The family as a health producer: household composition and health behaviours in a Southern Europe population

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Abstract Objectives In the context of rapid transformations in family structures, understanding how household composition can affect adults’ health behaviours is crucial, particularly when considering the potential role of such close social relationships in shaping those behaviours. This paper documents how household structure relates to individual health behaviours. Study design We pooled cross-sectional data from the Portuguese National Health Interview Surveys of 2014 and 2019, covering 26,000+ households. Methods Linear and logistic regression models were used to assess the association between different household compositions (single dwelling adults, single parents, couples with or without children) and adherence to the Mediterranean diet, frequency of physical activity, likelihood of risky alcohol consumption, and smoking, distinguishing between men and women. Results People living alone and single parents were significantly less likely to adhere to the Mediterranean diet than individuals living in couple. Single dwellers had significantly higher likelihood of engaging in risky alcohol consumption or being smokers than individuals living in couple and/or with children. Analyses by gender revealed that women in couples with children were less likely to practice physical activity than women in couples without children; this difference was not observed among men. Conclusions Overall, family contexts strongly correlate with individual health behaviours, with people living alone or in single-parent households appearing at higher risk of having less healthy diets, risky alcohol consumption, and smoking. This study identifies key target groups for policies aiming to improve population health (behaviours) including, critically, single dwellers and single parent households. Key massages What is already known on this topic Social relationships, particularly within the family, play a significant role in shaping individuals’ health behaviors. With rapid changes in family structures, understanding how household composition influences adult behaviors is crucial. What this study adds This study reveals that single dwellers generally exhibit unhealthier behaviors, except in the case of physical activity. Additionally, it highlights that having children tends to promote healthier lifestyles among couples. How this study might affect research, practice, or policy The findings underscore the importance of considering household composition in health interventions and policy development. Specifically, attention may need to be directed towards individuals living alone and single-parent households to address potential health disparities and promote healthier behaviors.

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