Skip to main content

Advertisement

SpringerLink
Log in

Association Between Maternal Health Status and Family Resilience: Results from a National Survey

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objective

The relationship between maternal health and health outcome of offspring has been studied extensively. However, measures such as family resilience in the context of maternal health are not well understood. The objective of this study was to determine if overall maternal health status is associated with family resilience.

Methods

Using the 2016 National Survey of Children’s Health, a nationally representative survey of parents/guardians of children ages 0–17, we evaluated the association of overall maternal health status with measures of family resilience. The analysis was performed using descriptive and multivariable analyses. The study adjusted for current health insurance status, family structure of child’s household, income level, highest education of adult in household, child race, primary household language, children with special health care needs, emotional support, neighborhood support, parental aggravation, and adverse childhood experiences.

Results

Compared to mothers who reported their physical health to be good, mothers who had a very good/excellent physical health status reported significantly higher adjusted rates for family resilience measures [Adjusted Odds Ratio (AOR) 0.741, 95% Confidence Interval (CI) (0.640, 0.859); p < 0.001]. Results suggested also that mothers whose mental health was very good/excellent were more likely to exhibit greater family resilience as compared to those that were good [(AOR) 0.452, 95% (CI) (0.390, 0.525); p < 0.001] or poor/fair [(AOR) 0.283, 95% (CI) (0.223, 0.360); p < 0.001].

Conclusion

Our findings suggest that maternal mental and physical health may contribute to how families respond to adversity. Our findings highlight the importance of evaluating interventions that target both physical and mental aspects of maternal health status to better the resilience of the family unit. In the healthcare setting, maternal health services should ensure early detection and prevention of chronic conditions beyond obstetric care and detection and treatment of mental health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Agha, S. S., Zammit, S., Thapar, A., & Langley, K. (2017). Maternal psychopathology and offspring clinical outcome: a four-year follow-up of boys with ADHD. European Child & Adolescent Psychiatry, 26(2), 253–262. https://doi.org/10.1007/s00787-016-0873-y.

    Article  Google Scholar 

  • Apter, G., Bobin, A., Genet, M. C., Gratier, M., & Devouche, E. (2017). Update on Mental Health of Infants and Children of parents affected with Mental Health Issues. Current Psychiatry Reports, 19(10), https://doi.org/10.1007/s11920-017-0820-8.

  • Aysola, J., Bitton, A., Zaslavsky, A. M., & Ayanian, J. Z. (2013). Quality and equity of primary care with patient-centered medical homes: results from a national survey. Medical care, 51(1), 68–77. https://doi.org/10.1097/MLR.0b013e318270bb0d.

    Article  PubMed  PubMed Central  Google Scholar 

  • Aysola, J., Orav, E. J., & Ayanian, J. Z. (2011). Neighborhood characteristics associated with access to patient-centered medical homes for children. Health Affairs, 30(11), 2080–2089. https://doi.org/10.1377/hlthaff.2011.0656.

    Article  PubMed  Google Scholar 

  • Bethell, C., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood Experiences and Adult Mental and Relational Health in a Statewide Sample. JAMA Pediatrics, 173(11), https://doi.org/10.1001/jamapediatrics.2019.3007.

  • Bethell, C. D., Gombojav, N., & Whitaker, R. C. (2019). Family resilience and connection promote flourishing among US children, even amid Adversity. Health Affairs, 38(5), 729–737. https://doi.org/10.1377/hlthaff.2018.05425.

    Article  PubMed  Google Scholar 

  • Bethell, C., Newacheck, P., Hawes, E., & Halfon, N. (2014). Adverse childhood experiences: assessing the impact on Health and School Engagement and the Mitigating Role of Resilience. Health Affairs, 33, 12:2106–2115.

    Article  PubMed  Google Scholar 

  • Black, K., & Lobo, M. (2008). A conceptual review of family resilience factors. Journal of Family Nursing, 14(1), 33–55. https://doi.org/10.1177/1074840707312237.

