PART III
FAMILIES ON THE FAULT LINE AND
SOCIAL POLICY ISSUES
While life for many Canadians is relatively comfortable and trouble free, a significant
number of families face considerable hardship and challenge. Some of these problems
may be relatively short term with relatively modest consequences, such as temporary
unemployment or a brief illness. Or these challenges can be chronic or long term (e.g.,
having a child with special needs) or occur at certain points in the life course (e.g.,
among certain cohorts or generations). From a life-course perspective, some of these
events can produce abrupt or serious effects that redirect our life paths. These signifi-
cant occurrences can produce a lasting shift in our linked lives and in our life-course
transitions and trajectories. For example, we might decide to retire early from the paid
labour force in order to provide daily care for a parent with Alzheimer’s disease.
Although previous parts of this text have also highlighted some critical issues
Copyright © 2021. Canadian Scholars. All rights reserved.
facing families, in this section, we focus on a number of particularly problematic areas
for families, with continued emphasis on how many of life’s challenges are socially
structured over the life course. In other words, social problems and what we often view
as “private troubles” are often related to access to key social and economic resources.
They therefore vary according to such aspects as gender/sexual orientation, race/ethni-
city, social class, and geographical locale. We will also consider how these inequities
and challenges affect, and are affected by, family relationships and shape family inter-
actions and life-course transitions.
In Chapter 13, for instance, we will learn that many serious health problems are
more likely to occur among individuals who live in poverty than those who are wealthier.
Health problems can also create cumulative disadvantages that also impact the entire
family system, such as when a family member has chronic physical or mental health
issues. And poverty and financial hardship (which will be covered in Chapter 14) are
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 373 09/08/21 6:49 PM
, 374 PART III FAMILIES ON THE FAULT LINE AND SOCIAL POLICY ISSUES
more likely to occur within certain social groups, such as among women, recent immi-
grants, and the disabled and racialized, and Indigenous populations. Similarly, certain
social groups are more likely to experience violence, stress, and abuse (the focus of
Chapter 15) because they are more vulnerable and dependent. They may also not have
access to important community resources and programs. As such, social policy can play
an important role in the distribution of societal resources and can play a pivotal role in
the overall general health and well-being of Canadian families. Thus, in Chapter 16,
we will examine some key social and family policy issues as well as some salient policy
concerns for the present and future. These “critical” issues will be reviewed in light of
many of the key family-related life-course patterns uncovered throughout this book.
Copyright © 2021. Canadian Scholars. All rights reserved.
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 374 09/08/21 6:49 PM
, CHAPTER 13
Families, Health, and Well-Being: Choices and
Constraints over the Life Course
LEARNING OBJECTIVES
Copyright © 2021. Canadian Scholars. All rights reserved.
In this chapter, you will learn that …
• experiences of health and well-being in families over the life course are embedded in socio-
cultural, economic, and political contexts
• definitions of health, disability, and “ableness” are subjective and multifaceted, and there
are overlapping and multiple social determinants or locations of health
• health issues can significantly affect family roles and relationships and present unique
challenges, particularly for low-income families and those without social support
• health policies and promotion strategies need to target families and their social conditions
early in the life course
• healthy public policy can improve population health and reduce structural barriers for
those experiencing problems, thereby reducing social and economic costs in the future
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 375 09/08/21 6:49 PM
, 376 PART III FAMILIES ON THE FAULT LINE AND SOCIAL POLICY ISSUES
INTRODUCTION
Our health and well-being are shaped by many factors and social contexts, such as where
we live, our income and education level, the quality of our home environment, genetics,
and our relationships with our friends and family. Fortunately, most Canadians report
being in good to excellent health, which is defined by the World Health Organization as
“a state of complete physical, mental, and social well-being and not merely the absence
of disease or infirmity” (WHO 1946). The widespread use of this overarching definition
reflects how our perception of health has shifted beyond the traditional Western biomed-
ical model that was prevalent in our society for most of the last century. This definition
also suggests that health encompasses more than the absence of illness and disease—it is
multidimensional, multidetermined, and also incorporates a subjective component.
