@article {25597,
	title = {What Are the Long-term Effects of Child Loss on Parental Health? Social Integration as Mediator},
	journal = {Comprehensive Psychiatry},
	volume = {100},
	year = {2020},
	pages = {1-8},
	abstract = {
Background
Some bereaved parents experience a decreasing trajectory of grief, while others fail to adapt over the long term and persistently suffer from negative health consequences. This study investigates the mediating role of social integration in the relationship between losing an only child and parental health in a family-oriented society.


Method
A sample of 1828 bereaved parents and 4739 non-bereaved parents was drawn from a 10-city survey in China. Regression methods were used to examine the impact of child loss on parental health, and Sobel test was applied to examine the mediating role of social integration.


Results
Bereaved parents who lost their only child have worse self-rated health and more negative affect than the non-bereaved parents, which lasted for years after the death of the only child. The Sobel test shows that 24.8\% of the total effects on self-rated health and 6.7\% of the total effects on negative affect can be explained via decreased social integration. The gender of parents and child as well as fertility intentions are important sources of heterogeneity in the Chinese culture.


Limitation
The results based on cross-sectional data may only reveal correlation rather than causality. The data was retrieved from self-reported questionnaires and there is a lack of objective measures of parental health. Moreover, the detailed mechanisms behind how child loss resulted in less social integration should be further explored.


Conclusions
Significant disparities in health outcomes and social integration were found for bereaved parents relative to the non-bereaved parents. Future work is needed to assess the health of bereaved parents, identify the vulnerable and disadvantaged groups, and design inclusive intervention programs.
},
	url = {https://doi.org/10.1016/j.comppsych.2020.152182},
	author = {Xintong Zhao and Hongwei Hu and Yi Zhou and Yang Bai}
}
