ترکیب یک کار و کودکان:تضاد سلامت زنان ازدواج کرده و طلاق گرفته در هلند.

Abstract The research question of this paper is whether the combination of paid employment and taking care of children promotes or damages the health of married and divorced women in the Netherlands. To answer this question, data are used from 936 women aged 30–54 years who were either living with a partner (N=431) or divorced and living alone (N=505). The findings show that combining a job outside the home and childcare does not harm women's health, irrespective of the length of the working week and the age of the children. In fact, some work–childcare combinations are associated with better health. This is true for both married and divorced women and especially holds true in the case of a part-time job and having older children. Two effects are responsible for the findings: enjoying good health enables mothers to work outside the home (selection effect) and working outside the home promotes mothers’ health (health effect).

Introduction In the Netherlands, female labour force participation has increased substantially in recent decades. Whereas no more than a quarter (26%) of all women aged 15–65 worked outside the home in 1960, this proportion had climbed to over a third (37%) in 1989 and to more than a half (51%) in 1999 (Marcus & Siegel (1982), Menaghan & Parcel (1990) and NCBS (1960)). The increase in female labour force participation may be attributed almost entirely to changes within the group of married women (Pott-Buter, Tijdens, Plantenga, & Janssens, 1998). Whereas in the past it was not customary—or in some cases even forbidden1—for married women to have a paid job, a substantial proportion of married women now remain active in the labour market. The percentage of married women with a paid job rose from 72 in 1960 to 31 in 1989 and to 45 in 1998 (Marcus & Siegel (1982), Menaghan & Parcel (1990) and More (1992)). Note, however, that most of these jobs are part-time. A majority of women decide to work fewer hours following the birth of their first child (Van der Lippe, 1993; Van der Vinne, 1998). Successive time budget surveys have shown that this strong increase in paid employment among married women has not led to a substantial redivision of unpaid work between men and women (Van den Broek, Knulst, & Breedveld, 1999; Van der Lippe, 1997). Household and family responsibilities are still largely the domain of women. In 1995, women spent an average of 21.9 h a week on housework and 3.7 h on caring for children and other household members (total 25.6 h); in 1975 this figure was 28.6 h (25.5 h housework and 3.1 h caring duties). Men, on the other hand, spent an average of 2.9 h more per week on household and family responsibilities in 1995 than in 1975: an increase from 8.2–11.1 h a week. Men, moreover, tend to spend these hours on the less tedious aspects of housework and childcare (Knijn, 1992; Pot & Deeg (1997) and Pott-Buter, Tijdens, Plantenga & Janssens (1998)). These days, for example, they are more inclined to wash the dishes, vacuum the house and put the children to bed, but tasks such as cleaning the kitchen floor, the windows or the lavatories, ironing and changing nappies are primarily left to their wives. So, for married women in general and mothers in particular working outside the home generally means having to take on an additional role: women still tend to assume prime responsibility for homemaking duties, alongside their paid jobs. Divorce does not improve women's circumstances but leads to undertaking increased household and childcare responsibilities. Divorced women are almost always granted custody over their children. Co-parenthood is still very uncommon in the Netherlands (Kalmijn & De Graaf, 1999). Even today, the most common parental access arrangement is that the children stay with their fathers every other weekend and that public and school holidays are divided amongst both parents. This means that as a rule, responsibility for day-to-day childcare is assumed by divorced women, and that they must inevitably combine these duties with paid employment. It has been said that combining work and children could damage women's health. Having to divide one's attention and time between ‘babies and briefcases’ could, for example, lead to a conflict of roles and put a strain on women, which in turn could result in fatigue, stress and, eventually, in illness (Van Poppel, 1996). Balancing work and children could, conversely, improve women's health since working outside the home could make a welcome change from the less pleasant activities and situations at home, and vice versa. In this article, we shall examine the effects of combining a job and childcare on the health of married and divorced women aged 30–54 years. The central research question is: Does combining work and children promote or damage the health of married and divorced women?

