A Global Study on Lone Mothers: Exploring the Associations of Self-Assessed General Health with Motherhood Types and Gender Inequality in 32 Countries

Published:February 18, 2014DOI:



      In a study of 32 mostly non-affluent countries, we aimed to i) compare lone mother's general health to the health of other women and ii) assess whether the association of health with gender inequality was stronger among lone mothers than among other women.


      World Health Survey data were analyzed on 57,182 women aged 18 to 50 in 32 countries. The main outcome was self-assessed general poor health. The Global Gender Gap Index (GGGI) was used to measure the magnitude of gender inequality within countries. Logistic multilevel regression was used to compare the health of different groups of women, and to study the possible influence of gender inequality.


      Compared with all other women, lone mothers had the highest odds of poor health odds ratio (OR, 1.15; 95% confidence interval [CI], 1.09–1.22), also at 35 years or older with an OR of 1.18 (95% CI, 1.10–1.27). Lone mothers in Ethiopia and Tunisia had the highest odds of reporting poor health (OR, 1.65 [95% CI, 1.21–2.26] and OR, 1.57 [95% CI, 0.92–2.68], respectively). The degree of gender inequality was weakly related to cross-national variations in health of women. These associations were about similar for all women. For example, the OR for the GGGI was 1.03 for all women except coupled mothers.


      As within North America, lone mothers in non-affluent countries tend to have higher rates of poor health. The degree of gender inequality is not related to the relative health of lone mothers, suggesting that other characteristics of nations might be more influential.
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      Margot I. Witvliet, MSc, PhD, is a post-doctoral researcher at the Norwegian University of Science and Technology (NTNU), studying the influence of country characteristics on population health.


      Onyebuchi A. Arah, MD, MSc, DSc, MPH, PhD, is Professor at the Department of Epidemiology, UCLA and specializes in epidemiologic methodology and the global context of health and disease.


      Karien Stronks, PhD, is professor of Social Medicine, and Head of the Department at the Academic Medical Center/University of Amsterdam and studies the health of vulnerable populations.


      Anton E. Kunst, MSc, PhD, is Associate Professor at the Academic Medical Center/University of Amsterdam and specializes in socioeconomic inequalities on health.