Ruth Sidel, appreciated

Some of Victor Sidel’s photos from Women and Child Care in China

I just learned that sociologist Ruth Sidel has died. These are a few scattered notes on the influence of some of her work. I always wanted to meet her but never did. I read her early work on China as a student, and I used her later work on poverty and welfare in the U.S. in my teaching.

She had a great influence on American leftists (and me) initially because of her writing on China, especially Women and Child Care in China, which came from a trip she took in 1971, during the Cultural Revolution, with her husband, Victor Sidel (and one of the founders of Physicians for Social Responsibility). At the time of that trip she was a social worker, having written only a masters thesis, invited in her role as wife, but found their hosts willing to open up their visit (which was supposed to be about medical care) to the issues of women’s liberation and education. She remembered in an oral history interview:

They integrated what I was interested in into every single thing we did. It was just remarkable. … Half way through the trip I said to Vic, “There is a book here.”… He said “How can you have a book after two weeks?” And I said “Trust me, there is a book here.” …and I did and wrote a book called “Women and Childcare in China” which was really like successful. People really wanted to read about it. They wanted to read about mutual aid. They wanted to read about how the communist government was trying to take care of children and women. We went to preschools and how the children were taught to help each other, love each other and take care of each other according to the words of Chairman Mao, literally, I’m quoting. The book went into paperback and sold even more copies and I spoke everywhere. I’d never given a speech before in my life, ever. Terrified but I had to do it because I knew stuff that other people didn’t know and I had to communicate it.

One book led to the next book about neighborhood organization [Families of Fengsheng: Urban Life in China] and I helped Vic finish his book on healthcare. The whole 70s I was writing about China and lecturing about China all over the country and in many parts of Europe. We were invited—I mean it was just unbelievable. It was a total life change and thrilling.

I am awed by that spirit of adventure, the confidence to seize that moment, and the commitment to doing social science for the public interest.

Later she got a PhD in sociology and went on to write on poverty and welfare, the work she was known for after the 1990s (see books listed below).

Although writing books promoting the Cultural Revolution in the early 1970s is not a fast-track ticket to respectability nowadays, if you go back to those books you will also see how close her observations are, and how incisive. The macro-political context of course is important (and she wrote about that), but that was not her primary contribution. In addition to what she learned (or didn’t) from official documents and statements, she did see some things with her own eyes. One of the key insights she brought back from China was the value of deprofessionalization, the role of non-professionals to improving community health and education. This was essential to the dramatic improvements in public health achieved in that period in China (which I wrote about in a remembrance on another China-inspired American feminist, Janet Salaff.) This was a radical-democratic view of public health in particular. From Families of Fengsheng:

Health care, perhaps better than any other single facet of Chinese society, vividly illustrates some of the principles that guide life in China today: a strong belief in mass involvement; recruitment of health workers from among those who live in the community to be served; short periods of training to minimize alienation from the community; a minimum of social distance between the helper and the helped; attempts to demystify as much of medicine as possible; decentralization; and motivating people through altruism rather than through prestige or material incentives.

Wouldn’t that be something!

I hope there will be more comprehensive remembrances from people who knew Ruth Sidel and her work more fully. This note is just to register my own deep appreciation.

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Some books by Ruth Sidel:

• Sidel, Ruth. 1972. Women and Child Care in China; a Firsthand Report. New York: Hill and Wang.
• Sidel, Ruth. 1974. Families of Fengsheng : Urban Life in China. Baltimore: Penguin Books.
• Sidel, Ruth. 1978. Urban Survival : The World of Working-Class Women. Boston: Beacon Press.
• Sidel, Ruth. 1986. Women and Children Last : The Plight of Poor Women in Affluent America. New York: Viking.
• Sidel, Ruth. 1990. On Her Own : Growing up in the Shadow of the American Dream. New York, N.Y., U.S.A.: Viking.
• Sidel, Ruth. 1996. Keeping Women and Children Last : America’s War on the Poor. New York, N.Y.: Penguin Books.
• Sidel, Ruth. 2006. Unsung Heroines : Single Mothers and the American Dream. Berkeley: University of California Press.

What drives the rise of stay at home fathers?

At Pew Social Trends, Gretchen Livingston has a new report on fathers staying at home with their kids. They define stay at home fathers as any father ages 18-69 living with his children who did not work for pay in the previous year (regardless of marital status or the employment status of others in the household). That produces this trend:

At least for the 1990s and early-2000s recessions, the figure very nicely shows spikes upward of stay-at-home dads during recessions, followed by declines that don’t wipe out the whole gain — we don’t know what will happen in the current decline as men’s employment rates rise.

