摘要：Objectives. We compared recent parents (married, cohabiting, not cohabiting but romantically involved, and not romantically involved) to examine the association between mental health problems and relationship status. Methods. We analyzed data from the Fragile Families and Child Wellbeing Study that followed a cohort of approximately 4900 births in large US cities. Our study included a large oversample of nonmarital births (n=3700) and interviews with both mothers and fathers. We used the Composite International Diagnostic Interview Short Form to assess depression and generalized anxiety 1 year after the birth. Self reports were used to measure heavy drinking, illicit drug use, incarceration, and partner violence. Results. Unmarried parents reported more mental health and behavioral problems than did married parents, and unmarried parents whose relationships ended before the birth reported more impairment compared with other groups of unmarried parents. Conclusions. A substantial number of children are born to unmarried parents and are at risk for poor parenting and poor developmental outcomes. Government initiatives aimed at increasing marriage rates among low-income couples need to consider the mental health status of unmarried parents. Mental health problems are a major public health concern. They affect more than a quarter of all Americans each year 1 and take an enormous toll on families in terms of economic well-being, 2 intimate relationships, 3 , 4 parenting quality, and child health and development. 5 – 7 The mental health of parents and children is a particular concern for researchers and public health professionals because of recent trends in marriage and fertility. Non-marital childbearing (i.e., childbearing outside marriage) has increased dramatically in the United States during the past 4 decades, especially among minorities and couples with limited education. 8 , 9 Whereas 1 out of 3 births in 2000 were to unmarried mothers, nearly 70% of Black births and 43% of Hispanic births occurred outside marriage. 10 Because nonmarital childbearing is associated with low socioeconomic status—an established risk factor for mental disorder—the mental health problems of families may be increasing. 11 – 13 Unfortunately, we know very little about parents who have children outside marriage. Although past research has shown that marriage is associated with positive mental health, 14 most of this research does not distinguish between divorced and never-married parents. This research also does not distinguish between the different types of never-married parents. According to a recent estimate, about 50% of unmarried parents are cohabiting at the time of birth, 30% are in a romantic relationship, and 20% are not in a romantic relationship. 15 Because of the diversity of relationships, there may be considerable variation in the mental health of unmarried parents. For example, cohabiting parents may resemble married parents, and parents who are no longer romantically involved may resemble divorced parents, with noncohabiting romantic parents falling somewhere in between. Mental health problems and the variation in mental health across relationship types are also of interest to policymakers. Congress has proposed spending $1.6 billion during the next 5 years on programs that seek to promote “healthy” marriage among unmarried parents. 16 These programs are based on the assumption that educating parents about the benefits of marriage and strengthening their communication and relationships skills will increase marriage rates and thus, improve child well-being. The mental health status of these parents is important for several reasons. First, assuming that marriage improves mental health, this information may tell us something about the potential benefits of the new programs and how the benefits may vary across subgroups. Because causality is likely to be bidirectional—with marriage improving mental health and better mental health increasing marriage—the difference between married and different types of unmarried parents should be viewed as an upper-bound estimate of the potential benefits of marriage. Second, assuming that poor mental health is one of the reasons people do not marry, knowing more about the problems of unmarried parents can tell us something about the obstacles that practitioners will face when trying to implement the new marriage programs. Moreover, information on mental health differences across relationship types will help professionals identify and target services for those who need them most. Finally, to ensure that the new marriage programs “do no harm,” practitioners need to know more about the prevalence of antisocial behavior and domestic violence among different groups of unmarried parents. Research has shown that partner violence is a relatively common experience among low-income single mothers 17 , 18 and that living with a violent or antisocial father is more harmful to children than living with no father. 19 Again, in order to know how to target the marriage programs, we need more information on which groups of mothers and children are most at risk. We examined the prevalence of mental health problems among mothers and fathers of infants, and we assessed the association between mental health and a variety of relationship statuses. We focused on 4 types of relationships—married, cohabiting, noncohabiting romantic, and nonromantic—and 6 indicators of mental health—depression, anxiety, alcohol use, illicit drug use, incarceration history, and partner violence. Although our data did not allow us to examine whether mental health is associated with the transition to parenthood, they did provide information about a new and rapidly growing population of interest to public health professionals and policymakers.
