From the AARP to politicians to the health care industry to the popular media, there is a lot of concern over the challenges that the U.S. faces taking care of an aging population and the toll it might take on individual Americans to care for their aging parents. These concerns are amplified by the fact that, unlike many other developed countries, the U.S. does not have a strong safety net to help with elder care. An added complication is the new reality that many Americans taking care of aging parents are also raising their own children at the same time—a phenomenon often referred to as being in the sandwich generation. As with many issues in a family studies course, this one has recently shifted from the professional realm to the personal realm for me when my own parents started having significant health problems right as my kids entered some very trying years of adolescence. So, count me as a member of the sandwich generation. That personal perspective helped to fine-tune my professional expertise on family processes and how what goes on within our intimate family lives offers us a way to think about the larger society and our place in it. That is one of the core perspectives of Families Now , reminding us to think about our families as something that develops in fits and starts over long periods of time within contexts—large and small—that shape us from the outside in. For example, multiple chapters (e.g., 6, 13, 15) in Families Now offer concrete ways to place our own experiences in such a context: More people are caught in the “sandwich” in families because of a demographic crunch in society , one created by longer life expectancy (more aging parents to care for indefinitely), a declining birth rate (fewer kids to share responsibilities for any one aging parent), and delayed age at birth (more years in which there are kids at home while parents need care). The historical economic and political marginalization of families of color in our society meant that, over time, they built stronger family and community networks of extended kin and non-kin to help people deal with the challenges of caring for aging parents (and raising children), so that social resources developed to deal with a dearth of other kinds of resources. The challenges of caring for aging parents has ripple effects across families and communities, as relationships between adult siblings can fracture in conflict and the strain on adult children can trickle down into their interactions with their own children. To build on this discussion, have your students estimate their chances of spending significant time in the sandwich generation based on their parents’ ages and different ages at which they want to become parents (if they do). You can even have them factor in their siblings’ situations to figure out how much of that time will be shared. Upon comparing different potential future experiences of the sandwich generation, you can lead a discussion of the ways that the government or community-based groups could help people—including, possibly, their future selves—with the challenges of caring for aging parents.
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Helicopter parent is a phrase that gets tossed around a lot these days, rarely as a compliment. It refers to the idea that modern parents hover over their children, vigilantly paying attention and ready to swoop in to take control at the first sign of trouble. I see them all the time, not just in my research on families but in my own life as a parent who likes to see himself as not helicopter parenting, but, really, does any helicopter parent think they are helicoptering? The point is that many American parents have become—or are thought to have become—overly involved in managing their children’s lives. As a sociologist who studies child development with a focus on parenting, I unpack, contextualize, and complicate widely discussed ideas like helicopter parenting in Families Now . In fact, I would argue that using parenting—and all the messy interactions and conflicted feelings it entails—as a window into the state of the family and the country is precisely what makes Families Now unique and necessary. I think that helicopter parenting—any kind of parenting, really—is so much more than what goes on between parent and child. For example, sections of Chapters 11, 12, and 13 of Families Now delve into the modern phenomenon of overly involved parents to connect such a personal experience to three macro-level forces: The growing economic uncertainty of life in a globalized world, which motivates anxious parents to increasingly attempt to exert control over the children’s lives to ensure (in their minds) that they will be OK. The widening socioeconomic and racial/ethnic inequality that results in helicopter-type parenting working very well for families who already have power and status—helping their already advantaged children gain more advantages in schools and elsewhere—while being far harder to achieve and less likely to have the same impact for other families. The convergence of the cultural evolution in the perceived starting point of adulthood and the insecurity of the modern labor market that increases the length of time that young people are dependent on their parents, which means that helicopter parenting is happening far past childhood and well into the 20s and 30s (and maybe even beyond!). To continue this discussion, pose two scenarios to your students: 1) a sports team suspends a high-performing 13-year old for speaking disrespectfully to officials, and 2) a 22-year old does well on tests in a college math course but is given a low grade because of poor attendance. Now, break the students into smaller discussion groups and pose the following questions: What are concrete examples of parental reactions to these situations that you would characterize as helicopter parenting? Can you articulate where the “line” is between helicopter and non-helicopter reactions? Does changing the identity of the young person in question from male to female, black to white, or low-income to high-income change how you think that parents would react or how “successful” their reactions would be in terms of serving their children’s interests? Bring the class together to determine where the consensus and disagreements arise, also providing opportunities for willing students to reflect on where their own parents fall in the spectrum of helicopter (or non-helicopter) parenting.
