Put Your Own Mask on First: Relationships between Self-Care, Poor Parental Health, and Parenting

Background: The majority of US adults aged 18-64 have a chronic health condition, suggesting that many parents of young children may be dealing with dual challenges of parenting and managing poor health. Limited research suggests that poor parental health is associated with aggressive parenting or child abuse or neglect, however this research has focused on self-rated health status and not examined the presence of chronic conditions or functional limitations. In addition, potential buffering mechanisms in this relationship are understudied. Parental self-care, where parents are able to engage in healthy or restorative behaviors, could help protect against the impact of chronic health conditions on parenting. We used data from the general population Parenting & Well-being Study to examine whether chronic illness or impairments in roles and activities were associated with corporal punishment, psychological aggression, and punitive parenting (all risk factors for abusive behaviors), and whether these relationships were moderated by parental self-care.

Methods: The Parenting & Well-being Study involved a one-time online survey and sampled parents of minor children through local social media sites, parenting list-serves, or flyers posted in public areas frequented by parents in March-May 2025. Advanced bot detection and verification systems were implemented via Qualtrics (n=221). We assessed the presence of a chronic health condition (e.g. diabetes, asthma) as well as impairments in roles or activities (e.g. level of difficulty running errands, etc.). The self-care scale measured the frequency parents engaged in specific activities such as hobbies or exercise. Corporal punishment, psychological aggression, and punitive parenting were all assessed via sub-scales of the Dimensions of Discipline inventory (Straus & Fauchier, 2007). Due to overdispersion of the count dependent variables, negative binomial regressions models were analyzed.

Results: The sample was majority women (72%), and the three largest racial and ethnic groups were White, non-Hispanic (42%), Hispanic (38%) and Black, non-Hispanic (7%). Fifty-three percent had less education than a four-year degree and 43% reported having a current chronic health condition. Negative binomial regression models found that less self-care was associated with greater use of corporal punishment, psychological aggression, and punitive parenting. Chronic illness was significantly positively associated with frequency of corporal punishment and aggressive parenting, but not psychological aggression. More impairments in roles and activities was also significantly positively associated with all three parenting outcomes. There were no significant interactions between self-care and chronic illness; there was a significant interaction between self-care and impairment in roles and activities on frequency of corporal punishment [(IRR)=0.995, 95% CI [0.991-0.998].

Discussion & Implications: Findings suggest that chronic illness and impairments in roles and activities are little recognized factors associated with negative parenting in the general population. Increased parental self-care among parents with impairments in roles and activities may protect against this relationship, suggesting that by “putting their mask on first” parents may also be preventing negative outcomes for children. Health clinics and social services settings could screen for risk and offer supportive interventions and self-care opportunities for parents to prevent aggressive parenting and enhance child well-being.