The association between household and family composition and mental health of the elderly: mediating role of lifestyle.

BACKGROUND: Mental health in the elderly has multiple determinants, and studies indicate household and family composition, economic status, and family support are key factors. However, these are difficult to modify, and better lifestyle for the elderly can be a possible intervention. The current study examined the mediating role of lifestyle in the association between these three types of the household and family composition (living alone, living with a spouse, and living with children) and mental health in older adults. METHODS: We studied 5,407 participants (58.7% female, age 45 + years) from the Beijing Aging Brain Rejuvenation Initiative Project. All participants underwent a battery of examinations to measure degree loneliness, depression, and global cognitive function. We also surveyed personal lifestyles. We used a mediation analysis to determine the relative contribution of each lifestyle factor on mental health outcomes. RESULTS: Older adults living alone rarely participated in mental and social activities and often had irregular diets; those adults living with children spent most of their time caring for grandchildren and had irregular eating and sleeping schedules; those living with a spouse often engaged in a variety of leisure activities and had the best life habits. Mediation analyses showed that dietary and sleeping irregularity partially mediated the negative effects of living alone on mental health, and were moderated by age and gender. CONCLUSIONS: Living with a spouse was associated with benefits for the mental health of middle-aged and older adults (especially older and female individuals), through modifying better lifestyles than those of individuals with the other two types of the household and family composition.

Comprehensively evaluating the relationships between marital status and other family factors with cardiovascular disease and long-term overall mortality in the elderly: a study of 48 510 Chinese individuals.

BACKGROUND: Marital status is associated with cardiovascular disease (CVD) incidence and overall mortality, yet limited research on this topic in elderly individuals is available. Our aim was to comprehensively assess the impact of marital status and other family factors on CVD incidence and long-term mortality among elderly people. METHODS: Data from the Chinese Longitudinal Healthy Longevity Survey (2002/2005/2008-2018) for participants aged ≥60 years were analysed. A cross-sectional study initially examined the correlation between spouses, offspring, living arrangements, and CVD using logistic regression. Subsequently, a retrospective cohort study investigated the long-term associations of these factors with overall mortality via Kaplan-Meier and Cox regression analyses. RESULTS: The study involved 48 510 subjects (average age: 87 years). The cross-sectional analysis revealed a correlation between living with a spouse and an increased incidence of heart disease (adjusted OR 1.27, 95% CI 1.04-1.55) and cerebrovascular disease/stroke (adjusted OR 1.26, 95% CI 1.11-1.42). According to the retrospective cohort analysis, living with a spouse significantly reduced overall mortality (adjusted HR 0.84, 95% CI 0.80-0.87), irrespective of marital relationship quality. Conversely, living with offspring (adjusted HR 1.12, 95% CI 1.08-1.16), having more children (adjusted Pnonlinearity = 0.427) or cohabitants (adjusted Pnonlinearity < 0.0001) were associated with increased overall mortality. CONCLUSION: In the elderly population, being married and living with a spouse were not significantly associated with a decrease in CVD incidence but were associated with a reduction in long-term overall mortality. Living with offspring, having more children, or having a larger family size did not replicate the protective effect but indicated greater overall mortality.

Associations between parental socioeconomic-, family-, and sibling status and risk of eating disorders in offspring in a Danish national female cohort.

OBJECTIVE: Studies on parental socioeconomic status (SES) and family risk factors for eating disorders (EDs) have yielded inconsistent results; however, several studies have identified high parental educational attainment as a risk factor. The aim was to evaluate associations of parental SES and family composition with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) in the offspring, adjusting for parental age and parental mental health. METHODS: The cohort included women born in Denmark between January 1, 1989 and December 31, 2010, derived from Danish national registers. Each person was followed from their sixth birthday until onset of the disorder of interest or to December 31, 2016. Exposure variables were: childhood SES, defined as individually evaluated parental level of income, occupation, and education; sibling status; and family composition. Outcomes were: AN, BN, EDNOS, and major depressive disorder (MDD), included as a psychiatric comparison disorder. Risks were estimated using Cox proportional hazards. RESULTS: High parental SES was associated with increased risk of especially AN, and less so BN and EDNOS, in offspring. In comparison, low SES was associated with a higher risk of MDD. No differences between maternal or paternal socioeconomic risk factors were found. Family composition and sibling status showed limited influence on ED risk. DISCUSSION: SES shows opposite associations with AN than MDD, whereas associations with BN and EDNOS are intermediate. The socioeconomic backdrop of AN differs markedly from that reported in other psychiatric disorders. Whether that is due to genetic and/or environmental factors remains unknown. PUBLIC SIGNIFICANCE STATEMENT: Parental socioeconomic background (SES) may influence eating disorders risk in offspring somewhat differently than other psychiatric disorders. In Denmark, higher parental SES was associated with increased risk of, particularly, anorexia nervosa (AN). Importantly AN does strike across the SES spectrum. We must ensure that individuals of all backgrounds have equal access to care and are equally likely to be detected and treated appropriately for eating disorders.

