How Families Affect Illness

Research on the Family’s Impact on Health
  • Susan H. McDaniel
  • Thomas L. Campbell
  • David B. Seaburn

Abstract

A basic premise of the biopsychosocial model is that various subsystems (biological, individual, family, community, etc.) impact each other in ways that affect both health and illness. Clinical experience supports the premise that families influence and are influenced by the health of their members and that family-oriented primary care can lead to better care and improved health for both the individual and the family as a whole. However, assumptions and experiences that point toward a new approach to medical care should be scientifically validated through empirical research. This chapter will examine some important lines of research on the family’s impact on health. While much of the family and health research suffers from conceptual and methodological problems (1), there is now a body of well-designed studies and randomized controlled trials (see Table 2.1) which demonstrate that the family has a powerful influence on health. The clinical implications of this research are presented in the Protocol section of the chapter. This research lends support to the contention of family-oriented medical care that a partnership among physician, patient, and family may provide the most effective and efficient form of health care.

Keywords

Cholesterol Sugar Obesity Depression Schizophrenia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Litman TJ: The family as a basic unit in health and medical care: A sociobehavioral overview. Soc Sci Med 1974; 8: 495–519.PubMedCrossRefGoogle Scholar
  2. 2.
    Campbell TL: Family’s impact on health: A critical review and annotated bibliography. Fam Syst Med 1986; 4 (23): 135–328.CrossRefGoogle Scholar
  3. 3.
    Doherty WJ, Campbell TL: Families and Health. Families studies text series. Beverly Hills, CA, Sage Publishing, 1988.Google Scholar
  4. 4.
    Turk, DC, Kerns RD (eds.): Health, Illness, and Families: A Life-Span Perspective. New York: Wiley, 1985.Google Scholar
  5. 5.
    Goldstein M: Psychosocial issues. Schizophr Bull 1987; 13 (1): 157–171.PubMedCrossRefGoogle Scholar
  6. 6.
    Keitner GI, Baldwin LM, Epstein NB, Bishop DS: Family functioning patients with affective disorders: A review. Inter J Fam Psychiatry 1985; 6: 405–437.Google Scholar
  7. 7.
    Steinglass P, Robertson A: “The alcoholic family;’ The biology of alcoholism. Psychosocial Factors 1983; 6: 243–307.Google Scholar
  8. 8.
    Stanton MD: Drugs and the family: A review of the recent literature. Marr Fam Rev 1979; 2: 1–10.CrossRefGoogle Scholar
  9. 9.
    Hepworth J: “Families and chronic pain.” In Rosenthal D (ed.), Families in Stress. Family Therapy Collection. Rockville, MD, Aspen, 1987.Google Scholar
  10. 10.
    Yager J: Family issues in the pathogenesis of anorexia nervosa. Psychosom Med 1982; 44: 43–59.PubMedGoogle Scholar
  11. 11.
    Rabkin JG, Struening EL: Life events, stress and illness. Science 1976; 194: 1013–1020.PubMedCrossRefGoogle Scholar
  12. 12.
    Holmes TH, Rahe RH: The social readjustment scale. J Psychosom Res 1967; 39: 413–431.Google Scholar
  13. 13.
    Cohen F: Stress and bodily illness. Psychiat Clin North Amer 1981; 4: 269–285.Google Scholar
  14. 14.
    Meyer RJ, Haggerty RJ: Steptococcal infections in families: Factors altering individual susceptibility. Pediatrics 1962; 29: 539–549.PubMedGoogle Scholar
  15. 15.
    Boyce WT, Jensen EW, Cassel JC, et al.: Influence of life events and family routines on childhood respiratory illness. Pediatrics 1977; 60: 609–615.PubMedGoogle Scholar
  16. 16.
    Beautrais AL, Fergusson DM, Shannon FT: Life events and childhood morbidity: A prospective study. Pediatrics 1982; 70: 935–940.PubMedGoogle Scholar
  17. 17.
    Jacobs S, Ostfeld A: An epidemiological review of the mortality of bereavement. Psychosom Med 1977; 39: 344–357.PubMedGoogle Scholar
  18. 18.
    Osterweis M, Solomon F, Green M, (eds.): Bereavement: Reactions, Consequences, and Care. Washington, DC: National Academy Press, 1984.Google Scholar
  19. 19.
    Kraus AS, Lillenfeld AM: Some epidemiological aspects of the high mortality rate in the young widowed group. J Chron Dis 1959; 10: 207–217.PubMedCrossRefGoogle Scholar
  20. 20.
