Children in Diverse Families

Abstract

Children in diverse families often have divergent life courses from children reared in other family forms. Diverse families, unlike first‐marriage nuclear families, often are not formed by marriage, and when they are, the marriage may not be the first for at least one of the adults. Children in diverse families may be genetically related to only one parent or to neither parent. Diverse families may include more than two adults who serve in parental roles, or only one adult, not always a genetic parent, may be rearing children. Legal connections between parents and children, like genetic bonds, vary widely in diverse families. In this chapter we examine several types of diverse families as environmental contexts within which children develop: Families headed by unmarried and cohabiting parents, children who have had a parent die or whose parents have divorced, stepfamilies, families headed by gay and lesbian individuals, grandfamilies (grandparents raising grandchildren), and parents who utilized assisted reproductive technologies (ART). These categories are not homogeneous, so when feasible, we examine the state of the scholarship within subcategories of these larger family types.

Conceptualizing Family Structure in a Social Determinants of Health Framework

“…In the context of socioeconomic status, for example, stratification in discrepant health outcomes is evident not just between the rich and the poor but also between the rich and the very rich (Marmot, ). There is evidence that such stratification and stigma may also exist regarding family structure, wherein “nuclear families”—composed of two married, different‐sex parents and their biological children—hold a privileged position in the United States over more diverse families (Ganong, et al, ). In the following sections, we consider historical and contemporary research on children living in diverse family structures and suggest that there is substantial evidence in the current family science literature for conceptualizing differences in children's well‐being and health across family structures as evidence of an unjust inequity in need of theoretical and concrete attention.…”

“…Are the differences in health outcomes inevitable, or might they be adjustable? Scholars working from a risk and resilience perspective have found mechanisms and personal attributes that allow children (and adults) to flourish while living in structurally diverse families (Ganong et al, ). For example, children who are lively, outgoing, and cognitively flexible in their definition of family may have an easier time adjusting to living in a stepfamily than will children who have more restrictive views of kinship (Ganong & Coleman, ; Papernow, ).…”

“…The most proximate determinants of health in the SDOH framework, such as stress, anxiety, depression, genetic susceptibility to illness, and access to economic resources and health services, are widely studied in the literature on family structure and childhood health (Amato, ; Ganong et al, ). For example, previous research has found that children in diverse family structures are more likely to be in financial distress (Barrett & Turner, ; Malone, Stewart, Wilson, & Korsching, ) and less likely to have health insurance coverage than their peers in married families (Karpman, Gates, Keeney, & McMorrow, ).…”

“…In agreement with Deatrick (), we suggest that the absence of substantive family concepts, such as family structure, from SDOH models and theory is a critical shortcoming. Furthermore, we believe the increasing prevalence of structurally diverse families, such as single‐parent families, divorced families, cohabiting families, stepfamilies, gay and lesbian families, and grandparents raising grandchildren, demands theoretical attention (Ganong, Coleman, & Russell, ; Pew Research Center, ). The health of individuals within these structurally diverse families and other family forms that vary from normative prescription—in the number, gender, and marital status of parents or adult care providers, the inclusion of complex arrangements and relationships among children residing in and out of the household, and the presence of family members linked only by personal choice, as well as by genetics and legal bonds—has historically been studied through a deficit‐comparison lens (Ganong et al, ).…”

“…Furthermore, we believe the increasing prevalence of structurally diverse families, such as single‐parent families, divorced families, cohabiting families, stepfamilies, gay and lesbian families, and grandparents raising grandchildren, demands theoretical attention (Ganong, Coleman, & Russell, ; Pew Research Center, ). The health of individuals within these structurally diverse families and other family forms that vary from normative prescription—in the number, gender, and marital status of parents or adult care providers, the inclusion of complex arrangements and relationships among children residing in and out of the household, and the presence of family members linked only by personal choice, as well as by genetics and legal bonds—has historically been studied through a deficit‐comparison lens (Ganong et al, ). We suggest, however, that applying an SDOH framework to this previous research on structurally diverse families provides support for conceptualizing family structure as a stratified social grouping in need of theoretical, empirical, and clinical attention.…”