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FAMILY EFFECTS ON HEALTH. Atatürk University Medical Faculty 2010-2011 Semester I Class 1 Family Medicine Lectures Yrd. Doç. Dr. Memet IŞIK [email protected] Objektives. At the end of this lecture, the participants will be able to;

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Family effects on health


Atatürk University Medical Faculty 2010-2011 Semester I

Class 1 Family Medicine Lectures

Yrd. Doç. Dr. Memet IŞIK

[email protected]


  • At the end of this lecture, the participants will be able to;

    • Describe “family” and discuss new forms of families.

    • Discuss functions of the family

    • Discuss the importance of social support

    • Discuss the role of family on individual’s health.

    • Discuss the role of family in the prevention of diseases.

What is a family

  • The smallest social unit in the community, based on marriage and blood ties, consisting of wife, husband, children and siblings.

    Pequengnant and Bray, 1997: Group of people who are biologically, emotionally and legally bound.

  • Major social institution found in all human societies

  • a group of individuals living under one roof and usually under one head

  • a group of persons of common ancestry

  • the basic unit in society traditionally consisting of two parents rearing their children

Family image
Family Image

  • Usual image: working father + housewife mother + dependent children

  • Reality: This is becoming less and less common as more & more mothers work outside the home. Also because of rising divorce rates.

Turkis h family structure
Turkish Family Structure

  • 1997 USA: The proportion of children out of wedlock 32%

    Bird ST. Beyond Marital Status: Relationship Type and Duration And the Risk of Low Birth Weight. Family Planning Perspectives 2000

  • 2003 TR: The proportion of children out of wedlock 0 %

    Turkish Population and Health Surveys 2003

Importance of social support
Importance of Social Support

  • The relation between social relationships and health is as important as morbidity and mortality effects of many diseases.

    House ve ark. 1988

  • We can categorize social supportas "structured" and "functional“.

Importance of links between relatives
Importance of Links Between Relatives

  • Social support is an important factor for mortality estimates.

  • Regardless of socioeconomic status, previous health status and health practices, dying of individuals who are alone is as twice as than individuals living within a family.

Importance of spouse
Importance of Spouse

  • Probability of dying of the surviving spouse within 6 month after dying of one of the couple is high.

    -Accidents, violence, alcohol, heart attack, lung cancer

    Martikainen P, Valkonen T. Mortality after the death of a spouse: rates and causes of death in a large Finnish cohort. Am J Public Health 1996;86(8):1087-1093.

  • Risk is higher in younger then older ones.

  • Compared to persons with living spouses, probability of dying of the remaining couple is 17% more in males, 6% in females.

    Martikainen P, Valkonen T. Mortality after death of spouse in relation to duration of bereavement in Finland. J Epidemiol Community Health 1996;50(3):264-268.

Preventive medicine and family
Preventive Medicine and Family

  • Family is the first application area of preventive medicine

    World Health Organization. Statistical Indices of Family Health No. 589:17, 1976.

  • A healthy lifestyle is learned, applied and will be replaced in family.

Chronic illness and family
Chronic Illness and Family

  • Cigarette

  • Obesity

  • Immobility

  • Hypertension

Family members interact
Family Members Interact

  • Family members have similar risk factors

  • Are fed from the same kitchen

  • Harmful habits in the family will be copied

    In the case of smoking parents or siblings, smoke are more likely

    Salt, calories, cholesterol, fat consumption ...

    Gegenetic also have effect

Chronic illness and family1
Chronic Illness and Family

  • Families affect the course of chronic illnesses.

  • Individuals with chronic illness affects the family

  • Family meetings can be helpful Psychiatric disorders The presence of chronic patients Bedridden patients Incompatibility

Family may be supportive or fetter
Family may be supportive or fetter

  • Sometimes families can be supportive can remind to take drug

    whole family out for a walk ...

  • Sometimes the opposite might be make fun of exercising family members make fun of of the individuals who sports .

New forms of the family
New Forms of the “Family”

  • Cohabiting couples (with or without children)

  • Single parent family (because of teen pregnancy, divorce or abandonment)

  • “Blended” family: a social unit consisting of two previously married parents and the children of their former marriages

  • Homosexual couples e.g. Netherlands has legalised homosexual marriages

Functions of the family
Functions of the Family


  • Companionship (“marry for love”)

  • Sex and reproduction

  • Social Obligations

  • Socialisation of children

  • Social support (especially during crises)

  • Economic cooperation

Family structure
Family Structure

  • Nuclear family: Father, mother and kids

  • Extended family: The above plus grandparents

  • “Family life cycle” – structure of an individual family changes over time

The family is changing
The Family is Changing

Changing roles (role = “expected behavior” that goes with a social position)

People marry later, have fewer kids, and also have them later

More divorces

Single parent families (these are more likely to be poor)

The family is changing1
The Family is Changing

  • More working mothers and “latchkey kids”

  • Children may be unsupervised and feel neglected and unloved

  • Working mothers are stressed (“Supermom Syndrome” and “Double Burden of Women”)

Stressed working mothers
Stressed Working Mothers


  • Female nurses with children

  • Female doctors with children

    Role conflict: Being a good doctor to one’s patients versus being a good mother to one’s kids

Effects of family on health
Effects of Family on Health

1) Effects on Illness Behaviour:

Stoic? self-medicate? seek alternative medicine? Effects on medical adherence: the extent to which a person's behavior coincides with medical or health advice

e.g. religion & health (faith healing)

Effects of family on health1
Effects of Family on Health

2) Effects on patients with long term illness:

Quality of care provided by family members (female relatives as care providers for kids, husbands, in-laws and elderly parents)

Effects of family on health2
Effects of Family on Health

3) Family and social networks promote health:

Socially isolated have poorer mental health; recover slower from sickness

The dysfunctional family
The Dysfunctional Family

“Troubled family that has a negative effect on the physical or psychological well-being of its individual family members”

Effects of family on health3
Effects of Family on Health

4) Dysfunctional families and poor parenting:

  • Child abuse – neglect, physical abuse, verbal abuse, sexual abuse

  • Overindulgence

  • Domestic violence

  • Alcoholism and substance-abuse in the family

  • Gambling problems


Families with divorced parents are NOT NECESSARILY dysfunctional families !

Effects of family on health4
Effects of Family on Health

5) Learning of health-related behaviour

e.g. quality of diet and health (including obesity), smoking and passive smoking, alcohol (religion & alcohol consumption), risk-taking behaviour, values and behaviour (including sexual behaviour)

Effects of family on health5
Effects of Family on Health

6) Family changes can affect health

“Stressful life events” such as marital breakdown and divorce, death of spouse etc. increase risk of sickness for other family members

Large families: can affect health of kids in a negative manner

Effect of sickness on the family
Effect of Sickness on the Family

1) Effect of chronic disease or death

Role changes: if the wife gets sick or dies, the husband has to adjust (or vice-versa)

Economic pressures: family member stops work to care for the sick, patient is unable to work, medical bills become high

Effect of sickness on the family1
Effect of Sickness on the Family

2) Stress from taking care of sick family member

e.g. Alzheimer’s disease, serious mental illness, relative who is bed-ridden or incontinent

3) Stigmatizing diseases such as HIV/AIDS

e.g. hostility from neighbours, abandonment by own family