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Family Relationships and Well-Being

Patricia a thomas.

1 Department of Sociology and Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana

2 Department of Sociology, Michigan State University, East Lansing

Debra Umberson

3 Department of Sociology and Population Research Center, University of Texas at Austin

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.

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.

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.

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 ).

Directions for Future Research

The rapid aging of the U.S. population along with significant changes in marriage and families indicate that a growing number of older adults enter late life with both complex marital histories and great heterogeneity in their relationships. While most research to date focuses on different-sex marriages, a growing body of research has started to examine whether the marital advantage in health and well-being is extended to same-sex couples, which represents a growing segment of relationship types among older couples ( Denney, Gorman, & Barrera, 2013 ; Goldsen et al., 2017 ; Liu, Reczek, & Brown, 2013 ; Reczek, Liu, & Spiker, 2014 ). Evidence shows that same-sex cohabiting couples report worse health than different-sex married couples ( Denney et al., 2013 ; Liu et al., 2013 ), but same-sex married couples are often not significantly different from or are even better off than different-sex married couples in other outcomes such as alcohol use ( Reczek, Liu, et al., 2014 ) and care from their partner during periods of illness ( Umberson, Thomeer, Reczek, & Donnelly, 2016 ). These results suggest that marriage may promote the well-being of same-sex couples, perhaps even more so than for different-sex couples ( Umberson et al., 2016 ). Including same-sex couples in future work on marriage and well-being will garner unique insights into gender differences in marital dynamics that have long been taken for granted based on studies of different-sex couples ( Umberson, Thomeer, Kroeger, Lodge, & Xu, 2015 ). Moreover, future work on same-sex and different-sex couples should take into account the intersection of other statuses such as race-ethnicity and SES to better understand the impact of marital relationships on well-being.

Another avenue for future research involves investigating complexities of marital strain effects on well-being. Some recent studies among older adults suggest that relationship strain may actually benefit certain dimensions of well-being. These studies suggest that strain with a spouse may be protective for certain health outcomes including cognitive decline ( Xu, Thomas, & Umberson, 2016 ) and diabetes control ( Liu et al., 2016 ), while support may not be, especially for men ( Carr, Cornman, & Freedman, 2016 ). Explanations for these unexpected findings among older adults are not fully understood. Family and health scholars suggest that spouses may prod their significant others to engage in more health-promoting behaviors ( Umberson, Crosnoe, et al., 2010 ). These attempts may be a source of friction, creating strain in the relationship; however, this dynamic may still contribute to better health outcomes for older adults. Future research should explore the processes by which strain may have a positive influence on health and well-being, perhaps differently by gender.

Intergenerational Relationships

Children and parents tend to remain closely connected to each other across the life course, and it is well-established that the quality of intergenerational relationships is central to the well-being of both generations ( Merz, Schuengel, & Schulze, 2009 ; Polenick, DePasquale, Eggebeen, Zarit, & Fingerman, 2016 ). Recent research also points to the importance of relationships with grandchildren for aging adults ( Mahne & Huxhold, 2015 ). We focus here on the well-being of parents, adult children, and grandparents. Parents, grandparents, and children often provide care for each other at different points in the life course, which can contribute to social support, stress, and social control mechanisms that influence the health and well-being of each in important ways over the life course ( Nomaguchi & Milkie, 2003 ; Pinquart & Soerensen, 2007 ; Reczek, Thomeer, et al., 2014 ).

Family scholarship highlights the complexities of parent–child relationships, finding that parenthood generates both rewards and stressors, with important implications for well-being ( Nomaguchi & Milkie, 2003 ; Umberson, Pudrovska, & Reczek, 2010 ). Parenthood increases time constraints, producing stress and diminishing well-being, especially when children are younger ( Nomaguchi, Milkie, & Bianchi, 2005 ), but parenthood can also increase social integration, leading to greater emotional support and a sense of belonging and meaning ( Berkman, Glass, Brissette, & Seeman, 2000 ), with positive consequences for well-being. Studies show that adult children play a pivotal role in the social networks of their parents across the life course ( Umberson, Pudrovska, et al., 2010 ), and the effects of parenthood on health and well-being become increasingly important at older ages as adult children provide one of the major sources of care for aging adults ( Seltzer & Bianchi, 2013 ). Norms of filial obligation of adult children to care for parents may be a form of social capital to be accessed by parents when their needs arise ( Silverstein, Gans, & Yang, 2006 ).

Although the general pattern is that receiving support from adult children is beneficial for parents’ well-being ( Merz, Schulze, & Schuengel, 2010 ), there is also evidence showing that receiving social support from adult children is related to lower well-being among older adults, suggesting that challenges to an identity of independence and usefulness may offset some of the benefits of receiving support ( Merz et al., 2010 ; Thomas, 2010 ). Contrary to popular thought, older parents are also very likely to provide instrumental/financial support to their adult children, typically contributing more than they receive ( Grundy, 2005 ), and providing emotional support to their adult children is related to higher well-being for older adults ( Thomas, 2010 ). In addition, consistent with the tenets of stress process theory, most evidence points to poor quality relationships with adult children as detrimental to parents’ well-being ( Koropeckyj-Cox, 2002 ; Polenick et al., 2016 ); however, a recent study found that strain with adult children is related to better cognitive health among older parents, especially fathers ( Thomas & Umberson, 2017 ).

Adult Children

As children and parents age, the nature of the parent–child relationship often changes such that adult children may take on a caregiving role for their older parents ( Pinquart & Soerensen, 2007 ). Adult children often experience competing pressures of employment, taking care of their own children, and providing care for older parents ( Evans et al., 2016 ). Support and strain from intergenerational ties during this stressful time of balancing family roles and work obligations may be particularly important for the mental health of adults in midlife ( Thomas, 2016 ). Most evidence suggests that caregiving for parents is related to lower well-being for adult children, including more negative affect and greater stress response in terms of overall output of daily cortisol ( Bangerter et al., 2017 ); however, some studies suggest that caregiving may be beneficial or neutral for well-being ( Merz et al., 2010 ). Family scholars suggest that this discrepancy may be due to varying types of caregiving and relationship quality. For example, providing emotional support to parents can increase well-being, but providing instrumental support does not unless the caregiver is emotionally engaged ( Morelli, Lee, Arnn, & Zaki, 2015 ). Moreover, the quality of the adult child-parent relationship may matter more for the well-being of adult children than does the caregiving they provide ( Merz, Schuengel, et al., 2009 ).

Although caregiving is a critical issue, adult children generally experience many years with parents in good health ( Settersten, 2007 ), and relationship quality and support exchanges have important implications for well-being beyond caregiving roles. The preponderance of research suggests that most adults feel emotionally close to their parents, and emotional support such as encouragement, companionship, and serving as a confidant is commonly exchanged in both directions ( Swartz, 2009 ). Intergenerational support exchanges often flow across generations or towards adult children rather than towards parents. For example, adult children are more likely to receive financial support from parents than vice versa until parents are very old ( Grundy, 2005 ). Intergenerational support exchanges are integral to the lives of both parents and adult children, both in times of need and in daily life.

Grandparents

Over 65 million Americans are grandparents ( Ellis & Simmons, 2014 ), 10% of children lived with at least one grandparent in 2012 ( Dunifon, Ziol-Guest, & Kopko, 2014 ), and a growing number of American families rely on grandparents as a source of support ( Settersten, 2007 ), suggesting the importance of studying grandparenting. Grandparents’ relationships with their grandchildren are generally related to higher well-being for both grandparents and grandchildren, with some important exceptions such as when they involve more extensive childcare responsibilities ( Kim, Kang, & Johnson-Motoyama, 2017 ; Lee, Clarkson-Hendrix, & Lee, 2016 ). Most grandparents engage in activities with their grandchildren that they find meaningful, feel close to their grandchildren, consider the grandparent role important ( Swartz, 2009 ), and experience lower well-being if they lose contact with their grandchildren ( Drew & Silverstein, 2007 ). However, a growing proportion of children live in households maintained by grandparents ( Settersten, 2007 ), and grandparents who care for their grandchildren without the support of the children’s parents usually experience greater stress ( Lee et al., 2016 ) and more depressive symptoms ( Blustein, Chan, & Guanais, 2004 ), sometimes juggling grandparenting responsibilities with their own employment ( Harrington Meyer, 2014 ). Using professional help and community services reduced the detrimental effects of grandparent caregiving on well-being ( Gerard, Landry-Meyer, & Roe, 2006 ), suggesting that future policy could help mitigate the stress of grandparent parenting and enhance the rewarding aspects of grandparenting instead.

