HEALTH AND FAMILY
DYNAMICS
Kai-Lit Phua, PhD FLMI
Associate Professor
School of Medicine & Health
Sciences
Monash University Malaysia
Biographical Details
Kai-Lit Phua received his BA (cum laude) in
Public Health & Population Studies from the
University of Rochester and his PhD in Sociology
(Medical Sociology) from Johns Hopkins
University. He also holds professional
qualifications from the insurance industry.
Prior to joining academia, he worked as a
research statistician for the Maryland
Department of Health and Mental Hygiene and
for the Managed Care Department of a leading
insurance company in Singapore.
He was awarded an Asian Public Intellectual
Senior Fellowship by the Nippon Foundation in
2003.
Highly Recommended
“The Lost Children of Rockdale County”

http://www.pbs.org/wgbh/pages/frontline
/shows/georgia/etc/script.html

http://www.pbs.org/wgbh/pages/frontline
/shows/georgia/isolated
WHAT IS A “FAMILY”?

Major social institution found in all human
societies

Usual image: working father + housewife
mother + dependent children

Reality: This is becoming less and less common
as more & more mothers work outside the
home. Also because of rising divorce rates.
New Forms of the “Family”
Cohabiting couples (with or without
children)
 Single parent family (because of teen
pregnancy, divorce or abandonment)
 “Blended” family
 Homosexual couples e.g. Netherlands has
legalised homosexual marriages

Functions of the Family
Functions:
Companionship (“marry for love”)
 Sex and reproduction
 Socialisation of children
 Social support (especially during crises)
 Economic cooperation

Family Structure

Nuclear family: Father, mother and kids

Extended family: The above plus
grandparents

“Family life cycle” – structure of an
individual family changes over time
The Family is Changing
Changing roles (role = “expected behaviour” that
goes with a social position)
People marry later, have fewer kids, and also have
them later
More divorces
Single parent families (these are more likely to be
poor)
The Family is Changing
More working mothers and “latchkey kids”
 Children may be unsupervised and feel
neglected and unloved
 Working mothers are stressed
(“Supermom Syndrome” and “Double
Burden of Women”)

Stressed Working Mothers
Examples:
 Female nurses with children
 Female doctors with children
Role conflict: Being a good doctor to one’s
patients versus being a good mother to
one’s kids
Effects of Family on Health
1) Effects on Illness Behaviour:
Stoic? self-medicate? seek alternative
medicine? Effects on medical adherence
e.g. religion & health (faith healing,
Jehovah’s Witness)
Effects of Family on Health
2) Effects on patients with long term illness:
Quality of care provided by family
members (female relatives as care
providers for kids, husbands, in-laws and
elderly parents)
Effects of Family on Health
3) Family and social networks promote
health:
Socially isolated have poorer mental health;
recover slower from sickness
The Dysfunctional Family
“Troubled family that has a negative effect
on the physical or psychological well-being
of its individual family members”
Effects of Family on Health
4) Dysfunctional families and poor parenting:





Child abuse – neglect, physical abuse, verbal
abuse, sexual abuse
Overindulgence
Domestic violence
Alcoholism and substance-abuse in the family
Gambling problems
NOTE !!
Families with divorced parents are NOT
NECESSARILY dysfunctional families !
Effects of Family on Health
5) Learning of health-related behaviour
e.g. quality of diet and health (including
obesity), smoking and passive smoking,
alcohol (religion & alcohol consumption),
risk-taking behaviour, values and
behaviour (including sexual behaviour)
Effects of Family on Health
6) Family changes can affect health
“Stressful life events” such as marital
breakdown and divorce, death of spouse
etc. increase risk of sickness for other
family members
Large families: can affect health of kids in a
negative manner
Effect of Sickness on the Family
1) Effect of chronic disease or death
Role changes: if the wife gets sick or dies,
the husband has to adjust (or vice-versa)
Economic pressures: family member stops
work to care for the sick, patient is unable
to work, medical bills become high
Effect of Sickness on the Family
2) Stress from taking care of sick family
member
e.g. Alzheimer’s disease, serious mental
illness, relative who is bed-ridden or
incontinent
3) Stigmatizing diseases such as HIV/AIDS
e.g. hostility from neighbours,
abandonment by own family
THE END
THANK YOU