This essay looks at the family and health care. In order to reveal what effects they have upon each other, the essay explores six main areas. These are the types of families in Britain today, marriage and divorce, the role of the woman, attachment, informal carers and State intervention.

Clarke (2007) explains that the family is a central part of British society and whilst there are a variety of different types that exist today, the family continues to perform many functions in order for adequate health care.

The traditional British family consisted of a man and woman marrying, producing children and living near the remainder of the family. This traditional family structure is known as the extended family. Brennand etal (2001) explains the main reason for the extended family is because during the early 1900’s women had large families due to the lack of contraception and it was common to have nine or ten children, however not all of these survived due to poor health care. Also the grandparents were able to provide childcare if the parents worked. Furthermore being in an extended family has certain advantages in relation to health care. There is always a family member available to look after the children in case of an emergency, health advice is easily obtainable from family members and other family members are able to observe if another family member is ill.

The nuclear family is the most common in British society today. It is a smaller unit than the extended family, consisting of parents and their children. The family may live a long distance from other relatives and this may be desirable or not. Britain has seen a rise in the nuclear family for many reasons. Family planning allows the parents to limit how many children they have and people are now more financially independent which therefore allows them to move away from their parents in able to live in areas with access to better health care and state education. However they are disadvantages to living in this type of family. In a time of crisis, it may be difficult for the parents to find childcare where as in an extended family this is not the case. Furthermore the grandparents may lack a close bonding with both their children and their grandchildren, which consequently mean it, will require more effort which could lower their self esteem.

Cencus (2001) has identified that 690 thousand people are living in step families, or sometimes referred to as reconstituted families. Probert (2007) outlines that a step family is where lone parents, either male or female, with or without children, join together to form a new partnership. This new partnership may result in cohabitation, marriage and even more children. Step families bring with them very different issues for children from previous relationships. However, it can have a positive effect on both the children and parents well being. The family may have a better quality of life and the children will have both a male and female role model.

Golombok (2000) describes that one of the most significant changes in the family structure is that of the single parent household. The evidence is clear that one parent families have more than trebled since 1961 according to social trends (2000). Furthermore they have also discovered that most single parents are mothers. They are a number of reasons why you may live in a single parent family. The parent may become widowed; divorce, separation or one parent may be imprisoned. In relation to health it can lead to both positive and negative effects to the parent and child. If the family has been in an unhappy or violent relationship, the parent and child are going to feel relieved and have a better outlook on life. The atmosphere at home may be happier and relaxed which could ultimately result in the parent finding a new partner. Nevertheless, the child is going to be lacking a mother or farther figure which may lead to bullying at school. The one parent may find it considerably harder to support the family financially, emotionally and physically. And Walsh etal (2000) explains that single mothers have a higher rate of depression and suicide.

There have been many reasons why the families in Britain are so diverse today. One of the main reasons is due to the increase and decrease in the marriage and divorce rates. Bates (2003) describes a marriage as a legally binding commitment between partners who wish to live together in a permanent relationship. At the beginning of the 1900’s Bates (2003) also describes that it was expected that most men and women would marry, and for various reason women felt they had little choice over many issues. Today, however, people have a romantic view on marriage, and it is expected to have a lavish and expensive wedding. Some marriages are still based on religious beliefs. Although many people consider love to be the most important factor. Today there is a lot of pressure for couple to get married and have the stereotypical large and expensive wedding. Not all couples can afford this, and as a consequence they choose to cohabit, living together as a family unit acting like they are married. This is primarily why the marriage rates have decreased from 350 thousand in 1961 to 190 thousand in 1997 as described Social Trends 36 (2006).

Divorce is where the legal marriage between the couple ends. Divorce was not common during the early 1900’s and adultery was the only grounds of divorce until 1938. Social Trends (2000) describes a sharp rise in the number of divorces after the 1971 Divorce Act and again after 1984, when The Matrimonial and Family Proceedings Act enabled couples to get divorced within one year, as opposed to three years. Today the divorce rate has levelled out, because there are fewer people getting married and therefore fewer people to get divorced.

The breakdown of the family can have negative effects on both the children and parents. Minett (1994) outlines that the parent that remains with the children is prone to become exhausted, sometimes hitting out at a child when they are at cracking point. Also the children may never get the opportunity to sit down and eat a healthy meal around the table due to the parent being stressed and having work demands. She also explains that the art of conversation is essential for a child’s development. Furthermore Emery (1999) argues that children getting caught up in custody battles can cause high levels of emotional stress for the parents and more importantly the child. All these factors affect the families’ physical and emotional health. Moonie et al (2000) illustrates that when the family unit breaks down the female parent and children are twice as likely to access public health services as apposed to being in a family with two parents.