Substantial evidence suggests that the experience of intergenerational relationships varies for men and women. Women tend to be more involved with and affected by intergenerational relationships, with adult children feeling closer to mothers than fathers ( Swartz, 2009 ). Moreover, relationship quality with children is more strongly associated with mothers’ well-being than with fathers’ well-being ( Milkie et al., 2008 ). Motherhood may be particularly salient to women ( McQuillan, Greil, Shreffler, & Tichenor, 2008 ), and women carry a disproportionate share of the burden of parenting, including greater caregiving for young children and aging parents as well as time deficits from these obligations that lead to lower well-being ( Nomaguchi et al., 2005 ; Pinquart & Sorensen, 2006 ). Mothers often report greater parental pressures than fathers, such as more obligation to be there for their children ( Reczek, Thomeer, et al., 2014 ; Stone, 2007 ), and to actively work on family relationships ( Erickson, 2005 ). Mothers are also more likely to blame themselves for poor parent–child relationship quality ( Elliott, Powell, & Brenton, 2015 ), contributing to greater distress for women. It is important to take into account the different pressures and meanings surrounding intergenerational relationships for men and for women in future research.

Family scholars have noted important variations in family dynamics and constraints by race-ethnicity and socioeconomic status. Lower SES can produce and exacerbate family strains ( Conger, Conger, & Martin, 2010 ). Socioeconomically disadvantaged adult children may need more assistance from parents and grandparents who in turn have fewer resources to provide ( Seltzer & Bianchi, 2013 ). Higher SES and white families tend to provide more financial and emotional support, whereas lower SES, black, and Latino families are more likely to coreside and provide practical help, and these differences in support exchanges contribute to the intergenerational transmission of inequality through families ( Swartz, 2009 ). Moreover, scholars have found that a happiness penalty exists such that parents of young children have lower levels of well-being than nonparents; however, policies such as childcare subsidies and paid time off that help parents negotiate work and family responsibilities explain this disparity ( Glass, Simon, & Andersson, 2016 ). Fewer resources can also place strain on grandparent–grandchild relationships. For example, well-being derived from these relationships may be unequally distributed across grandparents’ education level such that those with less education bear the brunt of more stressful grandparenting experiences and lower well-being ( Mahne & Huxhold, 2015 ). Both the burden of parenting grandchildren and its effects on depressive symptoms disproportionately fall upon single grandmothers of color ( Blustein et al., 2004 ). These studies demonstrate the importance of understanding structural constraints that produce greater stress for less advantaged groups and their impact on family relationships and well-being.

Research on intergenerational relationships suggests the importance of understanding greater complexity in these relationships in future work. For example, future research should pay greater attention to diverse family structures and perspectives of multiple family members. There is an increasing trend of individuals delaying childbearing or choosing not to bear children ( Umberson, Pudrovska, et al., 2010 ). How might this influence marital quality and general well-being over the life course and across different social groups? Greater attention to the quality and context of intergenerational relationships from each family member’s perspective over time may prove fruitful by gaining both parents’ and each child’s perceptions. This work has already yielded important insights, such as the ways in which intergenerational ambivalence (simultaneous positive and negative feelings about intergenerational relationships) from the perspectives of parents and adult children may be detrimental to well-being for both parties ( Fingerman, Pitzer, Lefkowitz, Birditt, & Mroczek, 2008 ; Gilligan, Suitor, Feld, & Pillemer, 2015 ). Future work understanding the perspectives of each family member could also provide leverage in understanding the mixed findings regarding whether living in blended families with stepchildren influences well-being ( Gennetian, 2005 ; Harcourt, Adler-Baeder, Erath, & Pettit, 2013 ) and the long-term implications of these family structures when older adults need care ( Seltzer & Bianchi, 2013 ). Longitudinal data linking generations, paying greater attention to the context of these relationships, and collected from multiple family members can help untangle the ways in which family members influence each other across the life course and how multiple family members’ well-being may be intertwined in important ways.

Future studies should also consider the impact of intersecting structural locations that place unique constraints on family relationships, producing greater stress at some intersections while providing greater resources at other intersections. For example, same-sex couples are less likely to have children ( Carpenter & Gates, 2008 ) and are more likely to provide parental caregiving regardless of gender ( Reczek & Umberson, 2016 ), suggesting important implications for stress and burden in intergenerational caregiving for this group. Much of the work on gender, sexuality, race, and socioeconomic status differences in intergenerational relationships and well-being examine one or two of these statuses, but there may be unique effects at the intersection of these and other statuses such as disability, age, and nativity. Moreover, these effects may vary at different stages of the life course.

Sibling Relationships

Sibling relationships are understudied, and the research on adult siblings is more limited than for other family relationships. Yet, sibling relationships are often the longest lasting family relationship in an individual’s life due to concurrent life spans, and indeed, around 75% of 70-year olds have a living sibling ( Settersten, 2007 ). Some suggest that sibling relationships play a more meaningful role in well-being than is often recognized ( Cicirelli, 2004 ). The available evidence suggests that high quality relationships characterized by closeness with siblings are related to higher levels of well-being ( Bedford & Avioli, 2001 ), whereas sibling relationships characterized by conflict and lack of closeness have been linked to lower well-being in terms of major depression and greater drug use in adulthood ( Waldinger, Vaillant, & Orav, 2007 ). Parental favoritism and disfavoritism of children affects the closeness of siblings ( Gilligan, Suitor, & Nam, 2015 ) and depression ( Jensen, Whiteman, Fingerman, & Birditt, 2013 ). Similar to other family relationships, sibling relationships can be characterized by both positive and negative aspects that may affect elements of the stress process, providing both resources and stressors that influence well-being.

Siblings play important roles in support exchanges and caregiving, especially if their sibling experiences physical impairment and other close ties, such as a spouse or adult children, are not available ( Degeneffe & Burcham, 2008 ; Namkung, Greenberg, & Mailick, 2017 ). Although sibling caregivers report lower well-being than noncaregivers, sibling caregivers experience this lower well-being to a lesser extent than spousal caregivers ( Namkung et al., 2017 ). Most people believe that their siblings would be available to help them in a crisis ( Connidis, 1994 ; Van Volkom, 2006 ), and in general support exchanges, receiving emotional support from a sibling is related to higher levels of well-being among older adults ( Thomas, 2010 ). Relationship quality affects the experience of caregiving, with higher quality sibling relationships linked to greater provision of care ( Eriksen & Gerstel, 2002 ) and a lower likelihood of emotional strain from caregiving ( Mui & Morrow-Howell, 1993 ; Quinn, Clare, & Woods, 2009 ). Taken together, these studies suggest the importance of sibling relationships for well-being across the adult life course.

The gender of the sibling dyad may play a role in the relationship’s effect on well-being, with relationships with sisters perceived as higher quality and linked to higher well-being ( Van Volkom, 2006 ), though some argue that brothers do not show their affection in the same way but nevertheless have similar sentiments towards their siblings ( Bedford & Avioli, 2001 ). General social support exchanges with siblings may be influenced by gender and larger family context; sisters exchanged more support with their siblings when they had higher quality relationships with their parents, but brothers exhibited a more compensatory role, exchanging more emotional support with siblings when they had lower quality relationships with their parents ( Voorpostel & Blieszner, 2008 ). Caregiving for aging parents is also distributed differently by gender, falling disproportionately on female siblings ( Pinquart & Sorensen, 2006 ), and sons provide less care to their parents if they have a sister ( Grigoryeva, 2017 ). However, men in same-sex marriages were more likely than men in different-sex marriages to provide caregiving to parents and parents-in-law ( Reczek & Umberson, 2016 ), which may ease the stress and burden on their female siblings.

Although there is less research in this area, family scholars have noted variations in sibling relationships and their effects by race-ethnicity and socioeconomic status. Lower socioeconomic status has been associated with reports of feeling less attached to siblings and this influences several outcomes such as obesity, depression, and substance use ( Van Gundy et al., 2015 ). Fewer socioeconomic resources can also limit the amount of care siblings provide ( Eriksen & Gerstel, 2002 ). These studies suggest sibling relationship quality as an axis of further disadvantage for already disadvantaged individuals. Sibling relationships may influence caregiving experiences by race as well, with black caregivers more likely to have siblings who also provide care to their parents than white caregivers ( White-Means & Rubin, 2008 ) and sibling caregiving leading to lower well-being among white caregivers than minority caregivers ( Namkung et al., 2017 ).

Research on within-family differences has made great strides in our understanding of family relationships and remains a fruitful area of growth for future research (e.g., Suitor et al., 2017 ). Data gathered on multiple members within the same family can help researchers better investigate how families influence well-being in complex ways, including reciprocal influences between siblings. Siblings may have different perceptions of their relationships with each other, and this may vary by gender and other social statuses. This type of data might be especially useful in understanding family effects in diverse family structures, such as differences in treatment and outcomes of biological versus stepchildren, how characteristics of their relationships such as age differences may play a role, and the implications for caregiving for aging parents and for each other. Moreover, it is important to use longitudinal data to understand the consequences of these within-family differences over time as the life course unfolds. In addition, a greater focus on heterogeneity in sibling relationships and their consequences at the intersection of gender, race-ethnicity, SES, and other social statuses merit further investigation.

