Does employment improve the health of lone mothers?

In Britain the government is currently proposing legislation that will encourage welfare recipients to gain employment. A central tenet of this ‘welfare to work’ policy is that employment will not only reduce the poverty of welfare recipients, but also improve their health. This research assessed the extent to which the movement from ‘welfare to work’ is likely to benefit the mental and physical health of lone mothers with preschool children. The sample was 719 lone mothers and a comparison group of 8779 women with partners drawn from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Data collected by self completion questionnaire at 33 months postpartum provided information about average weekly take home family income and the mother’s employment status. The health outcomes measured were general well being, both minor and major depression (using the Edinburgh Postnatal Depression Scale), self report of respiratory symptoms (cough/cold, wheeze, influenza) from 18–33 months postpartum and self report of symptoms common in the childbearing years (backache, haemorrhoids) also from 18–33 months postpartum. Lone mothers who were not employed were the poorest group in the sample; 94% of this group (402) had a family income of less than £200 per week, compared with 72% (188) of lone mothers who were employed, 25% (905) of partnered women who were not employed and 12% (466) of partnered women who were employed. Lone mothers were significantly more likely than women with partners to report poorer well being (χ2=11.7, df=3, P=0.01), to have a major depressive disorder (χ2=92.6, df=1, P=0.0001) and to report wheeze (χ2=31.1, df=1, P=0.0001), but significantly less likely to report cough/cold (χ2=9.9, df=1, P=0.0001) or haemorrhoids (χ2=16.6, df=1, P=0.0001). Lone mothers who were unemployed and living on less than £100 per week were significantly more likely to be depressed (χ2=3.9, df=1, P=0.05) than those who were employed and living on £200 or more per week, and significantly less likely to report cough/cold (χ2=3.8, df=1, P=0.05). Logistic regression analyses showed no significant independent association between employment and better health for lone mothers. Rather, when compared with lone mothers who were not working, those who were employed were more likely to report minor respiratory symptoms such as cough/cold (OR=1.51, 95% CI=1.00,2.31). Overall, the results suggested that the movement from ‘welfare to work’ is unlikely to improve the health of lone mothers.