Family's impact on health : a critical review and annotated bibliography / Thomas L. Campbell.

  • Campbell, Thomas L. (Thomas Lothrop)
Date:
1986
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Family's impact on health : a critical review and annotated bibliography / Thomas L. Campbell. Source: Wellcome Collection.

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    Family's Impact on Physical Health Overall Mortality; Bereavement and Social Supports t iff iff ж ■ Lipari mh lo -i'íí^fCr AU research on the family's impact on overall mortality uses the social epidemiology paradigm. In this model, stress is viewed as detrimental and lowers the host's resistance while social supports are considered beneficial and either buffer the effects of stress or directly raise the host's resistance. While these studies have not always been considered family research, they offer convincing evidence that family factors affect physical health. There is a large body of literature on the health consequences of bereavement, including several reviews (Jacobs and Ostfeld 1977; Süsser 1981) and a recent report by the National Academy of Sciences (Klerman and Clayton 1984). The two major types of studies of bereavement have obtained different results. Cross-sectional or prevalence studies, many of which have used census data, have demonstrated dramatically increased death rates for all causes amongst the widowed. The most famous study of this type was done by Kraus and Lilienfeld (1959) who found that for young widowers the death rates for certain diseases was increased by a factor of 10. There are two major problems with cross-sectional studies of this kind. First, within any age group the widowed tend to be older than the married and have a higher death rate due to age alone. Second, wid¬ ows or widowers who have remarried are counted as married, and since they are likely to be healthier than those who remain widowed, those who have not remarried will have a higher death rate due to selection alone. Prospective cohort studies avoid these problems and have generally found much less adverse effect of bereavement with an approximate 50 percent increase in mortality limited to men. Parkes et al. (1969) followed approximately 5,000 widowers for 9 years and compared their mortality rate to the general population matched for age and social class. There was a 40 percent increase in mortality primarily due to heart disease but only in the first 6 months of the bereavement period. A major problem with this and similar cohort studies is choosing an appropriate compari¬ son group. If the bereaved group differs from the comparison group in 19