1. PRESENTATION FOR THE 8 TH MEETING FOR THE SOCIOLOGICAL AND DEMOGRAPHIC STUDIES OF DIVORCE 14-16 OCTOBER 2010 VALENCIA – SPAIN ELIEN COLMAN, SARA SYMOENS & PIET BRACKE HEDERA DEPARTMENT OF SOCIOLOGY GHENT UNIVERSITY Differences in health care use among the divorced and the married: are they need-based?

2. Background 2 different approaches: * Measures based on need-adjusted health care utilization : comparing groups in their health care use, controlling for need factors (‘objective measures’) * Subjective measures of unmet need (SUN): R decides whether he/she has an unmet need Focus on health care use because of social or emotional problems

3. Background Previous research has indicated that: - the divorced have a higher health care use, even after controlling for need Divorced: seek more easily professional care => report less subjective unmet need?

4. Background Controls: Andersen’s Behavioral Model of Health Services Use Predisposing characteristics Enabling factors Need Marital status Gender Children Age Education Income Social support Employment Depression Use SUN

5. Data & Methods Data: Divorce in Flanders (2009-2010) Selection of marriages out of Public Register: 1/3 still married; 2/3 ever divorced Methods: Logistic Regressions Dependent variables: - contact with a health care professional because of social or emotional problems - subjective unmet need because of social or emotional problems Gender specific analyses N men: 1876 N women: 2205

6. Results: descriptives MenWomen MeanS.E.MeanS.E. Number of children 0,50,880,540,88 Age 47,118,3245,128,47 Financial strain 2,631,122,891,21 Social Loneliness (1-13) 4.362.304.092.23 Emotional Loneliness (1-13) 3.912.324.152.46 Depression (1-25) 4,843,565,934,25 MenWomen (%) Subjective Unmet Need 6,111,3 Contact with professional 13,623,6 Partner status: Married2727,5 Partnered divorced43,238,3 Non- partnered divorced29,834,2 Employment status: Not employed15,220,4 Part-time work5,833,8 Full-time work77,343,4 Education: Low24,220,5 Middle41,139,4 High34,239,9

7. Results: Logistic regressions: contact with health care provider Dependent variable: contact with professional health care provider because of social or emotional problems

8. Results: Logistic regressions: contact with health care provider The finding that a higher amount of single divorced women have contacted a health care provider because of social or emotional problems can only partially explained by their higher need for care Do feelings of loneliness add to this explanation?

9. Do single divorced feel less often that they needed professional help for social or emotional problems, without seeking this care? Results: Logistic regressions: subjective unmet need

10. Single divorced men and women have more often the feeling that they need professional help, without seeking this help Can this be explained by feelings of loneliness?

11. Conclusion Divorced single women:  Are more easily motivated to seek professional help  The seek professional help, but, are still not totally satisfied  Their feelings of unmet need are associated with emotional loneliness  Divorced single women need someone to talk to: informal or formal

12. Conclusion Divorced single men:  Only contact health care providers when the need is very high  As a result, there are high levels of subjective unmet need among them, compared to other men  Need a partner to stimulate them to seek help?

13. DISCUSSION Differences in health care use among the divorced and the married: are they need-based? - No difference between the divorced living with a new partner and the married - For single divorced women: only partially, they seek more easily professional care - For single divorced men: contact professional health care providers only when the need is high Limitations - Perspective of time - Narrow measurement of need

14. Thank you for your attention! Elien.Colman@UGent.be www.divorceinflanders.be