Although Canadians are among the healthiest people in the world, “good health”
is not enjoyed equally by everyone, as is consistently shown through our Canadian
Community Health Surveys. Indeed, not all social groups and individuals are healthy.
Families living in poverty, for example, are particularly vulnerable to health problems, and
this raises a number of implications for families, society, and the Canadian healthcare sys-
tem. In this chapter, we will review key social determinants of health, in addition to con-
sidering some of the limitations of this conceptual model in understanding family health
and well-being. Selected health and well-being issues that can occur over our life courses
and how they affect, and are affected by, our family environments will also be examined.
Focus will be placed on families and disabilities, special needs children, substance abuse,
mental health, caregiving for the elderly, and the death of a family member. Finally, we
will consider health promotion initiatives and state supports in the context of healthy
public policy and community programs.
THE SOCIAL DETERMINANTS OF HEALTH: WHY ARE SOME
FAMILIES HEALTHIER THAN OTHERS?
Copyright © 2021. Canadian Scholars. All rights reserved.
As previously noted, our health and well-being are influenced by factors that extend beyond
genetic endowment or biological realms. This has led Health Canada and researchers to
develop the social determinants of health framework, which refers to “the economic and
social conditions that influence the health of individuals, communities, and jurisdictions
as a whole” (Raphael 2004: 1). In 2001, the organizers of a York University conference on
health identified 11 social determinants of health, as shown in box 13.1.
Although many variants of this basic model have been created and presented in the
literature (e.g., see Lucyk and McLaren 2017), generally, a social determinant of health
framework highlights how structured inequality produces inequality of health conditions
and the way health is profoundly influenced by governments’ social policy decisions. For
example, we see in figure 13.1 that Canadians are more likely to report having unmet
healthcare needs when they are living in poverty and in certain provinces. Poor Canadians
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 376 09/08/21 6:49 PM
FAMILIES ON THE FAULT LINE AND
SOCIAL POLICY ISSUES
While life for many Canadians is relatively comfortable and trouble free, a significant
number of families face considerable hardship and challenge. Some of these problems
may be relatively short term with relatively modest consequences, such as temporary
unemployment or a brief illness. Or these challenges can be chronic or long term (e.g.,
having a child with special needs) or occur at certain points in the life course (e.g.,
among certain cohorts or generations). From a life-course perspective, some of these
events can produce abrupt or serious effects that redirect our life paths. These signifi-
cant occurrences can produce a lasting shift in our linked lives and in our life-course
transitions and trajectories. For example, we might decide to retire early from the paid
labour force in order to provide daily care for a parent with Alzheimer’s disease.
Although previous parts of this text have also highlighted some critical issues
Copyright © 2021. Canadian Scholars. All rights reserved.
facing families, in this section, we focus on a number of particularly problematic areas
for families, with continued emphasis on how many of life’s challenges are socially
structured over the life course. In other words, social problems and what we often view
as “private troubles” are often related to access to key social and economic resources.
They therefore vary according to such aspects as gender/sexual orientation, race/ethni-
city, social class, and geographical locale. We will also consider how these inequities
and challenges affect, and are affected by, family relationships and shape family inter-
actions and life-course transitions.
In Chapter 13, for instance, we will learn that many serious health problems are
more likely to occur among individuals who live in poverty than those who are wealthier.
Health problems can also create cumulative disadvantages that also impact the entire
family system, such as when a family member has chronic physical or mental health
issues. And poverty and financial hardship (which will be covered in Chapter 14) are
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 373 09/08/21 6:49 PM
, 374 PART III FAMILIES ON THE FAULT LINE AND SOCIAL POLICY ISSUES
more likely to occur within certain social groups, such as among women, recent immi-
grants, and the disabled and racialized, and Indigenous populations. Similarly, certain
social groups are more likely to experience violence, stress, and abuse (the focus of
Chapter 15) because they are more vulnerable and dependent. They may also not have
access to important community resources and programs. As such, social policy can play
an important role in the distribution of societal resources and can play a pivotal role in
the overall general health and well-being of Canadian families. Thus, in Chapter 16,
we will examine some key social and family policy issues as well as some salient policy
concerns for the present and future. These “critical” issues will be reviewed in light of
many of the key family-related life-course patterns uncovered throughout this book.