Relationships with family members are significant for well-being across the life course ( Merz, Consedine, et al., 2009 ; Umberson, Pudrovska, et al., 2010 ). As individuals age, family relationships often become more complex, with sometimes complicated marital histories, varying relationships with children, competing time pressures, and obligations for care. At the same time, family relationships become more important for well-being as individuals age and social networks diminish even as family caregiving needs increase. Stress process theory suggests that the positive and negative aspects of relationships can have a large impact on the well-being of individuals. Family relationships provide resources that can help an individual cope with stress, engage in healthier behaviors, and enhance self-esteem, leading to higher well-being. However, poor relationship quality, intense caregiving for family members, and marital dissolution are all stressors that can take a toll on an individual’s well-being. Moreover, family relationships also change over the life course, with the potential to share different levels of emotional support and closeness, to take care of us when needed, to add varying levels of stress to our lives, and to need caregiving at different points in the life course. The potential risks and rewards of these relationships have a cumulative impact on health and well-being over the life course. Additionally, structural constraints and disadvantage place greater pressures on some families than others based on structural location such as gender, race, and SES, producing further disadvantage and intergenerational transmission of inequality.

Future research should take into account greater complexity in family relationships, diverse family structures, and intersections of social statuses. The rapid aging of the U.S. population along with significant changes in marriage and families suggest more complex marital and family histories as adults enter late life, which will have a large impact on family dynamics and caregiving. Growing segments of family relationships among older adults include same-sex couples, those without children, and those experiencing marital transitions leading to diverse family structures, which all merit greater attention in future research. Moreover, there is some evidence that strain in relationships can be beneficial for certain health outcomes, and the processes by which this occurs merit further investigation. A greater use of longitudinal data that link generations and obtain information from multiple family members will help researchers better understand the ways in which these complex family relationships unfold across the life course and shape well-being. We also highlighted gender, race-ethnicity, and socioeconomic status differences in each of these family relationships and their impact on well-being; however, many studies only consider one status at a time. Future research should consider the impact of intersecting structural locations that place unique constraints on family relationships, producing greater stress or providing greater resources at the intersections of different statuses.

The changing landscape of families combined with population aging present unique challenges and pressures for families and health care systems. With more experiences of age-related disease in a growing population of older adults as well as more complex family histories as these adults enter late life, such as a growing proportion of diverse family structures without children or with stepchildren, caregiving obligations and availability may be less clear. It is important to address ways to ease caregiving or shift the burden away from families through a variety of policies, such as greater resources for in-home aid, creation of older adult residential communities that facilitate social interactions and social support structures, and patient advocates to help older adults navigate health care systems. Adults in midlife may experience competing family pressures from their young children and aging parents, and policies such as childcare subsidies and paid leave to care for family members could reduce burden during this often stressful time ( Glass et al., 2016 ). Professional help and community services can also reduce the burden for grandparents involved in childcare, enabling grandparents to focus on the more positive aspects of grandparent–grandchild relationships. It is important for future research and health promotion policies to take into account the contexts and complexities of family relationships as part of a multipronged approach to benefit health and well-being, especially as a growing proportion of older adults reach late life.

This work was supported in part by grant, 5 R24 HD042849, Population Research Center, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Conflict of Interest

None reported.

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Regions & Countries

Family & relationships, parents, young adult children and the transition to adulthood.

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• Published: 30 November 2020

Family perspectives of COVID-19 research

• Shelley M. Vanderhout 1 ,
• Catherine S. Birken 2 ,
• Peter Wong 3 ,
• Sarah Kelleher 4 ,
• Shannon Weir 4 &
• Jonathon L. Maguire 1 , 5  

Research Involvement and Engagement volume  6 , Article number:  69 ( 2020 ) Cite this article

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The COVID-19 pandemic has uniquely affected children and families by disrupting routines, changing relationships and roles, and altering usual child care, school and recreational activities. Understanding the way families experience these changes from parents’ perspectives may help to guide research on the effects of COVID-19 among children.

As a multidisciplinary team of child health researchers, we assembled a group of nine parents to identify concerns, raise questions, and voice perspectives to inform COVID-19 research for children and families. Parents provided a range of insightful perspectives, ideas for research questions, and reflections on their experiences during the pandemic.

Including parents as partners in early stages of COVID-19 research helped determine priorities, led to more feasible data collection methods, and hopefully has improved the relevance, applicability and value of research findings to parents and children.

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Plain English summary

Understanding the physical, mental, and emotional impacts of the COVID-19 pandemic for children and families will help to guide approaches to support families and children during the pandemic and after. As a team of child health researchers in Toronto, Canada, we assembled a group of parents and clinician researchers during the COVID-19 pandemic to identify concerns, raise questions, and voice perspectives to inform COVID-19 research for children and families. Parents were eager to share their experience of shifting roles, priorities, and routines during the pandemic, and were instrumental in guiding research priorities and methods to understand of the effects of COVID-19 on families. First-hand experience that parents have in navigating the COVID-19 pandemic with their families contributed to collaborative relationships between researchers and research participants, helped orient research about COVID-19 in children around family priorities, and offered valuable perspectives for the development of guidelines for safe return to school and childcare. Partnerships between researchers and families in designing and delivering COVID-19 research may lead to a better understanding of how health research can best support children and their families during the COVID-19 pandemic.

Children and families have been uniquely affected by the COVID-19 pandemic. While children appear to experience milder symptoms from COVID-19 infection than older individuals [ 1 ], sudden changes in routines, resources, and relationships as a result of restrictions on physical interaction have resulted in major impacts on families with young children. In the absence of school, child care, extra-curricular activities and family gatherings, children’s social and support networks have been broadly disrupted. Stress from COVID-19 has been compounded by additional responsibilities for parents as they adapt to their new roles as educators and playmates while balancing full-time caregiving with their own stressful changes to work, financial and social situations. On the contrary, families with greater parental support and perceived control have had less perceived stress during COVID-19 [ 2 ].

The COVID-19 pandemic has rapidly sparked research activity across the globe. Patient and family voices are increasingly considered essential to research agenda and priority setting [ 3 ]. Understanding the physical, mental, and emotional consequences of the COVID-19 pandemic for families will inform approaches to support parents and children during the pandemic and after. In this unusual time, patient and family voices can be valuable in informing health research priorities, study designs, implementation plans and knowledge translation strategies that directly affect them [ 4 ].

As a multidisciplinary team of child health researchers with expertise in general paediatrics, nutrition and mental health, we assembled a group of nine parents to identify concerns, raise questions, and voice perspectives to inform COVID-19 research for children and families. Parents were recruited from the TARGet Kids! primary care research network [ 5 ], which is a collaboration between applied health researchers at the SickKids and St. Michael’s Hospitals, primary care providers from the Departments of Pediatrics and Family and Community Medicine at the University of Toronto, and families. Parents were contacted by email and invited to voluntary meetings on April 7 and 23, 2020 via Zoom [ 6 ] for 3 h. In an unstructured discussion, we asked how parents imagined research about COVID-19 could make an impact on child and family well-being. Parents were encouraged to share their lived experience and perspectives on the anticipated effects of COVID-19 and social distancing policies on their children and families, and opinions to inform how research on child mental and physical health during and after the pandemic could best be conducted. Parents had opportunities to review proposed data collection tools such as smartphone apps and serology testing devices, and provided feedback about the feasibility and meaningfulness of each. Content, frequency and organization of questionnaires were also reviewed by parents to ensure they were appropriate in length and feasible to complete.

Parent perspectives

Parents were optimistic that research would provide an understanding of the effects of COVID-19 on families and deliver solutions to minimize negative effects and bolster positive effects. Parents wondered about several questions which they hoped research would answer including: What will be the effects of physical distancing and disrupted routines for my children? How can I help my children develop healthy coping habits? How can I appropriately talk about the virus with my children? What factors might predict resiliency against negative effects of the pandemic among children and families, and how can these be strengthened?

Parents speculated what risks children might face as a result of schoolwork transitioning to home, educational activities provided online, child care being limited or unavailable, social relationships changing, sports and extra-curricular activities being cancelled, and stress and anxiety increasing at home. Some parents reflected on feeling some relief from not having to coordinate usual extracurricular activities. However, they expressed frustration in finding high quality educational activities and resources to support physical and mental health for their children during physical isolation. Parents voiced a need for a centralized, accessible hub with peer reviewed, high quality resources to keep children entertained and supported while spending more time indoors, away from usual activities and school. They hoped for resources to help families adjust to new routines and roles, as well as answer children’s questions in truthful ways that would not increase anxiety.

Parents were curious about studying the impact of COVID-19 on children and families. How would researchers use information about children who are affected physically, mentally, or socially by the pandemic? What could be the possible implications of testing for COVID-19 on social relationships and parents’ employment? This question generated discussion about difficult positions families of lower socio-economic status, who may need to maintain attendance at work but have a suspected COVID-19 infected household member. Would health and social care for children going forward reflect the unique ways they had been impacted by changes in their daily routines and relationships? How can families return to school and everyday routines with a minimum of disruption? What will be done to prepare children and families for emergency situations in the future? Considering these questions may lead child health researchers to study relevant and contemporary concepts to families during the COVID-19 pandemic.

