Family health is a state in which the family is a resource for the day-to-day living and health of its members. A family provides its individual members with key resources for healthful living, including food, clothing, shelter, a sense of self-worth, and access to medical care. Further, family health is a socioeconomic process whereby the health of family members is mentioned.
As the basic socioeconomic unit of most societies, the family is the interface between societal and individual health, and the economic interface between the family and society determines what resources are available for a family's health. For example, in some families the father is the primary income earner, yet his skills are marketable only in remote, resource-based communities. In such families, members may have adequate financial resources for healthful living because of the father's stable employment, though their shared geographic location has the potential to negatively impact access to fresh foods, recreation facilities, and quality health care. Here, the community plays a primary role in mitigating the effects of geographic location. In healthy communities, many families will benefit from resources available in the community and, in turn, will produce members who contribute in kind, with family dynamics mediating this reciprocal process.
While a family may have adequate resources to support its members' health-related decisions, family dynamics influence if, how, when, and by whom resources are accessed. For example, while the family may have adequate financial resources to support the regular physical activity of all members, female family members may be less apt to participate in such activities because of family expectations regarding traditional feminine behavior, such as caregiving and household management. Further, it is in families that individuals learn about, and are exposed to, behaviors and patterns of living that may be key to their own health. Such learned patterns may include diet, exercise patterns, orientation to social support, religious practices, substance use or abuse, and domestic violence. And, it is in families that individuals share a genetic makeup that may influence their individual and collective health-related decisions, such as those related to genetic screening.
Public health has a mandate to set norms and values for health behavior, establish policies that protect the health of the public, and set directions for advocacy initiatives to ensure that health-related resources are available to citizens. The family environment mediates between societal views of health, often set by public health initiatives, and individual health. That is, in the family unit the norms and values set by the public health agenda are interpreted in relation to the family's values and norms. These values are constructed through a complex process of interpretation, which is influenced by family history, cultural context, and popular science and culture. Thus, the family environment may be a primary determinant of the impact of public health policy on health-related behaviors such as exercise, diet, and smoking. For example, public health in a particular jurisdiction may establish a policy for nutritional labeling of packaged food. Parents in a family in that area who subscribe to the belief that a low-fat diet reduces risk for heart diseases may attempt to influence family members' health by selecting and serving food
labeled "low fat," a strategy that may lead to reduced incidence of heart disease in family members.
At the broad societal level, public health advocacy efforts at global, national, and community levels impact resources available to families. For example, health care reform in Canada in the 1960s established a system that ensures equitable access to medical care for all families—in contrast to the U.S. system of health care in which some families are unable to afford medical care for ill members, or such care devastates the financial resources of the family.
Family health-related research and scholarship is evident in a variety of disciplines, including family science, nursing, medicine, health promotion, social work, sociology, and psychology. Traditional family theorists focus on interpersonal family dynamics and how such dynamics contribute to or detract from family functioning. Located within a problem-orientated, "dis-ease" perspective (itself grounded in the practice of counseling), authors have explored dimensions of family life that contribute to how well the family functions. The problem-orientation of family theories is an issue for those involved in family-health promotion who seek to build on the strengths and resiliencies of families. Emerging perspectives on family-health promotion explore the links between family life and individual members' health, with individual health defined as more than the absence of disease. Feminist scholars contribute to understanding family health by exploring how family life affects the health of females, including the health-related effects of domestic violence and role strain, an area of research largely ignored or invisible prior to feminist inquiry.
While research on families beyond a problem/dis-ease orientation is in an early stage, evidence in diverse cultural contexts points to family practices and processes that foster and support the development of members' health. Future research exploring the relationships between individual health, family, and social organizations has the
LYNNE E. YOUNG
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