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When people find out about the family research that I conduct as a social scientist, they often look at me quizzically and ask “that’s nice, but how useful is it?” To them, advancing understanding of how families work seems less than important if that research is not directly leading to explicit plans of actions to help or change families in some way. I do not agree with that sentiment, but I get where it is coming from to some extent. There is the need to point out and explain social problems and the need to remedy such problems, and it certainly seems efficient if those two things are part of the same enterprise even if they do not have to be. Yet, efforts to change families—even those that are grounded in sound research—often do not have any impact. Partly, that is because families—like people—are hard to change. One thing that is clear to me after many years in this line of work is that improving this less than ideal record of impact requires that we come together to construct beyond multifaceted approaches to problems facing families. One theme of Families Now is that the core element of a multifaceted approach is that it links macro and micro levels of understanding of some problem or challenge. With such a macro-micro linkage, we can connect family policies to family interventions. The former concern broad-scale efforts to shift the population of families in some intended direction, such as the federal welfare reform legislation discussed in Chapter 4 that was intended to increase employment rates in the population of low-income mothers and reduce the number of families on public assistance in the process. The latter are targeted efforts to shift dynamics within families in some intended direction, such as community-based programs discussed in Chapter 15 to help improve the climate of relationships in families with children with chronic illnesses by providing emotional supports to those children’s siblings. Surveying so many different policies and interventions collectively across the chapters in Families Now suggests to me—and I hope to your students—that family policy and intervention need to partner up. Consider the discussion of some major government-funded programs in Families Now : An effort to increase the quality and health of marriages among low-income couples by improving their communication and interactions had disappointing results, and one criticism of this program was that it focused too much on what was going on between spouses and not enough on the outside external pressures (e.g., economic instability) on them. An effort to improve the academic and health outcomes of young people from low-income families by moving them in large numbers to more affluent communities with greater economic opportunities did not consistently yield its intended benefits, and one criticism of this program was that it focused too much on the residential distribution of families across communities and not enough on the interpersonal dynamics (such as peer relations) that young people faced upon moving. In one case, a lot of money went towards something too micro, and, in another, it went towards something too macro. Is there some meeting point? To delve deeper into these issues, pose the following challenge to your students. The goal is to reduce the rate of child maltreatment (i.e., abuse or neglect) in families, and your state creates a blue-ribbon family to propose actions to achieve this goal. Separate the students into groups representing different blue ribbon panels, and ask each group to sketch out one general plan to address this problem. After the groups present their proposed plans to the class, lead a discussion of how much they lean towards the policy and intervention side and how they could balance these two approaches.
