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Families First EdmontonFamily Functioning & Primary Caregiver Health

Preliminary Analyses

Berna Skrypnek & Deanna WilliamsonDepartment of Human Ecology, University of Alberta

Community Learning Network: September 29, 2011

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Outline

FFE family characteristics

FFE family functioning

FFE primary caregiver mental and physical health

Implications

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Family Characteristics

What are FFE families like?

How similar/different are they from other Alberta families? ethnic origin size composition

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Primary Caregivers’ Ethnic Origin

45%

16 %

6%

Canadian-born

Foreign-born

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Family Size and Composition

61% are headed by a lone primary caregiver Co-caregiving families: 84% of co-caregivers are a spouse or

common-law partner 92% of families are made up of two generations

8% have three generations and less than a percent have four generations

range from 2 to 13 members average of 3.7 family

members range from 1 to 8 children average of 2.1 children

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Family Functioning

How well are FFE families functioning?

Is the level of family functioning related to family characteristics?

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Measuring Family Functioning

4 items from the General Functioning Scale of the McMaster Family Assessment Device (FAD) We can express our feelings to each other. There are lots of bad feelings in the family. We feel accepted for what we are. We don’t get along well together.

Primary caregivers were asked “How well does each statement describe your family as a whole—your family consisting of the family members living in this household?”; they responded along a 4 point rating scale (ranging from “not at all well” to “very well”) .

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Two ways to look at how FFE families are functioning

1. Calculate the average score for our FFE sample and compare our FFE sample average to general population norms.

2. Determine the number/percentage of families whose scores fall above the cut-off for healthy family functioning, that is, determine the percentage of families scoring in the unhealthy family functioning range.

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FFE Family Functioning

1. Average Level of Family Functioning FFE families look very similar to the general population

when average level of family functioning for the whole FFE sample is compared to the average level of family functioning in the general population. FFE family average = 1.77 General population average = 1.84

2. Percentage of Families Falling in the Unhealthy Range of Functioning (2.00 +)

53% of FFE families fall in the unhealthy range

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FFE Family Functioning

Average FAD Score

Percent of

Sample

53%unhealthy range

47%healthy range

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Is the level of family functioning related to family characteristics?

No significant differences between the family functioning of lone primary caregiving families and co-caregiving families.

Significant differences by ethnic origin.

60%

59%

59%

40%

0% 20% 40% 60% 80% 100%

Refugee

Immigrant

Aboriginal

Non-Aboriginal

Healthy

Unhealthy

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Poorer Family Functioningin Foreign-Born and Aboriginal Families

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Primary Caregiver Health

What is the health of FFE primary caregivers? How are FFE primary caregivers functioning in terms of

their mental and physical health?

Is primary caregiver health related to family characteristics? Is primary caregiver mental and physical health related

to gender, family composition, ethnic origin?

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Measuring Primary Caregiver Mental Health

Symptom Checklist 90 (SCL-90):Assesses the intensity of an individual’s psychological distress

90 physical and psychological symptoms respondents rate severity of symptoms (past 7 days)

5 point scale: 0 = “not at all” to 4 = “extremely” Global Symptom Index and 9 subscales:

1. anxiety 6. psychoticism 2. hostility 7. somatic complaints3. phobia 8. interpersonal sensitivity4. depression 9. obsessive-compulsive5. paranoia

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Primary Caregiver Mental Health

Overall FFE primary caregivers report significantly poorer mental health than adults in the general population.

Female primary caregivers report poorer mental health than male primary caregivers

Lone primary caregivers report poorer mental heath than those with a co-caregiver

Those with adolescent children report poorer mental health than those with infants, preschoolers, or school-age

Generally Canadian-born report poorer mental health than foreign-born

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Primary Caregiver Mental Health

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Measuring Primary Caregiver Physical Health

Primary caregivers were asked “in general, would your say your health is”, and responded by indicating that their health fell into one of the following 5 categories:

Poor Fair Good Very good Excellent

This single item has been found to be a valid and reliable measure of physical health and to predict morbidity and mortality.

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Primary Caregiver Physical Health

Overall FFE primary caregivers report poorer physical health than otherAlbertans

43%

62%

33%

38%

17% 7%

0% 20% 40% 60% 80% 100%

FFE parents

Alberta adults

Very Good/ Excellent

Good

Fair

Poor

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Primary Caregiver Physical Health

FFE primary caregivers’ physical health is related to a number of factors:

Gender: women report poorer health

Co-caregiver status: lone primary caregivers report poorer health than those with a co-caregiver

Age of child(ren): primary caregivers with adolescent children report poorer health than those with infants, preschool, and school age children

Ethnic origin: Canadian-born primary caregivers report poorer health than foreign-born primary caregivers

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Primary Caregiver Self-Reported Physical Health

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Key Points

Half of FFE families fall in the unhealthy range of family functioning Canadian-born non-Aboriginal families are more likely to be in the

healthy family functioning range; Aboriginal and foreign-born are more likely to be in the unhealthy range

FFE primary caregivers report poorer mental and physical health than adults in the general population Mental and physical health of primary caregivers are related to a

number of caregiver and family characteristics (e.g., gender, co-caregiving status, age of children, and ethnic origin)

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Implications

Similarities and differences in family functioning and primary caregiver health: implications for programming

The compromised health of primary caregivers in FFE families: interferes with parenting/caregiving and places

children at risk for poor development limits primary caregivers’ abilities to be fully

engaged citizens

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Acknowledgement

AHFMRAlberta Heritage Foundation of Medical Research