Lone Mothers Are at Higher Risk for Cardiovascular Disease Compared with Partnered Mothers. Data from the National Health and Nutrition Examination Survey III (NHANES III)

Lone mothers are a disadvantaged population, with research in several countries indicating that they experience low levels of physical and mental health. While research has demonstrated a socioeconomic gradient for cardiovascular disease (CVD), little research has explored lifestyle and clinical risk for CVD and prevalence of CVD events in lone mothers.

The purpose of this study is (1) to compare select CVD lifestyle risks (smoking, obesity, physical activity), health, and relevant sociodemographic variables in partnered versus lone mothers; (2) to examine the relationship between partner status and having experienced a CVD event (myocardial infarction [MI], congestive heart failure [CHF], stroke).

Data from the U.S. National Health and Nutrition Examination Survey III (NHANES III) included 1,446 women over 60 years with one or more children less than 17 years old. Lone mothers included women who were widowed, divorced, separated, never married, or married without the spouse living in the household (n = 623; weighted sample represents n = 3,904,450). Partnered mothers included women who reported living as married or married with the spouse in the household (n = 832; weighted sample represents n = 8,614,362). Weighted logistic regression was used to compare the prevalence of CVD risk factors in lone (43%) ver sus partnered (57%) mothers. Multivariate modeling was used to examine the relationship between partner status, CVD risks, and Coronary Heart Disease (CHD) events.

Compared with partnered mothers, lone mothers were less educated and reported lower levels of income, health, and social support; and they were more likely to report non-White ethnicity. Lone mothers were more likely to be current smokers, overweight or obese, and physically active than partnered mothers. Those with clinical risks for CVD, including diabetes, elevated C-reactive protein, hypercholesterolemia, or hypertension, or all of these were more likely to be lone mothers. After adjusting for age, we found that mothers who had experienced a CVD event (MI, CHF, or stroke) were 3.3 times more likely to be a lone mother than a partnered mother (95% confidence interval (CI) 3.24, 3.31).

Lone mothers are at increased risk for CVD. Health professionals and lone mothers should collaborate in the development of programs and policies not only to reduce lone mothers' risk for CVD, but also improve their conditions of living.

Support was received from Heart & Stroke Foundation of Canada, NINR Grant #2 P30 NR04001.

Notes

Support was received from Heart & Stroke Foundation of Canada, NINR Grant #2 P30 NR04001.

† Results are based on a weighted sample of 3,904,450 lone mothers and 8,614,362 partnered mothers.

‡ Wald test from univariate logistic regression model ≤0.001 for lone versus partnered mothers.

¹Lone mother: Woman with 1 or more children < 17 years.

† Results are based on a weighted sample of 3,904,450 lone mothers and 8,614,362 partnered mothers.

‡ Wald test from univariate logistic regression model ≤0.001 for lone versus partnered mothers.

²Social support: Phone contact or seeing friends > 1 time per month.

†Results are based on a weighted sample of 3,904,450 lone mothers and 8,614,362 partnered mothers.

‡ Wald test from univariate logistic regression model ≤0.001 for lone versus partnered mothers.

³Diabetes: Self-reported use of insulin or high fasting plasma glucose (= 126) or both, or high nonfasting plasma glucose (= 200).

⁴Hypertension: Self-reported use of antihypertensive medications, systolic = 140, or diastolic = 90, or all of these.

⁵Partnered mother: Woman who cohabits and has a child < 17 years.

^†Results are based on a weighted sample of 3,904,450 lone mothers and 8,614,362 partnered mothers.

‡Age adjusted odds of having a given outcome (e.g., CHF/MI/stroke) in lone versus partnered mothers. For example, women with hypertension are 2.5 times more likely to be lone mothers compared with partnered mothers.

*Multivariable models are adjusted for the following:

^a(age, education, poverty index ratio, receipt of Medicaid, body mass index, and physical activity)

^b (age, race/ethnicity, and education)

^c (age, receipt of Medicaid or food stamps or both, and education)

^d (age, receipt of Medicaid, race/ethnicity, education, and body mass index)

^e (age, poverty index ratio, receipt of food stamps, self-reported health, body mass index, and first-degree family history of myocardial infarction)

^f (age, receipt of Medicaid or food stamps or both, poverty index ratio, and education). The OR shown is the odds of having a given outcome (e.g., CHF/MI/stroke) in lone versus partnered mothers after adjusting for factors listed above.

⁶Elevated C-reactive protein: Levels > 1 mg/dl. Lone mothers' risk for CVD. NHANESIII