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Across the various socioeconomic and racial/ethnic groups within our diverse population, there are more similarities in how people think about families and engage in family life than there are differences. That does not mean that there are no differences. On average, one group may look slightly or even significantly different from another, and, rather than obscure that variability, we should dive into it to figure out what it means. As anybody who has taught a family class (or, watched the news really) knows, however, the identification of difference often leads to assumptions of deficit . In other words, there is a tendency—even among the well-meaning—to think about a single standard of family behavior and judge families who do not adhere to that standard as deviant. That widespread tendency makes having important conversations that much more difficult, which makes progress that much harder to come by. One thing that my training has given me is a constant voice in my head asking “what about history?” and “what about inequality?” That perspective forces me to try to understand something happening right now in some family or group of families and go backwards in time to capture the historical trend getting us to this point and go up in terms of levels of society to capture the stratification of our society and how it trickles down into our family lives. This perspective is woven through all chapters in Families Now , and I think it is especially helpful in understanding many instances of socioeconomic and racial/ethnic differences in family life—thinking historically rather than simply contemporaneously, thinking macro instead of solely micro. As a result, we can “cancel” deficit model and instead think of such differences in terms of the ways that the families adapt to their own unique sets of needs and challenges within their specific environments. To share some examples from Chapters 8, 11, and 12 from Families Now : Social scientists now tend to discuss the significantly higher likelihood that low-income parents will have children when unmarried (vs. married) in terms of economics rather than morals. They highlight how historical changes in the economy (e.g., rising inequality, declining job stability) have led economically vulnerable parents—much more than their economically stable counterparts—to view marriage as an insecure and unpredictable setting for having children. Qualitative studies have problematized the narrative around the relatively low rate of breastfeeding among African-American women over the last half-century, shifting the discussion from questions about good and bad maternal choices to highlight how they actively resist the too-narrow definitions of what it means to be a good mother that are imposed on them by the larger society. U.S. schools increasingly expect parents to be visibly involved in school activities, so the lower-than-average engagement of Latino/a parents was often interpreted by school personnel (and researchers) that they cared less about their children’s education than other parents. More culturally informed research has revealed that such interpretations ignore the barriers that schools erect to Latino/a parents’ involvement but also the many ways that they support their children’s education that school personnel (and researchers) do not see. To keep going with this discussion, present to your class the specific example, discussed in Chapters 2 and 8, in which the rate of fertility and extended family structures among Mexican immigrants in the U.S. is higher compared to the general U.S. population. Ask the students to explain this difference—why would Mexican immigrants have more children and more often live with other kin than, say, White non-immigrants in the U.S.? Remind students that the rates of fertility and extended family structures among Mexican immigrants in the U.S. is also higher than Mexicans in Mexico—what does that say about the use of any cultural explanations for the family behaviors of Mexican immigrants? If using both comparison points allows non-cultural explanations to emerge, what are those other kinds of explanations? Does the idea of adaptation to the environment factor into these explanations?
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From a source you know you can trust on COVID-19-- the world's foremost scientific magazine
Our sister company, Scientific American , has brought together and made available dozens of articles on the coronavirus outbreak that we can share with you. It's an extraordinary resource on what the virus actually is, how it affects us, how it became a pandemic, what we can do to fight it, and how it will change us going into the future.
View the articles on Scientific American.
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Chapter 1 What is Health Psychology
p. 2: Defining Health: Health is not merely the absence of disease, it is an optimal state of wellness that includes physical, emotional, and social well-being. How does coronavirus and being socially isolated impact these different domains to influence people’s perception of their health? p. 4: The Biopsychosocial Model: The coronavirus pandemic is clearly a biopsychosocial phenomenon. It influences individuals, families, communities, nations, and the world in similar and different ways. How is this pandemic, and COVID-19, a biopsychosocial phenomenon at each of these levels? pp. 6 – 11: Health Around the World, Global Approaches, and Global Health Disparities: From the first case in Wuhan, China onward, each country has handled the coronavirus pandemic differently based on their political structure, economy, population, and perspectives. We tend to have an ethnocentric view of the “right” ways to do things, but what are some of the features of different countries’ approaches that worked well to stem the contagion? Why did these approaches work? How much of a country’s success had to do with factors specific to that nation and its people? p. 13: Health Disparities in the United States: What trends in social disparities can you see in the effects of the coronavirus? What factors in the U.S. have contributed to these health disparities and what is being done about them? p. 17: Historical Views of Health: Many people have said that the coronavirus pandemic is “unprecedented.” But at the same time, comparisons to the Spanish Flu of 1918 are being made. What can we learn from history regarding pandemics, and how has the 21 st century influenced the spread, medical treatment, and collective global understanding and awareness of this virus? How will knowledge of history prepare us for the future?