When presented with options to include more measures on other family members, parents maintained that the focus of our COVID-19 research should be on children. Parents provided essential feedback about the length and frequency of questionnaires, to ensure they were appropriate given the limited time available for completing them. Parent involvement early in the research process helped to direct research priorities, informed data collection strategies and hopefully has increased the relevance of research conducted for children and families. Conducting a follow-up meeting with parents was important to understand shifting concerns and ensure data collection was reflecting current routines, habits and policies affecting families.

Conclusions

As researchers who are seeking to understand the impact of COVID-19 on children and families, we felt it important to involve families in designing and implementing new research. First-hand experience that parents have in navigating the COVID-19 pandemic with their children contributed to co-building between researchers and research participants. Parents were generous with their time and provided insightful, honest suggestions for how researchers could create knowledge that would be directly relevant to them. Next steps will include expanding our dialogue with a more diverse group of parents in terms of gender, as all parents in our meetings were women, and ethnicity to better represent the diversity of Toronto. Other researchers conducting COVID-19 research among children and families may consider engaging parents and caregivers in preliminary stages to identify priorities, understand lived experiences and help guide all stages of the research process. This presents value in focusing research on the most important priorities for families and developing data collection methods which are feasible in the context of the COVID-19 pandemic. As the nature of the COVID-19 pandemic is dynamic, ongoing communication between researchers and parents to understand changing perspectives and concerns is important to respond to family needs. We hope that ongoing partnerships between parents and researchers will promote leadership among parents as co-investigators in COVID-19 research, and result in research which addresses the needs of parents and children during the COVID-19 pandemic. Ideally, engaging with families in COVID-19 research will result in findings that will be valuable to families, assist them in developing collective resilience, and provide a foundation for family-oriented research throughout the COVD-19 pandemic and beyond.

Availability of data and materials

Not applicable.

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Acknowledgements

We thank the TARGet Kids! Parent And Clinician Team for their generous contribution of time and participation in discussions about COVID-19 in children and families.

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Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto, 209 Victoria St, Toronto, ON, M5B 1T8, Canada

Shelley M. Vanderhout & Jonathon L. Maguire

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Catherine S. Birken

Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research & Learning, 686 Bay Street, 11th floor, Toronto, Ontario, M5G 0A4, Canada

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Sarah Kelleher & Shannon Weir

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Shelley Vanderhout, Catherine Birken, Peter Wong, Shannon Weir, Sarah Kelleher and Jonathon Maguire participated in the concept and design, drafting and revising of the manuscript. All authors approved the manuscript as submitted and agree to be accountable for all aspects of the work.

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Vanderhout, S.M., Birken, C.S., Wong, P. et al. Family perspectives of COVID-19 research. Res Involv Engagem 6 , 69 (2020). https://doi.org/10.1186/s40900-020-00242-1

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• Volume 11, Issue 1
• Examining the impacts of the COVID-19 pandemic on family mental health in Canada: findings from a national cross-sectional study
• Article Text
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• http://orcid.org/0000-0001-6947-1052 Anne C Gadermann 1 , 2 ,
• http://orcid.org/0000-0002-4508-2463 Kimberly C Thomson 1 , 2 ,
• http://orcid.org/0000-0002-7641-7027 Chris G Richardson 2 , 3 ,
• http://orcid.org/0000-0002-3220-7351 Monique Gagné 1 , 2 ,
• http://orcid.org/0000-0002-7868-564X Corey McAuliffe 4 ,
• http://orcid.org/0000-0003-1084-3039 Saima Hirani 4 ,
• http://orcid.org/0000-0003-4649-2904 Emily Jenkins 4
• 1 Human Early Learning Partnership, School of Population and Public Health, University of British Columbia , Vancouver , British Columbia , Canada
• 2 Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute , Vancouver , British Columbia , Canada
• 3 School of Population and Public Health , University of British Columbia , Vancouver , British Columbia , Canada
• 4 School of Nursing , University of British Columbia , Vancouver , British Columbia , Canada
• Correspondence to Dr Anne C Gadermann; anne.gadermann{at}ubc.ca

Objectives In the first wave of the COVID-19 pandemic, social isolation, school/child care closures and employment instability have created unprecedented conditions for families raising children at home. This study describes the mental health impacts of the COVID-19 pandemic on families with children in Canada.

Design, setting and participants This descriptive study used a nationally representative, cross-sectional survey of adults living in Canada (n=3000) to examine the mental health impacts of the COVID-19 pandemic. Outcomes among parents with children <18 years old living at home (n=618) were compared with the rest of the sample. Data were collected via an online survey between 14 May to 29 May 2020.

Outcome measures Participants reported on changes to their mental health since the onset of the pandemic and sources of stress, emotional responses, substance use patterns and suicidality/self-harm. Additionally, parents identified changes in their interactions with their children, impacts on their children’s mental health and sources of support accessed.

Results 44.3% of parents with children <18 years living at home reported worse mental health as a result of the COVID-19 pandemic compared with 35.6% of respondents without children <18 living at home, χ 2 (1, n=3000)=16.2, p<0.001. More parents compared with the rest of the sample reported increased alcohol consumption (27.7% vs 16.1%, χ 2 (1, n=3000)=43.8, p<0.001), suicidal thoughts/feelings (8.3% vs 5.2%, χ 2 (1, n=3000)=8.0, p=0.005) and stress about being safe from physical/emotional domestic violence (11.5% vs 7.9%, χ 2 (1, n=3000)=8.1, p=0.005). 24.8% (95% CI 21.4 to 28.4) of parents reported their children’s mental health had worsened since the pandemic. Parents also reported more frequent negative as well as positive interactions with their children due to the pandemic (eg, more conflicts, 22.2% (95% CI 19.0 to 25.7); increased feelings of closeness, 49.7% (95% CI 45.7 to 53.7)).

Conclusions This study identifies that families with children <18 at home have experienced deteriorated mental health due to the pandemic. Population-level responses are required to adequately respond to families’ diverse needs and mitigate the potential for widening health and social inequities for parents and children.

• mental health
• public health
• community child health
• epidemiology

Data availability statement

Data are available upon reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/bmjopen-2020-042871

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Strengths and limitations of this study

Survey items were informed by a longitudinal COVID-19 mental health survey, first commissioned by the UK Mental Health Foundation and developed in consultation with people with lived experience of mental health conditions; adaptations were made for the Canadian context and to support analyses focussed on issues of equity.

The large sample size enabled subgroup analyses in mental health according to gender, age, pre-existing mental health conditions, disabilities and household demographics.

Targeted sampling supported participation from families of diverse backgrounds.

Cross-sectional observational design and lack of adjustment for potential confounding prohibits causal inference.

Introduction

The COVID-19 pandemic has led to unprecedented global morbidity and mortality, with population mental health impacts recognised as a growing concern, 1 and particular risks identified within the family context. 2–4 Specifically, the COVID-19 pandemic has posed new threats to families through social isolation due to physical distancing measures, school/child care closures, financial and employment insecurity, housing instability and changes to health and social care access. 3–5 These shifts have profoundly interrupted the systems and structures that previously operated to both support the mental health and well-being of families and mitigate the risks that contribute to health and social inequities.

During the pandemic, many parents have experienced increased pressures and erosions to social supports, with implications for their mental health. In a US survey, the majority of parents expressed that during the pandemic, concerns about finances, social isolation, criticism from others, as well as emotional experiences of sadness and loneliness were affecting their parenting. 6 Globally, school and child care closures and the hiatus of after-school activities has added to parental pressure to balance responsibilities, including becoming the sole providers of supervision and education for their children—all while experiencing heightened financial and emotional stress. 7 Families, generally, are affected by the disruptions of the pandemic. However, these pressures disproportionately affect families who experience health and social inequities, including fewer financial and social resources, crowded homes and limited technology and Internet access. 7–9 The collision of these stressors has contributed to increases in domestic violence, 10 11 and emerging studies have shown increased frequency of shouting and physical punishment of children since the pandemic began. 6

In Canada, federal and provincial governments began implementing lockdown measures mid-March 2020 including border closures and restricted travel, restrictions on group gatherings, school/child care closures, mandatory working from home and temporary suspension of non-essential health and public services. 12 National COVID-19 incidence rates first peaked in April 2020 with nearly 3000 new cases confirmed daily. 13 By early May 2020, incidence rates were decreasing and provinces began easing lockdown measures including re-opening businesses and encouraging rehiring of employees. 12 However, there were indications that the pandemic was already impacting the mental health and well-being of Canadian children. 1 For example, by April 2020, reports showed a dramatic surge in calls documented by Kids Help Phone, a national helpline for young people, with a 48% increase in calls about social isolation, a 42% increase in calls about anxiety and stress and a 28% increase in calls about physical abuse. 14 Experts raised alarms that disruptions to routines and services, combined with increased family stressors, social isolation and domestic violence, were creating conditions that risked increasing child mental health problems on an unprecedented scale, with children from marginalised and socioeconomically disadvantaged backgrounds likely to be disproportionately affected. 15 16 Thus, while young people initially appear to be less susceptible to the physical effects of the virus, they are experiencing significant challenges, likely resulting from the social and economic impacts of the pandemic within their family contexts. 4 17 This is particularly concerning as research consistently demonstrates that children’s early exposures to stress can have lasting effects. 18–21

Families and children are furthermore supported by a social ecological system that has been forced to adapt quickly to support families’ needs, often with limited information or evaluation. School and child care closures due to the pandemic are concerning not only for the disruption to typical classroom learning, but also for the loss of systems-level safeguards such as nutrition programmes, after-school care, school health and counselling services and vaccination clinics 22 23 that seek to mitigate some consequences of health and social inequities among structurally vulnerable children and families. And yet, even as schools and workplaces started to re-open, concerns were raised about the health risks of returning to populated spaces (including public transit) disproportionally affecting families with lower incomes, fewer resources and with limited options for returning to work. 24 Furthermore, families, child care settings and schools are nested within health authorities and government structures that determine many of the policies, services and financial and employment supports available to parents as well as the availability of these supports beyond the pandemic.

