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Research Findings: Age - Youth: Role of family life on health and health behaviours Summary Papers

Effect of family structure, culture and conflict on teenage health


Previously little has been known about the role of the family in the health inequalities debate.  The role of culture in producing health inequalities has traditionally focused on health behaviours such as smoking, drinking, diet and exercise.  Importantly, family life is central in cultural influences particular for children since it is usually within the home that early values and behaviours are learned and adopted that can impact on adulthood.

Using data from the youngest cohort of the Twenty-07 Study, three dimensions of family life (family structure, culture and conflict) were explored for associations with health at 15 and 18 years and with employment status at 18 years.  Despite a strong association between family structure and living standards, we found little differences in young person’s health whether from intact, reconstituted and single parent families. 

However, in contrast, certain aspects of family life, particularly poorer relationships and conflict with parent(s) were independently linked with lower self-esteem, poorer mental health and well-being and, among females, more symptoms of physical ill-health at both ages.  Furthermore, those from more family centred and lower conflict homes had a greater likelihood of reaching further education.  Our findings suggest that during teenage years and into adulthood, family culture may have more direct effects on health than poorer living standards or family structure.

Sweeting, H. and P. West (1995). "Family life and health in adolescence: a role for culture in the health inequalities debate?" Social Science and Medicine 40 (2): 163-175
pubmed
 


The relationship between family life and young people’s lifestyles

We examined aspects of family life among the 1970s cohort of the Twenty-07 Study when they were teenagers: 

  1. Structure (whether young people were living with both biological parents, ‘step-parent(s)’, or only one parent),
  2. Time spent by the young person in family activities, and
  3. Conflict (frequency of arguments between them and their parents).

Those who experienced positive aspects of family life (structure, time and conflict) at age 15 were least likely to have experienced illicit drugs or be unemployed three years later.  Young women living with both biological parents were also more likely to have left school with qualifications and least likely to have been pregnant by age 18.

For 18 year old women, drug use and pregnancy were much more common among those who had lost a parent through death than those whose parents had separated. 

Young people who reported more conflict with parents (regardless of family structure) were more likely to have health problems and lower self-esteem.  They were also more likely to smoke, to have done less well at school, and were less likely to be students.

The most consistent relationships occurred in respect of ‘family time’.  Young people who spent more time with the rest of their family were less likely to smoke or to have tried illicit drugs.  They were more likely to have left school later, to have some qualifications, and to be students, with women less likely to have been pregnant by age 18.

Sweeting, H. and P. West (1996). The relationship between family life and young people's lifestyles. York, Joseph Rowntree Foundation Social Policy Research Findings.
open access
 


Effect of family structure on teenage family life, behaviour and life-chances

Much research over the last three decades has focused on the relationship between family life and the development, well-being and behaviour of children through to young adulthood. 

This project investigated the youngest cohort from the Twenty-07 Study from age 15 years until they reached age 21.  We found that family structure was strongly linked to living standards.  However, patterns of teenage behaviour are complex and different outcomes were observed with different aspects of family life during mid-teens.  After controlling for generally better living standards, young people living with both birth parents at the age of 15 were less likely than those from ‘step’ and/or lone parent households to be heavy drinkers, have experience of drugs, heterosexual intercourse, to lack school qualifications, to be unemployed or, among young women, to have experienced pregnancy three years later. 

The poorest outcomes generally occurred among those from ‘step’ parent families.  Less time spent with family was strongly and most consistently linked to increased smoking, drinking, and experience of drugs, heterosexual intercourse, pregnancy, anti-social behaviour, poorer educational achievement and reduced employment after leaving school.   We found that young people from ‘step’ and lone parent households spent similar time with their families, but significantly less time than those from families with both birth parents.  Young people who spend less time with their families, may have more time for peer-orientated activities which may account for the observed poorer outcomes in ’step’ and/or lone parent families. 

Fewer outcomes were associated with parent-teenage conflicts.  However, we did find that the more conflict a young person has with parent(s) then the more likely they are to smoke and less likely they are to reach further education at 18 years.

Sweeting, H., P. West, et al. (1998). "Teenage family life, lifestyles, and life chances: associations with family structure, conflict with parents and joint family activity." International Journal of Law, Policy & the Family 12: 15-46.
open access
 


Influence of family and friends on teenage smoking habits

Despite the decline in the number of adults smoking in the UK, children and young people continue to take up smoking in increasing numbers.  Following the 1970s cohort from 15 years we tracked their regular smoking habits, and those of their family and friends, through to early adulthood at 23 years. 

Overall, we found that regular smoking more than doubled between ages 15 and 23 years.  Having parents who smoke did not appear to influence teenage smoking habits.  Teenagers who started smoking between the ages of 15 and 16 were influenced by having an older or younger brother or sister who smoked at this time.  Teenagers were 10 times more likely to take up smoking by 16 years if they had friends who were smoking at 15 years.  Furthermore, they were three times more likely to take up smoking between the age of 18 and 21 years if friends were smoking at 18 years.  Social class and gender type did not appear influence smoking habits.  The period from mid-adolescence to early adulthood is important for uptake of regular smoking, and in particular reveals friends’ smoking to have a significant influence, especially around school-leaving age when friendship networks often change dramatically.  In order for health promotion strategies to be more effective in reducing the burden of smoking related ill-health they need to understand the processes of peer selection during adolescent and post-school years and generate health education strategies to target different groups of potential smokers.

West, P., H. Sweeting, et al. (1999). "Family and friends' influences on the uptake of regular smoking from mid-adolescence to early adulthood." Addiction 94 (9): 1397-1412.
pubmed

 

Does the effect of family structure on teenage opportunities, lifestyle and health vary geographically?

The effect of family life on the life chances, lifestyles and well-being of children and young people is an issue receiving considerable attention by public health researchers and policy makers.  Most studies have found that children and young people growing up in non-intact families (i.e. households other than those with married or cohabiting birth parents) under-achieve in a variety of ways or are exposed to greater risk than those from intact families.  Across a range of factors there is increasing evidence suggesting a negative effect of growing up in a lone parent or reconstituted family on a young person’s life chances, lifestyle, and health. Several studies have reported that in comparison to children from intact families, children from lone parent or reconstituted families do less well educationally, have higher rates of smoking, drinking and illicit drug use, and experience poorer mental health such as depression.  The reasons for this are not fully understood but it has been suggested they could be linked to the geographical area where you live.

This study investigated whether the effects of family structure vary geographically by comparing the youngest cohort of the Twenty-07 Study with a similar cohort from mainland UK during the mid-80s.  In this study we measured the life-chances among 15-16 year olds in terms of educational achievement, lifestyle in terms of smoking and drinking habits, and general health in terms of mental and physical well-being. 

We found that the effects of family life and reason for family disruption on the future lifestyle, health and life-chances of teenagers are not significantly linked to which part of the country they live in.

Ely, M., P. West, et al. (2000). "Teenage family life, life chances, lifestyles, and health: a comparison of two contemporary cohorts." International Journal of Law, Policy & the Family 14: 1-30.
open access