    Article  PubMed  Google Scholar 

  • Boyd-Franklin, N., & Karger, M. (2012). Intersections of race, class, and poverty. In F. Walsh (Ed.), Normal family processes: growing diversity and complexity (4th ed., pp. 273–296). New York, NY: Guilford Press.

    Google Scholar 

  • Bramlett, M. D., & Blumberg, S. J. (2007). Family structure and children’s physical and mental health. Health Affairs, 26(2), 549–558. https://doi.org/10.1377/hlthaff.26.2.549.

  • Brown, J. D. (2008). Foster parents’ perceptions of factors needed for successful foster placements. Journal of Children and Family Studies, 17(4), 538–554.

    Article  Google Scholar 

  • Burchinal, M. R., Follmer, A., & Bryant, D. M. (1996). The relations of maternal social support and family structure with maternal responsiveness and child outcomes among African American families. Developmental Psychology. 1996;32(6):1073–1083. https://doi.org/10.1037/0012-1649.32.6.1073.

  • Ceballo, R., & McLoyd, V. C. (2002). Social support and parenting in poor, dangerous neighborhoods. Child Dev 2002 Jul-Aug, 73(4), 1310–1321.

    Google Scholar 

  • Child and Adolescent Health Measurement Initiative (2017). “Fast Facts: 2016 National Survey of Children’s Health.” Data Resource Center, supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Available at https://www.nschdata.org Revised 11/02/17.

  • Eik-Nes, T. T., Horn, J., Strohmaier, S., Holmen, T. L., Micali, N., & Bjørnelv, S. (2018). Impact of eating disorders on obstetric outcomes in a large clinical sample: a comparison with the HUNT study. International Journal of Eating Disorders, 51(10), 1134–1143. https://doi.org/10.1002/eat.22916.

    Article  PubMed  Google Scholar 

  • Ghandour, R. M., Jones, J. R., Lebrun-Harris, L. A., et al. (2018). The design and implementation of the 2016 National Survey of Children’s Health. Maternal Child Health Journal, 22, 1093–1102. https://doi.org/10.1007/s10995-018-2526-x.

    Article  PubMed  Google Scholar 

  • Hammerton, G., Zammit, S., Mahedy, L., Pearson, R. M., Sellers, R., Thapar, A., & Collishaw, S. (2015). Pathways to suicide-related behavior in offspring of mothers with Depression: the role of offspring psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry, 54(5), 385–393. https://doi.org/10.1016/j.jaac.2015.02.006.

    Article  Google Scholar 

  • Hashima, P. Y., & Amato, P. R. Poverty, social support, and parental behavior. Child Dev. 1994 Apr; 65(2 Spec No):394–403

  • Heerman, W. J., Samuels, L. R., González Peña, T., Wyk, C., Mayberry, L. S., Lounds Taylor, J., & Martin, N. C. (2021). Family resilience and childhood obesity among children exposed to adverse childhood experiences in a national survey. Obesity Science & Practice, 8(1), 3–11. https://doi.org/10.1002/osp4.497

  • Kreider, A. R., French, B., Aysola, J., Saloner, B., Noonan, K. G., & Rubin, D.M. (2016). Quality of health insurance coverage and access to care for children in low-income families. JAMA Pediatrics, 170(1), 43. https://doi.org/10.1001/jamapediatrics.2015.3028.

  • Lennon, S. L., & Heaman, M. (2015). Factors Associated with Family Resilience during pregnancy among Inner-City Women. Midwifery, 31(10), 957–964. https://doi.org/10.1016/j.midw.2015.05.007.

    Article  PubMed  Google Scholar 

  • Letourneau, N., Dewey, D., Kaplan, B. J., Ntanda, H., Novick, J., Thomas, J. C., …Giesbrecht, G. F. (2019). Intergenerational transmission of adverse childhood experiences via maternal depression and anxiety and moderation by child sex. Journal of Developmental Origins of Health and Disease, 10(1), 88–99. https://doi.org/10.1017/s2040174418000648.

