American Single Father Homes: A Growing Public Health Priority

Children and families in the United States have suffered greatly throughout the COVID-19 pandemic. School shutdowns, unprecedented job loss, and the grief and loss related to COVID-19 deaths have highlighted the mental health and financial needs of parents—particularly single parents. Yet, when the struggle of pandemic parenting is discussed, it is often focused on the needs of mothers. It is important, however, to not overlook the needs of single fathers—one of the fastest-growing populations in the country; the number of single fathers in the United States grew from approximately 1.7 million in 1990 to 3.3 million in 2020.¹ Research indicates that single fathers suffer from similar barriers as single mothers, but institutional stereotypes about fathers (e.g., a perceived lack of interest in child-rearing) make some barriers more gender specific.² The struggles of single fatherhood, coupled with the prolonged COVID-19 pandemic, highlight that supporting this hidden but sizable population of caregivers is a public health priority. We review some of the current evidence on the characteristics and needs of single fathers and outline recommendations for research, practice, and policy.

UNIQUE CHARACTERISTICS AND CHALLENGES

Single fathers are demographically distinct from married fathers. Single fathers are less educated, considerably younger (18% are younger than 30 years compared with 8% of married fathers), and 24% live at or below the poverty line (compared with 8% of married fathers).³ Single fathers are more likely to identify as Latino (24% vs 17% of married fathers) or African American (15% vs 7% of married fathers).³ Importantly, Latino and African American fathers do not fare as well economically. Because of structural racism, they are more likely to experience incarceration, unemployment, poor health, and homelessness than are their White counterparts.^4,5 This ultimately affects how single fathers access and receive needed services and supports.

The social assumptions related to single fathers’ ability to nurture and financially provide for their children create unique challenges. Single fathers report that this dual role causes them a great deal of stress, which is exacerbated when interacting with social service caseworkers and health care providers, who often question their discipline approaches and dedication to their children.^2,4,6 Specifically, single fathers applying for social services reported that they felt they received substandard customer service and that they were forced to manage more bureaucratic hurdles compared with their female counterparts.^2,4 The fathers attributed these negative experiences to societal assumptions about who should be the primary caregiver or not believing the father when he states that the mother is not involved with the children.⁴ The gendered role of being the sole provider coupled with pride leads many single fathers to rely on informal social networks (e.g., extended family or male-oriented support groups) over governmental systems for help with financial needs, educational understanding, medical advice, and general parenting concerns.^2,4,6

Compared with other family heads (e.g., single mothers, married couples, or cohabiting caregivers), single fathers tend to utilize health and behavioral health services for their children at lower rates. Children of single fathers have the lowest percentage (59%) of annual well-child visits to a consistent pediatrician compared with children of other family heads (e.g., 72% for married couples, 71% for single mothers, and 69% for cohabitating families) and are less likely to adhere to medical advice.⁷ Specific to behavioral health concerns, children of single fathers have higher rates of externalizing behaviors (i.e., delinquency, antisocial behavior) and substance use relative to children living in other family structures.^4,7

SINGLE FATHERS IN THE COVID-19 CONTEXT

Overall, health care utilization decreased during the COVID-19 pandemic for children and adults.⁸ Yet, in the event someone in the single father home becomes ill, the challenges of health care access and limited childcare options are compounded.⁶ When race and ethnicity are factored into the health outcomes of COVID-19, there are distinct differences between White individuals and people of color.^9,10 African Americans, Asian Americans, Latinos, Pacific Islanders, and Indigenous communities have disproportionately suffered as a result of the pandemic (e.g., having less access to quality health care, working as frontline responders). It is likely that single fathers and their children, who are more likely to be people of color, are especially susceptible to the negative and long-lasting impacts of the COVID-19 pandemic.

A CALL TO ACTION

Akin to research trends, prevailing public health messaging and programming designed to support parents should engage all family structures. We provide suggestions to ensure that single fathers are seen as a public health priority by targeting four main areas: health care bias, engagement strategies, research priorities, and policy changes.

Improve Awareness of Health Care Biases

Single fathers are not exempt from the long history of biases in health care. Indeed, some single fathers have reported being overlooked and untrusted when obtaining services.^2,4,6 One step in preventing this is to increase providers’ awareness that these biases are common and encourage them to more actively engage single fathers in their health care as well as their children’s.

Enhance Engagement of Single Fathers

Practitioners in social service agencies, pediatric offices, and school buildings must be cautious in the language they use and not assume the primary parent is a mother or female. Practitioners can also help by communicating directly with fathers rather than through the child or other caregivers. Because many single fathers rely on employment that is traditionally labor intensive (e.g., construction), their hours may not follow traditional business hours, and taking time off could equate to lost wages.⁹ Practitioners (health and behavioral health) and service agencies should offer virtual options for connecting with caregivers and visiting times during nonbusiness hours (e.g., after 5:00 pm or weekends). Among child-serving agencies (e.g., social services, schools, daycares), practitioners would benefit from training in strategies that improve father engagement. In general, we recommend that public health messaging be inclusive and gender neutral.

Prioritize Fathers in Research

Studies conducted before the COVID-19 pandemic suggest that single fathers have high rates of stress, anxiety, and depression but are less likely to seek out mental health treatment.^4,6 Given the ongoing COVID-19 pandemic, we recommend further examination of the impact of COVID-19 on these key health dimensions as well as on single fathers’ children’s health and behavioral health, service utilization, academic achievement, and intra- and interpersonal relationships, as there are no known studies on these subjects. To date, only one study focused on this parent group during the pandemic. The author concluded that fathers struggled with social isolation and fear of contracting the disease coupled with fears about keeping their children safe.⁶ In the year since this study concluded, the pandemic has worsened in most communities, leaving many unanswered questions about its long-lasting impact on single fathers and their children. We suggest that there needs to be an emphasis and available funding for researchers to focus on single fathers’ health and social service utilization and well-being, including health and behavioral health, employment, housing, parenting stress, and social support.

Create Equitable Policies

All parents would benefit from policies geared toward raising children, such as childcare subsidies and protected time off to deal with unexpected issues like illness. The United States has few protections related to childcare, and the few that do exist are often unpaid time off, which is often unfeasible for single parents. When raising children alone, especially in a gendered society, both male and female parents feel pulled between being the sole breadwinner and taking care of their children.^4,6 Although many single fathers make more in wages than single mothers, at least one third are at or below the federal poverty line.^3,4 State welfare, and ideally federal policies, need to be augmented to include fathers as a known population of service receipt. Abandoning gendered language in such policies, for example, can go a long way toward supporting all families, including those with single fathers.

We have argued that single fathers head a minority family structure with different needs because of gendered stereotypes about family and parenting. These unique concerns may result in adverse outcomes, such as unstable housing and inadequate childcare. This in turn affects the children of single fathers so that they are at higher risk for mental health problems, substance use, school problems, and limited access to needed medical and mental health services.^4,7 Gender stereotypes also harm women by perpetuating the assumption that their principal function is to be the primary caregiver, often at the expense of their well-being. These concerns are amplified in the current pandemic, as all parents have struggled with the stress to stay employed, educate their children, and maintain their homes. Better supporting single fathers could help to reduce the pressure on all parents to choose between professional and caregiver identities, with benefits for the entire family’s health and well-being. Although the population of single fathers may be relatively small, it continues to steadily grow.³ From a public health perspective, social policies, norms, and services must respond to and adapt accordingly.