Work-family conflict and depressive symptoms among dual-earner couples in Germany: A dyadic and longitudinal analysis.

This study contributes to the existing literature by testing the longitudinal effects of both types of work-family conflict (i.e., work-to-family conflict [WTFC] and family-to-work conflict [FTWC]) on depressive symptoms, using data from three waves of the German Family Panel (pairfam) survey collected over a four-year period. Using responses from 631 married or cohabiting heterosexual couples, the analyses are estimated using dyadic data analysis and auto-regressive and cross-lagged panel models. This analytical approach tests direct causation, reverse causation, and reciprocal relationships among WTFC, FTWC and depressive symptoms. The results suggest a reciprocal relationship with significant cross-lagged actor effects between WTFC (and FTWC) and depressive symptoms. However, there were no gender differences in the cross-lagged actor effects between men and women, and no significant partner effects. These results highlight the bidirectional nature of the relationship between work-family conflict and depressive symptoms, which has several implications for research and practice.

Longitudinal Analysis of Work-to-Family Conflict and Self-Reported General Health among Working Parents in Germany.

The combination of work and family roles can lead to work-to-family conflict (WTFC), which may have consequences for the parents' health. We examined the association between WTFC and self-reported general health among working parents in Germany over time. Data were drawn from wave 6 (2013) and wave 8 (2015) of the German family and relationship panel. It included working persons living together with at least one child in the household (791 mothers and 723 fathers). Using logistic regressions, we estimated the longitudinal effects of WTFC in wave 6 and 8 on self-reported general health in wave 8. Moderating effects of education were also considered. The odds ratio for poor self-reported general health for mothers who developed WTFC in wave 8 compared to mothers who never reported conflicts was 2.4 (95% CI: 1.54-3.68). For fathers with newly emerged WTFC in wave 8, the odds ratio was 1.8 (95% CI: 1.03-3.04). Interactions of WTFC with low education showed no significant effects on self-reported general health, although tendencies show that fathers with lower education are more affected. It remains to be discussed how health-related consequences of WTFC can be reduced e.g., through workplace interventions and reconciliation policies.

[Improving access to migrant populations for epidemiological research-guided interviews with German experts]. / Zugangswege zu Menschen mit Migrationshintergrund für die epidemiologische Forschung ­ eine Befragung von Expertinnen und Experten.

BACKGROUND: In Germany, reliable information on the health of people with migration background (PMB) is scarce. Therefore, the Robert Koch Institute initiated the project "Improving health monitoring in migrant populations (IMIRA)" to improve the inclusion of PMB into the federal health monitoring. OBJECTIVE: The objective of this article is to identify challenges and strategies in accessing migrant populations with epidemiological research. MATERIAL AND METHODS: A total of 24 guided interviews with experts from Germany were conducted. Experts were scientists from various disciplines with a research focus on migration, civil servants in the area of migration, and experts from the field. The interview focused on challenges and strategies regarding access to migrants in research. The written summaries of the interviews were analyzed. RESULTS: Challenges in accessing PMB include language, sociodemographic and cultural barriers, fears, structural, and practical difficulties. Further challenges arise from the heterogeneity and motivation of the groups. Strategies to increase accessibility among PMB can be found in the research process, methods, communication, and diversity-sensitive research culture. Confidence-building is considered significant. DISCUSSION: Experts report a variety of strategies that focus on addressing and including PMB directly: strengthening of participatory approaches, new forms of translation, and measures to increase trust in research should be the focus of future efforts. The willingness to participate in epidemiological research can be increased with appropriate strategies and thus data on the health of migrant populations can be improved sustainably.

Work-family conflict, self-reported general health and work-family reconciliation policies in Europe: Results from the European Working Conditions Survey 2015.