    Parkes CM, Benjamin B, Fitzgerald RG: Broken heart: A statistical study of increased mortality among widowers. Br Med J 1969; 1: 740–743.PubMedCrossRefGoogle Scholar
  21. 21.
    Helsing KJ, Szklo M: Mortality after bereavement. Am J Epidemiol 1981; 114: 41–52.PubMedGoogle Scholar
  22. 22.
    Kaprio J, Koskenvou M, Rita H: Mortality after bereavement: A prospective study of 95,647 widowed persons. Am J Pub Health 1987; 77: 283–287.CrossRefGoogle Scholar
  23. 23.
    Lynch J: The Broken Heart: The Medical Consequences of Loneliness. New York: Basic Books, 1977.Google Scholar
  24. 24.
    Verbrugge LM: Marital status and health. J Marr Fam 1977; 7: 267–285.Google Scholar
  25. 25.
    Carter H, Glick PC: Marriage and Divorce: A Social and Economic Study. Cambridge, MA: Harvard University Press, 1970.Google Scholar
  26. 26.
    Bruhn JG: Effects of chronic illness on the family. J Fam Pract 1977; 4: 1057–1060.PubMedGoogle Scholar
  27. 27.
    Klein R, Dean A, Bogdanoff M: The impact of illness of the spouse. J Chron Dis 1968; 20: 241–252.CrossRefGoogle Scholar
  28. 28.
    Ader R (ed.): Psychoneuroimmunlogy. New York, Academic Press, 1981.Google Scholar
  29. 29.
    Calabrese JR, Kling MA, Gold PW: Alterations in immunocompetence during stress, bereavement and depression: Focus on neuroendocrine regulation. Am J Psychiatry 1987; 144 (9): 1123–1134.PubMedGoogle Scholar
  30. 30.
    Bartrop RW, Luckhurst E, Lazarus L, Kiloh LG, Penny R: Depressed lymphocyte function after bereavement. Lancet 1977; 1: 834–836.PubMedCrossRefGoogle Scholar
  31. 31.
    Schleifer SJ, Keller SE, Camerino M, Thornton JC, Stein M: Suppression of lymphocyte stimulation following bereavement. JAMA 1983; 250: 374–377.PubMedCrossRefGoogle Scholar
  32. 32.
    Linn MW, Linn BS, Jensen J: Stressful events, dysphoric mood, and immune responsiveness. Psychol Rep 1984; 54: 219–222.PubMedCrossRefGoogle Scholar
  33. 33.
    Kiecolt-Glaser JK, Fisher LD, Ogrockl P, Stout JC, Spelcher CE, Glaser R: Marital quality, marital disruption, and immune function. Psychosom Med 1987; 49 (1): 13–32.PubMedGoogle Scholar
  34. 34.
    Berkman LF: Assessing the physical health effects of social network and social support. Ann Rev Pub Health 1984; 5: 413–432.CrossRefGoogle Scholar
  35. 35.
    Broadhead WE, Kaplan BH, James SA, et al.: The epidemiologic evidence for a relationship between social support and health. Am J Epidemiol 1983; 117: 521–537.PubMedGoogle Scholar
  36. 36.
    Cohen S, Syme SL (eds.): Social Support and Health. Orlando, FL: Academic Press, 1985.Google Scholar
  37. 37.
    Berkman LF, Syme SL: Social networks, host resistance and mortality: A nine year follow-up study of Alameda County residents. Am J Epidemiol 1979; 109: 186–204.PubMedGoogle Scholar
  38. 38.
    House JS, Robbins C, Metzner HL: The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. Am J Epidemiol 1982; 116: 123–140.PubMedGoogle Scholar
  39. 39.
    Ortho-Gomer K, Johnson JV: Social network interaction and mortality: A six year follow-up study of a random sample of the Swedish population. J Chron Dis 1987; 40: 949–957.CrossRefGoogle Scholar
  40. 40.
    Blazer DG: Social support and mortality in an elderly community population. Am J Epidemiol 1982; 115: 684–694.PubMedGoogle Scholar
  41. 41.
    Zuckerman DM, Kasl SV, Osterfeld AM: Psychosocial predictors of mortality among the elderly poor: The role of religion, well-being, and social contact. Am J Epidemiol 1984; 119: 410–423.PubMedGoogle Scholar
  42. 42.
    Nuckolls KB, Cassel J, Kaplan BH: Psychosocial assets, life crisis and the prognosis of pregnancy. Am J Epidemiol 1972; 95: 431–441.PubMedGoogle Scholar
  43. 43.
