"Just accept us how we are more": experiences of young Pakeha with their families in Aotearoa New Zealand.

• Author: McCreanor, Tim

Abstract

Families are widely recognised as among the most influential contributors to the environments experienced by young people as they mature. This paper brings together two independent studies--one quantitative, one qualitative--conducted concurrently within the same districts of urban Auckland in Aotearoa New Zealand. Survey data and life-story accounts are used to create a composite representation of the complexity and richness of the young participants' experiences. The importance of parents, siblings and more distant relations is discussed in terms of sample trends and case experience. The implications of the findings for health promotion, positive youth development and social equity are considered, with the conclusion that families remain a crucial site for interventions to enhance the wellbeing of young people.

INTRODUCTION

The relationships that constitute families are widely understood to be a vital part of the context of the wellbeing of young people. Along with other social environments, such as peer groups, school settings and community and workplace contexts, families exert enormous influence for good and ill upon the development and overall health of young people (Disley 1996, Pryor and Woodward 1996, Benson 1997, Durie 1998, Health Funding Authority 1999, Beautrais 2000, Cantor and Neulinger 2000, Ministry of Youth Affairs 2001).

Most young people travel the pathways between childhood and adulthood with energy, skill and considerable grace, gaining character and experience from the stumbles and challenges they experience along the way. A proportion struggle with intermittent or ongoing crises, while a minority experience debilitating and disastrous problems, usually with environmental origins (McGee et al. 1996, Fergusson et al. 1997).

In Aotearoa New Zealand, two longitudinal research projects involving large birth cohorts (one in Dunedin and the other in Christchurch) provide some of our most valuable data on the development and wellbeing of young people.

The Dunedin Multidisciplinary Study provides an important window on the development of young people and highlights that families play a central role in influencing the life experiences and available choices of the young participants (Silva and Stanton 1996). The impacts of weak or negative family environments were expressed in a wide range of distress, disorder and disadvantage, with long-lasting effects on the lives of young people (Pryor and Woodward 1996).

The Christchurch Longitudinal Study (Fergusson and Horwood 2001) has repeatedly reported measures of correlation between family style and stressors and the incidence of mental illness and other forms of social difficulty. Most of the findings from this longitudinal study relate specifically to mental illness in the cohort, and correlate such outcomes with parental separation and divorce, childhood sexual and physical abuse at moderate levels, and with other aspects of family functioning, such as interparental violence, parental alcohol problems and recombined families. The researchers looked at children who presented major mental illness by the age of 15 years and found that their childhoods were marked by multiple social and family disadvantages that spanned economic disadvantage, family dysfunction, impaired parenting and limited life opportunities.

These findings underline the importance of family life in relation to a range of physical and psychological outcomes. Crucial to the family environment is the relationship between young people and their parents or caregivers (Paterson et al. 1995, Pryor and Woodward 1996). This "connectedness" or mutual attachment between young people and their parents is one of the most important protective factors identified in the research literature (Bradley et al. 1994, Gribble et al. 1993, Herrenkohl et al. 1994, Resnick et al. 1997). There has also been considerable effort expended on identifying characteristics of parents that foster good outcomes for young people. (For a review of this work, see Lezin et al. 2004.) This body of work has consistently identified an authoritative parenting style of high warmth and caring combined with moderate levels of control as being associated with wellbeing among young people (Steinberg 2001). However, what is less clear is the detailed nature of such family relations from a young person's perspective--how young people experience their relations with their family. Such insights would advance our understandings of families as crucially influential environments.

Elsewhere, research has firmly established the contribution of the wider social environment to the health and wellbeing of young people (Paterson et al. 1995, Pryor and Woodward 1996, Bergman and Scott 2001, Bond et al. 2000). Reviewing a substantial literature on risk and resilience, Blum (1998) concludes, "It takes a community to raise a child". Resnick's work (Resnick 2000, Libbey et al. 2002) highlights the association between protective factors related to the quality of the connections to families and other institutions and better health and lowered risk behaviours among young people.

We argue that such observations represent a challenge and an opportunity for health promotion concerns to enhance the wellbeing of young people. While it is unusual perhaps for health promotion in practice to work with parameters of population health that produce or support wellbeing, there are strong theoretical arguments and policy imperatives for doing so. In this country and elsewhere, pragmatic political and fiscal restraint have seen much of the potential of health promotion targeted at the problem-focused "ambulance at the bottom of the cliff" approaches (Blum 1998). Antonovsky (1996) argues for the adoption of "salutogenic" (health-generating) approaches to health promotion to counter the predominant "pathogenic" orientation, the biomedical focus that suffuses mainstream health-related practices, shaping them toward dealing with disease and problems ones.

The concept of health promotion, revolutionary in the best sense when first introduced, is in danger of stagnation. This is the case because thinking and research have not been exploited to formulate a theory to guide the field. (Antonovsky 1996:11) Antonovsky (1996) rejected the dichotomizing of health and disease inherent in the pathogenic orientation, for a continuum model of health and illness. Antonovsky proposed a coherent theory for health promotion that prioritised the movement of populations toward health, wherever the health status of individuals might fall on the continuum. Barry (2001) and Anae et al. (2002) have critiqued the narrowness of the existing frameworks around promoting wellbeing--such as those of Mrazek and Haggerty (1994), which conceptualise promotion as consisting primarily of treatment, maintenance and targeted intervention--and argue the need for strong environmental interventions for population health gain. In the area of the wellbeing of young people, this has been expressed and researched in terms of a paradigm shift toward a "positive youth development" model (Pittman et al. 2001). Policy guidelines from the Ottawa Charter through to our own mental health promotion plan Building on Strengths (Ministry of Health 2002) endorse and extend this kind of thinking.

This paper reports from two Health Research Council of New Zealand funded research projects--the qualitative Youth Mental Health Promotion and the quantitative Adolescent Health Survey--that aim to identify and describe features of young people's lives as they relate to health and wellbeing. Fortuitously, the databases from these projects included two groups resident in the same...