Welcome:

Here you will find the somewhat random musings of a pediatrician in Watkinsville, Georgia. Some of my posts will involve medical topics, some political (maybe), and some spiritual. I will probably throw in an occasional comment about UGA athletics, or some other sports-related topic, as well.

Your comments are invited.

Rhinos

Rhinos
Walking with Rhinos

Friday, March 30, 2012

O Father, Where Art Thou?

If you have been sticking with me through this series about fatherhood, we have a bit more to discuss regarding the consequences of father absence and then on to more positive things.  This topic is important to me for several reasons.  First, I am a father of three children (hopefully four sometime in the next year or two) and I want to be the kind of father they need.  Second, I am tired of seeing friends separate and/or divorce.  If these posts do anything to help just one father decide not to leave, it will have been a worthwhile endeavor.  Third, I see kids who are suffering the consequences of father absence in my office very frequently and I am often called upon to help the kids deal with them.  I see these kids spiral downward in the wake of their parents' divorces and would love to see less of it.


Emotional and Behavioral Consequences

The emotional and behavioral consequences of father absence are numerous and profound, and I imagine that many of you are quite familiar with them.  Children from single-mother homes have a greater risk for psychosocial problems, an effect which is over and above the impact of coming from a low-income home.   Young girls experience the emotional loss of a father as a rejection of them.  Continued lack of involvement is experienced as ongoing rejection. 

There are a number of other emotional and behavioral problems that are more likely in kids with absent fathers.  Post-traumatic stress disorder is significantly more common in youths with an absent parent.  Children with eating disorders and children who self-mutilate (e.g., "cutting") often come from homes where fathers are absent.  Antisocial symptoms are also more common in kids with absent fathers, a risk that is not mitigated by the presence of a stepfather.  Even more frightening is this: three out of four teen suicides occur in households where a parent has been absent.

Educational and Developmental Consequences

Children living with a single parent have lower GPAs, lower college aspirations, worse attendance, and higher drop-out rates.  Fatherless children are 1.7-2 times as likely to drop out of school (after controlling for race, socioeconomic status, sex, age, and overall academic ability).


Family Structure and School Outcome
Journal of Pediatrics, Feb. 2001

Father absence has also been associated with delayed motor skill development in preschool children.  I would suggest that this is due to the fact that the way fathers interact with their kids is different than mothers.  Play with dads is often characterized by physicality - wrestling, tickling, tossing, spinning, etc.  This physical play certainly contributes positively to the motor development of children.


Criminal Consequences

Given what we have already discussed, it is likely no surprise that criminality is more common among children with absent fathers.  A study of male African-American adolescents found that delinquent behavior is more likely in father-absent homes, especially when combined with socioeconomic disadvantage.  Children born to teen mothers are 3 times more likely to be incarcerated during their adolescence and early twenties than children of older mothers (as you will recall, children of teen mothers frequently have absent fathers).  Children born out-of-wedlock (and therefore likely to have an absent father) are about 1.7 times more likely to become a juvenile offender and 2-3 times more likely to become a chronic offender than their peers.  They are also 8-10 times more likely to become a chronic juvenile offender if male and born to an unmarried teen mother.  A Finnish study published in 2002 found that the strongest predictor of later female criminality was the absence of the father during childhood (odds ratio of 2.5).  Previous studies have shown that being born to a teen or unmarried mother increases the risk of later criminality by 2.2 and 1.8 times, respectively.

Have I painted a bleak enough picture yet?  We still haven't talked about sexuality and medical problems that result from father absence.  We'll hit those topics in the next post.  Then, finally, we'll have some positive things to talk about.  

Let me close by reiterating what I have previously said.  Fathers, stay involved, whether you are in the home or not.  Mothers, facilitate the involvement of the fathers (as long as the father is not dangerous to the child).  It is in your child's best interest for dad to be there.

The gods visit the sins of the fathers upon the children.
 -Euripides (485-406 B.C.)

This is not a new concept.

Monday, March 19, 2012

Do Fathers Really Matter?

My last few posts have been setting the stage for this post.  I probably did not need to convince you that there are a lot fathers who are absent from the lives of their children, either partially or completely.  What I hope to do today by reviewing the consequences of father absence is to present a strong case for why fathers need to be very intentional about staying involved in the lives of their children.  

For married men and women, hopefully this will help strengthen your conviction to stay married and help maximize the positive impact you can have on your children.  For divorced men and unmarried fathers, I hope this will convince to stay as involved as possible in the lives of your children in order to be as strong a positive influence as possible.  For mothers who are not married to the father of their children, my desire is that you will encourage the fathers to remain involved, so long as they do not pose a threat to the children.

