Social Determinants of Health and Parent Burnout

Background and Purpose: Up to 26% of parents experience burnout related to exhaustion with their parenting roles. Parental burnout is associated with escape ideation, problems with sleep, addiction, emotional distancing, and child neglect and abuse. Assessment and intervention for parental burnout are typically conducted at an individual level. General recommendations revolve around practicing self-care or leaning on friends and family. However, not all parents have the requisite resources to do so. Identifying community-level indicators of parental burnout can aid in larger-scale interventions to positively impact more families. Through their Healthy People 2030 initiative, the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion has identified five social determinants of health (SODH) that affect physical and mental health and quality of life: (1) healthcare access and quality, (2) neighborhood and built environment, (3) social and community context, (4) economic stability, and (5) education access and quality. Deficits in these domains can contribute to chronic, increased stress. This secondary data analysis aimed to ascertain which SDOH domains are the strongest predictors of parental burnout.

Methods: Data for this study were taken from the 2021 National Survey of Children's Health (NSCH). The dataset consists of over 400 variables related to demographics, health, and living environment. The 2021 survey identified a stratified sample of 300,000 addresses with at least one child under 18. The responding sample consisted of 50,982 individuals. To enhance data integrity for this study, respondents whose child’s reported date of birth and age were incongruent were excluded from the analysis, resulting in a sample of 49,459. A multiple linear regression analysis was conducted to determine predictors of parent burnout. The dependent variable was a composite score of parent burnout based on items measuring self-perception of handling the demands of parenthood, difficulty in parenting, and feeling angry with or bothered by their child (α = 0.77). Scores ranged from four to 19, with a higher score indicating more burnout. Independent variables were individual or composite items related to each SDOH. Additional independent variables included race, number of children, single-parent status, and current employment status.

Results: The average parent burnout score was 6.3 (SD =1.7), with nearly 14% of respondents scoring 10 or higher. The overall model significantly predicted almost 20% of the variance in parent burnout scores (R² =0.198, p<0.001). Each independent variable in the model was a significant predictor and contributed to the variance in parent burnout.

Conclusions and Implications: Parent burnout impacts not only individuals but entire families. Parents experiencing burnout are often advised to take breaks and ask for help. This is not a realistic solution for all parents. Determining which SDOH domains have the most significant impact on parental burnout can inform community-level interventions that contribute to a reduced prevalence of parental burnout.