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Background
Previous research has shown the importance of the family in young people’s health. In particular, family structure has been associated with a range of health outcomes with those living in both-parent families generally faring best.
Objective
The aim of this study is to describe health and health behaviour in different family structures and to assess the mediating role of the family meal on this association.
Methods
Data from the 2006 Health Behaviour in School-Aged Children survey were modelled using Multilevel Binomial modelling for boys and girls, with 14 self-report health and health behaviour outcomes, adjusting for age, family structure and family meals.
Results
Family structure was associated with boys’ smoking, drinking, cannabis use, tooth brushing, life satisfaction, self-reported health, sexual intercourse and fruit consumption. Family structure was associated with girls’ smoking, drinking, cannabis use, fighting, life satisfaction, happiness, self-reported health, multiple health complains (MHC), sexual intercourse and fruit and vegetable consumption. Physical activity and bullying did not differ by family structure. For the majority of outcomes, boys living in step families and girls from single parent families fared the worst. Around two thirds of young people ate a meal with their family at least 4 days per week and this was associated with positive health and health behaviour for the majority of outcomes. For example, among girls who ate 4 or more times a week with their families, the odds of smoking cannabis were 0.20 (95% CI 0.12 to 0.33) those who ate with their family less often, while the odds of happiness were 1.72 (1.34 to 2.22). Similarly, among boys the odds of smoking tobacco were 0.59 (0.43 to 0.82) and tooth brushing 1.55 (1.21 to 2.00). Among girls, after adjusting for family meals, the association between family structure and vegetable consumption became insignificant, while the association with drinking, fighting, cannabis use, happiness and MHC was attenuated. Among boys, family meals mediated the relationship between family structure and smoking, drinking and cannabis use, and contributed to the association with sexual intercourse and fruit consumption.
Conclusions
Differences in family composition in contemporary society appear to have important implications for health outcomes of adolescents, and living with both parents is generally associated with the most favourable outcomes. While family transitions may be unavoidable, having a family meal 4 or more times a week mediates, in some cases entirely, the potential negative effects of living in single parent and step families.