This paper presents findings on the impact of the COVID-19 pandemic on families from the first wave of a nationally representative cross-sectional survey monitoring the mental health of people living in Canada. The study aimed to answer three questions: (1) How is the COVID-19 pandemic affecting the mental health of parents and children and what subgroups are most impacted by the pandemic? (2) How have parent–child interactions changed due to the pandemic? and (3) What are the factors that support mental health in the family context? The findings provide critical evidence to inform rapid, data-driven public health responses to meet the mental health needs of families and children in the context of the COVID-19 pandemic and beyond.

Survey development and approach

This investigation focusses on data from the initial wave of our cross-sectional survey, ‘Assessing the Impacts of COVID-19 on Mental Health’. The study represents a unique collaboration between academic researchers from the University of British Columbia, the Canadian Mental Health Association (Canada) and by an international research partnership with the Mental Health Foundation (UK).

Patient and public involvement

Survey items were informed by a longitudinal survey first commissioned by the Mental Health Foundation in March 2020 and developed in consultation with people with lived experience of mental health conditions via a citizen’s jury participatory methodology process. The citizen’s jury was a collaborative process that engaged people with diverse experiences and backgrounds in the development and interpretation of the research to enhance its relevance and impact, including insights on stressors, coping strategies and mental health. 25 26 Items on family mental health were adapted from previously developed community survey items related to the COVID-19 pandemic from the University of Michigan. 6 Modifications were made by the research team in consultation with collaborators from the Canadian Mental Health Association to reflect the Canadian context, aimed at examining indicators of mental health, stress and coping related to the COVID-19 pandemic among the Canadian population. Modifications included adding items on the impacts on young people’s mental health, potential sources of support, family dynamics, financial interventions introduced by the Government of Canada in response to the pandemic (eg, Canada Emergency Response Benefit) and food security systems. Survey items are provided in online supplemental file 1 .

Supplemental material

Data were collected between 14 May to 29 May 2020, via a rapid online survey distributed by polling vendor Maru/Matchbox. Maru/Matchbox maintains the Maru Voice Canada panel consisting of approximately 125 000 adults. Panel participants were recruited through direct email, with targeted sampling through affiliate community partners to increase inclusion of populations that may be difficult to reach via the Internet (eg, older adults, racialized populations). 27 Surveys were distributed to 3558 panel members to reach a total of 3000 respondents, yielding an invitation-to-response rate of 84%. Members of the panel were randomly invited by Maru/Matchbox to participate in the survey using Canadian national census informed stratifications defined by sociodemographic characteristics (age, gender, household income and region) with adjustments for response propensity to generate a representative sample by age, gender, income and region. 27 The data collection period captured the first phases of ‘re-opening’ across many Canadian provinces and territories, emerging from approximately 2 months of mandated physical distancing, school/child care and work closures and related disruptions.

All participants completed an online consent process prior to beginning the survey and were provided with a small honorarium through Maru/Matchbox to compensate for their time.

Measures and analyses

This investigation focusses on a subsample of participants who identified as parents with children <18 years old currently living at home (n=618). Changes in mental health due to the pandemic were compared between this parent subsample and the rest of the sample (ie, respondents who were not parents with children <18 living at home). Comparisons were also conducted within the subsample of parents. Participants completed sociodemographic questions as well as questions about their mental health, emotional responses to the pandemic, changes in substance use, experiences of suicidal thoughts and self-harm. Parents also completed questions on changes to parent–child interactions, impacts of the pandemic on their children’s mental health and were asked to identify sources of stress and support for themselves and their children.

Descriptive and bivariate analyses (frequencies, χ 2 tests) were used to examine self-reported changes in mental health since the onset of the pandemic across groups defined by gender, age, disability and pre-existing mental health conditions, as well as frequently identified stressors, supports and changes in parent–child interactions. Data were analysed using SPSS V.26. 28 The maximum margin of error for proportions derived from the parent subsample was ±3.9% at a 95% level of confidence. This was a complete case analysis. In χ 2 analyses, ‘don’t know’, ‘not applicable’ and ‘prefer not to answer’ responses were treated as ‘not yes’.

Sample description

Of the 3000 respondents, 618 identified as parents to a child <18 living at home. 2 The average age of the parent subsample was 43.0 years (SD=9.0 years) and 52.4% identified as women. Further sample characteristics are presented in table 1 .

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Sociodemographic characteristics of the parent subsample (n=618)

Pandemic-related changes in parent mental health

Parents identified more pandemic-related risks and vulnerabilities compared with respondents without children <18 years living at home across a number of mental health constructs. Since the onset of the COVID-19 pandemic, a significantly higher proportion of parents reported deteriorated mental health (44.3%) compared with 35.6% among their counterparts without children <18 years at home, χ 2 (1, n=3000)=16.2, p<0.001. Changes to mental health furthermore varied across sociodemographic characteristics within the parent subsample. Table 2 presents the proportions of parents reporting deteriorated mental health since the pandemic according to parent gender, age, pre-existing mental health conditions, disabilities, child age and employment and financial circumstances. Among parents with children at home, deteriorated mental health was significantly more prevalent among women, parents under age 35, parents with a pre-existing mental health condition, parents with a disability, parents of younger children (≤4 years) and parents reporting financial stress. When asked about their emotions in the past 2 weeks as a result of the COVID-19 pandemic, the most frequent response from parents was anxious and worried (51.9%; 95% CI 47.9 to 55.9), followed by stressed (46.1%; 95% CI 42.1 to 50.1) and bored (39.5%; 95% CI 35.6 to 43.5).

Changes in parent self-reported mental health since the onset of the COVID-19 pandemic

Overall, 8.3% of parents reported experiencing suicidal thoughts/feelings as a result of the COVID-19 pandemic in the past 2 weeks compared with 5.2% among their counterparts without children at home, χ 2 (1, n=3000)=8.0, p=0.005. Furthermore, 2.6% of parents reported deliberately hurting themselves as a result of the pandemic in the past 2 weeks compared with 1.3% among their counterparts, χ 2 (1, n=3000)=4.8, p=0.028.

As a means of coping with deteriorations in mental health and stressors of the pandemic, many parents identified an increase in alcohol use. Specifically, 27.7% of parents reported increased alcohol consumption compared with 16.1% among those without children at home, χ 2 (1, n=3000)=43.8, p<0.001. Within the parent subsample, increased alcohol consumption was more prevalent among men (32.3%) compared with women (23.5%), χ 2 (1, n=618)=6.0, p=0.014.

Pandemic-related stressors

As shown in figure 1 , when asked about stressors and worries resulting from the COVID-19 pandemic in the past 2 weeks, parents frequently reported mental health impacts, physical health threats related to the pandemic and relational and financial concerns. Being able to cope with uncertainty (59.2%; 95% CI 55.2 to 63.1), fear of a family member getting sick or dying (58.9%; 95% CI 54.9 to 62.8) and being separated from friends and family (58.7%; 95% CI 54.7 to 62.7) were the most frequent responses. A large proportion also reported being stressed about financial concerns (45.6%; 95% CI 41.2 to 49.7), losing/loss of job (31.4%; 95% CI 27.8 to 35.2) and having enough food to meet their household’s basic needs (20.4%; 95% CI 17.3 to 23.8). Further, 36.9% (95% CI 33.1 to 40.8) of parents reported being stressed about looking after children while continuing to work and 27.8% (95% CI 24.3 to 31.6) were stressed that the pandemic would make their existing mental health problems worse.

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Parent stressors in the past 2 weeks as a result of the COVID-19 pandemic. Note: Maximum margin of error for proportions was ±3.9% at a 95% level of confidence.

Relationship challenges were also a prominent concern among parents. For example, 28.3% (95% CI 24.8 to 32.1) of parents reported being stressed about experiencing relationship challenges with their partner and 11.5% (95% CI 9.1 to 14.3) reported being stressed about being safe from physical or emotional domestic violence during the 2 weeks prior. This proportion identifying concern about being safe from domestic violence was significantly higher among parents compared with the rest of the sample (7.9%), χ 2 (1, n=3000)=8.1, p=0.005. Within the parent subsample, a higher proportion of men (14.6%) reported being stressed about being safe from physical or emotional domestic violence compared with women (8.6%), χ 2 (1, n=618)=5.4, p=0.020.

