Date November 20, 2024

How does parental health impact a child's ability to flourish?

81% of children in the United States are categorized as "flourishing": indicating the presence of physical, mental and developmental well-being. A new Brown research study looks closer at these numbers, and how parental health has an impact on a child's flourishing.

In his Nicomachean Ethics of the late 4^th century BCE, Aristotle argued that the purpose of life was to flourish, which he termed eudaimonia. For Aristotle, flourishing—or living well—involves a life guided by virtue and reason, and supported by health, social connection and material stability.

In 2011, the National Survey of Children’s Health (NSCH) began measuring flourishing as a significant indicator of child health. The NSCH determined that children were flourishing if their parents answered “always/usually” to questions about their children’s levels of resilience, curiosity, affection and tendencies to smile or laugh.

While flourishing has emerged as a key framework for understanding child health, the influence of a parent’s health on their children is less understood. Addressing this gap, a research team led by Annie Gjelsvik, associate professor of epidemiology at Brown, and Brock Polnaszek, MD, a physician and Maternal Fetal Medicine Fellow at Women and Infants Hospital and the Warren Alpert Medical School, investigated how parental health affects their children’s well-being.

This study began as a class project of Polnaszek, who was Gjelsvik’s student in 2023-2024. “I’m thrilled to see research like this come out of the classroom,” Gjelsvik said. “I generally focus on maternal and child health, so I was excited to collaborate on it. What was particularly interesting was how we approached the family as a unit, rather than looking at parents and children separately. That’s really where the idea took shape.”

What was particularly interesting was how we approached the family as a unit, rather than looking at parents and children separately. That’s really where the idea took shape.

Annie Gjelsvik Associate professor of Epidemiology

The study specifically examined “flourishing” as an indicator—or the presence of physical, mental and developmental well-being. “It’s a broader look at a child’s overall wellness, not just their health in the absence of disease,” Gjelsvik said. “When you talk to parents, they often express a desire for their children to reach their full potential, not just avoid illness. That’s why we chose flourishing as our measure—it captures that holistic view of well-being.”

Analyzing publicly available data from the 2021 NSCH of more than 30,000 children aged six months to five years, researchers found that 81% of children in the U.S were flourishing. These rates ticked upwards as the overall health of parents increased.

Reciprocally, a subgroup analysis showed that poorer parental health was associated with lower rates of flourishing among children. For example, children of mothers in “poor/very poor” health were 32% less likely to flourish compared to mothers in “excellent/very good” health. Likewise, children of fathers in “poor/very poor” health were 41% less likely to flourish compared to those whose fathers reported “excellent/very good” health.

“The main finding was that a parent’s reported health was associated with their children’s flourishing, specifically physical health,” Gjelsvik said. “The overall association was clear. However, when we accounted for income, parents’ coping skills and education levels, the association was less pronounced. This suggests that factors like poverty and family resilience significantly impact both parental and child flourishing.”

In addition to levels of income and education, Gjelsvik stresses the importance of coping skills because they reflect whether parents have the abilities, resources and social networks to handle challenges.

In other words, much of what researchers observed as exerting downward pressure on parental and child health can be traced back to social determinants. “While interventions that directly support parental health are beneficial,” Gjelsvik said, “it’s really about these broader factors that promote the well-being of the whole family.”

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