Family relationships Plan

Family relationships
Plan:

1. 
   Pathways Linking Family Relationships to Well-Being
   
2. 
   Marital Relationships
   

Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.

Keywords: Caregiver stress, Gender issues, Intergenerational, Social support, Well-being

Translational Significance
It is important for future research and health promotion policies to take into account complexities in family relationships, paying attention to family context, diversity of family structures, relationship quality, and intersections of social statuses in an aging society to provide resources to families to reduce caregiving burdens and benefit health and well-being.

For better and for worse, family relationships play a central role in shaping an individual’s well-being across the life course (Merz, Consedine, Schulze, & Schuengel, 2009). An aging population and concomitant age-related disease underlies an emergent need to better understand factors that contribute to health and well-being among the increasing numbers of older adults in the United States. Family relationships may become even more important to well-being as individuals age, needs for caregiving increase, and social ties in other domains such as the workplace become less central in their lives (Milkie, Bierman, & Schieman, 2008). In this review, we consider key family relationships in adulthood—marital, parent–child, grandparent, and sibling relationships—and their impact on well-being across the adult life course.

We begin with an overview of theoretical explanations that point to the primary pathways and mechanisms through which family relationships influence well-being, and then we describe how each type of family relationship is associated with well-being, and how these patterns unfold over the adult life course. In this article, we use a broad definition of well-being, including multiple dimensions such as general happiness, life satisfaction, and good mental and physical health, to reflect the breadth of this concept’s use in the literature. We explore important directions for future research, emphasizing the need for research that takes into account the complexity of relationships, diverse family structures, and intersections of structural locations.

Go to:
Pathways Linking Family Relationships to Well-Being

A life course perspective draws attention to the importance of linked lives, or interdependence within relationships, across the life course (Elder, Johnson, & Crosnoe, 2003). Family members are linked in important ways through each stage of life, and these relationships are an important source of social connection and social influence for individuals throughout their lives (Umberson, Crosnoe, & Reczek, 2010). Substantial evidence consistently shows that social relationships can profoundly influence well-being across the life course (Umberson & Montez, 2010). Family connections can provide a greater sense of meaning and purpose as well as social and tangible resources that benefit well-being (Hartwell & Benson, 2007; Kawachi & Berkman, 2001).

The quality of family relationships, including social support (e.g., providing love, advice, and care) and strain (e.g., arguments, being critical, making too many demands), can influence well-being through psychosocial, behavioral, and physiological pathways. Stressors and social support are core components of stress process theory (Pearlin, 1999), which argues that stress can undermine mental health while social support may serve as a protective resource. Prior studies clearly show that stress undermines health and well-being (Thoits, 2010), and strains in relationships with family members are an especially salient type of stress. Social support may provide a resource for coping that dulls the detrimental impact of stressors on well-being (Thoits, 2010), and support may also promote well-being through increased self-esteem, which involves more positive views of oneself (Fukukawa et al., 2000). Those receiving support from their family members may feel a greater sense of self-worth, and this enhanced self-esteem may be a psychological resource, encouraging optimism, positive affect, and better mental health (Symister & Friend, 2003). Family members may also regulate each other’s behaviors (i.e., social control) and provide information and encouragement to behave in healthier ways and to more effectively utilize health care services (Cohen, 2004; Reczek, Thomeer, Lodge, Umberson, & Underhill, 2014), but stress in relationships may also lead to health-compromising behaviors as coping mechanisms to deal with stress (Ng & Jeffery, 2003). The stress of relationship strain can result in physiological processes that impair immune function, affect the cardiovascular system, and increase risk for depression (Graham, Christian, & Kiecolt-Glaser, 2006; Kiecolt-Glaser & Newton, 2001), whereas positive relationships are associated with lower allostatic load (i.e., “wear and tear” on the body accumulating from stress) (Seeman, Singer, Ryff, Love, & Levy-Storms, 2002). Clearly, the quality of family relationships can have considerable consequences for well-being.

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Marital Relationships

A life course perspective has posited marital relationships as one of the most important relationships that define life context and in turn affect individuals’ well-being throughout adulthood (Umberson & Montez, 2010). Being married, especially happily married, is associated with better mental and physical health (Carr & Springer, 2010; Umberson, Williams, & Thomeer, 2013), and the strength of the marital effect on health is comparable to that of other traditional risk factors such as smoking and obesity (Sbarra, 2009). Although some studies emphasize the possibility of selection effects, suggesting that individuals in better health are more likely to be married (Lipowicz, 2014), most researchers emphasize two theoretical models to explain why marital relationships shape well-being: the marital resource model and the stress model (Waite & Gallager, 2000; Williams & Umberson, 2004). The marital resource model suggests that marriage promotes well-being through increased access to economic, social, and health-promoting resources (Rendall, Weden, Favreault, & Waldron, 2011; Umberson et al., 2013). The stress model suggests that negative aspects of marital relationships such as marital strain and marital dissolutions create stress and undermine well-being (Williams & Umberson, 2004), whereas positive aspects of marital relationships may prompt social support, enhance self-esteem, and promote healthier behaviors in general and in coping with stress (Reczek, Thomeer, et al., 2014; Symister & Friend, 2003; Waite & Gallager, 2000). Marital relationships also tend to become more salient with advancing age, as other social relationships such as those with family members, friends, and neighbors are often lost due to geographic relocation and death in the later part of the life course (Liu & Waite, 2014).