Continuity and Change in U.S. Children's Family Composition, 1968-2017.

We document changes in U.S. children's family household composition from 1968 to 2017 with regard to the number and types of kin that children lived with and the frequency of family members' household entrances and departures. Data are from the U.S. Panel Study of Income Dynamics (N = 30,412). Children experienced three decades of increasing instability and diversification in household membership, arriving at a state of "stable complexity" in the most recent decade. Stable complexity is distinguished by a decline in the number of coresident parents; a higher number of stepparents, grandparents, and other relatives in children's households; and less turnover in household membership compared with prior decades, including fewer sibling departures. College-educated households with children were consistently the most stable and least diverse. On several dimensions, household composition has become increasingly similar for non-Hispanic Black and White children. Children in Hispanic households are distinct in having larger family sizes and more expected household entrances and departures by coresident kin.

The Identification of Family Social Environment Typologies Using Latent Class Analysis: Implications for Future Family-Focused Research.

The family social environment is the first environment that a child experiences and has implications for children's health. However, the majority of family social environment measures do not account for its complexity. There is a need for novel approaches for assessing the family social environment that transcends the traditional way of measuring family composition and interaction. The purpose of this secondary data analysis research was to identify distinct family social environment typologies that consider both family composition and interaction and to describe the characteristics of the identified family social environment typologies. A series of latent class analysis results indicated three distinct typologies of family social environment with significant differences in family composition, family problem-solving skills, and demographic characteristics. The process used to identify the typologies and significant differences between the typologies showcases how the field could advance family-focused research by considering family composition and interaction.

Immigrant mothers' preferences for children's sexes: A register-based study of fertility behaviour in Norway.

Parental sex preferences have been documented in many native populations, but much less evidence is available on immigrants' preferences for the sexes of their children. Using high-quality longitudinal register data from Norway, a country with a recent immigration history, we estimate hazards regression models of third birth risks by the sex composition of the first two children. A central question in the extant literature is whether the sex preferences of immigrant mothers match those observed in their country of origin, or if cultural adaption to local conditions is more important. Our analyses indicate that the sex preferences of immigrants generally match those previously documented for their native population, especially in the case of son preferences. The pattern of sex preferences is unmodified by the mother's exposure to the host society. In sum, our evidence generally supports theories emphasizing cultural persistence in preferences, rather than theories of adaption or immigrant selectivity.

Family composition and marital dissolution in rural Nepal, 1945-2008.

The presence, number, sex, and age composition of children within families can have important influences on couples' marital outcomes. Children are valued across settings, but their value in settings where there is an absence of formalized social security is distinctive. This paper explores the influences of childlessness, and different number, age, and sex compositions of children, on the odds of marital dissolution among couples in rural Nepal. Results reveal that childless couples face significantly higher odds of dissolution than couples with at least one child, and each additional child-up to three children-reduces couples' odds of dissolution. Furthermore, having a child aged under two reduces couples' odds of marital dissolution, but interactions reveal that this age effect only holds at parity one. Surprisingly, despite a history of son preference in this setting, there is no evidence that children's within-parity sex composition is associated with the odds of marital dissolution.

Family Matters: Development of new family interrelationship variables for US IPUMS data projects.

