Caribbean Family –Social and Health Concerns Dr. J. Rawlins Senior Lecturer Public Health and Primary Care Unit Faculty of Medical Sciences University of the West Indies
Family Structure and Health Objectives • define and identify “family” in the various presentations, structures and components • discuss the family’s impact on health behaviour, health beliefs and health promotion • discuss the issue of male marginalization and its implications for health
Reference(s) • Barrow, Christine (1996) “Family in the Caribbean- Themes and Perspectives” , Ian Randle Publishers, Mona, Jamaica. • Reddock, Rhoda and Bobb-Smith, Yvonne (2008)“Reconciling Work and Family. ILO. Geneva.
What do we mean by family? • a group of related kin, linked by blood relationships and /or marriage or “similar relationship” or adoption, usually occupying a common household and usually characterized by relations of economic cooperation and solidarity • in its simplest form a family consists of a husband, a wife and their non-adult children i.e. the nuclear family • the extended family- in which we get the the nuclear family intact or minus father or mother, but with other members of the family e.g. grandmothers, aunts, uncles and cousins
Family • Considered as the basic unit of social organization • Found in all societies (Thus it is a universal social institution) Functions - • protects members, nurtures, transfers values from generation to generation, educates- generally, acts as a buffer against all problems which family members might encounter, acts as and agency of socialization • NB. All these functions have implications for the individual’s health and well-being
Family and Health: the link The family: • is the first emotional and social situation that we experience • is our • first teacher • and first health care provider • determines our life-style in childhood • influences our life-style in later years (most likely)
Family: Trinidad and Tobago-style • Afro-Trinidadians • Indo-Trinidadians • Chinese Trinidadians • Syrian-Lebanese • Other Trinidadians
Explanation of some family patterns • Cultural diffusion approach attempts to explain family structure by referring to its roots in Africa, Asia and Europe, and argues that present structures represent modifications of these origins • Social Pathology Approach claims that the hazards of the middle passage and plantation slavery deformed the Afro-Caribbean family in a number of ways • Structural functionalist approach argued that the family is not deformed or dysfunctional, but has adopted certain forms as a response to a situation of poverty and economic marginality • Adaptive Response Approach
Adaptive Response Approach • This approach which has similarities to the Structural Functionalist Approach argues that families headed by females are not mal-adaptive but are positive responses to the absence of males through migration and other socio-economic forces. (Discuss) • These theorists argue that the movement from one union to another is an adaptive function, in responding to the changing economic conditions of the region and the concomitant unpredictable status of their partners
Common terms in relation to family • Matrifocal (Or matri-centric simply means mother or female centred and can be understood to designate a form in which only a mother and her dependent children are present or significant- • refers e.g. to the female headed household as is common in Caribbean and some other societies • Matriarchal • is sometimes used synonymously with matrifocal, but it is not really the same
Matriarchy • Matriarchal • . “Matriarchy has not been clearly defined by anthropologist and those who study culture, but if we consider it to be the opposite of patriarchy, then matriarchy should be a society ruled by women in which men have inferior social and political status, including basic human rights. According to this definition, there is no evidence of matriarchy in ethnology.
Women’s rule? • Matriarchy • The suffix -archy denotes leadership and ruling. True to its sense, any -archal society should follow that a group dominates the others. • Anthropologists know of no matriarchal society as so defined. But even without matriarchy, it is important to note that women in many societies do wield power and serve as leaders.
Patriarchy • Patriarchal refers to the male headed household within a family system and “patriarchy” to the system of male dominance and female subordination within a societal system • Matrilineal- is the family system in which people join the mother’s group at birth and stay members for life.
Criticism of the Matrifocal family Some accuse it of : • producing maladjusted families • producing juvenile delinquents • producing school drop-outs • not being a “proper family” and not a viable unit in its own right • Note: Female headed households 28-70% in the Caribbean
Single Mothers, Health and Death A (Swedish) Study reported in the Lancet, May 2000 • showed that single mothers die younger than non single mothers • 70% risk of dying earlier compared to their counterpart with husbands or partners • much of this increase is due to disparities in income and social standing • other researchers have shown that single motherhood poses unique health burdens both physical and mental • the research showed that married people live longer and are generally healthier than singles ( Ref. Gunilla Weitoft,2000)
Single Mothers and Health Single mothers: • were more than twice as likely to commit suicide • three times as likely to suffer a violent death • 2.5 times as likely to die an alcohol -related death Most likely these differences, in part, are related to the stress of working and trying to raise children on their own
Other historical reasons proposed to explain matrifocality in the Caribean • Cultural • West African origins influenced family structure. (There a system of polygamy existed)- a form of extended family with one husband and two or more wives. • This structure allowed for considerable economic independence • Plantation Slavery • The system of plantation slavery has resulted in Matrifocal families (note M.G. Smith the renown Anthropologist) • The Economic Model • the economic position of black males in the “new world” - created the matrifocality. ** (Matrifocality slightly less common in Trinidad and Guyana)
Poverty • A fourth argument cites poverty as the main cause of matrifocality, and argues that matrifocality had become a part of the subculture of poverty. • Oscar Lewis in his “Culture of Poverty” studies in Puerto Rico argued that matrifocality was not simply a product of poverty, but also of culture.
Commonly found union types • Married -legal; all religious and ethnic groups • Common law • like marriage but until recently did not have same legal status. Now has same status… children not discriminated against • Visiting relationship • no legal status • sexual relations • variable stability
Union Patterns in the Anglophone Caribbean in the mid 1990’s • Young mothers < than 25 years are usually in non-residential unions (marriage at these ages, except in the East Indian population, is negligible) • Up to 75% of total women will have a child before age 25 years • Age 25-45 majority of women are in residential unions • After 45 year there is an upward trend in: • separations • e.g. Widowhood and divorce
Divorces: In Trinidad • Divorce rates highest among the >40’s • As age increases up to the 40’s the rate increases • Divorce rates per 1000 (Trinidad 1998) • 35-39 547 per 1000 • 40-44 807 per 1000 • 45-49 718 per 1000 • 50 and 779 per 1000 • Source: Ministry of Gender and Culture, 1998
Divorce update T&T (2006) • Divorce rate has risen 29.7% in the past ten years (CSO) • 1554 in 2000, up from 1198 in 1990 • Significant numbers had only been married for 2 years; and in 2002, five of these had only been married for one year • The average age of first marriages in 2002 was 20-24 for women and 25-29 for men • Source: Woman Express, p.16. (3/9/2006)
Family and Health:Some Issues • family history • socio-economic situation • dietary preferences • exercise patterns • drinking choices • sexual behaviour
Specific health implications for these families?? • The young single mother • The older single mother • The Jehovah’s witness • The Catholic family • the Hindu family • The Muslim family • The traditional Christian family
Questions • Is the family all that we expect it to be? • Is the family always seen in a positive light? • Can the family protect the individual in a situation of serious economic challenge? • Can the family protect the individual’s health in today’ society?
Men’s marginalization • Men under the system of patriarchy are accustomed to being in charge • In the past 40-50 years the system of patriarchy ruled, within the Caribbean, or so it seemed • Nowadays women’s new roles, salaries, opportunities, responsibilities present challenges to men and to women also
Some challenges • Extremely disgruntled men • Insecure men • In some cases, more reasonable men • Increased incidence of Domestic Violence • Overworked women • Women unable to find suitable partners
Men’s marginalization: Implications for Health Some become marginal, not only to family but also to society as evidenced by: • alcohol abuse • drug abuse • domestic violence • psychiatric problems • involvement in the drug trade • Underperformance in many areas of life