Child mental health and parent–child interactions

The majority of parents (59.7%; 95% CI 55.7 to 63.6) reported their children’s mental health had stayed the same since the onset of the COVID-19 pandemic; however, 24.8% (95% CI 21.4 to 28.4) indicated that their children’s mental health had worsened.

Overall, due to the COVID-19 pandemic, parents reported more negative interactions with their children, including more conflicts (22.2%; 95% CI 19.0 to 25.7), yelling/shouting (16.7%; 95% CI 13.8 to 19.8), disciplining (16.0%; 95% CI 13.2 to 19.2) and using harsh words (10.7%; 95% CI 8.4 to 13.4). However, overall, parents also reported that they experienced increased positive interactions with their children, including having more quality time (65.4%; 95% CI 61.5 to 69.1), feeling closeness (49.7%; 95% CI 45.7 to 53.7), showing love or affection to their children (44.5%; 95% CI 40.5 to 48.5) and observing increased resilience (strength and perseverance) in their children (38.2%; 95% CI 34.3 to 42.2). Parents often reported increases in both negative and positive interactions due to the COVID-19 pandemic. For example, a higher proportion of parents who reported more conflicts with children also reported increased feelings of closeness (59.1%) compared with parents who did not report more conflicts with children (47.0%), χ 2 (1, n=618)=6.3, p=0.012.

Changes in parent–child interactions also varied according to salient sources of stress (ie, financial concerns and worries that the pandemic would make existing mental health problems worse). A higher proportion of parents reported increased harsh words with children when they were stressed about finances (13.8%) compared with parents who did not report this stressor (8.0%), χ 2 (1, n=618)=5.4, p=0.020. Parents who reported stress that the pandemic would make an existing mental health problem worse, compared with parents without this stressor, also more frequently reported increased harsh words with children since the pandemic (20.9% vs 6.7%), as well as increased discipline (23.8% vs 13.0%), conflicts (33.1% vs 17.9%) and yelling/shouting (31.4% vs 11.0%), χ 2 (1, n=618)=10.8 to 37.2, p ’s ≤0.001.

Interestingly, a higher proportion of parents stressed about financial concerns, compared with parents who did not report this stressor, also reported increased quality time with children (71.6% vs 60.1%), showing more love and affection to their children (49.3% vs 40.5%) and observing resilience in their children (43.3% vs 33.9%), χ 2 (1, n=618)=4.82 to 8.98, p’s <0.028. A higher proportion of parents stressed about an existing mental health problem also reported showing more love and affection to children as a result of the pandemic (53.5%) compared with parents without this stressor (41.0%), χ 2 (1, n=618)=7.8, p<0.005.

Sources of support

Figure 2 presents sources of support identified by parents that had helped them cope with stress related to the COVID-19 pandemic in the past 2 weeks. Parents most frequently identified going for a walk/exercise (59.1%; 95% CI 55.1 to 63.0), connecting with family and friends via phone and video chat (50.5%; 95% CI 46.5 to 54.5), connecting with those in their household (47.6%; 95% CI 43.6 to 51.6) and maintaining a healthy lifestyle (37.9%; 95% CI 34.0 to 41.8) as strategies that had helped them.

Parent-identified supports for coping with stress related to the COVID-19 pandemic in the past 2 weeks. Note: Maximum margin of error for proportions was ±3.9% at a 95% level of confidence.

Figure 3 presents sources of support identified by parents that had helped their children cope with stress related to the pandemic in the past 2 weeks. Parents most frequently identified these same strategies, as well as maintaining family routines (53.9%; 95% CI 49.9 to 57.9), playing inside (47.2%; 95% CI 43.2 to 51.3) and playing outdoors (45.8%; 95% CI 41.8 to 49.8) as having helped their children. Furthermore, 34.0% (95% CI 30.3 to 37.9) of parents identified staying in touch with teachers, school adults and child care workers as a source of support during the pandemic, and 5.8% (95% CI 4.1 to 8.0) identified accessing virtual educational or self-help mental health resources (eg, websites, applications) as a strategy that had helped their children. Additionally, 4.2% (95% CI 2.8 to 6.1) of parents had contacted a school or community-based mental health worker or counsellor virtually (eg, via phone or video chat).

Parent-identified supports for helping their children cope with stress related to the COVID-19 pandemic in the past 2 weeks. Note: Maximum margin of error for proportions was ±3.9% at a 95% level of confidence.

Regarding structural supports, a significantly higher proportion of parents (23.3%) identified having a supportive employer as a factor that helped their stress related to the pandemic in the past 2 weeks, compared with respondents without children at home (14.1%), χ 2 (1, n=3000)=30.9, p<0.001. Although overall access of structural supports was low, a significantly higher proportion of parents reported accessing federal financial benefits to help cope with stress in the past 2 weeks (13.6%) compared with the rest of the sample (9.2%), χ 2 (1, n=3000)=10.2, p=0.001. When restricted to parents stressed about financial concerns due to the COVID-19 pandemic (n=282), this proportion increased to 19.1% (95% CI 14.7 to 24.2). Finally, a significantly higher proportion of parents (7.9%) reported that they or a member of their household had accessed a food-based community programme since the onset of the pandemic such as the Food Bank, free meal programmes, community kitchens or food vouchers from a charity, compared with the rest of the sample (4.4%), χ 2 (1, n=3000)=12.5, p<0.001. When restricted to parents stressed about having enough food to meet household needs due to the COVID-19 pandemic (n=126), this proportion increased to 17.5% (95% CI 11.3 to 25.2).

This study identifies that following the first lockdown phase in Canada, 44.3% of parents of children <18 living at home reported worse mental health as a result of the pandemic. This aligns with research in the US identifying similar deteriorations in family mental health due to the COVID-19 pandemic. 29 International studies monitoring mental health trends in the general population throughout the first 5 months of the pandemic estimated prevalence rates of up to 51% for anxiety symptoms, up to 48% for depressive symptoms and up to 54% for symptoms of psychological distress. 30 Within parts of Canada during the same period, the prevalence of depressive symptoms in the general population had more than doubled compared with previous national estimates, 31 with experts projecting national increases in suicide based on trends in unemployment. 32 To our knowledge, the current study is the first national Canadian survey to identify that parents of children <18 living at home are a group at disproportionate risk of worsened mental health due to the COVID-19 pandemic. Compared with the rest of the population, a larger proportion of parents with children <18 at home reported increased alcohol consumption as a result of the pandemic, and suicidal thoughts or feelings, self-harm and stress about being safe from physical or emotional domestic violence in the past 2 weeks. These data validate early public health concerns regarding these mental health consequences of the pandemic. 2 10 33 Within our parent subsample, women, younger parents, parents of small children, those living with a disability and those with a pre-existing mental health condition reported worsened mental health since the start of the pandemic compared with other parents.

Within the subsample of parents with children living at home, more men reported increased alcohol use and being stressed about domestic violence compared with women. This gender difference in alcohol use aligns with pre-pandemic research findings that men generally consume more alcohol than women and are more likely than women to externalise distress through increased alcohol consumption. 34 35 However, the finding that men reported greater worry and stress from domestic violence than women is contrary to pre-pandemic studies showing that women are disproportionately affected by domestic violence. 36 37 Our survey question specifically asked about stress/worries about being safe from physical or emotional domestic violence as a result of the COVID-19 pandemic, which may not be comparable to the examination of this experience in other studies. This necessitates further research to unpack this association in the context of social isolation, financial stress and parenting responsibilities.

Parents with children <18 at home reported unique pressures, including worrying about their children’s health, mental health, education and being stressed about looking after children while continuing to work. A high proportion of parents reported being stressed about financial concerns (45.6%), about the pandemic making their existing mental health problems worse (27.8%) and about having enough food to meet their household’s basic needs (20.4%). A larger proportion of parents indicating stress about financial concerns or worsening of existing mental health problems due to the pandemic reported increased negative interactions with their children, including increased conflicts, discipline, use of harsh words and yelling/shouting compared with parents without these stressors. This aligns with other research showing that children have been relatively overlooked as a population vulnerable to the impacts of the COVID-19 virus, but are particularly vulnerable to stressful conditions exacerbated by the pandemic including financial stress, food insecurity, domestic violence and disrupted systems of care and education. 38 39

However, the majority of parents also reported increased positive interactions at home, including having more quality time together, feeling closeness, showing love and affection and observing resilience in their children. Parents often reported increases in both negative and positive interactions with children due to the COVID-19 pandemic, possibly due to increased opportunities for family interactions overall. Furthermore, a larger proportion of parents stressed about financial concerns due to the pandemic reported having more quality time, showing more love and affection and observing resilience in their children. A larger proportion of parents stressed about worsening mental health problems reported showing more love and affection with their children. Increased time and flexibility at home has created conditions for families to engage in more conversations and activities together. 40 41 Previous research has found that while parenting pressures during the pandemic have increased, so have opportunities to strengthen family connectedness. 7 Our results indicate that strengthened connectedness may be particularly salient for families experiencing heightened stress due to the pandemic, although the specific mechanisms underlying these associations are unclear.

