[Children of single mothers: health risks and environmental stress]

In Germany the risk for relative poverty has increased profoundly during the last 15 years, especially among single parent families. As poverty is often associated with bad health we examined the physical and mental health as well as health-related behaviour, housing and environmental conditions in children with lone mothers versus children in couple families.

In 3 cross-sectional surveys conducted during 2004-2007 in 3 cities and 3 rural areas in Bavaria data on 19 039 pre-school children (47% female) were collected. Health, behaviour and exposure assessment was based on parental reports. The 18 327 cases with complete information on family status were analysed. 10% of the children grew up with single mothers.

Single mothers evaluated the general state of health of their children more often as moderate to very poor than couple parents (OR [95% CI]: male: 1.37 [1.07-1.77], female 1.77 [1.33-2.35]). Sons with single mothers were more often obese (1.44 [1.09-1.90]). They scored significantly higher in the SDQ total difficulties score (1.94 [1.44-2.62]), on the emotional problem scale (1.91 [1.40-2.59]) as well as on the hyperactivity scale (1.82 [1.35-2.47]) compared to boys from couple families. No difference was found in prosocial behaviour. Girls with single mothers revealed more often conduct problems 1.36 [1.02-1.81] compared to those from couple families. They also showed a significantly higher prevalence of asthma (2.06 [1.29-3.30]). Children living with their single mothers were less often members of sports clubs and the boys were less physical active. No difference was found regarding the consumption of fruits and vegetables. Single mother family was associated with children's environmental tobacco smoke exposure at home (2.03 [1.79-2.29]). Single mothers perceived higher environmental exposures to noise and air pollution, suffered more often from a lack of accessible green spaces in the neighbourhood and reported a higher traffic load on the residential street.

Children with single mothers reveal increased health risks and live under significantly poorer housing and environmental conditions. Further analyses are necessary to identify the mediating factors.