at three months was 78% accurate in predicting levels of caregiver strain at six months. Carers at risk of later strain could be identified for further follow-up. Services to provide emotional support to carers might be effective in the reduction of carer strain.

Caring at a distance: Learning and practice issues

Emphasis on support for informal carers focuses on those who provide, in the words of the Carers (Recognition and Services) Act 1995, 'substantial' and 'regular' care. Following research and policy, professional education has also developed interest in those who live with the people they support, such as co-resident spouses and children of all ages. This article considers those who probably do not define themselves as carers and are usually referred to as 'relatives' or 'family', living at a distance from an older relative. It explores their possible need for support as well as the form and level of their involvement in relation to care managed services. It describes key areas or events to draw out practice issues and concludes with a discussion of the extent to which care management can work with such relatives. In many ways caring at a distance forces an examination of what is meant by 'care' and who can legitimately claim this as an emotion or status. The rationale for such interest is therefore three-fold. If social workers and social work educators restrict the meaning and their definitions of carers to those who provide 'hands on' services, as part of the care package, they risk alienating relatives from the learning experience of students. In doing so they may neglect these highly valued supports of older people and may leave relatives distressed and disempowered by anxiety over their contract with social work agencies.

SES10.02 Eurocare: A cross-national study of co-resident spouse carers for people with Alzheimer's disease

SES10.02 Eurocare: A cross-national study of co-resident spouse carers for people with Alzheimer's disease

Factors associated with strain in co-resident spouses of patients following stroke

Factors associated with strain in co-resident spouses of patients following stroke

Factors associated with strain in co-resident spouses of patients following stroke.

To identify the factors associated with carer strain following stroke. Co-resident spouses of stroke patients were sent questionnaire measures of their perceptions of strain, stress, mood, handicap, adjustment, social support, life satisfaction and personality, and patient's mood and independence in activities of daily living. Stroke spouses were identified from the stroke register at City Hospital, Nottingham. In a sample of 222 carers, 37% had significant strain. Strain was highly correlated with negative affectivity on the Positive and Negative Affectivity Scale, carer mood on the General Health Questionnaire-12 (GHQ-12) and carer's perceptions of patient's independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). Logistic regression analysis of 96 of these carers supported the correlations and showed three factors, carer GHQ-12, patient EADL and negative affectivity, were independently associated with carer strain. The relationship between these factors and strain needs to be tested prospectively. Early identification of carers who may be at risk of strain later on will enable services to be targeted at prevention rather than cure.

The impact of co-resident spouses and sons on elderly mortality in rural Bangladesh.

This paper uses prospective data from the Matlab surveillance system in rural Bangladesh to demonstrate that initially co-resident spouses and sons have a major impact on the subsequent mortality of old people, with significant differences by the sex of the elderly person, and the age of the son. Spouses significantly reduce mortality by similar magnitudes for both elderly men and women. On the other hand, co-resident adult sons reduce mortality for elderly women much more than for elderly men, with younger sons being more beneficial than older sons. Furthermore, both married and unmarried females appear to benefit equally from co-resident adult sons. Finally, this analysis suggests that the impact of spouses and sons on mortality in old age is not substantially mediated through changes in elderly economic status.

EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: II--A qualitative analysis of the experience of caregiving.

Spouses caring for a partner with dementia are subject to physical, psychological and social stresses. In view of the part played by spouse carers in preventing admission to institutional care, a fuller understanding of the subjective experience of caring is an important area of enquiry. Qualitative analysis of their accounts of the difficulties and rewards in looking after their partners may indicate strategies to support them and to alleviate the stresses that they experience. Twenty co-resident spouses of people with NINCDS-ADRDA probable dementia of the Alzheimer's type, who had been diagnosed as such within the past 12-36 months, were recruited from service contacts in each of 14 out of the 15 countries of the EU. All completed a semi-structured interview that included open-ended questions about the experience of caring. Overall, the most commonly expressed difficulties reflected: loss of companionship through diminished quality of communication; loss of reciprocity as carers experienced their partners' growing dependency; and deterioration in their partners' social behaviour. Satisfaction from caring stemmed from: a feeling of job satisfaction; continued reciprocity and mutual affection; companionship; and the fulfillment of a sense of duty. Spouse carers in the 14 countries described the difficulties and rewards of caring in similar terms. This suggests commonality of experience, in spite of diversity in informal and statutory provision of care for older people between different countries.