So, what are the consequences to children when their fathers are absent from the home?  I'm glad you asked.  The consequences of father absence are numerous and profound.  Consequences range from poverty to increased use of tobacco, alcohol, and drugs to increased rates of teen pregnancy and parenthood.

Let's start with poverty.  Young children living with unmarried mothers are five times more likely to be poor than other children and ten times more likely to be extremely poor.  Nearly 75% of children living in single-parent homes will experience poverty before the age of 11.  Only 20% of children from two-parent homes will do the same.  Nearly 80% of teen mothers, most of whom are unmarried, eventually receive welfare aid.    Homelessness is more common among children from broken homes.  A 2003 study of homeless teens found that only 14% were raised by both biological parents.  Finally, children of teen mothers are more likely to be unemployed.

Next, let's look at tobacco, alcohol and drugs.  Children who live apart from their fathers are 4.3 times more likely to smoke than those who grow up with their fathers in the home.  Additionally, teens who smoke are  more likely to me sexually active.  A study published in 2003 found that adolescents living with both biological parents engaged less frequently in heavy alcohol use.  Heavy use of alcohol is more common in all types of non-intact families.  Latchkey children, children who have daily unsupervised periods at home after school, are more common when the father is absent from the home.  These children are more than twice as likely to abuse drugs as children who are not left alone after school and begin abusing substances at younger ages.  Latchkey children are also at greater risk for teen pregnancy and are more likely to be victims of sexual abuse.

As you can see, the impact of fathers being absent from the home is enormous, and we haven't even made it to other consequences like criminality.  We will discuss a few more of the consequences of absent fathers in my next post, followed by posts on the positive impact of present/involved fathers and on practical ways fathers can be encouraged to remain involved.  Hang with me through the negatives, we will soon be talking about more positive things.  For now, let me leave you with a few quotes from children whose dads remained present (even if not physically in the same home).

"Sometimes as a joke I'll put my stinky socks in his briefcase, so at work the next day he will think of me! He's always at the concerts and plays that I'm in, even though he lives about an hour away."
4th grader (entry from the National Center for Fathering’s Father of the Year Essay Contest)

"One time I had an assembly and I was a soloist and my dad was in the first row and after my song I smiled at my dad and my dad smiled back and started crying.  That was the best thing I ever saw."
6th grader (entry from the National Center for Fathering’s Father of the Year Essay Contest)

Friday, March 16, 2012

Where are all the Fathers? Reasons for Father Absence

Our last two posts have begun to cover the issue of father absence in this country.  We'll explore this further today, but, before we do, perhaps I should explain why I am focusing primarily on fathers.  First, I am a father, so the issue is important to me.  It is easier for a father to talk to other fathers about their roles as fathers than it would be for a woman to tell men all the ways they are messing up.  Similarly, I don't think it would be a great idea for me to talk about ways that mothers may be failing at their jobs as mothers.  It is better for that to come from another woman.  Secondly, and more importantly, absent fathers are just much more common than absent mothers.

So, why do we have so many absent fathers?  What factors are leading to this?  The factors I will discuss below are not the only reasons for father absence, but they comprise a large proportion of them.  One of the largest reasons that fathers are absent from the homes of their children is divorce.  The number of currently divorced adults has nearly sextupled from 4.3 million in 1970 to 17.6 million in 1995 to 23.7 million in 2010.  The number of divorces per year has increased from 390,000 in 1960 to 1.2 million in 2009.  The number of US children affected by divorce has increased from 463,000 in 1960 to 1,052,000 in 1995.  More recent statistics would undoubtedly show even larger numbers of children affected by divorce, though there are recent reports of decreasing divorce rates.  The reported decreases in divorce rates are generally looking at divorces as a proportion of the general population, not as a proportion of marriages.  Additionally, the marriage rate has declined considerably, likely leading to an increase in the second factor contributing to absent fathers.

Another of the significant reasons for fathers who are absent from the child's home is births out-of-wedlock.  Forty-one percent of all newborns in the U.S. were born out-of-wedlock in 2009, up from 33% in 2000.  About 22% of out-of-wedlock births are to teens and about 37% are to mothers between the ages of 20-24.  About 75% of all teen births are out-of wedlock.  In many of these cases, the father never lives in the child's home, even at the beginning.  Live births to unmarried women in the U.S. increased from 224,300 in 1960 to 1,365,966 in 2002 and 1,727,000 in 2008.  Children living with never married mothers have grown from 221,000 in 1960 to 5,862,000 in 1995.  As of 2004, only 2-3% of live births to teens were placed for adoption.  A smaller, but still significant, reason for father absence is incarceration. As of 1991, there were an estimated 423,000 fathers in prison with children under the age of 18.  That number has increased to 744,200 as of 2007.

