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Summaries
The Effects of Family Composition, Health, and Social Support Linkages on Mortality
Rogers, Richard G., 1996. Journal of Health and Social Behavior,
37(4):326–338. †
This study aims to determine how mortality is affected by family composition, and the
strength of such associations. It also considers other factors by controlling for differences in health and
financial status and social relations outside the household.
The study used the National Health Interview Survey, Supplement on Aging, which includes
information about how each respondent is related to other family members as well as information on age, sex,
race and education. (Race was restricted to black and white due to small sample sizes.) Information was
obtained for individuals aged 55 and over and this was through personal interviews. There was a follow–
up period of 8 years. Family structures considered included married individuals living with their spouses,
young and old children, parents, and other relatives; previously married and never–married individuals
living alone, with their parents, and other relatives; and previously married individuals living with their
young and old children.
It was found that mortality is affected by family composition and health, as well as
informal and formal social support. Married couples enjoy low mortality but so do previously married
individuals who live with their young children and never–married individuals who live alone or who live
with other relatives. Some family arrangements result from strong social bonds, but others are a result of
financial needs or health problems. Indeed, the results suggest that, in some instances, it is not family
living arrangements that influence the risk of mortality but vice versa; the family rearranges itself to
deal with ill health and disability among its members. Generally families strive to promote health, prevent
disease, and encourage economic security. Thus, the family acts directly rather than indirectly to protect
against mortality.
The overall results obtained showed that death is more likely to occur among those who
are older; male; Black; less educated; in poor health; financially strapped; and previously married and
alone, with older children, or with other relatives. Death is less likely to occur among those who have
social ties with relatives, friends and the community.
Interestingly, this study showed that marriage is protective only for people in certain
kinds of families. Married individuals living with their spouses and with their young children retain low
mortality, but those who live with other relatives experience high mortality. It was also shown that
previously married individuals exhibit higher mortality than married individuals, if they live alone, with
older children or others. However, if previously married individuals live with young children, they exhibit
lower mortality than married individuals.
The high mortality associated with individuals who live with other relatives is partly
due to disabling health problems. Disabilities were found to contribute to both mortality and the need to
share a household, generally with adult children or other relatives. It was suggested that young children
provide social integration, whereas the constant care of older children may increase stress and strain and
therefore increase the risk of death. In the same way, the high mortality of never–married individuals
who live with their parents may result from providing instrumental support to their parents without receiving
emotional support in return.
While certain family configurations are associated with increased mortality, it was shown
that contacts with relatives, friends, the community and through volunteerism reduce mortality –
independently of baseline health status, socio–economic status, and health behaviors. Such relations
were found to be as, if not more, important than marital status in predicting health. It should be noted
that this study examined whether individuals engage in these relations rather than how often they engage in
these activities.
The paper suggests that family support is generally obligatory and therefore is more
likely to provide both positive and negative interactions, whereas support from friends is voluntary. This
would help explain why never–married individuals who live alone and who are financially and physically
independent do not appear to suffer health problems and exhibit mortality rates similar to those for married
individuals. Generally, currently married and never–married individuals report more friendships than
previously married individuals. Such extra–familial social relations may account for the lower
mortality they experience.
Health and financial status determine in part who can live alone and living arrangements
mandated by such constraints increase mortality. Health needs were found to be more directly linked to
mortality than income needs. It was shown that, controlling for financial and health constraints,
never–married individuals who live with relatives fare as well, if not better, than married couples.
Family composition affects the family's income, housing, health, education, social
standing, and, ultimately, mortality. Future research could explore possible interactive effects between sex
and family composition, the effects of household composition of other, particularly younger, age groups, or
comparing family composition by ethnicity.
† This study is based on data from the United States.