    Norbeck JS, Tolden VP: Life stress, social supports, and emotional dis-equilibrium in complications of pregnancy: A prospective, multivariate study. J Health Soc Behav 1983; 24: 30–46.PubMedCrossRefGoogle Scholar
  44. 44.
    Ramsey CN, Abell TD, Baker LC: The relationship between family functioning, life events, family structure and the outcome of pregnancy. J Fam Pract 1986; 22: 521–527.PubMedGoogle Scholar
  45. 45.
    Healthy People: The Surgeon General’s report on health promotion and disease prevention. DHEW (PHS) Pub No. 79–55071. Public Health Service Washington, DC: Government Printing Office, 1979.Google Scholar
  46. 46.
    Baranowski T, Nader PR, Dunn K, Vanderpool NA: Family self-help: Promoting changes in health behavior. Journal of Communication 1982; Summer:161–172.Google Scholar
  47. 47.
    Sackett DL, Anderson GD, Milner R, Feinleib M, Kannel WB: Concordance for coronary risk factors among spouses. Circulation 1975; 52: 589–595.PubMedCrossRefGoogle Scholar
  48. 48.
    Bewley BR, Bland JM: Academic performance and social factors relating to cigarette smoking by school children. Br J Prev Soc Med 1977; 31: 8–24.Google Scholar
  49. 49.
    Stunkard AJ, Sorensen TIA, Hanis C, et al.: An adoption study of human obesity. N Engl J Med 1986; 314: 193–201.PubMedCrossRefGoogle Scholar
  50. 50.
    Garn SM, Cole PE, Bailey SM: Effect of parental fatness levels on fatness of biological and adoptive children. Ecology of Food and Nutrition 1976; 6: 1–3.Google Scholar
  51. 51.
    Hartz A, Giefer E, Rimm AA: Relative importance of the effect of family environment and heredity on obesity. Ann Human Genet 1977; 41: 185–193.CrossRefGoogle Scholar
  52. 52.
    Feinleib M, Garrison RJ, Fabsitz R, et al.: The NHLBI twin study of cardiovascular disease risk factors: Methodology and summary of results. Am J Epidemiol 1977; 106: 284–295.PubMedGoogle Scholar
  53. 53.
    Sutton G: Assortive marriages for smoking habits. Ann Human Biol 1980; 7: 449–456.CrossRefGoogle Scholar
  54. 54.
    Venters MH, Jacobs DR, Luepker RV, Maiman LA, Gillum RF: Spouse concordance of smoking patterns: The Minnesota heart survey. Am J Epidemiol 1984; 120: 608–616.PubMedGoogle Scholar
  55. 55.
    Graham S, Gibson RW: Cessation of patterned behavior: Withdrawal from smoking. Soc Sci Med 1971; 5: 319–337.PubMedCrossRefGoogle Scholar
  56. 55a.
    Price RA, Chen KH, Cavallii SL, et al.: Models of spouse influence and their applications to smoking behavior. Soc Biology 1981; 28: 14–29.Google Scholar
  57. 56.
    Ockene JK, Nuttall RL, Benfari RS, et al.: A psychosocial model of smoking cessation and maintenance of cessation. Preventive Medicine 1981; 10: 623–638.PubMedCrossRefGoogle Scholar
  58. 57.
    Mermelstein R, Lichtenstein E, McIntyre K: Partner support and relapse in smoking cessation programs. J Consult Clin Psychol 1983; 51: 465–466.PubMedCrossRefGoogle Scholar
  59. 58.
    Heinzelman F, Bagley RW: Response to physical activity programs and their effects on health behavior. Pub Health Rep 1970; 85: 905–911.CrossRefGoogle Scholar
  60. 59.
    Doherty WJ, Schrott HG, Metcalf L, lassiello Vailas L: Effect of spouse support and health beliefs on medication adherence. J Fam Pract 1983; 17: 837–841.PubMedGoogle Scholar
  61. 60.
    Barbarin OA, Tirado M: Family involvement and successful treatment of obesity: A review. Fam Sys Med 1984; 2: 37–45.CrossRefGoogle Scholar
  62. 61.
    Bryan MS, Lowenberg ME: The father’s influence on young children’s food preferences. J Am Diet Assoc 1958; 34: 30–35.PubMedGoogle Scholar
  63. 62.
    Stuart RB, Davis B: Slim Chance in a Fat World: Behavioral Control Obesity. Champaign IL: Research Press, 1972.Google Scholar
  64. 63.