Chapter 2 Gathering Information on Health & Illness pp. 29 – 31: At the forefront of the coronavirus pandemic are the daily reports of incidence, prevalence, and mortality rates within regions, states, and nations. Epidemiological research is at the heart of everything we know about the spread and global impact of this virus. Take any recent news report of the COVID-19 predictions, death rates, projections for “flattening the curve,” and apply what you know about epidemiological research to help you understand how these results and conclusions are drawn. pp. 32-40 This chapter presents research methods, including clinical trials, the role of placebos, and the ethics of science, all of which are relevant when considering the factors influencing who was tested for COVID-19, how treatment decisions were made, the progress for testing for antibodies, and the development of a vaccine. Additionally, there have been pharmaceutical agents and home remedies suggested that scientists have pointed out have no scientific or medical evidence to indicate that they work, and data that suggests they may actually be harmful. How do you absorb this information in light of what you know about scientific research methods? p. 47: Around the World: The Health Threat of the Century: At the time this edition was published we did not know about coronavirus and COVID-19. How would you change the focus of this “Around the World” feature now?
Chapter 3 Health Beliefs and Behaviors pp. 52 – 53: Health Behaviors: Washing hands, wearing masks, staying six feet apart, not touching our faces—these are all health behaviors, some of which will be new to most of us. Many people find it is especially difficult to change a behavior like touching the face. How can we change this behavior? What steps are necessary to create a new health habit? Using the information from the textbook on health behavior and behavioral change, can you design a method for breaking the face-touching habit or increasing adherence to the 6-foot rule? p. 70: There are many ways our country, our towns, the businesses, schools, and organizations in our areas have used social engineering to help us follow restrictions designed to curb the spread of COVID-19. Think and share with others the things that you’ve noticed with regard to social engineering. p. 70: When counties and cities started opening again and people talked about the “new normal” after the COVID-19 outbreak, how do you think people’s behaviors changed? Are there some health behaviors adopted during the pandemic that may not change? Are there any ways in which you think the pandemic has changed your behavior permanently?
Chapter 4 Health-Enhancing Behaviors p. 88: Patterns of Eating: The pandemic caused many shifts in our eating behaviors. What factors (from stress eating, personality, to the patterns of eating mentioned in the textbook) may influence the way people eat while they are coping with the lifestyle changes brought about by social isolation, quarantine, and the restrictions associated with the COVID-19 pandemic? p. 92: The Benefits of Exercise: Many people were prevented from going to the gym or getting their regular exercise during the pandemic. Maybe this has happened to you as well. How challenging has it been to find new ways to get physical exercise? What do these lifestyle changes tell us about our perception of the barriers to exercise? How has this influenced your mental and physical well-being? p. 96: Sleep: There have been many news reports about the impact of the coronavirus pandemic on peoples’ sleep patterns. From the textbook we know the importance of sleep for health and well-being. How has this pandemic influenced your sleep? What are the individual factors that seem to be affecting you? p. 102: Other Health-Enhancing Behaviors: Many people engage in preventative medicine and visit their doctors regularly for cancer screenings, routine blood work, and regular annual examinations. With the lockdown and closure of medical offices and on non-essential medical visits, people’s preventive health behaviors have been impacted. What do you think the long-term effects of this pandemic will be on people’s preventive health behavior in the future? Will some people be more conscientious about keeping track of health or will they become more lax about getting regular medical check-ups? How will this pandemic impact the medical profession?
Chapter 5 Health-Compromising Behaviors p. 111: Why Take Risks?: The concept of risky behaviors has changed dramatically with the coronavirus pandemic. As we know from this chapter, there are many factors that influence the perception of risk. Looking at the theory of triadic influence, how can you explain the patterns in risk behaviors that you observed around you during this pandemic? p. 124: Eating Disorders: How did the perception of threat, the stress of the pandemic, and the perception of food availability or scarcity impact peoples’ consumption of food during the pandemic? How might this have exacerbated eating disorders? p. 131: Substance Use and Abuse: How did the perception of threat, the stress of the pandemic, and social isolation, quarantine, and other restrictions influence peoples’ substance use during the pandemic? How might this have exacerbated substance abuse disorders?
