This inter-disciplinary project investigates the relationship between family structure and early child health. The two main aims are: (1) to determine whether family structure and changes in family structure are associated with children's physical health in the Millennium Cohort Study; (2) to explore potential pathways through which these associations operate.
In spite of much public debate around families, marriage, and child outcomes, UK literature on this topic remains incomplete. This thesis aims to fill two gaps: first, testing whether there is a link with children's physical health, rather than more commonly reported outcomes such as cognitive function or education achievements. Physical health outcomes included are respiratory health, childhood growth, and unintentional injuries. Second, few studies use prospective, longitudinal data and methods. Cross sectional studies cannot examine the direction of the relationship, nor capture the dynamics of changes in family structure. Here, longitudinal techniques test a complex model made up of variables ordered a priori.
In unadjusted analyses, family structure presented a consistent gradient in child health: cross-sectionally, children living with married parents had better health than those living with cohabiting parents, while those living with lone parents had the worst health. Longitudinally, those who experienced changes in family structure fared worse than those living with continuously married parents, with some important exceptions, such as those living with cohabiting parents who subsequently married. Socio-economic factors were important predictors of family structure and child health. Proximal pathways through which socio-economic characteristics and family structure affected child health varied according to health outcome. Maternal mental health appeared to be important across outcomes.
Concluding, this work shows the importance of using nuanced definitions of family, particularly when it comes to capturing its fluidity over time. Children who experienced changes in family structure were a heterogeneous group with diverse backgrounds and outcomes. Socio-economic factors emerged as important antecedents to both family structure and child health