As the family has changed, we have also seen the role of the woman change. In the early 1900’s it was expected that women stopped at home to provide health and childcare for their children and husband. Now the woman is seen to have financial independence and the industry now recognises their valuable contribution. However it can be argued that a woman working has had an effect on attachment.

Bowlby (1969) concluded that the deprivation of a mothers love in early childhood can have far – reaching detrimental effects on the development of personality. Bruce and Meggitt (2005) explains that Mary Ainsworth worked alongside John Bowlby in order to confirm that babies who do not make close emotional bonds with their parents will have difficulty in forming stable and loving relationships in their future. Bowlby (1976) believed that early attachment was very important, but the relationship between the mother and child was the main focus. This was because the mothers tended to be at home with their babies. He did not believe that the most important attachment figure should be the natural mother, but he did say that the baby needed one central person, or a mother figure. With this in mind it is evident that if both parents are absent from a sustainable period from the primary care giver, they can be adverse effects. Glasper and Ireland (2000) explains that Bowlby and Ainsworth’s theory has affected health care. Attachment is now recognised within the NHS and babies and now mothers are usually allowed to stay together on maternity wards. Additionally social workers are more careful about separating children and parents when experiencing family difficulties. This can also be known as family centred care.

It is a known fact that the family is the first part of the patient’s journey when accessing health care. A family member is highly likely to seek advice from either family or friends when they feel unwell. Or a family member may notice a change in someone’s actions or personality. Langa (2007) explains that the family offers the main support when a family member is taken ill. An illness in a spouse, parent, or a child will almost certainly affect on their time management, for instance missing work or giving up leisure activities in order to provide direct care, emotional support, or transportation to the doctor. In addition, Langa also outlines that there is on going research to suggest that illness in a family member may also have important effects on the health and happiness of other family members. If a family member suffers from a long term illness, the family may need to provide informal care.

Informal carers are family; friends or neighbours who provide voluntarily care for loved ones. Carers UK (2007) states that they are 6 million informal carers throughout the United Kingdom, and 58% of these are female. 70% of the people being cared are over the age of 65. Although informal care can be beneficial to the person being cared for, they are certain strains upon the carer. Morrison and Bennett (2006) argue these disadvantages. Caring can cause ill health, especially if the carer has health problems to start with. Consequently this can affect their emotional and physical well being. Carers UK (2007) outline that 1.25 million carers provide care for more than 50 hours per week, this can cause them to become isolated and sacrificing activities they enjoy or time with other family members. If they are providing care for a disabled child, Sheridan (1992) explains that no matter how much a child loves their sibling they will see that the child needs, and gets much more attention than themselves. Additionally hospital appointments, special equipment, special carers can disrupt the normal routine of any home.

The interaction between the state and family has a major influence upon a family’s health and well being. There is currently no agreed definition of family policy however the government has certain frameworks and acts in place in order to maintain some control over the family. Some of the main areas which the government are currently interested in are parenting, education and healthy eating. As described by Boyer (1990) The Poor Law 1834 tried to discourage what they saw as reckless parenting by removing children from some families. The State placed these children in institutions believing that it was rescuing them from the negligence and lawlessness of their families. The Children Act 1989 is found to be very different from The Poor Law and is now the main association between the state and children. Harding (1996) explains that the main spirit behind this Act is that families should be respected and given help in bringing up their children. At the same time the Act promotes the care and health of the child should always remain paramount. Like all other landmark legislations before it, The Children Act is only a beginning. Under the Act, statutory services for children are based on five linked principles. These are: children in need, partnership with parents, race, culture, religion, language, the coordination of services and meeting the identified needs of an individual family. Allen (2005) clarifies the Act was drafted at a time when there was great public and professional concern about children who suffered abuse. An now it has lead to a new approach centred on the belief that children are better off when brought up and cared for in their own family.

Building upon The Children Act there are now numerous benefits available in order to support parents financially. Not all benefits are income-related, such as child benefit and incapacity or disablement benefits. Other benefits are income related and paid to low-income families, such as housing and council tax benefit or income support. Yeo and Lovell (2002) explain that childcare is essential in supporting parents to take up or return to employment. Childcare can be provided by formal paid sources such as nurseries, craches, playgroups, childminders, breakfast clubs or holiday play schemes.

To summarise, it has been identified that the family and health are closely interlinked and can have adverse effects upon family life. In addition health can be affected positively and negatively through divorce or marriage, attachment and informal care. It has also been established that there is no clear family policy; however the State intervenes with the family through Government legislation.