Health and Families

Family also influences children's health behavior in several ways. Several international studies (see Wold and Anderssen 1992 for references) have found that health programs aimed at decreasing smoking and engaging in dental hygiene were more effective when the parents were involved. Sandra Hunter and her colleagues (1982), however, found that for some ethnic groups in the United States, family members played a more important role in the prevention of smoking than for other ethnic groups. Specifically, they found that close parent-child relationships and the time children and parents spent together were more significant predictors of smoking for African Americans than for Hispanic Americans or white Americans. This finding may be due to the attitudes held about the role of parents in a smoking prevention program. Both African-American children and their parents were more likely than others to think it is important that the parents be involved in a smoking prevention program (Koepke, Flay, and Johnson 1990).

In addition to involvement in health promotions, family members can model appropriate health behaviors. Albert R. Marston and his colleagues (1988) reported that adolescents who did not use drugs were more likely to have parents who were not drug or alcohol users. Moreover, David Koepke and his colleagues (1990) found that African-American adolescents had a higher rate of smoking than other ethnic groups. They also reported that African-American children and adolescents were more likely to come from a household where others smoked and to live in a household where smoking was permitted.

Family members can support our decision to enact healthier behaviors. Robert Coombs and his colleagues (1991) found that adolescents who abstained from drug use felt better understood by their parents than adolescents who used drugs. Furthermore, those who abstained from drug use reported that their parents influenced them the most, whereas those who used drugs indicated that their friends influenced them the most.

In addition to modeling, families can influence health behaviors by affecting what is available to children. For example, Michael Resnick and his colleagues (1997) found that in the United States, adolescent use of cigarettes, alcohol, and marijuana was associated with how easily accessible these substances were in their own homes. Koepke and his colleagues (1990) found that African-American adolescents were more likely to come from a household where others smoked and to live in a household where smoking was permitted.

Jess Alberts and her colleagues (1991) and Michael Hecht and his colleagues (1997) found that occasionally adolescents were offered drugs by family members. Melanie Trost and her colleagues (1999) reported that the adolescent boys in their study found it most difficult to resist a drug offer from an elderly relative (aunts, uncles, or grandparents) and that adolescent girls in their study found it most difficult to resist a drug offer from brothers or male cousins.

Many researchers have found that during adolescence, family, friends, and school influence one's health attitudes and behaviors. Resnick and his colleagues (1997), in their longitudinal U.S. study on adolescent health, found that parent-family connectedness and perceived school connectedness were protection against every health risk behavior measured (emotional distress; suicidal thoughts and behaviors; violence; substance use; and sexual-risk behaviors) except the history of pregnancy. Koepke and his colleagues (1990) found that although family influenced whether an adolescent smoked, peers and the adolescent's own attitudes toward risk taking were also significant determinants. Bente Wold and N. Anderssen (1992), who looked at sports participation in ten European countries, also reported that the sport participation of parents, siblings, and peers was related to an adolescent's participation in sports. Also, older siblings who do not take part in sports have a negative influence on sport participation of their young adolescent siblings.