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Public Health and the Aging Family

Public Health Reviewsvolume 32, pages512–531 (2010) | Download Citation

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Abstract

The role of the family in the health of its members is critical from birth to death. This review focuses on the aging family, recognizing that the family is one of the earliest and longest lasting contexts influencing health. In particular, we emphasize the changing demographics of the family including the increased numbers of older family members and the decreased number of children. We consider how best to adapt to the changing family so that its critical role in maintaining individual and public health can be retained and enhanced. We begin by highlighting the importance of taking both a life span and life course perspective, recognizing that individuals develop and change over their lifetime. At the same time, they are members of groups and organizations, which shape their life course. We next consider the dramatically changing demographics of the population generally and within families specifically. We reflect on how these changes impact public health both positively and negatively, taking into account the potential of the family as a resource and a risk factor. We next consider five life course epidemiological models of health: the immediate effects model, the social trajectory model, the cumulative biological model, the sensitive period or latency model and the physiological effects of trajectory model. We explicitly consider the relevance of these models for the family and its aging members. Finally, we highlight what we consider the most important implications of these issues for the health and well-being of older adults and families in an aging society.

References

  1. 1.

    Crimmins EM. Trends in the health of the elderly. Ann Rev Public Health. 2004;25:79–98.

  2. 2.

    Hamburg DA, Elliott GR, Parron DL. Institute of medicine. Health and behavior: Frontiers of research in the biobehavioral sciences. Washington (DC): National Academy Press; 1982.

  3. 3.

    Fuller-Iglesias H, Smith J, Antonucci TC. Theoretical perspectives on life span and life course development. In: Antonucci TC, ? Jackson JS, (editors). Ann Rev Gerontol Geriatr. 2010;29:3–26.

  4. 4.

    Baltes P, Lindenberger U, Staudinger U. Life-span theory in developmental psychology. In: Lerner RM, (editor). Handbook of child psychology, 6th ed. New York (NY): Wiley; 2006. p. 569–664

  5. 5.

    Elder GH Jr, Shanahan MJ. The life course and human development. In: Lerner RM, (editor). Handbook of child psychology, Vol. 1. New York (NY): Wiley; 2006. p. 665–781.

  6. 6.

    Settersten RA. The new landscape of adult life: Roadmaps, signposts, and speedlines. Res Human Develop. 2007;4:239–52.

  7. 7.

    Jacobsen LA, Mather M. Social and economic trends since 2000. Population Bull. 2010;65, 2–16.

  8. 8.

    Bedford VH, Bleiszner R. Personal relationships in later-life families. In: Duck S, (editor). Handbook of personal relationships, 2nd ed. Chichester (UK): John Wiley; 1997. p. 523–530.

  9. 9.

    Crawford JM. Co-parent adoption by same-sex couples: From loophole to law. Families Soc. 1999;80:271–278.

  10. 10.

    Rothausen TJ. ‘Family’ in organizational research: A review and comparison of definitions and measures. J Organizational Behav. 1999;20:817–836.

  11. 11.

    Eurostat. Population Statistics. Luxembourg: European Communities. 2006.

  12. 12.

    U.S. Bureau of the Census. America’s families and living arrangements. 2003. Available from URL. http://www.census.gov/prod/www/abs/p20.html (Accessed 30 September 2010).

  13. 13.

    Casper LM, Cohen PN. How does POSSLQ measure up? National estimates of cohabitation. Demography. 2000;37:237–245.

  14. 14.

    U.S. Department of Health and Human Services. The effects of marriage on health: A synthesis of recent research evidence. 2000. Available from URL: http://aspe.hhs.gov/hsp/07/marriageonhealth/rb.htm (Accessed 30 September 2010).

  15. 15.

    Geggie J, Weston R, Hayes A, Siberberg S. The shaping of strengths and challenges of Australian families. Marriage Family Rev. 2007;41:217–239.

  16. 16.

    Sassler S, Cunningham A, Lichter DT. Intergenerational patterns of union formation and relationship quality. J Family Issues. 2009;30:757–786.

  17. 17.

    Bumpass L, Lu H. Trends in cohabitation and implications for children’s family contexts in the U.S. Popul Stud. 2000;54:29–41.

  18. 18.

    Ganong L, Coleman M. Obligations to stepparents acquired in later life: Relationship quality and acquity of needs. J Gerontol B Psychol Sci Soc Sci. 2006;61:580–588.

  19. 19.

    Sweeney M. Remarriage and stepfamilies: Strategic sites for family scholarship in the 21st century. J Marriage Family. 2010;72:667–684.

  20. 20.

    Sherman CW, Bass P. Spousal dementia caregiving in the context of later life remarriage. Dementia. 2007;6:245–270.

  21. 21.

    Sherman CW, Bauer JW. Financial conflicts facing late life remarriage. Alzheimer’s Disease. Family Relations. 2008;57:492–503.

  22. 22.

    Casper LM, Bianchi SM. Continuity and change in the American family. Thousand Oaks (CA): Sage; 2002.

