Single fathers, less care

Single fathers are less likely to provide their children with health insurance and regular checkups, according to a new study -- thus putting the children at greater risk for limited access to care in case of an emergency.

The report, published online by the journal Health Services Research, analyzed data for more than 62,000 children in the first study to consider single fathers and healthcare on a nationwide scale.

Single-father households represent 6% of families with children, and their numbers are growing.

“Most single fathers are undoubtedly doing the best they can,” said study author Kathleen Ziol-Guest, a research fellow in public health at the Harvard School of Public Health. “But they may need more education and support.”

In the study, released July 17, the researchers analyzed data from the nationwide Urban Institute’s National Survey of America’s Families, which included interviews of families taken in 1997 and 2002.

Children of single fathers were more likely to have spent the entire year preceding the survey without any health insurance; 8.4% of single-father offspring went without coverage, compared with 7.6% of single-mother households.

When adjusted for factors such as income, education and race, the authors calculated that children of single fathers were 23% more likely to go without health insurance for the entire year than were children in other family structures.

Single fathers were also 8% less likely to provide preventive care for their children.

The cost of insurance cannot explain the discrepancy, the authors said. Overall, single fathers are better situated economically than single mothers, although not as well off as two-parent households.

Does this mean that kids of single-father households get less care when they need it?

That is hard to know, the authors said, because the study did not assess doctor visits when the child was sick or injured. Thus, it was unclear whether healthcare was actually compromised in single-father households.

Single mothers were actually 2.3% more likely to take their children to the doctor than dual parents, the study found.

“Single mothers really seem to be navigating the systems very well for their children,” Ziol-Guest said, despite low incomes in many of those families.

She suggested that mothers may be more likely to think their children’s health is in danger.

In support of this, she noted that single mothers were more inclined to report that their children were in poor health, and the study authors think that this has more to do with the parent’s perception than the child’s state.

Men are more likely to take chances with their own health, Ziol-Guest said, and this tendency could also lead to risks with their children’s healthcare. When asked about their children’s lack of insurance coverage, men were more likely to respond that it wasn’t necessary.

Social scientist Kevin Roy at the University of Maryland, who was not involved with the study, found the results to be in line with his experience working with low-income fathers.

However, he noted that many single fathers have the help of a partner, grandmother or aunt as a secondary caretaker.

Those families were excluded from the current study, Ziol-Guest said.

Ziol-Guest’s concern is what will happen to children in single-father families if they have an accident or suddenly become ill. Only 87% of single fathers reported a steady relationship with a doctor outside of the emergency room, whereas 90% of single mothers, and 95% of two-parent families, had a usual healthcare provider.

To combat this problem, Ziol-Guest suggests reaching out to men in new venues, such as at the kids’ schools -- not just the usual ones such as welfare offices and healthcare services for low-income patients.

“If men aren’t using such services,” she said, “they’ll miss the advertising.”

“Men are motivated to help their kids,” Roy said. “When they see that their attitude about health impacts their children, they may sit up and do something about it.”