Free digital technologies have furthermore facilitated connecting with others outside the home, as well as tools for managing parenting stress and enabling children to participate in school and child-friendly activities online. 7 8 41 However, digital technologies and online learning are not easily accessible for everyone, particularly for families with limited Internet or digital device access and language barriers, and for children with learning difficulties and special needs. In the current study, fewer than 6% of families reported accessing virtual mental health supports as strategies for addressing children’s stress related to the pandemic. Although online mental health services have been found to be effective, feasible and acceptable among adults and youth, 42 real-world uptake and retention has generally been found to be low. 43 44 Early COVID-specific research from China has found that uptake of any mental health services since the start of the pandemic has been as low as 3.7%, with concerns raised that online mental health services may still not address present needs due to existing digital divides, appropriateness for all populations and quality assurance. 45

Considering the needs of diverse families, as well as issues of health equity, early examinations of the COVID-19 pandemic have also emphasised the importance of community organisations and governments in providing access to economic and social supports. 46 47 In the current study, a significantly greater proportion of parents with children <18 living at home compared with the rest of the population had relied on supportive employers and government financial supports in the past 2 weeks, and had accessed food programmes since the start of the pandemic. Parents also frequently identified school, community and government supports that had helped them and their children cope with stress related to the COVID-19 pandemic. Other studies have also identified supports such as paid emergency leave, unemployment insurance, rent protection and access to safe and secure housing and outdoor spaces as critical in supporting parents to have the time and resources necessary to care for their children. 46 47 Although these policies and relief systems may not have been designed specifically for families and children, they hold the potential to help address some of the underlying causes 48 of compromised parent and child mental health at the population level, including family financial stress, employment and food insecurity, stigma, overcrowding and violence. The effectiveness of these policies, however, will depend on the human resources to organise, distribute and implement services when workforces are already overloaded. For example, in the current study, fewer than one in five families with financial stress or concerns about having enough food to meet their household basic needs had recently accessed federal benefits or food programmes, respectively, warranting further investigation into the ease of access to these services. 49 Furthermore, many of these underlying causes of health inequities will remain after the COVID-19 crisis has subsided, 50 suggesting that many of these interventions should be sustained irrespective of the pandemic.

Strengths and limitations

A notable strength of this study was the large, nationally representative sample that enabled population subgroup analyses to examine disparities in mental health for parents and across parent subgroups. The study was designed to include participation from families of diverse backgrounds, although small numbers of parents identifying as Indigenous or LGBT2Q+ ((lesbian, gay, bisexual, transgender, two-spirit and queer) prohibited us from examining these populations of interest. We also did not have a reliable measure of single parent status to investigate mental health trends among this group. Although strategies including oversampling and community partnerships were used to minimise selection bias and reduce possible technology barriers, it is possible that survey respondents differed from survey non-respondents on key measures of interest including mental health, financial security or family conflict, which may have affected our estimates. The study design was cross-sectional, therefore we cannot determine if outcomes such as parent–child interactions and parent stressors were causally related, only that they were associated. We also did not control for potential confounding variables that might have introduced bias; further in-depth investigations would complement this study by providing more understanding of these associations. This study did not measure the prevalence of specific mental health outcomes or include clinical assessments of mental illness which may limit comparability with other research. This study also did not take into account baseline measures of mental health or multiple comorbidities and was specific to the Canadian context during the first re-opening phase of the COVID-19 pandemic. It will be important to monitor the impact of the pandemic on family mental health over time and in different contexts. We were also unable to assess the impact of the pandemic from the perspectives of children and youth themselves, including children’s reactions to parents’ stress during the pandemic and children’s reported supports including use of mental health services. This is a critical knowledge gap for future research to address. The purpose of the current study was to assess preliminary impacts of the COVID-19 pandemic on families’ general mental health at a community level and to provide early data to inform relevant policy and programming actions. Examining specific impacts on the prevalence of mental health disorders and effective clinical responses is an important focus for future research.

Conclusions and implications

In response to the COVID-19 pandemic, policymakers and service providers globally have been faced with the challenge of having to make rapid decisions that will have immediate and long-term effects on the mental health and well-being of families and children. In the early days of the first ‘re-opening’ phase in Canada, nearly two in every five people reported worse mental health since the pandemic began, with this proportion increasing to nearly one in every two people for parents with children <18 living at home. Schools/child care, communities and government systems play an essential role in protecting and supporting parents and children, particularly for families without reliable access to the Internet or virtual technologies. While pressure is put on parents, it is important to remember that families exist within a social ecosystem with opportunities to promote child and youth mental health. Supports such as affordable child care, low barrier Internet access, publicly-funded stepped care and psychotherapy and easily available financial supports are interventions that can directly benefit families. 41 51 Continuations of financial interventions beyond the pandemic have also been suggested, including the idea of a universal basic income. 52 The effectiveness of these systems further depends on intersectoral communication, collaboration and action, and therefore seeking feedback and advice from community stakeholders will be critical for monitoring whether these systems are working for families and children during the remainder of the pandemic and beyond.

Ethics statements

Patient consent for publication.

Not required.

Ethics approval

Ethics approval was provided by the Behavioural Research Ethics Board at the University of British Columbia (H20-01273).

Acknowledgments

We are appreciative of the support and partnership we received in mobilising this project from the Canadian Mental Health Association (CMHA) and Mental Health Foundation. We are grateful for the financial support provided by CMHA to fund Maru/Matchbox to deploy the survey. AG and EJ would also like to thank the Michael Smith Foundation for Health Research for financial support (Scholar Awards) and KT would like to thank the Canadian Institutes of Health Research and Michael Smith Foundation for Health Research for financial support (Fellowship Awards). Special thanks to Katherine Janson, Margaret Eaton and Jonathan Morris (CMHA) for facilitating study communications and government relations outreach and to Jacqueline Campbell, Neesha Mathew and Stacey Kinley (Maru/Matchbox) for supporting survey deployment and data preparation. We also thank Dr Antonis Kousoulis for his role in the early conceptualisations of the study, including survey design.

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Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1

Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

Contributors AG, KT, MG, EJ and CM co-led the conceptualisation of this investigation. AG directed the data analyses, interpretation and writing of this manuscript. KT conducted the data analyses and contributed to data interpretation and writing of this manuscript. EJ, CGR, MG, CM and SH contributed to the interpretation and writing of this manuscript.

Funding The Canadian Mental Health Association (CMHA) funded survey data collection through national polling vendor, Maru/Matchbox. Collaborators from CMHA also contributed to the survey development. CMHA had no further role in the study design, data collection, data analysis or interpretation.

Conflict of Interest Declaration CGR reports receiving personal fees from the University of British Columbia during the conduct of this study. All other authors report no competing interests.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

↵ For the context of this study, children are defined as children and youth below the age of 18.

↵ In the following when we refer to parents, these are parents living with children <18 years old unless otherwise specified.

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Top Five Family Formation Research Findings in 2021

Posted by Daily Citizen Staff | Dec 31, 2021 | Family

2020 was certainly a rough year and we were glad to see it fade in the rear-view mirror. But that annual turn of the calendar into 2021 brought more unexpected challenges to life.

It’s worth asking, “How has the family fared this year? How has it gotten stronger? Has it weakened? What new knowledge did we gain?”

Amid the pandemic, scholars have continued studying the family and its fascinating dynamics. As we put a satin bow on the year, let’s look at some of the most important developments in family research in 2021.

#5 – COVID Strengthened Marriage in Important Ways

As The Daily Citizen reported in early June, two leading sociologist of the family from Bowling Green State University’s  Center for Family and Demographic Research  provided what they describe as “our first opportunity to assess how the pandemic may have influenced both marriage and divorce levels” across the United States. Their  research  explained that, compared with data from 2018 and 2019, disruptions from the pandemic brought “about 21,000 fewer marriages and 16,000 fewer divorces” in five states (Arizona, Florida, Missouri, New Hampshire, and Oregon).

Research-based evidence demonstrated the COVID pandemic brought married couples closer. Sociologists at the Institute for Family Studies  found  that even though American couples felt increased life-strain, they also reported the trials helped their marriages in many ways, allowing them to develop a growing appreciation for each other. These scholars discovered “the share of married people who said their marriage is in trouble”  fell during the pandemic. They add, “While there is no question that some couples are struggling, the evidence generally points in the opposite direction.”

The rate of married couples, aged 18-55, who stated their marriage was in trouble declined markedly from 40% in 2019 to 29% in 2020. In light of these findings, the lead researcher on this project, Professor W. Bradford Wilcox of the University of Virginia, told  The Daily Citizen , “As the pandemic fallout unfolded, we are seeing many husbands and wives are turning, not away from one another, but towards one another.” He adds, “They are seeking more practical and emotional support from one another.” Specifically, Wilcox contends, “From what I see, I think the people who are currently married will generally emerge from all of this trial and tribulation stronger in their marriages.”

