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Do flexible work policies improve parents’ health? A natural experiment based on the UK Millennium Cohort Study
  1. Mauricio Avendano1,2,3,
  2. Lidia Panico3
  1. 1 Department of Global Health and Social Medicine, King’s College London, London, UK
  2. 2 Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
  3. 3 Institut National d’Etudes Démographiques (INED), Paris, France
  1. Correspondence to Dr Mauricio Avendano, Department of Global Health and Social Medicine, King’s College London, London WC2R 2LS, UK; mauricio.avendano_pabon{at}


Background There is limited evidence of the impact of policies to promote work–family balance on family health. Exploiting the introduction of the UK Flexible Working Act (2003), we examined whether a policy that grants parents the right to request flexible work influences their health and well-being.

Methods Using the UK Millennium Cohort Study, we focus on 6424 mothers employed in 2001–2002, when the cohort child was 9 months old, until their child’s seventh birthday. We used a difference-in-differences (DiD) approach to compare changes in outcomes before and after the policy among mothers most likely to benefit and mothers unlikely to benefit from the policy.

Results Flexible working increased in a small group of mothers (n=548) whose employer did not offer work flexibility before the reform (treatment group). By contrast, among mothers whose employer already offered flexible work before the reform (control group, n=5810), there was little change or a slight decline in flexible working. DiD estimates suggest that the policy was associated with an increase in flexible working (37.5 percentage points, 95% CI 32.9 to 41.6), but it had no impact on self-rated health (−1.6 percentage points, 95% CI −4.4 to 1.1), long-term illness (−1.87 percentage points, 95% CI −4.3 to 0.5) or life satisfaction scores (β=0.04, 95% CI −0.08 to 0.16).

Conclusion The Flexible Working Act increased flexible working only among a small group of mothers who had not yet the right to request work flexibility, but it had no impact on their health and well-being. Policies promoting work flexibility may require stronger incentives for both parents and employers.

  • workplace
  • policy
  • maternal health
  • lngitudinal studies
  • cohort studies

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  • MA and LP contributed equally.

  • Contributors Both authors contributed to study conception and design, data acquisition and interpretation of data, and drafted and approved the manuscript. MA carried out the analyses.

  • Funding MA was supported by grant no. 633666 (Lifepath) from the European Commission Horizon 2020 Programme, the National Institute on Ageing (award number R01AG040248) and the European Research Council (grant no. 263684).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The MCS data for surveys 1–4 can be downloaded from the UK Data Archive: