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Family has been shown to be one of the most relevant socio-demographic factors in understanding health differences among individuals in Western countries.

Despite considerable changes in family forms during the past decades, the influence of family on health is strong and persistent. All over Europe the elderly still live in more traditional family forms related to marriage and their family biographies are closely tied to the civil status of their partnership.

This review of research on the role of family relations in shaping individuals’ health (and vice versa) conceptualizes health as a multidimensional outcome with objective and subjective components. The family-health nexus is considered from the adult’s perspective (focusing on partnership and parenthood) as well as from the child’s perspective (focusing on the consequences of parental separation and divorce). We also review findings from research addressing the association of childhood circumstances and intergenerational relations with health. While our primary interest is on universal relationships between individuals’ family circumstances and different health outcomes, we particularly seek to include current European evidence. The evidence reviewed here suggests that family matters greatly—and in various ways—for individuals’ health across the entire life-course: from early childhood, through adulthood, to very old-age. We conclude with a brief outlook on directions for future research.

This keynote chapter presents main research findings on new gender roles and their implications for families and societies. It first depicts the development of family forms in Europe over the past fifty years, with a focus on increasingly diverse family biographies and the changes in the roles of women and men. It highlights that changes in women’s role have been more comprehensive, whereas in most countries the transformation of the male role has barely started. Next, views in contemporary scholarship on the interplay between the increasing family complexity and gender role changes are addressed. A detailed discussion of new challenges of transitions in and organization of family life follows, with a focus on four main topics: women’s new role and the implications for family dynamics, the gendered transition to parenthood, new gender roles in doing families, and coping strategies in family and work reconciliation under conditions of uncertainty and precariousness and impacts on fertility. A brief conclusion ends this chapter.

This keynote chapter provides an overview of research into the relationship between health and gender/sex. Since health has multiple dimensions, several measures are needed to capture variations by gender and the use of multiple measures can help us better understand the underlying explanations for gender differences. Although life expectancy and mortality are the most extreme measures of health, relative to most other health metrics they are more amenable to accurate measurement, and are more comparable across countries and over time. We start with a review of the existing literature on sex differences in survival followed by a review of the empirical evidence on gender differences in objective and subjective health. Data on objective health are collected through physical performance tests or cognitive tests, or are based on medical diagnoses that are either recoded in administrative databases or collected through self-reports of diagnoses made by physicians. Subjective health measures strongly depend on individual perceptions that can be modified by contextual factors (socioeconomic, cultural, gender roles, etc.) and awareness of objective health status. We focus on three main subjective health indicators: self-perceived health, functional status, and health-related quality of life (HRQOL). These indicators have become core components of epidemiological, social, and economic research. Later in this chapter, we review the most frequently cited explanations for gender differences in health and mortality, grouping them into the following categories: biological (genetic and hormonal), lifestyle factors (tobacco and alcohol consumption, diet, and physical activity), and social profiles (education and employment). Finally, we conclude by providing possible directions for future research in this area.

This study extends the institutionalization hypothesis which proposes that in societies with a more flexible value climate, well-being is less influenced by living in a non-traditional family form. Using data from the EU-SILC 2012 about self-rated health at ages 30–59 we explore twelve European countries representing different welfare state regimes. We characterize household arrangements by an individual’s position within the household which is defined by whether the person shares a household with a partner, children, or another person outside the family nucleus. In addition, we distinguish whether partners live in a consensual union or in a marriage. We test whether self-rated health is associated with the frequency of a certain household arrangement in a given country and hypothesize that higher frequencies of non-traditional household arrangements should go hand in hand with better health.

Demographers and social epidemiologists have widely recognized that determinants of health operate on different levels. Among all of the relational networks, the family deserves a special place as it is the context where lifestyles and health-related behaviors are generally developed and shared. Using data from the Italian Health Interview Survey 2004/2005 for ages 18 and above, this chapter aims to provide an estimation of the magnitude of influence that the household has on self-perceived health, controlling for individual characteristics and the geographical context. We select three outcome variables to investigate perceived health: Physical Component Summary, Mental Component Summary, and poor Self-Rated Health. We develop an index of homogeneity within households and explore to what extent of health perception exist within a household, resulting in a high resemblance of health for people living together, independent of or in addition to the effect of household covariates. Eventually, we try to gain a better understanding of the pathways through which these mutual influences are spread between people in the same household.

Humans share their lives with parents, siblings, partners, children, relatives, friends, neighbours, and colleagues. These relational and institutional embedding and shared events—or the lack of events—over the life course as well as personal characteristics and the needs of those involved strongly influence an individual’s health. This study is based on the Austrian Generations and Gender Survey and examines women’s and men’s health in young and middle adulthood from a household and family perspective, focusing on reproductive years from a cross-sectional and a longitudinal perspective. We concentrate on household position by gender and account for partner status and the existence of pre-union children, parity, and the arrival of a newborn. While our primary interest is on the general relationships between an individuals’ family context and different health outcomes, we specifically include non-standard living arrangements, especially stepfamilies and individuals living apart together.

Households are a long-term determinant for health outcomes and act as an important factor in the preservation and promotion of their members’ health. Because the motives and requirements to build a specific household type are culturally shaped, the influence of the household structure on individual health may be shaped by the culture of origin. We examined whether the influence of the household structure is independently associated with individual health outcomes among migrants and non-migrants in Germany. Using pooled data from more than 300,000 individuals aged 30 to 65 years in the German Microcensus 2005 and 2009, we explored health in terms of illness which lasted for at least four weeks. The generation composition of the household was used as a measure of the household structure. To account for the heterogeneity of migrants in Germany, we performed an internal differentiation of the migrant population, considering migrants in both first and second generation by distinguishing between native born Germans, Turks, Aussiedler, and people with a migration background from other countries. In addition we controlled for socioeconomic characteristics, lifestyle factors, and family characteristics.

Beginning living with a partner and becoming a parent are major life events for both men and women, bringing important changes. These life changes may translate to a more responsible concern with lifestyle and health, and alterations in the evaluation of health behaviours. From the perspective of health behaviour, the transition to marriage exerts a positive influence—in marriage, an enhanced sense of obligation inhibits harmful behaviours and encourages healthy ones. Parenting similarly increases responsibility and greater self-regulation. Based on the theoretical background and the previous empirical research, the chapter investigates whether there is an association between health behaviour and either partner or parental status insofar, that partnered persons and persons living with children display healthier behaviours than individuals without a partner or without children, respectively. Because of higher levels of social control, parents of preschool-aged children and/or a higher number of children may show healthier behaviours than parents of older children or lower number of children, respectively; and single parents may display higher risk behaviour than do partnered parents because of higher levels of stress and lower levels of social support. These relationships should strongly depend on gender and may depend on SES and/or employment status. The chapter tests these hypotheses by using pooled data from the German Health Update (GEDA) survey for the years 2009 and 2010 for ages 18–45. Health behaviour is defined by tobacco consumption, at-risk alcohol consumption, fruit and vegetable consumption, and physical activity.