Photo Hugues Siegenthaler

A young "LIVES" author wins award for a paper on single parenthood and health

Emanuela Struffolino is the 2015 winner of the Population Young Author Prize. The journal is edited by the French National Institute for Demographic Studies (INED). The series LIVES Working Papers had published a first version of her article last year.

INED and the journal Population announced on February 29, 2016 that the Population Young Author Prize has been awarded to Emanuela Struffolino for her paper "Self-reported health among lone mothers: Do employment and education matter?", written in collaboration with Laura Bernardi and Marieke Voorpostel. This award was recently created in tribute to Valeria Solesin, a PhD student at Université Paris 1 and hosted at INED, who died at the Bataclan concert hall in Paris during the terrorist attacks of 13 November  2015.

Abstract

Lone mothers are more likely to be unemployed and in poverty, which are both factors associated with a risk of poor health. In Switzerland, weak work-family reconciliation policies and taxation that favours married couples adopting the traditional male breadwinner model translate into low labour market participation rate for mothers.

In the case of lone mothers, employment can be associated with better health because it eases the potential economic hardship associated with being the sole earner. However, working can represent an additional stress factor due to lone mothers’ responsibility as the main caregiver. We investigate how family arrangements and employment status are associated with self-reported health in Switzerland.

Our analyses on the Swiss Household Panel (waves 1999-2011) suggest that lone mothers who are out of the labour market have a higher probability of reporting poor health, especially if holding an upper-secondary diploma. Lone mothers reported being in better health when working full-time vs. part-time, whereas the opposite applied to mothers living with a partner.

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>> Struffolino, E., Bernardi, L., & Voorpostel, M.. (2016). Self-reported Health among Lone Mothers in Switzerland: Do Employment and Education Matter? Population-E, 71 (2), 187-214

A first version of the article had been published in 2015 by the LIVES Working Papers:

>> Struffolino, E., Bernardi, L., & Voorpostel, M.. (2015). Self-reported health among lone mothers: Do employment and education matter?. LIVES Working Papers, 2015(44), 1-28.

Image iStock © AtnoYdur

Strong partnerships: an important resource for coping with the effects of cancer

The partners of women suffering from breast cancer show considerable signs of distress, but the more satisfied men are with their relationship, the less heavy their burden seems. What is more, a happy marriage reduces the likelihood that women will suffer from changes to their body image. And although two-thirds of couples report that the illness has changed their sex life, more than half remain sexually active, while others talk of "increased tenderness". These are the main conclusions of a doctoral thesis by Sarah Cairo Notari, which was brilliantly defended on 25 January 2016 at the University of Geneva. The thesis has also inspired several other scientific publications.

Women are not the only victims of breast cancer. Every year in Switzerland there are around 6,000 new cases and it leads to more than 1,000 deaths. But, as with all potentially fatal diseases, it also affects the sufferer’s family and friends – and especially her partner. However, the partner’s feelings are rarely the subject of much attention. In order to understand how this disease affects couples, the National Centre of Competence in Research LIVES funded a study in 2011. Longitudinal data were gathered from 80 women undergoing treatment at Lausanne University Hospital, plus 55 of their male partners. Sarah Cairo Notari, an assistant at the unit for the clinical psychology of interpersonal relationships at the University of Geneva, analysed the data as part of her PhD research in psychology, L’ajustement psychologique de la femme et de son partenaire au cancer du sein (The psychological adjustment of women and their partners to breast cancer).

Psychological distress in men

First of all, Cairo Notari carried out a systematic review of the scientific literature on psychological distress in the partners of women affected by breast cancer. There had not been a lot of research in this field so far. Her summary of 23 selected articles shows that the level of distress experienced by these men is higher than that of the general population. However, "contrary to what is generally believed in this area, the partners do not report higher levels of psychological distress than the patients do," she points out.

The subjective burden of the "partner-carer"

When women have breast cancer, their partner often becomes their main carer within the family, taking on a whole range of tasks including providing practical help and emotional support, looking after the children and running the household. The study showed that the perceived weight of this burden is closely linked to the patient’s physical and psychological condition, and that it declines over time and as the disease goes into remission. But above all, Cairo Notari was able to demonstrate that the higher the level of marital satisfaction, the lighter this burden seems to men, regardless of their partner’s condition. These results will soon be presented in the Journal of Health Psychology.

Changes to the woman's body image

Marital satisfaction can also play an important and lasting role in protecting patients against changes to their body image. The study showed that women who have had a mastectomy and/or chemotherapy have fewer problems with their appearance if they are part of what is considered a positive partnership. This tendency was observable at various points during the study, whether it was two weeks, three months or one year since the participants had undergone surgery. Cairo Notari also noted that women who were cohabiting but unmarried reported a more significant change in their body image than married women did. Her conclusions suggest that "marital satisfaction and the fact of being married can mitigate the impact of treatment, reducing the extent to which women’s body image changes."

Changes to sexual function

The study also looked at couples’ sexual function, given that an intimate relationship is recognised as an important aspect of quality of life. For this part of the study, a semi-structured interview was conducted by a nurse and member of the team with 75 participants during a meeting two weeks after their surgery. It was carried out in addition to the first written questionnaire. The quantitative data suggest that for 64% of the women questioned, their illness and treatment had changed their sexual relations. However, 53% of the patients said that they maintained an active sex life, with or without changes. But for 29% of the patients, sexual relations had stopped completely. The qualitative data made it possible to demonstrate that the cease in sexual activity was not linked to marital difficulties: for 40% of the women who had become sexually inactive following surgery, sexual relations had even been replaced with an "increased feeling of intimacy and closeness", or a "strengthening of emotional bonds".

