Laboratory

MaxHel Center

At a Glance Projects Publications Team

Research Area

Family

Studies on social inequalities in health have tended to focus on the role of working-age adult characteristics and risk factors, but interest has increasingly extended to the entire life course. According to life-course theory and a growing body of empirical evidence, family background, early-life health, as well as educational, labor market and family choices in adulthood all contribute to inequalities in later health and mortality, poverty, and social relations. The relative contribution of these life-course processes may change over time. For example, the heritability of education has increased with growing social mobility. Previous research on childhood conditions and health in later life relied largely on cohorts born in the early years of the 20^th century when infectious diseases, poor nutrition and hygiene, and material hardship were still relatively common. Given the subsequent demographic, social, and economic changes – such as increasing life expectancy, changing family forms, educational expansion, deindustrialization, and regional fragmentation – the findings obtained from these studies may no longer apply. Overall, many earlier studies, based on small regional samples with considerable loss to follow-up, are restricted in terms of generalizability and do not allow for contextual variation by family or macro-level characteristics.

In addition to gradual societal transformations, potential drivers of trends in social inequalities in health and mortality include macro-level social shocks, such as economic fluctuations. European societies experienced major economic fluctuations over the past 50 years, with significant busts in the 1970s, 1990s, and 2008. Significant economic transformations may follow the current COVID-19 pandemic and ongoing war in Ukraine. However, potential changes in resilience to the effects of economic change remain unclear. In particular, most of the evidence on the effects of economic cycles is based on aggregate data, and there is relatively little evidence on differential effects according to individual social characteristics and the family context.

Family is the key social institution that shapes individual life-course processes and protects from, moderates, or exacerbates the health effects of life-course events and structural shocks, such as recessions and unemployment, victimization, or emerging pandemics. Family and kin networks may be beneficial as important sources for social and emotional support, financial resources, information and knowledge; and the consequences of life-course events may propagate through the network of individuals within a family with lasting effects. Increasing family diversity and changing family formation dynamics in increasingly mobile societies underscore the importance of family as an important lens through which changing health inequalities must be analyzed. From a methodological perspective, longitudinal data on family and kin networks are highly valuable as they allow for various within-individual, within-family, and within-kin designs that can reduce unobserved confounding and improve the identification of causal associations. The Nordic countries have been forerunners in family change and in the adoption of new family formation patterns, with other high-income countries following suit. This makes analyses of the dynamics between family, social position, and health in Finland ideal and forward looking, with results that can inform future trends in other countries.