Copyright © 2021. Canadian Scholars. All rights reserved.
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 374 09/08/21 6:49 PM
, CHAPTER 13
Families, Health, and Well-Being: Choices and
Constraints over the Life Course
LEARNING OBJECTIVES
Copyright © 2021. Canadian Scholars. All rights reserved.
In this chapter, you will learn that …
• experiences of health and well-being in families over the life course are embedded in socio-
cultural, economic, and political contexts
• definitions of health, disability, and “ableness” are subjective and multifaceted, and there
are overlapping and multiple social determinants or locations of health
• health issues can significantly affect family roles and relationships and present unique
challenges, particularly for low-income families and those without social support
• health policies and promotion strategies need to target families and their social conditions
early in the life course
• healthy public policy can improve population health and reduce structural barriers for
those experiencing problems, thereby reducing social and economic costs in the future
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 375 09/08/21 6:49 PM
, 376 PART III FAMILIES ON THE FAULT LINE AND SOCIAL POLICY ISSUES
INTRODUCTION
Our health and well-being are shaped by many factors and social contexts, such as where
we live, our income and education level, the quality of our home environment, genetics,
and our relationships with our friends and family. Fortunately, most Canadians report
being in good to excellent health, which is defined by the World Health Organization as
“a state of complete physical, mental, and social well-being and not merely the absence
of disease or infirmity” (WHO 1946). The widespread use of this overarching definition
reflects how our perception of health has shifted beyond the traditional Western biomed-
ical model that was prevalent in our society for most of the last century. This definition
also suggests that health encompasses more than the absence of illness and disease—it is
multidimensional, multidetermined, and also incorporates a subjective component.
Although Canadians are among the healthiest people in the world, “good health”
is not enjoyed equally by everyone, as is consistently shown through our Canadian
Community Health Surveys. Indeed, not all social groups and individuals are healthy.
Families living in poverty, for example, are particularly vulnerable to health problems, and
this raises a number of implications for families, society, and the Canadian healthcare sys-
tem. In this chapter, we will review key social determinants of health, in addition to con-
sidering some of the limitations of this conceptual model in understanding family health
and well-being. Selected health and well-being issues that can occur over our life courses
and how they affect, and are affected by, our family environments will also be examined.
Focus will be placed on families and disabilities, special needs children, substance abuse,
mental health, caregiving for the elderly, and the death of a family member. Finally, we
will consider health promotion initiatives and state supports in the context of healthy
public policy and community programs.
THE SOCIAL DETERMINANTS OF HEALTH: WHY ARE SOME
FAMILIES HEALTHIER THAN OTHERS?
Copyright © 2021. Canadian Scholars. All rights reserved.
As previously noted, our health and well-being are influenced by factors that extend beyond
genetic endowment or biological realms. This has led Health Canada and researchers to
develop the social determinants of health framework, which refers to “the economic and
social conditions that influence the health of individuals, communities, and jurisdictions
as a whole” (Raphael 2004: 1). In 2001, the organizers of a York University conference on
health identified 11 social determinants of health, as shown in box 13.1.
Although many variants of this basic model have been created and presented in the
literature (e.g., see Lucyk and McLaren 2017), generally, a social determinant of health
framework highlights how structured inequality produces inequality of health conditions
and the way health is profoundly influenced by governments’ social policy decisions. For
example, we see in figure 13.1 that Canadians are more likely to report having unmet
healthcare needs when they are living in poverty and in certain provinces. Poor Canadians
Mitchell, Barbara A.. Family Matters, Fourth Edition : An Introduction to Family Sociology in Canada, Canadian Scholars, 2021. ProQuest Ebook
Central, http://ebookcentral.proquest.com/lib/ubc/detail.action?docID=6708065.
Created from ubc on 2022-01-31 23:04:49.
Book 1.indb 376 09/08/21 6:49 PM