To this point, we have looked primarily at the physical absence of fathers from the home.  I do want to briefly mention fathers who are emotionally absent from their children.  As of 2004, less than 25% of children in two-parent homes received at least one hour per day of relatively individualized contact with their fathers.  The average amount of daily one-to-one father/child contact is less than 30 minutes.  Forty-one percent of fathers do not know the name of their child's physician and 43% do not know the name of their child's teacher.

To be fair, many men have busy work schedules which are major factors that limit their contact with their children.  As a pediatrician, I understand how difficult it is to balance a demanding work schedule and family life, and I don't always do a great job at maintaining that balance.  We will next discuss the consequences of absent fathers.  I point these issues out not for the sake of being critical, but in order to spur men on to take a larger role in the lives of their children and to become more physically and emotionally present for them.   We have a relatively short time to raise our children.  Let's make the most of it.

Wednesday, March 14, 2012

Absent Fathers: The Scope of the Problem

My last post introduced the idea that the absence of fathers in U.S. homes is a significant problem.  Today we will define what we mean by the term absent father and we will discuss the prevalence of absent fathers.  The definition of an absent father depends a bit on the specific study or source of data.  In general, when we use the term absent father, we are speaking of fathers who are physically absent from the child's primary home.  This includes fathers who have only joint custody of their children.

A caveat before we continue with our series of posts on absent fathers: the statistics that will be quoted are a few years old.  The exact numbers are almost certainly a bit different today than the numbers I will quote.  The reason for this is two-fold.  First, it takes time for researchers to assemble and interpret all the data they collect, so information is a bit out of date by the time it is ever published.  Second, my acquisition of the data I will present took place several years ago and I have not recently searched out current statistics that  supersede the ones I will present in these posts.

On to the statistics.  As of 2004, approximately 24.7 million U.S. children (36.3%) lived absent from their biological fathers.  In 1997, according to Gallup, 33% of all U.S. teens and 43% of urban teens lived away from their father.  Nearly half of all children from disrupted families have not seen their fathers in the past year.  Nearly 1 in 5 children in female-headed households have not seen their fathers in five years.  Finally, 1 out of every 6 kids in America is a step-child.

From 1960 to 2000, the proportion of children living with just one parent increased from 9% to 28% over that 40 year span.  When the statistics are broken down by race, results become even more alarming.  As of the year 2000, 20.9% of all white children lived in single-parent homes.  At the same time, 31.8% of all Hispanic children and 57.7% of all black children were living in single-parent homes.  The reasons for the racial differences are debatable, but what is clear is that this is a problem that is not limited to a single race.

The problem of fathers either shirking their responsibility or being prevented from fulfilling their responsibility as fathers in the United States is enormous.  We will soon examine why this is a big deal and explore the impact that fatherlessness has on children.

Monday, March 12, 2012

Who's Your Daddy?

Although this is a popular taunt insinuating one's dominance over another, the question is one that more and more American children are unable to answer, if asked seriously.  While completing my pediatric residency, one of the other male pediatric residents was asked by a child he was examining, "Are you my daddy?"  This unfortunate child realized that he needed a father and was seeking to find him. How heartbreaking.  The epidemic of father absence in this country has led to a nation of children who lack legitimate male role models and are searching for father figures. 

A question for the men out there: for whom, besides your own biological children, can you be a father figure?  Can you be a Big Brother?  Can you mentor a child or teen you know?  Can you be a foster parent?  Would you consider adoption?  There are over 13 million "double orphans" (children who have lost both their mothers and fathers) in the world.  Would you choose to be a father to one of them?

The absence of a father in a child's life can do immense harm and the presence of a father can do immense good.  More posts will follow on those topics, as well as on the topic of adoption.

"Religion that is pure and undefiled before God,the Father, is this: to visit orphans and widows in their affliction and to keep oneself unstained from the world" - James 1:27


Monday, March 5, 2012

Writer's block

If anyone who reads my blog is wondering why I haven't posted in a while, let's just say I just haven't had anything to say.  I know you are supposed to keep the posts coming regularly so that people will keep checking the blog, but I just have not been able to come up with anything I really wanted to write.  The one topic that did come to me recently turned out to become irrelevant practically as soon as it was written, so it was never posted.

I do have a couple of themes in mind that I will be probably be developing over the next few months when I have time to write.  For the time being, I will mention that one of the themes relates to fatherhood and the impact of absent fathers.  I presented this topic about 8 years ago at a grand rounds in residency, so I need to update some of the data before I post.

That's it for now.  Hopefully I'll produce some more interesting posts in the near future.