The increasing labor market participation of women in Europe leads to many women and men having to reconcile paid work with family work and thus reporting work-family conflict (WFC). WFC is related to different dimensions of health. In the present article, we analyzed the role different reconciliation policies among European countries may play regarding WFC and its association with self-reported health. The analyses are based on data from Eurofound's European Working Conditions Survey 2015. The working populations from 23 European countries aged between 18 and 59 with at least one child up to 18 years of age are included (n = 10,273). Weighted logistic regression was applied to estimate the association between WFC and self-reported general health (SRH). Using multilevel models, country-level variations in the association of individual-level WFC and health were calculated. In a second step, the effect of country-level reconciliation policies on WFC was examined (adjusted for age, sociodemographic and occupational characteristics). The odds ratio for moderate to very poor SRH is 2.5 (95% CI: 1.92-3.34) for mothers with high WFC compared to mothers with low WFC. For fathers with high WFC, the adjusted odds ratio is also 2.5 (95% CI: 1.80-3.37). Between countries, the association between WFC and health is similar. Country-level parental leave policies, the use of formal childcare and mothers' labor market participation are associated with reduced WFC in Europe. In conclusion, the results reveal a strong association between WFC and SRH in Europe. The multilevel analyses show that certain reconciliation policies have an impact on the prevalence of WFC, with different results for mothers and fathers. Mothers in particular can be supported by sufficient maternal leave and formal care for children. These are tangible policy approaches for reducing WFC and may thus improve health in Europe.

Health-Related Consequences of Work-Family Conflict From a European Perspective: Results of a Scoping Review.

Background: Rising percentages of working mothers and increasing numbers of dual-earner couples are putting work-family conflicts on the agenda. Studies based on data from the US have already proven a link between work-family conflict and health in working parents with heterogeneous results for certain health outcomes and subgroups. Also, to date no comprehensive overview of the existing evidence regarding the impact of work-family conflict on health among European working parents exist. Methods: A scoping review was conducted to identify and analyze knowledge gaps regarding health-related consequences of work-family conflicts. To search for relevant publications on work-family conflicts and health, a systematic prospective literature search was carried out in two international databases (PubMed and Scopus) based on four landmark publications. The search was complemented by a systematic retrospective search in Scopus and hand searches. Inclusion criteria were a focus on work-family conflict, an analysis of health-related outcomes, and the presentation of empirical results. The publications were summarized in narrative style. Results: A total of n = 25 publications on work-family conflict and health in Europe were identified. The data suggests that a variety of instruments is used to measure work-family conflict. Also, work-family conflict and health are linked in Europe, although longitudinal data do not always show robust causal interrelations. Most studies focus on self-rated, mental, and physical health. Results for gender-specific health outcomes remain controversial. Conclusion: The review provides an overview of existing evidence for health-related consequences of work-family conflicts in Europe. The results of the review strengthen the evidence for a link between work-family conflict and health. However, heterogeneous results regarding the direction of work-family conflict and high-risk groups are a matter for discussion. This study investigates whether differences in the results can be accounted for by diverse measurement methods and study populations. Furthermore, different family policies in the European region as well intersectional approaches should be taken into account in further research.

Partnership, parenthood, employment and self-rated health in Germany and the EU - Results from the European Health Interview Survey (EHIS) 2.

Partnership, parenthood and employment constitute three main social roles that people adopt in middle adulthood. Against the background of the discussion about multiple roles and the reconciliation of family and work, this article analyses the association between the combination of social roles and self-rated health in Germany and the European Union (EU). The analysis is based on data from the second wave of the European Health Interview Survey (EHIS 2), which was conducted in all EU Member States between 2013 and 2015. The final sample included 62,111 women and 50,719 men aged between 25 and 59. Using logistic regression models, predictive margins for fair to very bad health in different family and employment constellations were calculated for the EU and Germany (in the case of men only for the EU in total). A difference was identified according to employment status in all family groups for women and men at the EU level: non-employed people rated their health as fair or bad more often, followed by part-time and full-time workers. Smaller differences by employment status were found for mothers with a partner in terms of the proportion of mothers who self-rated their health as bad compared to women in other family groups. No differences in health by employment status were found in Germany among mothers. This applies also to single parents. Different patterns of associations were identified between groups of EU Member States with diverse welfare systems.

[Single Parents in Germany: The Interrelation Between Social Support and Mental Health]. / Alleinerziehende Eltern in Deutschland: Der Zusammenhang zwischen sozialer Unterstützung und psychosozialer Gesundheit.