In Pew’s numbers 21% of the stay at home fathers report their reason for being out of the labor force was caring for their home and family; 23% couldn’t find work, 35% couldn’t work because of health problems, and 22% were in school or retired.

It is reasonable to call a father staying at home with his kids a stay at home father, regardless of his reason. We never needed stay at home mothers to pass some motive-based criteria before we defined them as staying at home. And yet there is a tendency (not evidenced in this report) to read into this a bigger change in gender dynamics than there is. The Census Bureau has for years calculated a much more rigid definition that only applied to married parents of kids under 15: those out of the labor force all year, whose spouse was in the labor force all year, and who specified their reason as taking care of home and family. You can think of this as the hardcore stay at home parents, the ones who do it long term, and have a carework motivation for doing it. When you do it that way, stay at home mothers outnumber stay at home fathers 100-to-1.

I updated a figure from an earlier post for Bryce Covert at Think Progress, who wrote a nice piece with a lot of links on the gender division of labor. This shows the percentage of all married-couple families with kids under 15 who have one of the hard core stay at home parents:

That is a real upward trend for stay at home fathers, but that pattern remains very rare.

(The Census spreadsheet is here)

Time with young children

On weekdays, women in households with young children spend twice as much time caring for the children as men do. On weekends the ratio is only 1.5-to-1. Details on the chart, which has grid-lines at 6-minute intervals (click to enlarge):

Source: Bureau of Labor Statistics.

These are averages per day calculated from time diaries recording the “primary activity” at each point in the day. Note that this does not do anything with marital status or household composition, so a lot more of these women are single mothers. That’s not a flaw in the presentation, though. Part of having a lot of single mothers means they spend more time with children, as these data show.

Father care: The more things don’t change, the more they stay the same

The U.S. Census Bureau has released its new report on childcare. This provides a good followup treatment for the hyperventilation induced by fear of fathers taking over (or being relegated to) childcare.*

First, the trend that fits my story of stalled gender progress. Among married fathers with employed wives, how many are providing the “primary care” for their children? That is, among the various childcare arrangements the children are in while their mother is at work, how many are in their fathers’ care more than in any other arrangement? Answer: 10%, which is virtually unchanged from a quarter-century ago:

Source:  U.S. Census Bureau, Who’s Minding the Kids? Child Care Arrangements: Spring 2011. (There was a methodology change in 1997, before which Census asked parents to name their primary arrangement, which they now calculate from the hours in each arrangement.)

Not a lot of change for a quarter century in which we’re told everything has changed.

However, in fairness to the change-is-happening community, here is the trend for the percentage of fathers who say they are providing ANY care to their children while their mothers were at work.

Source: As above.

I don’t give this much weight since it might reflect greater sensitivity to the importance of saying fathers provide care, but there you have it: it’s higher, and it shows some increases up until the early 1990s, which is when gender equality in general stalled on many indicators. Since the mid-1990s: Nothing.

Please note these figures don’t show the total contribution of fathers, but only reflects those married with children, whose wives are employed.

One interesting source of father care is mothers’ shiftwork. As Harriet Presser reported two decades ago, the 24/7 economy stimulates some task sharing among couples. In the current report, the Laughlin writes:

Preschoolers whose mothers worked nights or evenings were more likely to have their father as a child care provider than those with mothers who worked a day shift (42 percent and 23 percent, respectively)

* The report was written by Lynda Laughlin — have you credited a government bureaucrat by name for something valuable they did today?

Work-family decisions, in person

Here’s an interesting new study on work-family decisions around the time of childbirth.

Medora Barnes has written, “Having a First Versus a Second Child: Comparing Women’s Maternity Leave Choices and Concerns,” in Journal of Family Issues. It’s a nice research design, with 16 school teachers interviewed — half having a first child, half having a second — before and after they have the baby, interviewed with and without their partners.

Here’s one nugget:

Nate: The day care is more her decision. I would say it was mainly Jenn who makes those decisions. Ultimately when it came down to making the final decision, we discussed it. But she took more of the lead on finding things out, especially with the first [child]. The second time around, she did the leg work and then—that one might have been more equal, but ultimately it was her decision on where they were going to go.

Jennifer: Yeah, the first time Nate had no part in it. The second time, I think he did more because I said to him, “You need to help me with this!” I was torn . . . and he was kind of like, “Whatever you think is right.” I got annoyed and I said, “I’m asking you. I want your help with this! What do you think?” I was like, “They’re your kids too!  What do you really think?” Because I didn’t want it to just be choosing [a day care] based on which person was cheaper or whatever.