  23. 23.

    Teachman JD, Tedrow LM, Crowder KD. The changing demography of America’s families. J Marriage Family. 2000;62:1234–1246.

  24. 24.

    Martin MT, Emery RE, Peris TS. Single-parent families: Risks, resilience, and change. In: Coleman M, Ganong LH, (editors). Handbook of contemporary families: Considering the past, contemplating the future. Thousand Oaks (CA): Sage; 2004. p. 282–301.

  25. 25.

    Matthews TJ, Hamilton BE. Delayed childbearing: more women are having their first child later in life. NCHS Data Brief. 2009;21:1–8.

  26. 26.

    Hughes ME, Waite LJ, LaPierre TA, Luo Y. All in the family: The impact of caring for grandchildren on grandparents’ health. J Gerontol B Psychol Sci Soc Sci. 2007;62,S108–S119.

  27. 27.

    Antonucci TC, Birditt KS, Webster NJ. Social relations and mortality: A more nuanced approach. J Health Psyhcol. 2010;15:649–659.

  28. 28.

    Birditt KS, Jackey LMH, Antonucci TC. Longitudinal patterns of negative relationship quality across adulthood. J Gerontol B Psychol Sci Soc Sci. 2009;64B:55–64.

  29. 29.

    Brubaker TH. Families in later life: A burgeoning research area. J Marriage Family. 1990;52:959–981.

  30. 30.

    Fingerman KL, Pitzer LM, Chan W, Birditt KS, Franks MM, Zarit S. Who gets what and why: Help middle-aged adults provide to parents and grown children. J Gerontol B Psychol Sci Soc Sci. In press.

  31. 31.

    Repetti RL, Taylor SE, Seeman TE. Risky families: Family social environments and the mental and physical health of offspring. Psychol Bull. 2002;128:330–366.

  32. 32.

    Bachman, JG, O’Malley PM, Schulenberg JE, Johnston LD, Bryant AL, Merline AC. The decline of substance use in young adulthood: Changes in social activities, roles, and beliefs. Mahwah (NJ): Lawrence Erlbaum Associates; 2002.

  33. 33.

    Birditt KS, Fingerman KL, Zarit S. Adult children’s problems and successes: Implications for intergenerational ambivalence. J Gerontol B Psychol Sci Soc Sci. 2010;65B:145–153.

  34. 34.

    Ross CE, Mirowsky J, Goldsteen K. The impact of the family on health: The decade in review. J Marriage the Family. 1990;52:1059–1078.

  35. 35.

    Wood RG, Goesling B, Avellar S. The effects of marriage on health. 2007. Available from URL: http://aspe.hhs.gov/hsp/07/marriageonhealth/rb.htm (Accessed 29 September 2010).

  36. 36.

    Roberts BW, Smith J, Jackson JJ, Edmonds G. Compensatory conscientiousness in older couples. Psychol Science. 2009;20:553–559.

  37. 37.

    Windsor TD, Ryan LH, Smith J. Individual well being in older adulthood: Do spousal beliefs matter? J Gerontol B Psychol Sci Soc Sci. 2009;64:586–596.

  38. 38.

    White L. Sibling relationships over the life course: A panel analysis. J Marriage Family. 2001;63:555–568.

  39. 39.

    Hetherington EM. Siblings, family relationships, and child development: Introduction. J Family Psychol. 1994;8:251–253.

  40. 40.

    Cicirelli VG. Sibling relationships in middle and old age. Adv App Develop Psychol. 1996;10:47–73.

  41. 41.

    Gold DT. Sibling relationships in old age: A typology. Int J Aging Human Dev. 1986;28:37–51.

  42. 42.

    Loucks EB, Berkman LF, Gruenewald TL, Seeman TE. Relations of social integration to inflammatory marker concentrations in men and women 70 to 79 years. Am J Cardiol. 2006;97:1010–1016.

  43. 43.

    Antonucci TC, Birditt KS, Akiyama H. Convoys of social relations: an interdisciplinary approach. In: Bengston V, Silverstein M, Putney N, Gans N, (editors). Handbook of theories of aging. New York (NY): Springer Publishing Company. 2009. p.247–260.

  44. 44.

    Uchino BN. Social support and physical health: Understanding the health consequences of relationships. New Haven (CT): Yale University Press; 2004.

  45. 45.

    Birditt KS, Antonucci TC. Life sustaining irritations? Relationship quality and mortality in the context of severe illness. Soc Sci Med. 2008;67:1291–1299.

  46. 46.

    Antonucci TC, Akiyama H. Convoys of social relations: Family and friendships within a life span context. In: Blieszner R, Bedford VH, (editors). Handbook of aging and the family. Westport (CT): Greenwood Press; 1995. p. 355–372.

  47. 47.

    Antonucci TC, Jackson JS. Social support, interpersonal efficacy, and health. In: Carstensen LL, Edelstein BA, (editors). Handbook of clinical gerontology. New York (NY): Pergamon Press; 1987. p. 291–311.

