2.3 Mesosystem: the family or carers
The family that a child is born into has a profound influence on their health. and to a large extent the ability to control such factors are likely to be beyond the control of children. For example, a baby may spend a great deal of their time in ‘containers’ such as a car seat, a buggy or a highchair, and consequently have limited opportunities for physical activity which can impact on their health.
There are many social, economic, religious and cultural factors that can influence children’s health.
Social and economic factors are often interrelated. A family’s socio-economic status can have a positive or negative impact on children’s health. Families that can provide the everyday routines that meet children’s physical and mental needs, such as adequate sleep, good nutrition and hydration, and a loving and nurturing environment immediately provide a health advantage to their children. In contrast, families that are living in unstable environments and in chaotic circumstances may be less able to provide the basic requirements of health to their children. Put simply, the poorer the child and family, the poorer the child’s health is likely to be. Conversely, better off children are more likely to have better health. The effect of poverty on children’s health is discussed in more detail later in the course.
The approach that parents take to parenting children can have a direct influence on their health. If parents are permissive, they may not set boundaries for their children, this may apply to household routines which could affect when children are fed.
If parents are neglectful, this can affect children’s safety, or it can lead to children not being provided with the basic needs of life, such as nourishment, sleep and hygiene. Parents who neglect their children and can’t or don’t provide their basic physical needs may also neglect children’s emotional needs which can have a negative impact on their wellbeing and mental health.
Religious beliefs and cultural practices also affect children’s health
Culture and religion are different concepts, however they can both exert strong influences on parents’ beliefs and this, in turn, can affect children’s health. For example, some religions encourage their believers to refuse certain medical interventions. Parents may have an objection to their child receiving childhood immunisations on religious grounds. This can make children susceptible to contracting preventable communicable diseases, such as measles.
Gypsy, Roma and Traveller families have a way of life that is deeply rooted in a long cultural history. Some of their cultural beliefs influence the way that they access health services, and in turn, this can affect their health. To illustrate this point, infant mortality is 4 times higher in Irish Traveller families.
Looked-after children
It’s important to remember that many children don’t live in a family with biological parents. Some children are taken from their parents and are ‘looked-after’ by the state. Looked-after children can be cared for by foster or adoptive parents, or they may live in a children’s home. The health outcomes for looked-after children are often not as good as for children who live with their birth families (Department for Education, 2024).