    Brownell KD, Heckerman CL, Westlake RJ, Hayes SC, Monti PM: The effects of couple’s training and partner co-operativeness in the behavioral treatment of obesity. Behav Res Ther 1978; 16: 323–333.PubMedCrossRefGoogle Scholar
  65. 64.
    Pearce JW, LeBow MD, Orchard J: Role of spouse involvement in the behavioral treatment of overweight women. J Consult Clin Psychol 1981; 49: 236–244.PubMedCrossRefGoogle Scholar
  66. 65.
    Saccone AJ, Israel AC: Effects of experimental versus significant other-controlled reinforcement and choice of target behavior on weight loss. Behav Ther 1978; 9: 271–278.CrossRefGoogle Scholar
  67. 66.
    McKenney JM, Slining JM, Henderson HR, Devine D, Barr M: The effect of clinical pharmacy services on patients with essential hypertension. Circulation 1973; 48: 1104–1111.PubMedCrossRefGoogle Scholar
  68. 67.
    Morisky DE, Levine DM, Green LW, Shaprio S, Russell RP, Smith CR: Five year blood pressure control and mortality following health education for hypertensive patients. Am J Pub Health 1983; 73: 153–162.CrossRefGoogle Scholar
  69. 68.
    Levine DM, Green LW, Deeds SG, Chwalow J, Russel RP, Finlay J: Health education for hypertensive patients. JAMA 1979; 241: 1700–1703.PubMedCrossRefGoogle Scholar
  70. 69.
    Haynes RB, Mattson ME, Chobanian AV, Dunbar JM, Engerbretson TO, et al.: Management of patient compliance in the treatment of hypertension: Report of the NHLBI working group. Hypertension 1982; 4: 415–423.CrossRefGoogle Scholar
  71. 70.
    Lask B, Matthew D: Childhood asthma: A controlled trial of family psychotherapy. Arch Dis Child 1979; 54: 116–119.PubMedCrossRefGoogle Scholar
  72. 71.
    Liebman R, Minuchin S, Baker L: The use of structural family therapy in the treatment of intractable asthma. Am J Psychiatry 1974; 131: 535–540.PubMedGoogle Scholar
  73. 72.
    Reiss D, Gonzalez S, Kramer N: Family process, chronic illness, and death. Arch Gen Psychiatry 1986; 43: 795–804.PubMedCrossRefGoogle Scholar
  74. 73.
    Steidl JH, Finkelstein FO, Wexler JP, Feigenbaum H, Kitsen J, AS, Quinlan DM: Medical condition, adherence to treatment regime and family functioning: Their interaction in patients receiving long-term dialysis treatment. Arch Gen Psychiatry 1980; 37: 1025–1027.PubMedCrossRefGoogle Scholar
  75. 74.
    Ruberman W, Weinblatt E, Goldberg JD, Chaudhary BS: Psychosocial influences on mortality after myocardial infarction. N Engl J Med 1984; 311: 522–557.CrossRefGoogle Scholar
  76. 75.
    Koskevuo M, Kaprio J, Kesaniemi A, Sarna S: Differences in mortality from ischemic heart disease by marital status and social class. J Chron Dis 1980; 33: 95–106.CrossRefGoogle Scholar
  77. 76.
    Horne RL, Picard RS: Psychosocial risk factors for lung cancers. Psychosom Med 1979; 41: 503–514.PubMedGoogle Scholar
  78. 77.
    Thomas CB, Duszynski BA, Shaffer JW: Family attitudes reported in youth as potential predictors of cancer. Psychosom Med 1979; 41: 287–302.PubMedGoogle Scholar
  79. 78.
    Anderson BJ, Auslander WF: Research on diabetes management and the family: A critique. Diabetes Care 1980; 3: 696–702.PubMedCrossRefGoogle Scholar
  80. 79.
    Johnson SB: Psychosocial factors in juvenile diabetes: A review. Journal of Behavioral Medicine 1980; 3: 95–116.PubMedCrossRefGoogle Scholar
  81. 80.
    Klus J, Habbick BF, Abernathy TJ: Diabetes in children: Family responses and control. Psychosom 1983; 24: 367–372.CrossRefGoogle Scholar
  82. 81.
    Grey MJ, Genel M, Tamborlane WV: Psychosocial adjustment of latency-age diabetics: Determinants and relationship to control. Pediatrics 1980; 65: 69–73.PubMedGoogle Scholar
  83. 82.
    Koski ML, Kumento A: The interrelationship between diabetic control and family life. Pediat Adol Endocrin 1977; 3: 41–45.Google Scholar
  84. 83.
