Sickness in the Family: A Register Study on the Short- and Long-Term Effects of Severe Sickness on Family Members

Even in a well-developed welfare state like in Norway, severe sickness of a person can severely affect the situation of their family members. While this is well-known in the context of older family members with care needs, this project focuses on the situation in young families, where parents live together with their minor children. When a child or parent falls sick, both family members of the other generation (i.e., parents or children) and those of the same generation (i.e., siblings or partners) might be affected. The short- and long-term consequences we study in this project include family members’ education (e.g., school performance and educational attainment of children), employment (e.g., labor force participation, changes in working hours and wages) and health (e.g., health care usage). Besides describing such associations, a major goal of the project is to find out to what extent these are causal. The consequences of having a family member that is sick are likely to depend on individual and family characteristics. Thus, identifying societal groups that are specifically prone to – or resilient against – the negative consequences from having a family member that becomes sick is the second goal of this project. The characteristics examined will include sociodemographic information (age and gender), socioeconomic resources (family income and education), family structures (e.g., single parenthood) and community level resources (access to timely and high-quality health services). A third goal of the project is to identify pathways through which the sickness of a family member affects a person’s own educational or employment outcomes. Examining changes in behaviors (e.g., drug use, sleeping, exercise), mental health, attitudes and preferences will be key here. To shed light on the above issues, the project utilizes a combination of different Norwegian population-based registers, as well as on large longitudinal surveys. As of 2023, several analyses in the project are at an advanced stage, and several research papers are under review. Ongoing work addresses both intergenerational spillover effects from parents to children and from children to parents, but also intragenerational spillover effects from children to their siblings and from parents to their partners. Completed and ongoing work includes studies of (1) Effects from parental suicide and from parental cancer (and possible cancer death) on children's mental health, (2) Consequences of teenage mental health problems for the health of their parents and siblings, (3) Consequences of child disability on parental relationship stability, fertility, and employment careers, (4) Long-term spillover effects of losing a close family member in childhood on entries into the labor market (“NEET”) in early adulthood and health service use as an adult later in life, (5) Spillover effects of a partner’s cancer on health, welfare use and labor market participation. Webpage: https://www.fhi.no/en/cristin-projects/ongoing/sickness-in-the-family--sickfam--a-register-study-on-the-short--and-long-te/

Even with a well-developed welfare scheme like in Norway, severe sickness can have significant negative effects on the life trajectory of both the patient and their close family members. We investigate the effects of severe sickness on family members’ labor market participation, educational achievements and health, both in the short and long term. Our focus will be on young families, where the offspring are particularly dependent on the parents. To document the extent to which severe sickness contributes to inequality and reduced social mobility, the project will use rich register data linked with large longitudinal studies. The project will make scientific contributions in three areas. Firstly, in contrast to most previous studies, we will derive well-powered causal estimates of the effects of sickness in the family. We will apply modern econometric methods for causal inference, using register data containing detailed school, work and health information for the whole population over several decades. Secondly, the project will give important insights into whether some groups are specifically prone to, or resilient against, the negative consequences of having a sick family member. Specifically, we will examine how the effects vary with age and gender, the family’s socioeconomic resources, family structures (e.g., whether there are two parents in the household) and access to health care services in the municipality. Thirdly, explanatory mechanisms will be investigated through large longitudinal surveys. These provide in-depth information on, for example, changes in behaviours (drug use, sleep, exercise), mental health, social relationships and attitudes, which can be important for explaining the effects on education, employment and health.