(PS5-A9) Causal Effects of Couple-focused Interventions on Family Health and Economics

In many Western countries, the likelihood of divorce is disproportionately higher for couples with low socioeconomic status. Children of divorced parents report lower mental health (e.g., increased level of depressive symptoms), physical health, and lower academic and job market success than children of parents who stay together. For adults, divorce is associated with lower mental and physical health, including increased use of primary health care for mental health problems. Thus, it has been suggested that divorce is a major driver of inequality in family health and economics. However, a common critique in the literature on the effects of divorce is that the role of family structure(e.g., divorce) is overstated or at least that the role of family process (e.g., parental conflict) prior to marital dissolution is understudied.

In this relation, an emerging literature has begun to suggest that the effects on health and economics might precede the actual change in family structure. This indicates that changes in the family process is causing the heterogeneous patterns of change in health and economics. We contribute to this debate by investigating to what extent couple-focused interventions influence family health and economics. We exploit data on five different couple-focused interventions which were all aimed at improving family process, although some were offered as universal prevention (e.g., to all couples having their first child) and others as targeted prevention (e.g., to couples with initial distress levels). To examine the (potential) causal effects, we link experimental data on family process from randomized controlled trials of the five couple-focused intervention (N > 5,000 parents) with high-quality register-based data on health outcomes (e.g., use of primary and secondary health care) and economic outcomes (e.g., unemployment for adults and academic achievement for children). With the unique combination of experimental -and register-based data, we make a significant contribution by disentangling the effect of changes in family process from the effect of changes in family structure.  

To test the causal effects of couple-focused interventions empirically, we will compare changes in family health and economics between treatment -and control groups from before to after the intervention (i.e., a difference-in-differences approach). As the register-based data allows us to follow couples over time, multiple measures of outcomes after the intervention will be used to test long -and short-term effects. We rely on OLS regression with standard errors clustered at the couple-level. We plan to complement the regression-analysis with a growth curve model, allowing us to compare trajectories between treatment -and control groups over multiple time points. The analysis will also test the influence of pre-registered moderators: type of intervention, initial relationship quality, and couples’ socioeconomic status. The results will be presented at the conference.

Findings will not only provide information on potential short and long term “hard outcome” benefits from couple-focused interventions aimed at reducing parental conflict. Results will also inform the development of public and social policies targeting the family.