The partnership as a victim AND a resource

 The disease clearly has a negative impact on partnerships. This is evident from the distress felt by both partners, the woman’s physical and psychological suffering, the subjective burden that the man has to bear and the changes to the couple’s sex life. But Cairo Notari points out that the partnership is not a powerless victim. In the conclusion to her thesis she writes, "The role of the couple’s relationship as a source of strength is without doubt the most significant aspect that we were able to bring to light in this study." She adds that these results have "confirmed that a satisfying relationship plays a role in protecting women and their partners who are dealing with breast cancer." She therefore suggests that it is important to "look after the health of the relationship as well as the woman’s health", although she recognises that the complex nature of marital satisfaction makes it difficult to carry out preventive clinical interventions.

Next steps

This thesis, which was supervised by Professor Nicolas Favez, will soon be followed by further publications on the subject. A fourth set of data, gathered two years after diagnosis of the illness, still needs to be analysed. In addition, French and Belgian teams are interested in sharing their respective research with the Swiss team.

Speaking at Cairo Notari’s public defence of the thesis, Friedrich Stiefel, a professor at Lausanne University and head of the psychiatric liaison service at Lausanne University Hospital, said, "This work opens up a whole new line of research." Another member of the jury, Professor Darius Razavi from the Université libre de Bruxelles, called the research a "marvellous study" dealing with "people in very vulnerable situations". Now financing must be found so that the study can be continued. "It is easier to obtain funding for collecting rather than analysing data," rightly says Nicolas Favez...

 

>> Cairo Notari, S. (2016). L’ajustement psychologique de la femme et de son partenaire au cancer du sein. / The psychological adjustment of women and their partners to breast cancer. Supervised by Nicolas Favez. University of Geneva

Previous publication:

>> Favez, N., Cairo Notari, S., Charvoz, L., Notari, L., Ghisletta, P., Panes Ruedin, B., Delaloye, J.-F.. (2015). Distress and body image disturbances in women with breast cancer in the immediate postsurgical period: The influence of attachment insecurity. Journal of Health Psychology. 1–10. 2015.

PS = Social Democratic Party / UDC = Swiss People's Party

Workers’ move to the Swiss People’s Party came a decade after their shift away from socialism

In a new article for the journal Social Change in Switzerland, Line Rennwald and Adrian Zimmermann examine the development of the blue-collar vote in Switzerland between 1971 and 2011. Based on data from ten electoral surveys, the authors show that the Swiss People's Party has been able to fill a gap since the 1990s, after four consecutive parliamentary terms in which the Social Democratic Party lost influence among the working classes.

The article by Line Rennwald and Adrian Zimmermann presents the first systematic analysis of all electoral surveys between 1971 and 2011. Their analysis makes it possible to retrace the steps that led to the divorce between the Social Democratic Party and a significant part of the blue-collar electorate.

Two distinct processes

The authors highlight two distinct processes: firstly a weakening of support from workers for the Social Democratic Party in the 1980s; then the dramatic rise of the Swiss People's Party among this electorate from 1995 onwards. Between the two, and especially at the federal elections of 1987 and 1991, the blue-collar vote was marked by high levels of abstention, which the authors identify as the key stage in the loosening of ties to the Social Democratic Party.

The proportion of workers who voted for the Social Democratic Party decreased from 38% in 1975 to 16% in 2011. At this point, nearly 40% of workers voted for the Swiss People's Party, compared to 8% in 1975. While the Social Democratic Party has lost blue-collar votes in all of Switzerland's linguistic regions, it secures more support among the working classes of the French-speaking cantons.

Changes in the policy programmes

The authors mainly explain these changes with the development of the parties' policy programmes. While the Social Democratic Party has taken up the issues relating to the "new social movements" such as environmentalism, feminism and pacifism, the Swiss People's Party has focused its activity on the subjects of immigration policy and sovereignty in the face of Europe. The populist stance of the Swiss People's Party on these issues has succeeded in uniting the working classes – even though they have little to gain from this party's ultraliberal positions in terms of economic policy.

>> Line Rennwald et Adrian Zimmermann. (2016). Le vote ouvrier en Suisse, 1971-2011. / Der Wahlentscheid der Arbeiter in der Schweiz, 1971-2011.
Social Change in Switzerland No 4. Retrieved from
www.socialchangeswitzerland.ch

Contact: Dr. Line Rennwald, +41 79 761 32 81, line.rennwald@gmail.com

The series Social Change in Switzerland documents the evolution of Switzerland’s social structure. It is edited by the Swiss Centre of Expertise in the Social Sciences FORS, the Life Course and Inequalities Research Centre of the University of Lausanne LINES , and the Swiss National Centre of Competence in Research LIVES – Overcoming Vulnerability: Life Course Perspectives (NCCR LIVES). The aim is to monitor change in employment, family, income, mobility, voting, or gender in Switzerland. Based on cutting edge empirical research, the series targets a wider audience than just academic experts.