EUROCARE: a cross-national study of co-resident spouse carers for people with Alzheimer's disease: I—factors associated with carer burden

The challenges presented by the increasing public health and social impact of caring for people with dementia have become clear in recent years. Previous research has identified that, while there are positive as well as negative elements to the caring role, carers are at high risk of mental health problems and that the comprehensive burden of caring has social, economic and health based elements. Co-resident carers, especially spouses, are of primary importance in maintaining people with dementia in their own homes in the community rather than in institutional settings which may be both more costly and have greater environmental poverty. There have, however, been few studies which have sought to investigate factors associated with carer burden and differences and similarities between countries. In this study we aimed to produce a cross-national profile of co-resident spouse carers across the European Community, with particular attention to: living arrangements; formal and informal support; service satisfaction; perceived burden; and psychological well-being. Twenty co-resident spouse carers of people with NINCDS-ADRDA probable dementia, who had been diagnosed as such within the past 12-36 months, were recruited from service contacts in each of 14 out of the 15 countries of the EU. All completed a semi-structured interview which included: sociodemographic data; data on health and social service use; the Carer Burden Inventory (CBI); the General Health Questionnaire-12 (GHQ-12); and open-ended qualitative questions about the experience of caring. Two hundred and eighty couples were recruited. There was marked variation in all variables of interest between countries, but there were consistently high ratings of carer burden (mean CBI scores between 28 and 52) and psychological distress (between 40% and 75% scoring 4 or more on the GHQ-12). Using multivariate analyses (generalized linear modelling) to estimate the individual associations of variables of interest with carer burden, controlling for the effects of all other variables in the model, the following results were obtained: 11.4% (p = 0.003) of the variance was accounted for by between-country variation; 4.9% (p < 0.001) by expressed financial dissatisfaction; 4.5% (p = 0.001) by lower carer age; 3.2% (p = 0.004) by difficulties with spouse behavioural deficits; and 2.0% (p = 0.024) by perceived negative social reactions. There was a low level of contact with support groups and Alzheimer's disease societies despite the samples having been of service contacts. This study confirms the high level of burden and mental distress in spouse carers for people with Alzheimer's disease in the European Community. It suggests that there are elements of burden which may vary by country but also elements which have a common effect in all. These data suggest avenues for the primary and secondary prevention of burden by addressing clinical issues (e.g. behavioural disturbance); public attitudes and education (e.g. negative social reactions); economic support for carers (e.g. financial dissatisfaction); and higher risk groups (e.g. younger spouse carers).

Age and gender variation in the impact of household structure on elderly mortality.

There is little information about the impact of household structure and composition on elderly mortality in developing countries. This study examines the impact of relationship to head of household, and the presence of co-resident spouses and sons on elderly mortality in rural Bangladesh with a particular focus on age and gender differences. A total of 9365 individuals aged > or = 60 at baseline (5128 males and 4237 females) in the Matlab Surveillance area in rural Bangladesh were followed for a period of 8 years (1974-1982) with all predictors (the presence of a spouse, one or more co-resident adult sons, relationship to head of household, household economic status, age and disability status) being measured at the beginning of follow-up. Cox proportional hazard models were used in the analysis. Being the head of household had a significant impact on reducing elderly mortality for both men and women. The presence of a spouse reduced mortality for all elderly men but had a significant beneficial impact only on women whose husbands were heads of households. Finally the presence of one or more co-resident adult sons reduced mortality for elderly women but not for elderly men. For all three of the above predictors there was a decline in effect with the age of the elderly. Relationship to head of household and the presence of spouses and sons have powerful impacts on reducing mortality for elderly men and women in rural Bangladesh with the effects varying significantly by gender and age. Furthermore, individual rather than joint access to material resources is an important determinant of elderly mortality.

“Queer housewives?”: Some problems in theorising the division of domestic labour in lesbian and gay households

Abstract This article attempts to explore some of the difficulties that are present in existing theorisations of the domestic division of labour in lesbian and gay households. Arising from research on heterosexual couple households, which highlights the persistence of the gendered allocation of routine tasks and responsibilities between co-resident spouses, it is argued that research on lesbian and gay households has been narrowly framed. Whilst heterosexual households are theorised as gender-full, lesbian and gay households have been seen as altogether empty of gendering processes and practices. This article points toward more comprehensive ways of theorising the organization of sex/gender, sexuality and household work, and how these might be constitutive of domestic relations in lesbian and gay households.