Results Work and health In the upper part of Table 2, columns 1 and 3 show the average state of health (range: 1 (bad)–5 (very good)) of married and divorced women, respectively, in relation to the average number of hours worked outside the home per week and adjusted for differences in age and level of education. There were clear differences in state of health between working and non-working women: women in paid employment tend to be in better health than full-time housewives (F=49.16, p<0.001). Although this applies to both married and divorced women, health differences between working and non-working women are much greater within the group of divorced women (married: F=14.84, p<0.001; divorced: F=39.97, p<0.001). Within the group of working women, on the other hand, there appeared to be no significant differences in state of health. This means that the average number of hours worked per week is not related to good or poor health. Differences in the state of health between married and divorced women are greatest among those who do not have a job outside the home and among those who work more than 36 h a week. In both cases divorced women are in poorer health (no job: F=7.20, p<0.01; 36 h or more: F=3.26, p<0.10). Table 2. Average state of health (range: 1–5) among married and divorced women in the 30–54 year age group, by employment and motherhood status, adjusted for differences in age and education and health differences in the pasta Married (N=431) Divorced (N=505) adj. for age and education (1) adj. for age, education and previous health problems (2) adj. for age and education (3) Adj. for age, education and previous health problems (4) Employment status Having a job 3.98 3.93 3.90 3.83 Working 1–11 h 3.85 3.87 3.92 3.98 Working 12–23 h 4.01 3.97 3.93 3.90 Working 24–35 h 3.95 3.90 3.96 3.85 Working 36 h or more 4.00 3.92 3.81 3.73 No job 3.65 3.74 3.34 3.50 Motherhood status Having children 3.88 3.87 3.75 3.74 Youngest child 0–4 3.87 3.89 3.70 3.73 Youngest child 5–12 3.95 3.89 3.81 3.79 Youngest child 13–18 3.87 3.83 3.80 3.74 Youngest child 19+ 3.88 3.89 3.76 3.74 Never had children 3.58 3.70 3.65 3.68 a Source: SIN ’98. Table options Two explanations can be put forward for the health differences between working and non-working women. One can either argue that working outside the home promotes women's health (the health effect) or that enjoying good health enables women to have a job outside the home (self-selection). Comparing columns 1 and 3 with columns 2 and 4, respectively, shows that both explanations are likely to be valid. In columns 2 and 4 the relationship between having a paid job and one's state of health is adjusted for the two measures of health differences in the past. It appears that health differences between working and non-working women are much smaller after adjustment has taken place. On average, women who have suffered chronic diseases/disabilities and/or prolonged medical treatment in the past are less likely to have a paid job, or else they have a ‘small’ part-time job of less than 12 h a week. More ‘extensive’ jobs, on the other hand, tend to be performed by women who have not had health problems in the past. However, health differences between working and non-working women remain significant (married: F=8.12, p<0.01; divorced: F=17.45, p<0.001). In other words, apart from the fact that healthy women are better able to participate in the labour force, having a job also appears to promote women's health. Children and health In the lower part of Table 2, columns 1 and 3 show that on average women with children are in better health than women without children (F=6.01, p<0.05). However, this correlation is only significant in the case of married women (married: F=6.04, p<0.05; divorced: F=1.07, p=0.302). When these figures are adjusted for health problems in the past (see columns 2 and 4), we see that the differences in health status may be partially attributed to selection effects: women without past health problems are more likely to decide to have children. However, there still appear to be differences in health between married mothers and childless married women (F=2.87, p<0.10). In other words, apart from the fact that women's state of health appears to be one of the factors determining whether or not they have children, caring for children appears to have a beneficial effect on the health of married women. Furthermore, caring for young children does not seem to put a heavier strain on women's health than caring for older children. The health status of mothers is barely affected by the age of the youngest child. Finally, the greatest health differences between married and divorced women are found within the group of mothers with the oldest or the youngest children, with divorced women in poorer health. These differences are not significant, however. Combining work and children in relation to health We have seen above that having a paid job appears to promote the health of both married and divorced women, regardless of the average number of hours worked per week. However, whether or not these working women also take care of (young) children was not taken into consideration. The positive effect of labour force participation on women's health could therefore be related to the fact that in most cases their employment circumstances are compatible with the situation at home. This could mean that most women who work outside the home are either childless or have older children, whereas most mothers with young children have (temporarily) given up their jobs, or have a part-time job that can be easily combined