In demographic datasets, researchers frequently want to identify how members of a household are related. In this paper, we develop a new method of estimating parental and spousal relationships using data on fertility patterns and family interrelationships. The improved method includes cohabiting and same-sex couples and is comparable across all modern US IPUMS data projects. A detailed variable indicates how the relationship was inferred and the level of ambiguity around that inference. The new IPUMS family interrelationship variables are very accurate, matching self-reported spouse/partner for 99.99% and parent for over 99.00% of respondents. Among those identified as same-sex couples, we match self-reported spouse/partner for 100% of respondents, 87.57% of whom self-identify as lesbian, gay, or bisexual. We further demonstrate that the new family interrelationship variables closely track temporal variation in teenage fertility.

Why Do People Choose a Particular Dog? A Mixed-Methods Analysis of Factors Owners Consider Important When Acquiring a Dog, on a Convenience Sample of Austrian Pet Dog Owners.

Selecting a dog that is incompatible with the owner's expectations can negatively impact both parties. Previous studies on dog acquisition have primarily focused on shelter environments, using closed-ended questions to assess hypothetical preferences. In contrast, our study employed open-ended questions with a convenience sample of Austrian dog owners (N = 1077) to retrospectively explore why the owners chose their dogs. We also examined consistency in owners' responses and the influence of owner characteristics (age, education, household composition, previous dog experience, purpose of acquisition) on their reasons. Content analysis revealed 24 codes; the frequency of codes was 2.4/response. The most frequent codes were breed-based choice (29%), choosing on a whim, without careful consideration (24%), work/sport skills (22%), and rescuing a dog (17%). The least frequent were the age (1%), health (1%), sex (1%), and guarding skills (0.6%) of the dog. Twelve codes were consistent over time, and ten were consistent across dogs, indicating that the owners showed a consistent preference for certain traits. Except for the owner's education level, all characteristics affected the likelihood of mentioning at least one code. Most associations were found with the presence of children in the household: owners with children preferred friendly, easily manageable, and easy-to-train dogs and were less likely to adopt or rescue compared to owners living without children. Our findings also highlight discrepancies between spontaneous (free-text) reports and responses to closed-ended questions, underscoring the importance of qualitative data in better understanding the motivations behind and the factors influencing dog acquisition.

Determinants of trajectories of informal caregiving in later life: evidence from England.

Although the long-term consequences of informal care provision have been well investigated, few studies have examined the trajectories of informal care provision among older people and the socioeconomic, demographic, health, and family characteristics associated with them. We use data from four waves of the English Longitudinal Study of Ageing, with 6561 respondents followed for 6 years (2012/3-2018/9). We used group-based trajectory modelling to group people's provision of care over time into a finite number of distinct trajectories of caregiving. Using multinomial logistic regressions, we then investigated the characteristics associated with these trajectories. Four distinct trajectories of caregiving were identified: "stable intensive", "increasing intensive", "decreasing", and "stable no care". Results suggest that although there are socioeconomic, demographic, and health differences across the trajectories of caregiving (with younger women in good health and poorer socioeconomic status more likely to care intensively throughout), family characteristics are their main drivers. Respondents who live alone, with no children, and no parents alive are more likely to never provide care, whereas those with older parents and who live with adults in poor health are more likely to provide stable intensive care. Also, changes in family characteristics (e.g. death of parents, widowhood, or deterioration of the partner's health) are associated with trajectories representing increases or decreases in caregiving over time. Overall, trajectories of informal caregiving undertaken by older people are varied and these patterns are mostly associated with both the availability and health of family members, suggesting that need factors represent the most immediate reason for caregiving commitments.

Examining Factors Associated with the Use of Community Food Resources: An Application of the Andersen Model to Inform Future Interventions.

The role of the food environment in shaping nutrition and health has gained substantial attention from policymakers, public health researchers, and advocacy groups. To promote equities in food access and nutrition outcomes, understanding factors linked with the utilization of local community food resources is crucial. Using Andersen's service utilization model, we explained how adults use their neighborhood food resources. In a cross-sectional study design, an online survey was conducted in REDCap Version 13.4.0 via the Amazon Mechanical Turk (MTurk) involving 1830 adults with a mean age of 37.9 ± 12.1 years. Participants answered questions on predisposing, enabling, and need factors that influence their use of different community food resources. The predisposing factors that were statistically significant included age, family size, marital status, race, and ethnicity. The enabling factors included travel time, travel mode, income, and shopping decision motivators (such as being able to use Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vouchers, delivery services, great sales, and coupons). Food security and community food resources need for lower food price were the significant need factors. However, these factors vary by the types of food resources. In conclusion, enhancing the utilization of community-based food access initiatives and programs among underserved families requires consideration of family composition, racial and ethnic diversity, and transportation access.