  • Li, E. (2019, October). Assessing the Effect of Family Resilience on Bullying in U.S. Children with Adverse Childhood Experiences. Abstract presented at American Academy of Pediatrics (AAP) 2019 National Conference and Exhibition, Hilton New Orleans Riverside, Louisiana.

  • McConnell, D., Breitkreuz, R., & Savage, A. (2011). From financial hardship to child difficulties: main and moderating effects of perceived social support. Child Care Health Dev. 2011 Sep; 37(5):679 – 91

  • McGoldrick, M., Carter, B., & Garcia-Preto, N. (2016). The expanded family life cycle: individual, family, and social perspectives (4th ed.). Boston, MA: Pearson.

    Google Scholar 

  • Morris, H., Tumin, D., Kroeger, R. A., & Buckman, C. (2021). Medical home access among children of parents in same-sex couples. Children’s Health Care, 51(3), 250–262. https://doi.org/10.1080/02739615.2021.2005599.

  • Octoman, O., & McLean, S. (2014). Challenging behavior in foster care: what supports do foster carers want? Adoption & Fostering, 38(2), 149–158.

    Article  Google Scholar 

  • Oken, E. (2009). Maternal and child obesity: the Causal Link. Obstetrics & Gynecology Clinics, 36(2), 361–377.

    Google Scholar 

  • Polan, H. J., Kaplan, M. D., Kessler, D. B., Shindledecker, R., Newmark, M., Stern, D. N., & Ward, M. J. (1991). Psychopathology in mothers of children with failure to thrive. Infant Mental Health Journal, 12(1), 55–64. https://doi.org/10.1002/1097-0355(199121)12:1<55::aid-imhj2280120106>3.0.co;2-x.

    Article  Google Scholar 

  • Racine, N., Plamondon, A., Madigan, S., Mcdonald, S., & Tough, S. (2018). Maternal adverse childhood experiences and Infant Development. Pediatrics, 141(4), https://doi.org/10.1542/peds.2017-2495.

  • Rolland, J. S. (2016). Chronic illness and the family life cycle. In M. McGoldrick, B. Carter, & N. Garcia Preto (Eds.), The expanded family life cycle: individual, family, and social perspectives (4th ed., pp. 430–450). Boston, MA: Pearson.

    Google Scholar 

  • Schuez-Havupalo, L., Lahti, E., Junttila, N., Toivonen, L., Aromaa, M., Rautava, P.,… Räihä, H. (2018). Parents depression and loneliness during pregnancy and respiratory infections in the offspring: A prospective birth cohort study. Plos One, 13(9). https://doi.org/10.1371/journal.pone.0203650.

  • Song, J., Fogarty, K., Suk, R., & Gillen, M. (2021). Behavioral and mental health problems in adolescents with ADHD: Exploring the role of Family resilience. Journal of Affective Disorders, 294, 450–458. https://doi.org/10.1016/j.jad.2021.07.073.

  • Suzuki, K., Hiratani, M., Mizukoshi, N., Hayashi, T., & Inagaki, M. (2018). Family resilience elements alleviate the relationship between maternal psychological distress and the severity of children’s Development Disorders. Research in Developmental Disabilities, 83, 91–98. https://doi.org/10.1016/j.ridd.2018.08.006.

    Article  PubMed  Google Scholar 

  • Thompson, R. A., Flood, M. F., & Goodwin, R. (2006). Social support and developmental psychopathology. In D. Cicchetti, & D. J. Cohen (Eds.), Developmental psychopathology. 2 (3 vol., pp. 1–37). Hoboken, NJ: John Wiley & Sons, Inc. Risk, disorder, and adaptation.

    Google Scholar 

  • Walsh, F. (1996). The Concept of Family Resilience: Crisis and Challenge. Family Process, 35, 261–281.

