Single mothers: Rising population, declining health

Introduction: The number of Single mother households in the U.S. is higher than ever before. Though the annual income and employment among this group has increased, self-reported health has declined. The purpose of the study was to investigate differences in healthcare utilization and access among employed and unemployed single mothers.

Methods: We analyzed pooled data from the 1997 to 2009 U.S. National Health Interview Survey to examine single mothers >= 18 years (n=21,492). Multivariable logistic regression with contrasts between health insurance and mother's employment status was used to evaluate indicators of healthcare access and utilization. Analyses were adjusted for socio-demographic variables (including age, race/ethnicity, education and poverty income ratio).

Results: Seventeen percent of employed single mothers received public assistance, though 27% of all single mothers lived below 200% of the poverty level. More than 14% of single mothers reported delayed medical care; 14.8% needed prescription medicines, 4.8% needed mental health counseling and 19.6% needed a dental but reported not getting one because they could not afford it. Sixty-seven percent of women who reported delayed care as a result of not getting an appointment when needed were working mothers. Among single mothers with insurance data, 13.7% reported not having a place to visit for routine checks and minor illnesses.

Conclusion: Employment is a double edge sword for single mothers; it provides sufficient financial stability to be independent of public assistance such as welfare, but does not allow many enough time and money to afford health care costs or seek care.