PREVENTIVE MEDICINE 27, 488–492 (1998) ARTICLE NO. PM970312 Maternal Employment and Preventive Child Health Practices 1 Jeannine Coreil, Ph.D.,* ,2 Frances Wilson, MSPH,* Deril Wood, Ph.D.,† and Karen Liller, Ph.D.* *Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida, 33612; and †Department of Research and Accountability, Evaluation and Research, Pinellas County School District, Largo, Florida 34649 Background. The impact of maternal employment on the absence of adult supervision. 1998 American Health Foundation and Academic Press preventive child health practices has not been studied empirically. Using a household production model, we Key Words: maternal employment; immunization; in- jury prevention; child health. investigated the relationship between level of mater- nal employment and child immunization status, use of automobile seat belts, and use of bicycle helmets. Methods. Data from a longitudinal study of public INTRODUCTION school children in Pinellas County, Florida, were used One of the most profound demographic changes that to draw an analytic sample of 4,153 African American has occurred in the United States during the 20th cen- and white non-Hispanic children whose mothers re- tury is the number of women who have entered the sponded to school surveys in 1989, 1991, and 1993. Anal- yses of the relationship between maternal hours paid labor force, leading to unprecedented changes in worked per week and preventive child health practices family organization. In 1995, over 76% of married were performed using multiple logistic regression pro- women with children between 6 and 18 years of age cedures, controlling for maternal age and education, were employed outside the home, compared with only household income, ethnicity and gender of child, and 39% in 1960 [1]. Current labor force participation rates number of siblings living at home. are even higher for widowed, divorced, and separated Results. No significant statistical relationships were mothers and for minority women. For example, among found between maternal employment and child immu- African American married women with children 14 to nization status or use of automobile seat belts. How- 17 years, 85.4% were employed in 1995. This trend has ever, maternal employment was significantly associ- focused attention in recent decades on the impact of ated with bicycle helmet use, after controlling for maternal employment patterns on child health and confounders. Children of mothers who worked less well-being. Studies have investigated a wide variety of than 21 h per week were 37% more likely to wear hel- outcome variables, including cognitive abilities, school mets compared with children of mothers who worked achievement, psychosocial development, emotional ad- 21 h or more per week. justment, behavior problems, and health and nutri- Conclusions. Findings suggest that children of full- tional status. Reviews of this diverse literature have time working mothers are not at greater risk for under- found few consistent effects [2–7]. immunization or failure to use seat belts regularly, but Studies of local and national samples have found both they may be less likely to use bicycle helmets. These positive and negative relationships between work out- results support the hypothesis that employment does side the home and pediatric care utilization, with medi- not affect episodic child health practices but may have ating factors such as social support, stress, and avail- some negative impact on preventive practices involv- ability of adults to accompany minor patients to health ing daily, repetitive activities. It also suggests that the effects of maternal employment may be greater on pre- care providers [8,9]. Reported barriers to immunization ventive practices that are nonnormative and occur in use have been related to labor force participation, such as lost wages from leave time, absence of family medical leave, and conflict between clinic hours and work sched- * Department of Community and Family Health, College of Public ules [10,11]. However, no studies that directly measured Health, University of South Florida, Tampa, Florida, 33612; and † Department of Research and Accountability, Evaluation and Re- maternal employment and child immunization status search, Pinellas County School District, Largo, Florida, 34649. were found. A few studies have suggested that there 1 Research supported by the University of South Florida Research may be a relationship between maternal employment and Creative Scholarship Award, 1995–1996. and childhood injury such as poisoning [12,13], motor 2 To whom reprint requests should be addressed. Fax: (813) 974- 5172. vehicle accidents [14], and burns [15], and these effects 488 0091-7435/98 $25.00 Copyright  1998 by American Health Foundation and Academic Press All rights of reproduction in any form reserved.