Family risk factors

Violence, unemployment, drug abuse and mental illness are few of the risk factors that
directly impact family health. When family life is characterized by stress and conflict, the
health of family members tends to be negatively affected.

The following issues should be considered as indicators of high risk for health of the family:

1. Economic stress issues (e. g. loss of a job, unable to pay bills, loss of primary income
source, homeless, etc.);

2. Substance abuse in the family (e. g. alcoholic in the family, drug addict, etc.); child abuse
and neglect issues, or domestic violence;

3. Recent divorce or loss of family members due to death;

4. Child development issues; children with disabilities;

5. Mentally ill in the family; disabled person in the family;

6. Other factors which contribute to the family’s inability to deal with stress in a way that is
healthy;

8. Family literacy issues.

There is a growing amount of research that demonstrates that chronic and serious illnesses
have a profound effect on other family members and on the family as a whole. There is also
a growing body of evidence that shows families can have a beneficial or harmful effect on an
individual family member’s health. When serious illness or disability strikes a person, the
family as a whole is affected by the disease process and by the entire health care experience
(1, 2). Because each person in a family plays a specific role that is part of the family’s
everyday functioning, the illness of one family member disrupts the whole family. When a
family member becomes ill, other family members must alter their lifestyle and take on
some of the role functions of the ill person, which in turn affects their own normal role
functioning. The extent of the family disruption depends on the seriousness of the illness,
the family’s level of functioning before the illness, socioeconomic considerations, and the
extent to which other family members can absorb the role of the person who is ill. If the
person who does most of the family’s cooking has surgery and can’t shop or prepare meals
for several weeks, other family members must take on this responsibility in addition to the
tasks they already do. When a working parent is up most of the night trying to console a
child with an ear infection, the parent not only loses sleep, but must either arrange for
emergent child care or take a day off from work (1). If a man who is the primary income
producer in a family has a heart attack, his wife may have to return to work, increase
working hours if she is already employed, or become the family’s breadwinner. Illness may
cause additional strain as the result of economic problems and interruptions in career
development. If the patient is a young child, there may be additional strain to the family if
there are siblings whose needs must also be met. In some instances, a major illness brings a
family closer together; in others, even a minor illness causes significant strain. It is important
to identify what the illness means, not only to the individual but also to the family. Asking
them what they consider major problems and how they plan to handle specific situations
can help you assess the meaning of the patient’s illness to the family. A family's social
support is one of the main ways that family positively impacts health. Social relationships,
such as those found in close families, have been demonstrated to decrease the likelihood of
the onset of chronic disease, disability, mental illness, and death. Of the three types of
support (instrumental, informational, emotional and a sense of belonging), research shows
that emotional support is the most important and influential type of support provided by
families (2, 3). Marital status affects mortality from specific illnesses and morbidity. Marriage
is thought to protect well-being by providing companionship, emotional support, and
economic security. Married individuals are healthier than the widowed, who are in turn
healthier than either divorced or never married individuals. Separation and divorce is also
associated with increased mortality (3, 4). One does not have to be married to obtain the
health benefits from family. Studies have also confirmed that social support from parents,
friends, and relatives has positive effects, especially on mental health (4). Negative, critical,
or hostile family relationships have a stronger influence on health than positive or
supportive relationships (3). In several studies including schizophrenia, depression, smoking,
weight management, asthma, diabetes, and migraine headaches, researchers found that
conflict and criticism can have a profound negative influence on health. Though good familial
relations and social support serve as protective and improve overall health, studies have
shown that not all family relations positively impact health. Poor-quality family relationships
(e.g. non-supportive familial interactions, violence in the family, problematic relationships,
etc.) can harm physical and mental health. Indeed, persons in unhappy marriages exhibit
worse physical and mental health than unmarried persons (4, 5, 6).

The family environment has a huge impact on a person’s health status. The first way is by a
direct biological pathway. This includes the shared physical environment. People living in
close proximity are at increased risk of transmitting airborne and blood-borne diseases. They
share the same toxic environments including smoking and asbestos. Of course, there are also
genetic influences. Another pathway that influences health is through health behaviour. Our
families strongly influence our health behaviours including smoking, exercise, diet, nutrition,
and substance abuse. Parents have a strong influence on what kind of health behaviours
their children or adolescents will adopt. And the third general way that families can
influence health is psychophysiological pathways. Family relationships can influence physical
health by changes in cognition and emotion that results in physiological responses, which in
turn can influence health outcomes." (3). This includes the effect of stress on the immune
system and psychosomatic illness. By understanding these pathways, medical and mental-
health professionals can choose appropriate and effective family interventions to improve a
patient's health status (e.g. family education and support, family psychoeducation, family
therapy, etc.).

References:

1. http://www.euromedinfo.eu/impact-of-illness-on-the-family.html/
2. http://www.happyheartfamilies.com/articles/article/7175581/168681.htm
3. Campbell, T.L. The effectiveness of family interventions for physical disorders.
Journal of Marital and Family Therapy. 2003; 29 (2), 263.
4. http://www.uniteforsight.org/gender-power/module1
5. Seeman TE. Health promoting effects of friends and family on health outcomes in
older adults. Am J Health Promot. 2000;14(6):362-70.
6. George, L. “The Health-Promoting Effects of Social Bonds.” Accessed on 15 November
2010.