Chapter 6 Understanding Stress pp. 153 – 171: Everyone reacts differently to stress. However, the biopsychosocial stress process is common to most people. From a biopsychosocial approach, how has the stress of COVID-19 influenced your life in each of these domains? From the transactional approach, have you viewed the pandemic as a loss, threat, or challenge? Were there acute episodes of stress within the chronically stressful time period of the pandemic? How did you experience each of those events? If you think about the developmental influence of the coronavirus, how might the stress of the pandemic be experienced differently by children, teens, and young-, middle-aged-, and older adults? Are there particular things associated with the pandemic and the virus that are stressful at different stages of life? pp. 181 – 182: In this chapter we examine the link between stress and physical and mental health. We delve into PTSD as well. Can you think about how your health has been negatively affected by the stress of COVID-19? Do you know any essential workers or people who were on the front lines in treating this virus? Did they experience PTSD? How has reading and watching the daily death tolls of this virus and the tragic stories of this pandemic influenced your mental and physical health? p. 182: Increased exposure to traumatic information from news and social media can have a triggering effect on those who have previously experienced trauma and PTSD. How might the constant media attention create stress in all of us and exacerbate or trigger episodes of PTSD in those who have had previous trauma? Think of someone who has experienced domestic violence being forced to quarantine at home in an unsafe environment, for example. What signs could you look for if you were concerned about a loved one’s well-being? Where would you recommend that they go to get help? How does telemedicine and e-therapy provide assistance?
Chapter 7 Coping with Stress p. 188: Coping Across the Lifespan: We have thought about how age might differentially influence how stress is perceived and experienced. But how does age influence coping? We know how important resources are to coping, but how did the coronavirus pandemic influence people’s resources and how did that, in turn, affect their coping? p. 191: Choosing the Best Fit: The matching hypothesis suggests that to cope well we need to tailor our coping strategies to the stressor. In the many new and highly stressful experiences associated with coronavirus, how do you tailor your coping? How do you identify those stressors that are problems that can be solved and those events that are not solvable but must be emotionally managed? Can you think of examples of each of these? What is the role of personal control in coping with COVID-19 and the coronavirus pandemic? We know that things that are unexpected, unpredictable, and create change in our lives are the most stressful. How has this virus impacted your life in these ways? How do you cope?p. 208: In The News: When No News Is Good News: In this feature we look at how major traumatic events such as terrorism, natural disasters, and war impact peoples’ lives. We look at resilience and how to go beyond coping to growth. Specifically, this feature examines how we can control our exposure to the media to promote coping and resilience in the face of trauma. There are many ways we can apply what we learn here to our own lives during COVID-19 and find ways to cope better, develop resilience, and even find opportunities for growth. Can you apply these principles to your life and your experiences?
Chapter 8 Symptom and Pain p. 212: Recognizing symptoms: Many people were very confused about the conflicting information regarding the symptoms associated with COVID-19, as the symptoms overlap with many strains of the flu, the common cold, or other respiratory infections. Many people initially thought they might have had the virus, but when they sought medical treatment they were not tested. Given that people are notoriously poor at recognizing, labeling, and seeking treatment for symptoms in general, how will the pandemic influence peoples’ perceptions of their internal physiological experiences and when they should seek treatment for them? Think about the illness perception model. Has the coronavirus pandemic changed what we interpret as concerning symptoms worthy of seeking medical care? p. 217: Delay in Seeking Treatment: Many factors influence when people seek treatment for disease. In the unprecedented times of the coronavirus it became difficult to go to one’s primary care doctor, and many people feared going to the emergency center or urgent care because of the number of cases being treated in hospitals. How do you interpret peoples’ delay behavior in terms of the anxieties and fears that this pandemic created for seeking medical care?
Chapter 9 Cardiovascular Disease and Diabetes
pp. 243 – 266: There are some research findings on COVID-19 that suggest that obesity and pre-existing conditions, as well as age, made the virus more dangerous and life-threatening for some people. What are the physiological factors associated with cardiovascular disease and diabetes that might have elevated risk for COVID-19 for people who have these conditions?
Chapter 10 Psychoneuroimmunology and Related Disorders pp. 267 – 296: People with immune disorders or compromised immune systems were at higher risk for COVID-19. There are many accounts in the news about people who were in the midst of cancer treatment who were impacted by the virus. It must have been extremely stressful for them. How might these people have managed their risks and how might the changes in treatments impacted their mental and physical health during this pandemic?
