Family in Health and Disease - Dr. Sujatha Sathananthan

1. Dr. Sujatha Sathananthan MD., DPH.,
Assistant Professor
Department of Community Medicine
Chengalpattu Medical College

2.  Is a group of biologically related individuals
living together and eating from a common
kitchen
 Is a primary unit of all societies
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3.  Family is the fundamental unit of all societies – the
health status of a society and its behavior in a disease
state largely depends on the outlook of the families.
 Socio cultural factors are deeply involved in health and
diseases – eg: food taboos.
 Some of the cultural factors have stood in the way of
implementing health programmes esp where a change in
behavior is warranted. Eg: open air defecation
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4.  Many habits – good and bad are mostly are
inculcated from the family – these have a bearing
on the health of the individual- eg: regular
exercise , diet etc.,
 Medical practice / community health activities
ultimately deals with only families
 Information regarding cultural beliefs, customs,
habits are essential in providing a medical advice /
health programme.
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5.  As a Biological unit
 As a Social unit
 As a Cultural unit
 As a Economical unit
 As a Epidemiological unit
 As a Operational unit
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6.  Biological unit: members share a pool of genes –
familial diseases
 Social unit : they share a common physical and
social environment – environmental factors for
diseases
 Cultural unit: family reflects the culture of wider
societies – acceptance of newer initiatives
 Epidemiological unit: a unit for providing social
services and comprehensive health care.November 9, 2018 6Chengalpattu MedicalCollege

7.  Family of origin: family into which one is born
 Family of procreation: family which one sets up
after marriage
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8. Phases of family
cycle
Beginning of
phase
End of phase
1. Formation Marriage Birth of first child
2. Extension Birth of first child Birth of last child
3. Complete
Extension
Birth of last child 1st child leaves
home of parents
4. Contraction 1st child leaves
home of parents
Last child leaves
home of parents
5. Complete
Contraction
Last child leaves
home of parents
1st spouse dies
6. Dissolution 1st spouse dies Death of the
survivor
[extinction]November 9, 2018 8Chengalpattu MedicalCollege

9. Formation
Extension
Complete
extension
Contraction
Completed
contraction
Dissolution
marriage to 1st
child birth
Birth of 1st child to
birth of last child
Birth of last child unti
1st child leaves home
1st child leaves home up to last
child leaves home of the parents
Last child has left
the home of
parents up to 1st
spouse dies
death of 1st spouse
to death of the
other spouse
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11. Critical
developme
nt period Outcome ?
Stress
factors
Disaster,
death of dear ones
etc.,
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12. Critical
developme
nt period
Outcome ?
Stress
factors
Disaster,
death of dear ones
etc.,
Emotional
support, social
support ,
provisions
Succesfull
tiding over
the period
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13.  In child hood: insecurity , marital discord, prenatal rejection,
institutional rearing .
 Adolescence: drug abuse, in appropriate sexual behaviour.
 Parenthood: art of parenting does not come naturally and
easy.
 Ageing: social adaptations during the old age, mental health
aspects.
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14. Threat outcome
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15.  Nuclear family
 Joint family
 Three generation family
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16. Nuclear family:
 elementary family
 Consists of married couple and their
dependent children
 Husband plays a dominant role
 More burden on child rearing due to absence
of grand parents , aunts etc.,
 Husband – wife relation ship is more
intimate
 New families: < 10 years
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17. Joint / extended family:
 Family grouping common in India,
Africa, far east and the Middle
East.
 More in agricultural areas
than in urban areas
 Consists of number of married
couples and their children living in
the same house hold
 All men are blood related and
women are their wives, or
daughters
All property is held in common
Senior male member is vested with the
authority
Familial relations enjoy primacy over
marital relations
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18.  Sharing of responsibilities in all matters
 Gives a greater economic and social security
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19.  Household with representatives of three
generations
 Related to each other by direct descent , live
together.
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20.  Residence
 Division of labour
 Reproduction and bringing up of children
 Socialization
 Economic functions
 Social care
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21.  Residence: clean and decent home . Patrilocal/
matrilocal
 Division of labour: male – earns the living and
supports the family female – day to da
responsibility of children, running the
household. Now a days coming together and
sharing responsibilities – heading towards
communal family.
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22.  Reproduction and bringing up children:
 Very important function
 Mother takes care of the infant upto a certain age..
 Father provides for education and teaches social
customs
 Socialization: transfer point of civilization , cultural
patterns relating to eating, cleanliness, dress, speech ,
language, behaviour and attitudes are all transmitted
through family.
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23.  Economic functions: - Inheritance of property ,
control over certain property.
 Social care:
 Status
 Protecting members from insult, defamation
 regulating marital activities of the members
 Regulating to political, religious, social activities
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24.  Child rearing
 Socialization
 Personality formation
 Stabilization of adult personality
 Care of the dependant adults
 Familial susceptability to disease
 Broken family
 Problem family
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25.  Child rearing: physical care of the young is based
upon the capital sources, knowledge, state of
technology and system of values
 Socialization:
 process by which individuals devlop quantities
essential for functioning effectively in the society
in which they live.
 Teaching the young values of society, culture,
beleifs, code of conduct .
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26.  The capacity of an individual to withstand
stress and strain and the way he interacts with
others is determined by his experiences with
the family members.
 Family = placenta
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27.  Care of the sick and the injured: family is charged with
responsibility of care of the sick, esp mother. Much depends
on her understanding and her attitude.
 Care of women during pregnancy and child birth: attitude
of the society determines maternal and childhood morbidity
and mortality.some societies give financial, nutritional help
and maternity leave
 Care of the aged and handicapped: much needed with
increase in the population of the aged and their health
problems.
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28.  Shock absorber to the stress and strain of life.
 Helps the individual to obtain mental
equilibrium
 Strive to maintain stable relationship with
others
 Helps to meet their emotional needs
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29.  Share a pool of genes,common environment
 Hemophilia , colour blindness, diabetes,
mental illness
 Communicable diseases common
 Congenital abnormalities common in
consanguineous marriage
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30.  The parents have separated or death has occured
of one or both parents
 Parental separation
 Dual – parental seperation
 Children of broken families early in childhood
later they develop psychopathic behaviour,
immature personality ,retardation of growth,
speech and intellect.
 Children of broken families may drift away to
prostitution, crime and vagrancy
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31.  Standards of life are generally far below the
accepted minimum and parents are unable to meet
the physical and emotional needs of their children.
 Home life is utterly unsatisfactory
 Underlying factors : Personality, relationship,
backwardness ,poverty, illness, mental and
emotional instablity, character defects and marital
hormony
 Children reared in these families are victims of
prostitution, crime and vagrancy
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