Families First Edmonton

1. Families First Edmonton Family Functioning & Primary Caregiver Health Preliminary Analyses Berna Skrypnek & Deanna Williamson Department of Human Ecology, University of Alberta Community Learning Network: September 29, 2011

2. Outline • FFE family characteristics • FFE family functioning • FFE primary caregiver mental and physical health • Implications

3. Family Characteristics • What are FFE families like? • How similar/different are they from other Alberta families? • ethnic origin • size • composition

4. Primary Caregivers’ Ethnic Origin 6% 45% Canadian-born Foreign-born 16 %

5. Family Size and Composition • range from 2 to 13 members • average of 3.7 family members • range from 1 to 8 children • average of 2.1 children • 61% are headed by a lone primary caregiver • Co-caregiving families: 84% of co-caregivers are a spouse or common-law partner • 92% of families are made up of two generations • 8% have three generations and less than a percent have four generations

6. Family Functioning • How well are FFE families functioning? • Is the level of family functioning related to family characteristics?

7. Measuring Family Functioning • 4 items from the General Functioning Scale of the McMaster Family Assessment Device (FAD) • We can express our feelings to each other. • There are lots of bad feelings in the family. • We feel accepted for what we are. • We don’t get along well together. • Primary caregivers were asked “How well does each statement describe your family as a whole—your family consisting of the family members living in this household?”; they responded along a 4 point rating scale (ranging from “not at all well” to “very well”) .

8. Two ways to look at how FFE families are functioning • Calculate the average score for our FFE sample and compare our FFE sample average to general population norms. • Determine the number/percentage of families whose scores fall above the cut-off for healthy family functioning, that is, determine the percentage of families scoring in the unhealthy family functioning range.

9. FFE Family Functioning • Average Level of Family Functioning • FFE families look very similar to the general population when average level of family functioning for the whole FFE sample is compared to the average level of family functioning in the general population. • FFE family average = 1.77 • General population average = 1.84 • Percentage of Families Falling in the Unhealthy Range of • Functioning (2.00 +) • 53% of FFE families fall in the unhealthy range

10. FFE Family Functioning Percent of Sample 47% healthy range 53% unhealthy range Average FAD Score

11. Is the level of family functioning related to family characteristics? • No significant differences between the family functioning of lone primary caregiving families and co-caregiving families. • Significant differences by ethnic origin.

12. Poorer Family Functioningin Foreign-Born and Aboriginal Families Canadian-born Foreign-born 12

13. Primary Caregiver Health • What is the health of FFE primary caregivers? • How are FFE primary caregivers functioning in terms of their mental and physical health? • Is primary caregiver health related to family characteristics? • Is primary caregiver mental and physical health related to gender, family composition, ethnic origin?

14. Measuring Primary Caregiver Mental Health • Symptom Checklist 90 (SCL-90): • Assesses the intensity of an individual’s psychological distress • 90 physical and psychological symptoms • respondents rate severity of symptoms (past 7 days)5 point scale: 0 = “not at all” to 4 = “extremely” • Global Symptom Index and 9 subscales: • 1. anxiety 6. psychoticism 2. hostility 7. somatic complaints 3. phobia 8. interpersonal sensitivity 4. depression 9. obsessive-compulsive 5. paranoia

15. Primary Caregiver Mental Health • Overall FFE primary caregivers report significantly poorer mental health than adults in the general population. • Female primary caregivers report poorer mental health than male primary caregivers • Lone primary caregivers report poorer mental heath than those with a co-caregiver • Those with adolescent children report poorer mental health than those with infants, preschoolers, or school-age • Generally Canadian-born report poorer mental health than foreign-born

16. Primary Caregiver Mental Health Intensity of distress

17. Measuring Primary Caregiver Physical Health • Primary caregivers were asked “in general, would your say your health is”, and responded by indicating that their health fell into one of the following 5 categories: • Poor • Fair • Good • Very good • Excellent • This single item has been found to be a valid and reliable measure of physical health and to predict morbidity and mortality.

18. Primary Caregiver Physical Health Overall FFE primary caregivers report poorer physical health than other Albertans

19. Primary Caregiver Physical Health • FFE primary caregivers’ physical health is related to a number of factors: • Gender: women report poorer health • Co-caregiver status: lone primary caregivers report poorer health than those with a co-caregiver • Age of child(ren): primary caregivers with adolescent children report poorer health than those with infants, preschool, and school age children • Ethnic origin: Canadian-born primary caregivers report poorer health than foreign-born primary caregivers

20. Primary Caregiver Self-Reported Physical Health

21. Key Points • Half of FFE families fall in the unhealthy range of family functioning • Canadian-born non-Aboriginal families are more likely to be in the healthy family functioning range; Aboriginal and foreign-born are more likely to be in the unhealthy range • FFE primary caregivers report poorer mental and physical health than adults in the general population • Mental and physical health of primary caregivers are related to a number of caregiver and family characteristics (e.g., gender, co-caregiving status, age of children, and ethnic origin)

22. Implications • Similarities and differences in family functioning and primary caregiver health: • implications for programming • The compromised health of primary caregivers in FFE families: • interferes with parenting/caregiving and places children at risk for poor development • limits primary caregivers’ abilities to be fully engaged citizens

23. Acknowledgement AHFMR Alberta Heritage Foundation of Medical Research