  48. 48.

    McAvey GJ, Seeman TE. Rodin J. A longitudinal study of change in domain specific self-efficacy among older adults. J Gerontol. 1996;51b:243–53.

  49. 49.

    Luszczynska A, Gutierrez-Dona B, Schwarzer R. General self-efficacy in various domains of human functioning: Evidence from five countries. Int J Psychol. 2005;40:80–89.

  50. 50.

    Fiori K, McIlvane J, Brown E, Antonucci T. Social relations and depressive symptomatology: Self-efficacy as a mediator. Aging Mental Health. 2006;10:227–239.

  51. 51.

    Smith J, Goodnow JJ. Unasked-for support and unsolicited advice: Age and the quality of social experience. Psychol Aging. 1999;14:108–121.

  52. 52.

    Kahn RL, Antonucci TC. Convoys over the life course: Attachment, roles and social support. In: Baltes BP, Brim OG, (editors). Life-span development and behavior, Vol. 3. New York (NY): Academic Press; 1980. p.253–286.

  53. 53.

    Antonucci TC. Social relations: An examination of social networks, social support and sense of control. In: Birren JE, Schaie KW, (editors). Handbook of the psychology of aging, 5th ed. New York (NY): Academic Press; 2001. p. 427–453.

  54. 54.

    Plath D. Long engagements: Maturity in modern Japan. Stanford (CA): Stanford University Press; 1980.

  55. 55.

    Glymour MM, Ertel KA, Berkman LF. What can life course epidemiology tell us about health inequalities in old age. In: Antonucci TC, Jackson JS, (editors). Ann Rev Gerontol Geriatr. 2010;29:27–32.

  56. 56.

    Gallant MP. The influence of social support on chronic illness self-management: A review and directions or research. Health Educ Behav. 2003;30:170–195.

  57. 57.

    Nicklett EJ, Liang J. Diabetes-related support, regimen adherence, and health decline among older adults. J Gerontol B Psychol Sci Soc Sci. 2010;65B:390–399.

  58. 58.

    Pinquart M. Loneliness in married, widowed, divorced, and never-married older adults. J Soc Personal Relationship. 2003;20:31–53.

  59. 59.

    Ellis DA, Zucker RA, Fitzgerald, HE. The role of family influences in development and risk. Alcohol Health Res World. 1997;21:218–226.

  60. 60.

    McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15:351–378.

  61. 61.

    Lau RR, Quadrel MJ, Hartman KA. Development and change of young adults’ preventive health beliefs and behavior: Influence from parents and peers. J Health Soc Behav.1990;31:240–259.

  62. 62.

    Martorell R. Undernutrition during pregnancy and early childhood: Consequences for cognitive and behavioral development. In: Young ME, (editor). Early child development: Investing in our children’s future. Amsterdam and New York (NY): Elsevier Science BV; 1997. p. 39–83.

  63. 63.

    Najman JM, Clavarino A, McGee TR, Bor W, Williams GM, Hayatbakhsh MR. Timing and chronicity of family poverty and development of unhealthy behaviors in children: A longitudinal study. J Adolesc Health. 2010;46:538–544.

  64. 64.

    Bergman CS, Plomin R, Pedersen NL, McClearn GE. Genetic mediators of the relationship between social support and psychological well-being..Psychol Aging. 1991;64:640–646.

  65. 65.

    Shanahan MJ, Boardman JD. Gene-environment interplay across the life course: Overview and problematics at a new frontier. In: Elder GH Jr, Giele JZ (editors). The craft of life course research. New York (NY): Guilford Press; 2009.

  66. 66.

    Kouzis AC, Eaton WW. Absence of social networks, social support and health services utilization. Psychol Med. 1998;28:1301–1310.

  67. 67.

    Avlund K, Lund R, Holstein BE, Due P. Social relations as determinant of onset of disability in aging. Arch Gerontol Geriatr. 2004;38:85–99.

  68. 68.

    Arozullah AM, Lee S-YD, Khan T, Kurup, S, Ryan J, Bonner M, etal. The roles of low literacy and social support in predicting the preventability of hospital admission. J Gen Intern Med. 2006;21:140–145.

  69. 69.

    Jackson JS, Antonucci TC, Brown EE, Daatland SO, Sellers B. Race and ethnic influences on normative beliefs and attitudes: Toward provision of family care. In: Booth A, Coulter AC, Bianchi S, Seltzer JA, (editors). Intergenerational caregiving. Washington (DC): Urban Institute Press; 2008. p. 317–331.

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Affiliations

  1. University of Michigan, USA

    • Toni C. Antonucci
    •  & Kristin M. Wong

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Correspondence to Toni C. Antonucci.

Additional information

Recommended Citation: Antonucci TC, Wong KM. Public Health and the Aging Family. Public Health Reviews. 2010;32:512–31.

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Key Words

  • Aging
  • family
  • lifespan
  • lifecourse
  • social relations
  • epidemiological models

Public Health Reviews

ISSN: 2107-6952

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