The role of early-life family composition and parental socio-economic status as risk factors for obsessive-compulsive disorder in a Danish national cohort.

Research on early-life family environment on obsessive-compulsive disorder (OCD) risk is limited, and sex differences have not been sufficiently studied. We investigated early-life family composition and parental socio-economic status (SES) as OCD risk factors while stratifying for sex in a sample of 1,154,067 individuals from the Danish population (7550 of whom had OCD). Data on early-life family composition (birth order, number of siblings, number of parents in household at proband age 6), parental SES at age 6 (parental income, occupation, and education level), history of parental psychiatric illness, and parental age at birth on OCD risk (i.e., an ICD-10 diagnosis of F42.x) were obtained from Danish population registers. Survival analyses using Cox regression were performed with age as the underlying time variable. Analyses were adjusted for calendar time, and differential effect by sex was tested for exposures. We found that birth order and advanced maternal age were risk factors for OCD in males, and being an only child was associated with increased OCD risk in both sexes. Early childhood SES variables including parental education, occupation, and income were associated with OCD risk, and these effects were more pronounced in females. Significant interaction effects for parental education/occupation and the presence of non-OCD psychiatric diagnoses in the proband also emerged. Our results suggest that early-life SES and family composition may be important risk factors for OCD, and heterogeneity in OCD cases in terms of psychiatric comorbidities, as well as sex differences should be carefully examined in relation to risk factors.

Family Composition and Stability for Orphans: A Longitudinal Study of Well-Being in 5 Low- and Middle-Income Countries.

Objectives: Many orphaned children in low- and middle-income countries live with family. Yet, their household composition and its stability are not well-characterized, nor is impact of stability on longer-term outcomes. Methods: We used the longitudinal, multi-country Positive Outcomes for Orphans cohort to describe adult family living with orphans. Stability was measured by changes in presence of six familial relations over time, and related to three outcomes: 1) incident abuse, 2) cognitive functioning, 3) emotional difficulties. Associations were estimated using generalized linear models fit with generalized estimating equations. For abuse, Poisson regression estimated risk ratios. For continuous scores of cognitive functioning and emotional difficulties, linear models estimated mean differences (MDs) with 95% confidence intervals. Results: Among 1,359 orphans, 53-61% reported living with their mother each year; 7-13% with father; nearly 60% reported ≥1 change in composition over follow-up. Compared to 0 changes, difficulties increased with 1 change [MD: 0.23 (-0.33, 0.79)], 2 changes [MD: 0.57 (0.00, 1.16)] and ≥3 changes [MD: 0.73 (0.18, 1.29)]. No associations were found with abuse or cognitive functioning. Conclusion: Orphan well-being may be improved through supports stabilizing household composition or targeting emotional resilience.

Sibship Size, Height and Cohort Selection: A Methodological Approach.

This article deals with the historical relationship between the number of siblings in a family or household and height, a proxy for biological living standards. Ideally, this relationship is better assessed when we have evidence on the exact number of siblings in a family from its constitution onwards. However, this generally requires applying family reconstitution techniques, which, unfortunately, is not always possible. In this latter case, scholars must generally settle for considering only particular benchmark years using population censuses, from which family and household structures are derived. These data are then linked to the height data for the young males of the family or household. Height data are generally obtained from military records. In this matching process, several decisions have to be taken, which, in turn, are determined by source availability and the number of available observations. Using data from late 19th-century Catalonia, we explore whether the methodology used in matching population censuses and military records as described above might affect the relationship between sibship size and biological living standards and, if so, to what extent. We conclude that, while contextual factors cannot be neglected, the methodological decisions made in the initial steps of research also play a role in assessing this relationship.

What role do family composition and functioning play in emotional and behavioural problems among adolescent boys and girls?

