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Alcohol‐related morbidity and mortality by fathers' parental leave: A quasi‐experimental study in Sweden.

Background and Aims: Fathers' parental leave has been associated with decreased risks of alcohol‐related hospitalizations and mortality. Whether this is attributable to the health protections of parental leave itself (through stress reduction or behavioral changes) or to selection into leave uptake...

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Published in:Addiction Vol. 119; no. 2; pp. 301 - 311
Main Authors: Honkaniemi, Helena, Juárez, Sol Pía
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Feb2024
Online Access:View this record in EBSCOhost
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      dt: Feb2024
      vid: 119
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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      tig:
        atl: Alcohol‐related morbidity and mortality by fathers' parental leave: A quasi‐experimental study in Sweden.
      aug:
        au:
          Honkaniemi, Helena
          Juárez, Sol Pía
        affil: Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
      sug:
        subj:
          Alcoholism Mortality
          Parental Leave
          Fathers
          Morbidity Prevention and Control
          Death Prevention and Control
          Behavioral Changes
          Paternal Role
          Human
          Motivation
          Health Care Reform
          Quasi-Experimental Studies
          Interrupted Time Series Analysis
          Sweden
          Alcoholic Intoxication Complications
          Mental Disorders
          Funding Source
          Cardiovascular Risk Factors Risk Factors
          Stomach Diseases Risk Factors
          Liver Diseases Risk Factors
          Hospitalization
          Descriptive Statistics
          Confidence Intervals
          Stress, Psychological Prevention and Control
      ab: Background and Aims: Fathers' parental leave has been associated with decreased risks of alcohol‐related hospitalizations and mortality. Whether this is attributable to the health protections of parental leave itself (through stress reduction or behavioral changes) or to selection into leave uptake remains unclear, given that fathers are more likely to use leave if they are in better health. Using the quasi‐experimental variation of a reform incentivizing fathers' leave uptake (the 1995 Father's quota reform), this study aimed to assess whether fathers' parental leave influences alcohol‐related morbidity and mortality. Design: Quasi‐experimental interrupted time series and instrumental variable analyses. Setting: Sweden. Participants: Fathers of singleton children born from January 1992 to December 1997 (n = 220 412). Measurements Exposure was indicated by the child's birthdate before or after the reform and used to instrument fathers' 2‐ and 8‐year parental leave uptake. Outcomes included fathers' hospitalization rates for acute alcohol‐related (intoxication; mental and behavioral disorders) and chronic alcohol‐related diagnoses (cardiovascular, stomach and other diseases; liver diseases), as well as alcohol‐related mortality, up to 2, 8 and 18 years after the first child's birthdate. Findings In interrupted time series analyses, fathers of children born after the reform exhibited immediate decreases in alcohol‐related hospitalization rates up to 2 (incidence rate ratio [IRR] = 0.66, 95% confidence interval [CI] = 0.51–0.87), 8 (IRR = 0.74, 95% CI = 0.57–0.96) and 18 years after birth (IRR = 0.72, 95% CI = 0.54–0.96), particularly in acute alcohol‐related hospitalization rates, compared with those with children born before. No changes were found for alcohol‐related mortality. Instrumental variable results suggest that alcohol‐related hospitalization decreases were driven by fathers' parental leave uptake (e.g. 2‐year hospitalizations: IRR = 0.16, 95% CI = 0.03–0.84). Conclusions: In Sweden, a father's parental leave eligibility and uptake may protect against alcohol‐related morbidity.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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