    Orr DP, Golden MP, Myers G, Marrerro DG: Characteristics of adolescents with poorly controlled diabetes referred to a tertiary care center. Diabetes Care 1983; 6: 170–175.PubMedCrossRefGoogle Scholar
  85. 84.
    White K, Kolman ML, Wexler P, Polin G, Winter RJ: Unstable diabetes and unstable families: A psychosocial evaluation of diabetic children with recurrent ketoacidosis. Pediatrics 1984; 73: 749–755.PubMedGoogle Scholar
  86. 85.
    Shouval R, Ber R, Galatzer A: Family social climate and the health status and social adaptation of diabetic youth. Pedia Adol Endocrin 1982; 10: 89–93.Google Scholar
  87. 86.
    Fischer AE, Dolger H: Behavior and psychosocial problems of young diabetic patients. Arch Intern Med 1946; 78: 711–732.CrossRefGoogle Scholar
  88. 87.
    Anderson BJ, Miller JP, Auslander WF, Santiago JV: Family characteristics of diabetic adolescents: Relationship to metabolic control. Diabetes Care 1981; 4: 586–594.PubMedCrossRefGoogle Scholar
  89. 88.
    Khurana R, White P: Attitudes of the diabetic child and his parents towards his illness. Postgrad Med 1970; 48: 72–76.PubMedGoogle Scholar
  90. 89.
    Minuchin S, Baker L, Rosman BL, Liebman R, Milman L, Todd TC: A conceptual model of psychosomatic illness in children: Family organization and family therapy. Arch Gen Psychiatry 1975; 32: 1031–1038.PubMedCrossRefGoogle Scholar
  91. 90.
    Minuchin S, Rosman BL, Baker L: Psychosomatic Families. Cambridge, MA: Harvard University Press, 1978.Google Scholar
  92. 91.
    Baker L, Minuchin S, Milman L, Liebman R, Todd T: Psychosomatic aspects of juvenile diabetes mellitus: A progress report. Mod Prob In Paediatr 1975; 12: 332–343.Google Scholar
  93. 92.
    Cederblad M, Helgesson M, Larsson Y, Ludvigsson J: Family structure and diabetes in children. Pediat Adol Endocrin 1982; 10: 94–98.Google Scholar
  94. 93.
    Clark NM, Feldman CH, Evans D, Millman EJ, Wailewski Y, Valle I: The effectiveness of education for family management of asthma in children: A preliminary report. Health Educa Quart 1981; 8: 166–174.CrossRefGoogle Scholar
  95. 94.
    Gustafsson PA, Kjellman NI, Cederblad M: Family therapy in the treatment of severe childhood asthama. J Psychosom Res 1986; 30: 369–374.PubMedCrossRefGoogle Scholar
  96. 95.
    Baranowski T, Nader PR, Dunn K, Vanderpool NA: Family self-help: Promoting changes in health behavior. Journal of Communications 1982;Summer:161–172.Google Scholar
  97. 96.
    Earp JL, Ory MG, Strogatz DS: The effects of family involvement and practitioner home visits on the control of hypertention. Am J Pub Health 1982; 72: 1146–1153.CrossRefGoogle Scholar
  98. 97.
    Brownell KD, Heckerman CL, Westlake RJ, Hayes SC, Monti PM: The effects of couples training and partner co-operativeness in the behavioral treatment of obesity. Behau Res Ther 1978; 16: 323–333.CrossRefGoogle Scholar
  99. 98.
    Saccone AJ, Israel AC: Effects of experimental versus significant other-controlled reinforcement and choice of target behavior on weight loss. Behan Ther 1978; 9: 271–278.CrossRefGoogle Scholar
  100. 99.
    Wilson GT, Brownell K: Behavior therapy for obesity: Including family members in the treatment process. Behau Ther 1976; 9: 943–945.CrossRefGoogle Scholar
  101. 100.
    Pearce JW, BeLow MD, Orchard J: Role of spouse involvement in the behavioral treatment of overweight women. J Consult Clin Psychol 1981; 49: 236–244.PubMedCrossRefGoogle Scholar
  102. 101.
    Brownell KD, Kelman JH, Stunkard AJ: Treatment of obese children with and without their mothers: Changes in weight and blood pressure. Pediatrics 1983; 71: 515–523.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Susan H. McDaniel
    • 1
  • Thomas L. Campbell
    • 1
  • David B. Seaburn
    • 1
  1. 1.School of Medicine and Highland Hospital, Jacob B. Holler Family Medicine CenterUniversity of RochesterRochesterUSA

Personalised recommendations