Chapter 11 Chronic and Terminal Illness pp. 301 – 303: Emotional Responses to Stress: The number of people who have died from COVID-19 worldwide is astounding. Treatment in hospitals and other treatment facilities (such as nursing homes) required that people with the virus were kept quarantined and isolated, their only contact being with the medical staff overseeing their care. Many people faced the end of their lives alone. How do you think that exacerbated the emotional processes associated with death and dying? pp. 315 – 319: End of Life: In the early stages of the coronavirus as the alarming number of cases in countries like China, Italy and in New York City began rising, there was concern about the number of available ventilators and hospital beds to care for all those who were projected to become ill with COVID-19. Several articles appeared in reputable news outlets about the ethical, moral, and practical challenges for hospital physicians in determining who should get life-saving equipment. These challenges presented difficult end-of-life decisions and changed the way medical care was thought about during this crisis. If you saw these news reports, what were your thoughts? How did these discussions change the way you think about health care and end-of-life care? pp. 320 – 322: Coping with Loss: The pandemic has also impacted the way that we cope with loss, the way that we mark death, and the way that we grieve. For example, in the time of quarantine and social distancing it became impossible to have funerals and bury the dead the way we might in other times. Many families whose loved ones died from COVID-19 had to deal with the fact that they could not be with or say their goodbyes to their loved one, because they were being kept in isolation in hospitals/nursing homes and because COVID-19 deaths often happen very quickly with little time to prepare the family. Families also could not hold ceremonies, funerals, memorial services, or worship the dead person in the desired way since gatherings of two or more people were against restrictions in many states. ? What additional emotional impact might this have on the grief process and how does it affect survivors?
Chapter 12 Health Care Services, Systems, and Alternatives p. 327: There have been so many changes to the health care system and the way health care is performed due to the coronavirus pandemic, from telemedicine, to a cancellation of “elective” surgeries, to a shortage of supplies to protect health care providers and treat patients. How will this pandemic change the health care profession? How will it impact health care delivery? How will hospitals change to be better prepared for the future? What does this mean for our health care system nationally and globally? p. 328: Health Care Services: Nursing homes and other long-term care facilities were hit hard by COVID-19. Some of the largest death rates are associated with these institutions. What caused these high rates of contagion and high death rates? How will these institutions need to change to be better prepared for the future? What is the public perception of these health care institutions now? How must that be repaired for the people to feel comfortable and safe placing a loved one in one of these facilities? p. 328: Health Care Services: The President of Bard College, Dr. Leon Botstein, gave a webinar for the parents of students of the college about how the coronavirus pandemic will affect students, faculty, staff, parents, and the future of education. In it, he predicted that this pandemic will impact the importance of higher education in general, that more students will consider seeking education in the health care and medical fields, and that there will be an increased interest in biomedicine, medical and nursing training, and hospital and health care administration. Do you agree?
Chapter 13 Achieving Emotional Health and Well-being p. 357: Health & Well-Being: The individual wellness wheel shows the important pieces that go together to promote mental and physical health and well-being. This pandemic has certainly presented challenges in many of these domains. Through self-reflection can you think of the ways in which your emotional, intellectual, physical, social, environmental, financial, and spiritual life has been affected by the pandemic? What did you need to do to preserve your well-being? Are there things that you began doing during the pandemic that helped you to cope and stay well that you will carry into your future? pp. 364 – 365: Resilience: What does the term “resilient” mean to you and how can we be more resilient in the face of a pandemic such as coronavirus?
Chapter 14 The Future of Health Psychology Health psychology is at the foundation of everything that we learn about coronavirus and COVID-19. It helps us to understand the data and information shared by the media, to understand the science and medical advances being made, to evaluate the global, federal, and local policies that have impacted our lives, and it helps us to think about how we, as individuals, fare through a crisis of such unpredictable and unprecedented magnitude. What do you think the future of the field will look like? What will the next edition of this textbook need to present? Can you think about all the ways that what you have learned has been changed by what you now know about COVID-19 and the coronavirus pandemic? When will this become history? And what will the world look like when we are there?
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