    Article  CAS  PubMed  Google Scholar 

  • Walsh, F. (2003). Family Resilience: a Framework for Clinical Practice. Family Process, 42(1), 1–18.

    Article  PubMed  Google Scholar 

  • Walsh, F. (2016). Family resilience: a developmental systems framework. In special issue: resilience in developing systems. European Journal of Developmental Psychology, 13(3), 313–324.

    Article  Google Scholar 

  • Wang, J., Wang, L., Liu, H., Zhang, S., Leng, J., Li, W., … Hu, G. (2018). Maternal gestational diabetes and different indicators of childhood obesity: a large study.Endocrine Connections, 1464–1471. https://doi.org/10.1530/ec-18-0449.

  • Weijers, D., Steensel, F. J. A. V., & Bögels, S. M. (2018). Associations between psychopathology in mothers, fathers and their children: a structural modeling Approach. Journal of Child and Family Studies, 27(6), 1992–2003. https://doi.org/10.1007/s10826-018-1024-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • White, J., Morris, H., Cortright, L., Buckman, C., Tumin, D., & Jamison, S. (2020).Concordance of data on children’s unmet health care needs between 2 national surveys.Journal of Public Health Management and Practice, 28(1). https://doi.org/10.1097/phh.0000000000001223.

  • Walsh, F. (2006). Family Resilience. New York: Guilford Press.

Download references

Acknowledgements

Child and Adolescent Health Measurement Initiative (CAHMI), Data Resource Center for Child and Adolescent Health. (2016). 2016 NSCH Child and Family Health Measures and Subgroups, SAS Codebook, Version 9.4, Retrieved [09/01/2018] from www.childhealthdata.org.

Funding

No external funding for this manuscript.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 E 210th Street, Bronx, New York, USA, 10467

    Sitara Soundararajan

  2. Janssen Pharmaceuticals, 1125 Trenton Harbourton Road, Titusville, New Jersey, USA, 08560

    Shyla Jagannath

  3. Department of Internal Medicine and Pediatrics, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive 1229 Blockley Hall, Philadelphia, Pennsylvania, USA, 19104

    Jaya Aysola

Authors
  1. Sitara Soundararajan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shyla Jagannath
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaya Aysola
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Dr. Sitara Soundararajan conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript.

Dr. Jagannath carried out the initial data analysis and reviewed and revised the manuscript.

Dr. Aysola conceptualized and designed the study, coordinated, supervised data analysis, and critically reviewed the manuscript for important intellectual content.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jaya Aysola.

Ethics declarations

Financial Disclosure

The authors have indicated that they have no financial relationships relevant to this article to disclose.

Conflict of interest

The authors have indicated that they have no potential conflicts of interest to disclose.

Clinical Trial Registration (if any)

De-identified individual participant data will not be made available.

Abbreviations

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Table of Contents Summary

Using the 2016 National Survey of Children’s Health, this study highlights the association between maternal mental/physical health and response to adversity in US households.

What’s Known on this Subject

Family resilience is a newly emerging topic that has been studied in the context of racial-minority families, military families, and inner-city families. Higher levels of family resilience have been associated with child flourishing and lower levels of bullying among children.

What this Study Adds

There are currently no studies that have assessed how overall maternal health may influence the family unit’s ability to adapt in situations of adversity on a national scale.

Prior Presentations

A poster abstract of this study was presented at the American Federation for Medical Research Eastern Regional Meeting (ERM) on March 30, 2019, the American College of Physicians (ACP) Internal Medicine Meeting on April 13, 2019, and the Society of General Internal Medicine Annual Meeting on May 10, 2019.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Soundararajan, S., Jagannath, S. & Aysola, J. Association Between Maternal Health Status and Family Resilience: Results from a National Survey. Matern Child Health J 27, 307–317 (2023). https://doi.org/10.1007/s10995-022-03569-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-022-03569-1

Keywords

Search

Navigation