Work–Family Strain and Health Care For Children

Abstract

Comments on the chapter by Lisa F. Berkman and Emily M. O'Donnell (see record [rid]2013-06314-012[/rid]). Berkman and O'Donnell's model of work-family strain provides a useful backdrop for an examination of family leave policies and parents of chronically ill children. About 15% of children in the USA are children with special health-care needs (CSHCN), and their parents are at particularly high risk of employment instability and financial problems. Even the health-care needs of healthy children are substantial, and both the demands placed on parents of CSHCN and the destabilizing loss of control that their child's illness generates create often unsustainable work-family strain. Until recently, however, US government work-family policies and programs were generally not designed to address the needs of employees with ill family members. In 1993, the federal Family and Medical Leave Act (FMLA) became the first federal law to do so. Because of FMLA's limited reach, in 2004, California enacted the Paid Family Leave Insurance program, which has since been followed by a few similar programs in other states and by work on additional federal legislation. If strengthened, such programs have the potential to provide critical support for employed parents of CSHCN, as well as other employees with ill family members. Berkman and O'Donnell provide an illuminating evaluation of the maternal and child health effects of various family-related social policies in industrialized countries that are designed to help individuals enter or remain in the labor force while caring for their children or other family members. Policies examined by the authors include public policies such as parental leave, child allowances, maternity grants, flat-rate childcare leave, and tax deductions, with infant mortality serving as the primary indicator of child well-being. As a framework for their analysis, Berkman and O'Donnell employ a model of work-family strain to explain how social policies may affect the health and well-being of children and families. In this chapter, we use this work-family strain model to address an additional area in which federal, state, and employer policies intersect with family and child health: The ability of employed parents to take leave from work—either paid or unpaid—to care for their child's health needs. (PsycInfo Database Record (c) 2022 APA, all rights reserved)