OBJECTIVES: The aim was to explore the associations of family composition, family support and communication with emotional and behavioural problems among adolescents as well as a possible moderating effect of gender on these associations. METHODS: Data from the Health Behaviour in School-aged Children study conducted in 2014 in Slovakia were used. The final sample consisted of 2908 students (mean age 14.36; 49.7% boys). We explored the association using generalized linear models. RESULTS: We found that non-intact family was significantly associated with a higher score in emotional and behavioural problems. Family support and communication were found to be significantly associated with a lower score in emotional and behavioural problems. Significant interactions of gender and family communication with emotional and behavioural problems were found, showing that family communication decreased emotional and behavioural problems only in girls. CONCLUSIONS: Family composition, family support and communication play an important role in the occurrence of emotional and behavioural problems in adolescence. Family communication lowers these problems only in girls. Prevention and intervention programmes could be focused on parent-child communication strategies with the importance of differences in the needs of boys and girls.

Estrutura e antecedentes de famílias de jovens que tentaram suicídio com agentes químicos / Families' structure and background of suicide, attempted young people with chemical agents

Resumo Introdução: Jovens representam um grupo de alta vulnerabilidade à tentativa de suicídio, e a autointoxicação é o meio mais utilizado para o ato suicida. Objetivo: Descrever a estrutura e os antecedentes de famílias de jovens internados por tentativa de suicídio com agentes químicos. Método: Pesquisa descritiva e transversal, em entrevistas com familiares de 12 jovens internados por autointoxicação, de 2011 a 2016, e notificados a um centro de informação e assistência toxicológica do noroeste do Paraná - Brasil. Utilizou-se entrevista semiestruturada e a confecção de genogramas, agrupados por núcleos de similaridade. Resultados: A maioria dos jovens era do sexo feminino, idades entre 14 e 19 anos; quatro casos com tentativa de suicídio anterior, sete com transtorno mental e três com abuso de drogas. Ao longo das duas gerações, a estrutura familiar acompanhou as diversidades da sociedade, com diminuição da taxa de fecundidade, aumento de famílias chefiadas por mulheres, separação conjugal, avós responsáveis pelo cuidado dos netos e fragilidade dos laços familiares. O relacionamento intrafamiliar apresentou dependência emocional entre o jovem índice e os avós, mas constantes atritos e desavenças no meio familiar, pouco contato emocional com os pais e baixo suporte familiar antes da tentativa de suicídio. Como antecedentes para a tentativa de suicídio, verificou-se o uso de drogas de abuso, os transtornos mentais e os conflitos de identidade de gênero. Conclusões: O genograma auxiliou na compreensão da estrutura e diferenças intergeracionais, na identificação do familiar significante e das relações familiares como fatores para as tentativas de suicídio.

Abstract Introduction: Young people represent a group of high vulnerability to suicide attempts and self-intoxication is the most used means for suicide. Aim: To describe the structure and background of families of young people hospitalized for suicide attempt with chemical agents. Method: Descriptive and cross-sectional research, in interviews with family members of 12 young people hospitalized for self-intoxication, from 2011 to 2016, and notified to a center for information and toxicological assistance in northwestern Paraná - Brazil. Semi-structured interviews and genogram making were used, grouped by similarity nuclei. Results: Most young people were female, aged between 14 and 19 years; four cases with previous suicide attempt, seven with mental disorder and three with drug abuse. Over the two generations, the family structure followed the diversity of society, with a decrease in the fertility rate, an increase in families headed by women, marital separation, grandparents responsible for the care of grandchildren and fragility of ties Family. The intrafamily relationship presented emotional dependence between the young index and the grandparents, but constant frictions and disagreements in the family environment, little emotional contact with parents and low family support before the suicide attempt. As a antecedent for suicide attempt, there was the use of drugs of abuse, mental disorders and gender identity conflicts. Conclusions: The genogram assisted in understanding the structure and intergenerational differences, in the identification of significant family members and family relationships as factors for suicide attempts.

Gender preferences among antenatal women: a cross-sectional study from coastal South India.