Nate: Whatever.  [There is a pause, and then we all laugh at his clear dismissal of the issue]

And on the issue of being pressured to take more time off work:

Oh yeah! I remember having a conversation with Matthew’s sister. She said, “What! Oh! Only taking six weeks? Blah, blah, blah.” And I was thinking, “I am not going to put us in debt so that I can stay home for six more weeks!” I’m just not going to do it. It’s ridiculous. The baby’s not going to remember if I was there or not. You know? She’ll be fine! (Jill, elementary special education teacher, second-time mother)

Lots of good material for discussing women’s and couple’s decision-making about work-family issues (based on research, not stereotypical cartoons).

No-leave policy’s long-lived effects

Human Rights Watch has produced a report on how the lack of parental leave hurts US families.

Rather than just a compilation of statistics, this report includes interviews with a few dozen people, with vivid descriptions of how working parents and children suffer when work-family policies let them down. Here is one vignette:

Diana T. was 18 and worked full-time at a large retail store when her first daughter was born. Her manager was unhappy about her pregnancy, and forced Diana to pick items off the floor late in her pregnancy, even if other staff was available to do so. Diana took a six-week leave with no pay when her first daughter was born since her employer did not allow her to use accrued sick pay. She had a nine-week leave when her second daughter arrived: six paid at 60 percent of her salary (of less than $30,000 per year), and one paid in full through accrued paid time off. Diana fell into credit card debt and had trouble paying rent during her unpaid leave. She also needed two surgeries shortly after the second birth. She requested, but was denied, a week off to heal and returned to work three days after surgery. Lacking a space at work to pump, Diana breastfed her first baby for two months, well short of the four to twelve months she had originally hoped. Diana had post-partum depression after both children, but especially after her first baby, who was ill. Diana’s employer regularly threatened to replace her if she took time off for the baby’s frequent medical appointments and often switched her to night work, which was especially difficult for her as a single parent. Diana went without health insurance for more than a year, and was therefore never treated for her depression.

There is a nice compilation of policies for many countries in an appendix, too.

Healthy family leaves

Getting the story straight on working mothers and children’s risks

When the result is not the news. Or, woe is the status of most social science reporting.

The news release was titled, “Children Of Working Moms Face More Health Problems.”

The news headlines, repeated around the world on the Internet’s instant, editor-free news rebroadcasting systems, were predictable:

• Kansas City Star: Study: Working moms have sicker kids
• Sify: Kids of working mums more likely to be ill
• Top News Arab Emirates: Kids of moms who work outside get hurt more
• Food Consumer: Does a child’s health pay the price for working moms?
• Parent Dish: Study: Working Mothers Have One More Reason to Feel Guilty

Corbis helpfully sold clip art of a working mother putting her child at risk (note the ancient computer monitor and elephant-sized phone, showing the venerability of this story…):

In fact, we had the whole panoply of clip art on display, helpfully collected by Google news:

A complicated story

The research, by North Carolina State University economist Melinda Morrill, is in press at the Journal of Health Economics (the abstract is here, and Morrill has an earlier version for free on her website here).

Her conclusion, reasonably justified by the analysis was this: “I identify the effects on overnight hospitalizations, asthma episodes, and injuries/poisonings for children ages 7–17. Maternal employment increases the probability of each adverse health event by nearly 200 percent.”

Wow. Sounds awful. But understand one thing. The risk of all these events is very low, whether the kids mothers are employed or not. Doubling or tripling these rates still means that the vast majority of children are unaffected (triple-emphasis added). Using her data, a few hundred thousand National Health Interview Survey respondents from 1985 to 2004, the overall rates of each outcome look like this:

At a glance, it doesn’t match the headlines. Children whose mothers worked are less likely to be hospitalized or have asthma attacks (but more likely to have injury or poisoning). That’s probably just because healthy, rich mothers are more likely to work and have healthy, rich, safer kids. (It’s OK, we can control for that.) More importantly, the rates are low and the differences are small. Nevertheless…

The real contribution of this article is a clever application of what Belinda Luscombe at Time helpfully (I mean that) called “difficult-to-explain statistical techniques.” Specifically, Morrill used — there is no way to sugar-coat this — an instrumental variable method with two-stage least-squares regression, otherwise known as IV-2SLS.

Can this be explained to a non-expert audience? As a non-practitioner who has read a bunch of these papers, let’s see if I can do it.