with their caring duties. In the latter case, a job may be a welcome change from the lives these women lead—and thus beneficial to their health—rather than a heavy additional burden. In order to determine whether this is actually the case, we have examined health differences between women based on the pressures of balancing ‘babies and briefcases’. Fig. 1 and Fig. 2 present the average state of health of married women in relation to both their employment and family situation, controlling for age and educational differences (Fig. 1) and previous health status (Fig. 2). Fig. 3 and Fig. 4 show similar results for divorced women. Health differences among married women in the 30–54 year age group, by family ... Fig. 1. Health differences among married women in the 30–54 year age group, by family and job situation, adjusted for differences in age and education. Figure options Health differences among married women in the 30–54 year age group, by family ... Fig. 2. Health differences among married women in the 30–54 year age group, by family and job situation, adjusted for differences in age and education and health differences in the past. Figure options Health differences among divorced women in the 30–54 year age group, by family ... Fig. 3. Health differences among divorced women in the 30–54 year age group, by family and job situation, adjusted for differences in age and education. Figure options Health differences among divorced women in the 30–54 year age group, by family ... Fig. 4. Health differences among divorced women in the 30–54 year age group, by family and job situation, adjusted for differences in age and education and health differences in the past. Figure options What is immediately apparent from Fig. 1 and Fig. 3 is that the positive relationship between paid employment and health is manifested primarily among married and divorced mothers with children aged five and over. Health differences between working and non-working mothers are most marked when the children are over eighteen (F=51.55, p<0.001), followed by mothers whose youngest child is aged 13–18 (F=13.74, p<0.001). The smallest, yet significant health differences are found among mothers whose youngest child is aged 5–12 (F=4.07, p<0.05). Comparing Fig. 1 and Fig. 3 with Fig. 2 and Fig. 4, respectively, shows that these health differences may be attributed in part to health selection: in order to be able to combine a job with caring for children, women need to enjoy good health. After adjustment for this fact, the health differences found between working and non-working mothers with a youngest child aged 5–12 years is no longer significant. However, if the youngest child is older than twelve health differences persist (age youngest child nineteen years or older: F=22.20, p<0.001; age youngest child 13–18 years: F=11.33, p<0.01). So, combining a job with caring for children older than four is not detrimental to the health of married and divorced women. In fact, balancing these responsibilities appears to promote health once the children have left primary school. Upon closer examination, we see that the work–childcare combination promotes health most strongly among women with a part-time job of less than 24 h a week. These jobs appear to be most compatible with homemaking duties. The only exception is found among married women with adult children, most of who live outside the home. The positive effect on the health of these women is strongest for those in paid employment for an average of 24 or more hours per week. It is likely that children in this age group require so little care that these responsibilities do not conflict with a longer working week. The situation is different for mothers with one or more children under five. Health differences between married working and non-working mothers are not significant with young children. In this group, the average state of health of women in paid employment is only fractionally higher (Fig. 1), and after adjustment for health problems in the past fractionally lower (Fig. 2) than that of women without a job. This suggests that the advantages of working outside the home are ‘disrupted’ by the pressures of having to combine a job with childcare. However, substantial health differences do exist among divorced mothers with young children. On average, divorced mothers of preschool children with a part-time job of less than 24 h a week are in better health than divorced women who do not combine childcare and a paid job (Fig. 3), the more so after these figures are adjusted for health problems in the past (Fig. 4). Differences in health status are not found between full-time housewives and divorced mothers of preschool children with a job of at least 24 h a week. However, if health problems in the past are taken into account, the average previous state of health of the latter turns out to be better. In other words, divorced young mothers who succeed in combining childcare with a long working week tend to be physically robust. A final noteworthy finding was that labour force participation was not associated with the health of married and divorced women without children. Among married childless women, this is also the case prior to adjustment for health problems in the past. Although paid employment appears to have a positive effect on the health of divorced women without children—working women in general, and those with a long working week in particular, tend to enjoy better health—this effect disappears following adjustment for health problems in the past. Those who are in good health tend to work on average 24 or more hours a week.