BACKGROUND: A balanced sex ratio is essential for a stable society. OBJECTIVE: The main objective of the present research was to study the perceptions of women attending the antenatal care (ANC) facility regarding their gender preferences and family composition. METHOD: In this cross-sectional study 132 antenatal women were interviewed in their preferred language using a predesigned semi-structured questionnaire. The collected information was analyzed using SPSS version 11.5. RESULTS: The mean age of the study participants was 27.2 ± 4.1 years. The majority of the antenatal women (60.6%, n=80) did not have any gender preferences. Among those who had a gender preference (39.4%, n=52), male and female preference was reported by 55.7% (n=29) and 44.3% (n=23) of the participants respectively. The overall son preference index was observed to be 1.3. No consistent relationship could be established between the socio-demographic factors and the preference for gender. The mean preferred family size in our study was 1.85±0.531 and more than half of the participants had a balanced gender preference. The majority of the participants were aware that the adverse sex ratio can lead to fall in the number of brides and that it would bring about a social imbalance. CONCLUSION: As a developed society we need to ensure that both the genders get equal respect and are free from any sort of preferences and prejudices. To achieve this, more and more people need to be made aware of the consequences of gender imbalance and adverse sex ratio in a society.

Hierarchical clusters in families with type 2 diabetes.

Families represent more than a set of individuals; family is more than a sum of its individual members. With this classification, nurses can identify the family health-illness beliefs obey family as a unit concept, and plan family inclusion into the type 2 diabetes treatment, whom is not considered in public policy, despite families share diet, exercise, and self-monitoring with a member who suffers type 2 diabetes. The aim of this study was to determine whether the characteristics, functionality, routines, and family and individual health in type 2 diabetes describes the differences and similarities between families to consider them as a unit. We performed an exploratory, descriptive hierarchical cluster analysis of 61 families using three instruments and a questionnaire, in addition to weight, height, body fat percentage, hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein. The analysis produced three groups of families. Wilk's lambda demonstrated statistically significant differences provided by age (Λ = 0.778, F = 2.098, p = 0.010) and family health (Λ = 0.813, F = 2.650, p = 0.023). A post hoc Tukey test coincided with the three subsets. Families with type 2 diabetes have common elements that make them similar, while sharing differences that make them unique.

Efecto del contexto, rutinas y funcionamiento en la salud de familias mexicanas con diabetes tipo 2

RESUMEN Objetivo: Explicar el efecto del contexto, rutinas y funcionamiento familiar en la salud de familias mexicanas donde un integrante padece Diabetes mellitus tipo 2 (DM2). Material y Métodos: Diseño transversal-correlacional; previo consentimiento informado el reclutamiento y recogida de datos fue entre enero a abril de 2015; participaron 60 díadas familiares (n=120), conformadas por persona con DM2 y cuidador familiar, entre 18 a 66 años, sin distinción de género, que hubieran convivido bajo el mismo techo al menos por un año y asistían a consulta en una institución de salud en México durante el 2015. El contexto familiar se midió con una cédula, dos escalas midieron rutinas, funcionamiento y salud familiar. Resultados: Predominaron las mujeres (64,2%), de 47,5 (±11,5) años de edad, con escolaridad de 7,2 años (± 4,4), los enfermos diagnosticados hace 11,5 años (± 8,4), con tratamiento desde hace 9,2 años (± 8,6). Se encontraron interrelaciones significativas entre las variables del contexto (edad, años de estudio, tiempo de diagnóstico y tratamiento), rutinas y funcionamiento con la salud familiar (todas entre p≤ ,0001 y p ≤ ,005). El funcionamiento explicó el 39,1% y las rutinas el 18,8% de la varianza de la salud familiar (R2 ajustada= , 391; F(1,118)= 77,4; p≤ ,0001; R2ajustada= ,188; F(1,118)= 28,6; p≤ ,0001). El funcionamiento explicó la varianza de rutinas en 19,3% (R2= ,193; F(1,118)= 28,1 p≤ ,0001). Conclusiones: La salud familiar se relaciona significativamente con el contexto, rutinas y funcionamiento de las díadas familiares que viven con diabetes tipo 2; además la salud familiar está influida significativamente por rutinas y funcionamiento familiar.

