Family Health

Maternal and Child Health has traditionally focused on the health status of women and children. However, the reality is that the health of women and children can not be viewed as independent from the health of the families in which they reside. In Maternal and Child Health, o ur definition of family continues to evolve; we characterize "family" broadly to include families with or without children, one- or two- parent headed households, same-sex parents, and couples who are unable or choose not to have children. Families with children may be headed by non-biological parents, grandparents or aunts and uncles, among other individuals. We are especially sensitive to the fact that many families include men and that men have been neglected from certain facets of research and programs that promote healthy families.

Programming

There are many local, regional, and national initiatives and programs that have been designed and implemented to aid in the development of healthy families.

•  The Minnesota Family Planning Program offers low-cost family planning services to both men and women in Minnesota .

•  The Minnesota Fathers and Families Network, based out of the Twin Cities, is a network of programs that serve both fathers and families that seeks to “enhance healthy father-child relationships by promoting initiatives that inform public policy and further develop the field of fatherhood practitioners statewide”.

•  http://www.ncoff.gse.upenn.edu/ is an interdisciplinary research center that seeks to expand the “the knowledge base on father involvement and family development, and that informs policy designed to improve the well-being of children.”

•  The University of Minnesota 's Children, Youth & Family Consortium works to build the capacity of Minnesota communities to “use research, influence policy and enhance practice to improve the well-being of Minnesota 's children, youth, and families.”

Policy

Several policies have dramatically influenced the health of families. Two of the most influential programs include the Family and Medical Leave Act (FMLA) and the State Children's Health Insurance Program (SCHIP). Effective August 5, 1993, FMLA mandates that certain employers are obligated, among other things, to provide time off of work for new parents and family members to care for ill members of their immediate family. Although not comprehensive, FMLA in many ways supports the foundation of family health. SCHIP, a joint project between federal and state governments, aims to provide high-quality, low-cost health insurance for children and families. SCHIP is an important step towards healthier children and families. For an overview of additional policies that impact the health of families, see the U.S. Department of Health & Human Services Administration for Children & Families.

Emerging Issues in Research

Recent trends reflect significant changes in the structure of our families, leading to further research into the ways these changes impact the health and functioning of family units. During the past four decades, the percentage of children living in grandparent-maintained households has risen considerably from 3.2% in 1970 to 5.1% in 2002. 1 This increase reflects households where the grandparent is the primary caregiver, regardless of whether or not a parent is present. There have also been substantial increases in unmarried childbearing. It is estimated that in 2006, nearly 32% of births in Minnesota were to unmarried women. 2 The national percentage in 2006 was nearly 36%, 3 representing a 20% increase since 2002 and a dramatic increase from the national percentage in 1960 (5.3%). 4 This evolution of family structure has provided the opportunity to explore the health of children born into ‘fragile families', or families with unmarried parents.

Childstats.gov offers a database with access to a wide variety of family health indicators, including childhood living arrangements, family structure, marriage/cohabitation, and nonmarital childbearing.

University of Minnesota Involvement:

There are many renowned researchers at the University of Minnesota School of Public Health who work hard to promote family health, including:

• Ann Garwick, PhD, MS : caregiving experiences of families from diverse cultural backgrounds; family health and health promotion
• Joän Patterson, PhD, MA : child and family adaptation to childhood chronic illness and disability; prevention of mental health problems in children; family health promotion

Resources:

• The Center for Leadership Education in Maternal and Child Public Health
• Children, Youth & Family Consortium
• University of Minnesota Department of Family Social Science
• University of Minnesota Extension: Parenting Education Resources http://www.parenting.umn.edu/

Healthy Generations :

• Healthy Generations: Fatherhood in the United States Today

1. Fields, Jason. 2003. Children's living arrangements and characteristics: March 2002 . Current PopulationReports, P20-547. U.S. Census Bureau, Washington , DC .
2. Minnesota State Demographic Center. Minnesota births and fertility rates rise in 2006. 2007. Available at: www.demography.state.mn.us/documents/MNBirthsFertilityRates
Risein2006.pdf
3. Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary data for 2006. National Vital Statistics Report 2007; 56(7). Available at: www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_07.pdf 4. Child Trends . Percentage of births to unmarried women.2005. Available at: www.childtrendsdatabank.org/indicators/75UnmarriedBirths.cfm .