#4 – Just 18% of American Households Are Families with Married Parents

While marriages appear to be strengthening during the pandemic years, marriage as a foundational institution is sadly declining. In late 2021, demographers at the U.S. Census Bureau discovered that fewer than 20% of American families are founded and maintained by married parents.

In raw numbers, there are 23.1 million American homes with nuclear families (married mother and father raising their own children) out of 130 million households. The Census Bureau explains this number “ is  the fewest since 1959.”

This means only 17.8% of U.S. households are established on the healthy bedrock of a husband and wife raising their kids together. This is down from 18.6% in 2020, and down even more drastically over previous decades. In 1970, 40% of U.S. households consisted of a married mother and father with children. This year, that number has been more than halved.

Accounting for the decline between 2020 and 2021, the reasons given for the drop include the pandemic delaying marriage and a continued decline in birth rate.

Given the rich, research-based benefits of marriage for adults and children, this decline is a tragedy. And it leads us to our next major research discovery for 2021.

#3 – Marriage Continues to Dramatically Boost All Important Measures of Human Well-Being

The Daily Citizen reported in April just how profoundly the best, university-based medical, psychological, and social science research continues to demonstrate that marriage is far more than just a sacred or sentimental institution. It makes a real demonstrable difference in all of the most important measures of human thriving for women, men, children, and society at large.

Harvard Medical School  explains ,

[T]here is fascinating — and compelling — research suggesting that married people enjoy better health than single people. For example, as compared with those who are single, those who are married tend to

– live longer

– have fewer strokes and heart attacks

– have a lower chance of becoming depressed

– be less likely to have advanced cancer at the time of diagnosis and more likely to survive cancer for a longer period of time

– survive a major operation more often.

Our April article offered four reasons for improved health among married couples. 

First  is that married people tend to have better immune function. Marriage seems to actually improve disease resistance.  Second , married people take fewer risks, eat better, and maintain generally healthier lifestyles than those in other relational categories.  Third , married people tend to have better emotional support systems that contribute to improved health and healing.  Finally , married people tend to be healthier prior to marriage and stay that way.

Thus, fighting for and working toward a more pro-marriage culture is essential and an effort all genuine social justice sectors should engage in.

#2 Cohabitation Still Linked to Increased Divorce

Professor Scott Stanley from the University of Denver is a long and valued friend of Focus on the Family. He is one of the leading scholars in a very small but distinguished group who carefully study the nature and consequences of unmarried cohabitation. It has long and consistently been established that living together before marriage is related to a significant host of negative relational outcomes and habits, including increased infidelity, physical and verbal abuse, relational manipulation, unequal sharing of income and household chores, as well as increased likelihood of divorce.

Stanley published a very important and influential article in 2021 showing how the best data continues to demonstrate that cohabitation is still related to increased divorce. Despite this, more than 70% of marriages today are preceded by living together. The elevated risk of divorce is true for those who cohabit with or without their eventual spouse, but to varying degrees. Stanley explains, “Most people believe cohabitation should improve one’s odds of marital success. [One recent study] suggests this may only be true very early in marriage. Otherwise, not so much. As ever on this subject, questions abound.” Stanley adds, “One of the most intriguing questions remains: why is there any association with risk?”

In the work Stanley has done with his colleagues, he leans strongly in the direction that the act of cohabiting, and its defined lack of commitment and relational clarity, actually trains couples to interact with each other and future partners in increasingly unhealthy ways. Cohabitation is still not a wise way to test a relationship.

#1 – Divorce Rate Continues to Drop and Active Faith Reduces Divorce

It has been well-established among family demographers that the divorce rate in America has been declining over the last few decades. For every 1,000 marriages in the last year, only 14.9 ended in divorce, according to the newly released American Community Survey data from the Census Bureau. This is the lowest rate seen in 50 years. It is even slightly lower than 1970, when 15 marriages ended in divorce per 1,000 marriages. And all indications point to this trend continuing into 2022.

This is great news for Americans who are married. It means their marriages will likely be more stable, and their children more likely to grow up with two married parents, which provides them the best chance for success later in life.

And finally, two leading family scholars, and men of deep faith, just published original research showing that young people who grow up with an active faith are significantly less likely to face divorce when they do marry. As these scholars explain, “religiosity is associated with a markedly higher likelihood of going directly from singleness to a married union without cohabiting ahead of time, and generally at younger ages.” Broken down by faith groups, the data on likelihood of marrying  without  having ever cohabited looks like this…

They add, “Our results also suggest that religion fosters relationship stability by pushing young adults away from cohabitation, which is highly unstable, and toward marriage, which is much more stable.”

These scholars conclude, “The upshot of all this is that the religious model of marriage and family appears to boost the odds that young adults can marry before 30 without increasing their risk of landing in divorce court.”

These new findings mean science  continues  to show that couples, young and old, who have a serious connection to their faith,  enjoy markedly lower risk of divorce.

The entire staff at The Daily Citizen looks forward to continuing to track important research findings on the family into 2022. We invite you to join us as faithful partners in this vital work.

Photo from Shutterstock .

About The Author

Daily Citizen Staff

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Articles on Families

Displaying 1 - 20 of 180 articles.

Family unbound: how western society is redefining and assembling families through digital platforms

Lydia Ottlewski , University of Southern Denmark ; John Schouten , and Joonas Rokka , EM Lyon Business School

Teenagers often know when their parents are having money problems − and that knowledge is linked to mental health challenges, new research finds

Jamie Hanson , University of Pittsburgh

What you’re really saying with your Mother’s Day gift

Chih-Ling Liu , Lancaster University and Robert Kozinets , USC Annenberg School for Communication and Journalism

MAID and mental health: Does ending the suffering of mental illness mean supporting death or supporting better lives?

Charmaine C. Williams , University of Toronto

The UK’s two-child limit on benefits is hurting the poorest families – poverty experts on why it should be abolished

Yekaterina Chzhen , Trinity College Dublin and Jonathan Bradshaw , University of York

Marriage is not as effective an anti-poverty strategy as you’ve been led to believe

Eleanor Brown , Fordham University ; June Carbone , University of Minnesota , and Naomi Cahn , University of Virginia

Most people would be equally satisfied with having one child as with two or three – new research

Arnstein Aassve , Bocconi University

Some of the Renaissance’s most romantic love poems weren’t for lovers

Shannon McHugh , UMass Boston

‘Thirst trap’ and ‘edgelord’ were recently added to the dictionary – so why hasn’t ‘nibling’ made the cut?

Roger J. Kreuz , University of Memphis

When ‘rights’ divide: Trans kids need supportive families

Heather B MacIntosh , McGill University

Rural communities are being left behind because of poor digital infrastructure, research shows

Aloysius Igboekwu , Aberystwyth University ; Maria Plotnikova , Aberystwyth University , and Sarah Lindop , Aberystwyth University

Gentle parenting can be really hard on parents, new research suggests

Annie Pezalla , Macalester College

Philly parents worry about kids’ digital media use but see some benefits, too

Denise E. Agosto , Drexel University

Why term-time holidays can be a lifeline for children and young people with attachment needs

Sarah Wall , Anglia Ruskin University

Men say they are spending more time on household chores, and would like to do more – survey of 17 countries

Wessel Van Den Berg , Stellenbosch University

Philadelphia undercounts students who are homeless – here’s what parents need to know to advocate for their child

Stacey Havlik , Villanova University

Ontario needs to remove barriers to child-care subsidies for low-income  families

Michal Perlman , University of Toronto ; Petr Varmuza , University of Toronto , and Samantha Burns , University of Toronto

Navigating the complexities of caregiving for dementia in South Asian communities

Navjot Gill , University of Waterloo

Being the main breadwinner didn’t necessarily keep married mums in work during the pandemic

Leah Ruppanner , The University of Melbourne ; Caitlyn Collins , Arts & Sciences at Washington University in St. Louis ; Liana Christin Landivar , University of Maryland , and William Scarborough , University of North Texas

‘The Blind Side’ lawsuit spotlights tricky areas of family law

Naomi Cahn , University of Virginia

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Professor of Sociology and Founding Director of The Future of Work Lab, The University of Melbourne

Associate Professor, Director, MScA Couple and Family Therapy, School of Social Work, McGill University

Associate Professor of Human Development and Family Studies, Iowa State University

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Associate Professor of Rural Sociology, The Ohio State University

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Associate Professor of Sociology and Director of Canadian Studies, Brigham Young University

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Provost Professor of Sociology and Public Policy, UMass Amherst

Associate Professor of Public Policy, University of Michigan

Senior Lecturer in Sociology, University of Sheffield

Associate Research Scientist in Rural Sociology, Adjunct Faculty - National Farm Medicine Center, The Ohio State University

Professor of Human Rights Law, Monash University

Associate Dean (Research Training), College of Arts and Social Sciences, Australian National University

Senior Research Fellow, School of Justice, Queensland University of Technology

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