ABSTRACT Objective: To explain the effect of the context, routines and family functioning on the health of Mexican families where a member suffers from Type 2 Diabetes mellitus. Materials and Methods: Cross-correlational design; after prior informed consent, recruitment and data collection were carried out between January and April 2015. The sample included 60 family dyads (n = 120), consisting of a person with 2DM and a family caregiver, between 18 and 66 years old, without gender distinction, who had lived in the same home for at least one year and attended a consultation in a health institution in Mexico during 2015. The family context was measured with a card, two scales measured routines, family functioning and health. Results: There were more women (64.2%), aged 47.5 (± 11.5), with 7.2 years (± 4.4) of schooling; patients diagnosed 11.5 years ago (± 8.4), under treatment for 9.2 years (± 8.6). Significant interrelations were found between the context variables (age, years of study, diagnosis and treatment time), routines, and functioning regarding family health (all between p≤ .0001 and p ≤ .005). Functioning explained 39.1% and routines 18.8% of the family health variance (adjusted R2= .391; F (1.118) = 77.4 p≤ .0001; adjusted R2= .188; F (1.118) = 28.6 p≤ .0001). Functioning also explained the variance of routines in 19.3% (R2 = .193; F (1.118) = 28.1 p≤ .0001). Conclusions: Family health is significantly related to the context, routines and functioning of family dyads living with type 2 diabetes. In addition, family health is significantly influenced by routines and family functioning.

RESUMO Objetivo: Explicar o efeito do contexto, rotinas e funcionamento na saúde de famílias mexicanas onde um membro sofre de Diabetes mellitus Tipo 2 (DM2). Material e Métodos: Desenho transversal-correlacional; com consentimento informado prévio o recrutamento e coleta dos dados foram entre janeiro e abril de 2015; participaram 60 díades familiares (n = 120), formadas por pessoa com DM2 e cuidador familiar, entre 18 e 66 anos, sem distinção de gênero, que moraram na mesma casa por pelo menos um ano e que assistiam a uma consulta em uma instituição de saúde no México durante 2015. O contexto familiar foi medido com um cartão, duas escalas avaliaram as rotinas, o funcionamento e a saúde familiar. Resultados: Predominaram as mulheres (64,2%), de 47,5 (±11,5) anos, com escolaridade de 7,2 anos (± 4,4), as pessoas diagnosticadas há 11,5 anos (± 8,4), com tratamento há 9,2 anos (± 8,6). Foram encontradas inter-relações significativas entre as variáveis do contexto (idade, anos de estudo, tempo de diagnóstico e de tratamento), rotinas e funcionamento com a saúde familiar (todas entre p≤ ,0001 e p≤ ,005). O funcionamento explicou o 39,1% e as rotinas o 18,8% da variância da saúde familiar (R2ajustada= ,391; F(1,118)= 77,4 p≤ ,0001; R2 ajustada= ,188; F(1,118)= 28,6 p≤ ,0001). O funcionamento explicou a variância das rotinas em 19,3% (R2= ,193; F(1,118)= 28,1 p≤ ,0001). Conclusões: A saúde familiar está significativamente relacionada ao contexto, rotinas e funcionamento das díades familiares que vivem com diabetes tipo 2; além disso, a saúde familiar está significativamente influenciada por rotinas e funcionamento familiar.

Getting help from others: the effects of demand and supply.

OBJECTIVES: This article investigates whether the help with care needs that is received from others depends on the potential supply of family helpers. METHODS: Data from the first round of survey data collected in the National Health and Aging Trends Study are used to create measures of whether help is received, the number of helpers, and the hours of help received. Regression analysis is used to relate these outcomes to indicators of the demand for and supply of helpers. RESULTS: Analyses suggest limited evidence that the receipt of help is a supply-driven phenomenon. Although the measures of child-caregiver supply are not associated with a binary indicator of help received, caregiver-supply factors are associated with the number of helpers and the total hours of help received. DISCUSSION: Findings on the total number of helpers and total hours of care have implications for the division of care labor within families and between families and nonfamily members. Foreseeable trends in the demand for and the supply of help suggest further evolution in patterns of elders' receipt of help with care needs. Even if those with needs for care continue to have their needs addressed by one or more helpers, the number of helpers, and the aggregate amount of help they provide, is likely to undergo adjustment in response to changing family patterns.