• Whereas, for many questions in social science, we would like to investigate a causal relationship, but the complexity of such relationships makes that difficult to establish; and,
• Whereas, from a scientific point of view, the ideal study design is a true experiment, in which we randomly assign people to different conditions and trace their effects, thereby removing contaminating factors such as past experience, personal decisions and preferences, strengths and weaknesses, etc.; and,
• Whereas, social scientists often can’t do true experiments because of ethics (and other reasons), and when we do experiments (like laboratory simulations), they differ substantially from real-life situations;
• Therefore, some social scientists (usually called “economists”) use instrumental variable (IV) analysis, in which the trick is to find something (an “instrument”) that acts like an experiment, (more or less) randomly assigning people to different conditions, so that their true effects can be identified.

That’s the gist of it: has something (more or less) random occurred which (a) causes the independent variable to change (e.g., driving mothers into the labor force) while (b) neither causing, nor resulting from, the dependent variable (hospitalization, injury or asthma attack).

In this case, Morrill cleverly split children into two groups: those who had younger siblings who were just old enough to start kindergarten, and those who had younger siblings that were just too young to start kindergarten. Because mothers have a tendency to start work when the younger child goes off to kindergarten, but children reaching kindergarten age is neither cause nor effect of older children’s health outcomes, this acts like an experiment — some moms are assigned to the go-to-work group and some aren’t, and membership in the two groups is more or less random.

The method is called 2SLS because, using a complex prediction model, the economist first identifies those mothers whose employment was likely the result of the the younger child reaching kindergarten age, and then (in the second stage) uses a complex prediction model to determine whether those mothers’ older children were more likely to end up sick or injured than the children of those who did not start work.

Bottom lines

This method creates something close to an experiment, close enough that it is sometimes called a “natural experiment,” since the scientist didn’t engineer it. However, it also analyzes events that are extremely narrowly construed. It really is only a test of what happens when American mothers of two or more children started work after the younger child reached kindergarten age (over a 20-year period) — holding constant a wide array of social and demographic variables. Since the randomness of the school-age “instrument” can, in a practical sense, be confirmed statistically, the effect is reasonably called “causal,” but caution in the interpretation is wise.

And Morrill was cautious. Although she found that older children of mothers who went off to work in these conditions were indeed more likely to suffer these ill effects, she did a number of other checks to make sure things were as they appeared.

In fact, one of the mostly-overlooked aspects of the paper was a section on “heterogeneous effects.” Here, she tested whether the overall effect she found actually resulted from some subset of the families experiencing large effects while others experienced none. In my interpretation, this is where the real story is.

The effect of mothers going off to work on children’s hospitalization was three-times greater for Blacks than for Whites (and non-existent for Hispanics). The effect was only significant for mothers who had no more than high school education (unlike most or all of the women in the clip art above!). And the effect was three-times larger for single mothers than married mothers.

With no measures of child care availability or any details about the care arrangements of the families’ children, I’m left to conclude that the results probably reflect the simple fact that poorer women have fewer good options for childcare, so that when they enter the labor force, their children experience some increased risk of accident or illness.

Stop the presses

I see this result as a confirmation of common sense, not shocking or disturbing, or in any substantive way altering my understanding of the work-family-children situation: mothers working for pay increases the risks of illness or injury associated with non-supervision, or supervision by others. That this seems obvious does not detract from the value of the study, just from the breathlessness of its news coverage.

What are the implications of this? I can think of two. First, mothers (or, obviously, any caretakers) who are considering entering the labor force need to consider the availability and quality of alternative care arrangements for the children they will no longer be caring for during their working hours. Hopefully, they already knew this. Second, for public policy, we need to consider the availability and affordability of care arrangements for children whose parents are employed.

As for the bigger question, the one about mothers’ guilt and hard choices, Belinda Luscomb was good enough to link to a recent meta-analysis — a study of studies — that analyzed 69 different studies of the effect of mothers’ early employment on their children’s school achievement and psychological health, published by the American Psychological Association. That study concluded:

The small effect size and primarily nonsignificant results for main effects of early maternal employment should allay concerns about mothers working when children are young. However, negative findings associated with employment during the child’s first year are compatible with calls for more generous maternal leave policies. Results highlight the importance of social context for identifying under which conditions and for which subgroups early maternal employment is associated with positive or negative child outcomes.

Now we can confirm that another risk — small and manageable in the vast majority of cases — is illness or injury associated with loss of parental supervision. Something to watch out for. But didn’t we already know that?

There, I said it. Sorry it took so long.