FAMILY-LIFE AND HEALTH IN ADOLESCENCE - A ROLE FOR CULTURE IN THE HEALTH INEQUALITIES DEBATE

Until recently, the role of the family in the 'health inequalities' de bate has been largely ignored. Using data from the youngest cohort in the West of Scotland Twenty-07 Study, three dimensions of family life (family structure, culture and conflict) are examined in respect of th eir association both with health when respondents were aged 15 and 18, and with labour market position at 18. Despite a strong association b etween family structure and material deprivation, those from intact, r econstituted and single parent families were largely undifferentiated in terms of health. By contrast, aspects of family functioning, partic ularly a poorer relationship and conflict with parent(s), were indepen dently associated with lower self-esteem, poorer psychological well-be ing and (among females) more physical symptoms at both ages. In additi on, both family culture and conflict were associated with labour marke t position over and above the effects of material deprivation, with th ose from family centred and lower conflict homes having a greater like lihood of being in tertiary education. While the relationships between the family and psychological well-being and, to a lesser extent, phys ical symptoms appeared to be mediated by self-esteem, those between th e family and labour market position did not. These findings suggest th at in adolescence family life may have more direct effects on health t han material factors and, through social mobility, may be indirectly l inked to health inequalities in adulthood. These family processes, we argue, are expressions of cultural influences, the scope of which to d ate has been too narrowly focused on health behaviours.