Married people, on average, enjoy better mental health, physical health, and longer life expectancy than divorced/separated, widowed, and never-married people (Hughes & Waite, 2009; Simon, 2002), although the health gap between the married and never married has decreased in the past few decades (Liu & Umberson, 2008). Moreover, marital links to well-being depend on the quality of the relationship; those in distressed marriages are more likely to report depressive symptoms and poorer health than those in happy marriages (Donoho, Crimmins, & Seeman, 2013; Liu & Waite, 2014; Umberson, Williams, Powers, Liu, & Needham, 2006), whereas a happy marriage may buffer the effects of stress via greater access to emotional support (Williams, 2003). A number of studies suggest that the negative aspects of close relationships have a stronger impact on well-being than the positive aspects of relationships (e.g., Rook, 2014), and past research shows that the impact of marital strain on health increases with advancing age (Liu & Waite, 2014; Umberson et al., 2006).

Prior studies suggest that marital transitions, either into or out of marriage, shape life context and affect well-being (Williams & Umberson, 2004). National longitudinal studies provide evidence that past experiences of divorce and widowhood are associated with increased risk of heart disease in later life especially among women, irrespective of current marital status (Zhang & Hayward, 2006), and longer duration of divorce or widowhood is associated with a greater number of chronic conditions and mobility limitations (Hughes & Waite, 2009; Lorenz, Wickrama, Conger, & Elder, 2006) but only short-term declines in mental health (Lee & Demaris, 2007). On the other hand, entry into marriages, especially first marriages, improves psychological well-being and decreases depression (Frech & Williams, 2007; Musick & Bumpass, 2012), although the benefits of remarriage may not be as large as those that accompany a first marriage (Hughes & Waite, 2009). Taken together, these studies show the importance of understanding the lifelong cumulative impact of marital status and marital transitions.

Gender Differences

Gender is a central focus of research on marital relationships and well-being and an important determinant of life course experiences (Bernard, 1972; Liu & Waite, 2014; Zhang & Hayward, 2006). A long-observed pattern is that men receive more physical health benefits from marriage than women, and women are more psychologically and physiologically vulnerable to marital stress than men (Kiecolt-Glaser & Newton, 2001; Revenson et al., 2016; Simon, 2002; Williams, 2004). Women tend to receive more financial benefits from their typically higher-earning male spouse than do men, but men generally receive more health promotion benefits such as emotional support and regulation of health behaviors from marriage than do women (Liu & Umberson, 2008; Liu & Waite, 2014). This is because within a traditional marriage, women tend to take more responsibility for maintaining social connections to family and friends, and are more likely to provide emotional support to their husband, whereas men are more likely to receive emotional support and enjoy the benefit of expanded social networks—all factors that may promote husbands’ health and well-being (Revenson et al., 2016).

However, there is mixed evidence regarding whether men’s or women’s well-being is more affected by marriage. On the one hand, a number of studies have documented that marital status differences in both mental and physical health are greater for men than women (Liu & Umberson, 2008; Sbarra, 2009). For example, Williams and Umberson (2004) found that men’s health improves more than women’s from entering marriage. On the other hand, a number of studies reveal stronger effects of marital strain on women’s health than men’s including more depressive symptoms, increases in cardiovascular health risk, and changes in hormones (Kiecolt-Glaser & Newton, 2001; Liu & Waite, 2014; Liu, Waite, & Shen, 2016). Yet, other studies found no gender differences in marriage and health links (e.g., Umberson et al., 2006). The mixed evidence regarding gender differences in the impact of marital relationships on well-being may be attributed to different study samples (e.g., with different age groups) and variations in measurements and methodologies. More research based on representative longitudinal samples is clearly warranted to contribute to this line of investigation.

Race-Ethnicity and SES Heterogeneity

Family scholars argue that marriage has different meanings and dynamics across socioeconomic status (SES) and racial-ethnic groups due to varying social, economic, historical, and cultural contexts. Therefore, marriage may be associated with well-being in different ways across these groups. For example, women who are black or lower SES may be less likely than their white, higher SES counterparts to increase their financial capital from relationship unions because eligible men in their social networks are more socioeconomically challenged (Edin & Kefalas, 2005). Some studies also find that marital quality is lower among low SES and black couples than white couples with higher SES (Broman, 2005). This may occur because the former groups face more stress in their daily lives throughout the life course and these higher levels of stress undermine marital quality (Umberson, Williams, Thomas, Liu, & Thomeer, 2014). Other studies, however, suggest stronger effects of marriage on the well-being of black adults than white adults. For example, black older adults seem to benefit more from marriage than older whites in terms of chronic conditions and disability (Pienta, Hayward, & Jenkins, 2000).