The lives of single mothers and fathers are associated with specific demands, which may result in higher psychosocial and physical strain compared to parents sharing their household with a partner. In this context, social support is known to function as a protective resource. The present article examines how different levels of social support interrelate with levels of mental health in single mothers and fathers in Germany. The data is drawn from the surveys 2009, 2010 and 2012 of the study "German Health Update" (GEDA) by the Robert Koch Institute. The sample includes 2062 single mothers and 242 single fathers. Logistic and negative binomial regressions estimate the interrelation between social support and psychosocial strain (self-reported number of unhealthy days due to psychological strain in the last 4 weeks) and depression (12-month prevalence) for single parents (adjusted for family and socio-economic factors). Single mothers with low social support have a 2-fold statistical odds (OR=2.0, 95% CI: 1.35-2.87) for at least one unhealthy day due to psychosocial strain compared to single mothers with strong social support. The odds for single fathers with low social support are 3.3-fold (95%-CI: 1.09-10.23). Furthermore, the number of unhealthy days increased by a factor of 1.4 (95%-CI: 1.20-1.66) for single mothers with low social support (IRR). The IRR for single fathers of the same group was 1.7-fold (95%-KI: 0.97-3.01). The odds of reported depression in the past twelve months is 1.8-fold (95%-CI: 1.18-2.67) for single mothers and 2.1 (95%-CI: 0.51-8.83) for single fathers with low social support compared to single parents with high social support. The results show that social support is an important resource for the mental health of single parents, regardless of other social circumstances. The results identify key populations to target for future health interventions. However, the correlations between social support and socio-economic status have to be explored further.

The subjective health of adults in Germany.

The term 'subjective health' reflects not only existing illnesses and health complaints, but particularly emphasizes the personal well-being. Studies often collect data on subjective health by asking participants to provide self-assessments of their general state of health. This was also the case with GEDA 2014/2015-EHIS, which employed the internationally renowned Minimum European Health Module (MEHM) as part of the study. Its results demonstrate that 68.2% of adults in Germany rate their general health as very good or good, with the remaining 31.8% rating it as fair, poor or very poor. The proportion of women who rate their general health as very good or good is slightly lower than the proportion of men who do so (66.6% compared to 69.9%). With increasing age, women and men view the condition of their general health as worsening. The study also identified educational differences which showed that men and women with low levels of education tend to rate their health worse compared to self-assessments provided by women and men with higher levels of education, and in some cases also regional differences.

The health of single mothers and fathers in Germany.

In every fifth family in Germany, one parent lives alone with children in the household. Life as a single parent is often marked by challenges that include adopting sole responsibility for the child's education and care, alongside employment commitments, and the difficulties of reconciling work and family life. Moreover, despite comparatively high employment rates, single parents - and their children - are greatly affected by poverty. This paper compares the health of single parents and parents living in partnership and analyses the extent to which single parents' health varies according to their socio-economic and employment status, and social support. The analysis was conducted using data from the German Health Update (GEDA) study in 2009, 2010 and 2012 on fair or poor self-rated general health, as well as depression, back pain, obesity, smoking, sporting inactivity and the non-utilization of dental check-ups. The analyses are based on data from 9,806 women and 6,279 men living in a household with at least one child under the age of 18. The study identified a significantly higher prevalence for all health indicators (apart from obesity) among single mothers compared to mothers living with a partner. In the case of single fathers, higher prevalences were found for depression, smoking and the non-utilization of dental check-ups. On average, the lower socio-economic status of women can explain a certain proportion of the health impairment of single parents, but not for men. However, a lower socio-economic status or social support do not account for the health impairments of single parents. Therefore, the higher prevalence of health impairments among single parents cannot simply be attributed to differences in employment status or to lower levels of social support; rather, certain health indicators show a cumulative effect between single-parents status and the social factors mentioned above. The results presented here provide a differentiated view of the relationship between the health and social situation of single parents. Improving the financial position of one-parent families and making it easier to reconcile work and family life are important steps that would help improve the health of single parents.

Social support as a health resource in Germany.

Social support is a psychosocial resource that results from social ties and networks. It has a significant impact on health and can improve mental well-being, reduce stress and mitigate the impact of unfavourable living conditions. The GEDA 2014/2015-EHIS survey undertaken by the Robert Koch Institute (RKI) is used to examine the extent and distribution of perceived social support among the adult population in Germany (n=23,617). The results show that both women and men largely feel supported by the people they are close to and their neighbours. However, perceived social support is not distributed equally across the population: the elderly, people with low levels of education and the unemployed report relatively frequently that they receive low levels of social support. As such, the sections of the population that are more frequently affected by health problems are also less likely to be able to rely on social support.