Complex Living Arrangements and Child Health: Examining Family Structure Linkages with Children's Health Outcomes

U.S. children today live in an increasingly diverse set of living arrangements. In 2012, most children (68%) lived with two parents, 92% of those lived with both biological/adoptive parents.Atotal of 28% of children lived with one parent, the majority (86%) with their mothers. In addition, 10% of children lived with at least one grandparent; 8% lived in three-generational households consisting of a parent and a grandparent, while 2% lived with a grandparent and no parent in the household, often called a custodial grandparent family. Finally, 8% of U.S. children lived with cohabiting parents, consisting of one parent and his or her nonmarital romantic partner, who may or may not be the child's biological parent (U.S. Census Bureau, 2012). These diverse living arrangements may have implications for child health. However, research examining the linkages between a wide range of children's living arrangements and their health outcomes is rare. This study fills that gap.Specifically, we address two research questions: (1) What are the linkages between complex living arrangements and children's health outcomes - specifically, does child health differ depending on the marital relationship between parents, the biological relationship between parents and the child, the gender of the parent, the number of adults in the household, or the different types of care provided when both parents are absent? (2) What roles do income and health insurance status play in explaining these linkages?Family Structure and Child HealthA large body of research documents improved well-being for children living with both biological married parents compared to those in other family types (Brown, 2004; Harris, Cavanagh, & Elder, 2000; J. P. Hoffman & Johnson, 1998; McLanahanS Bramlett & Blumberg, 2007; Cherlin & Furstenberg, 1994; Dawson, 1991; McClanahan & Sandefur, 1994). These studies did not distinguish living with a stepfather from living with a stepmother; however, this study does so. The limited work on single-father families suggest that children in such families fare just as well or better on indicators of mental and physical health as do children residing with two biological parents (Bramlett & Blumberg, 2007; Ulveseter, Breivik, & Thuen, 2010). We are not aware of previous studies linking cohabitation and child health, nor those that distinguish cohabiting with a child's biological parent from cohabiting with a stepparent.Children who are not living with either parent typically live in one of two arrangements - either with a relative (usually a grandparent) or with a nonkin foster parent. Research on the health of children in such living arrangements is quite sparse. Evidence shows high rates of health problems among children not living with their parents, including those in custodial grandparent families (Bilaver, Jaudes, Koepke, & George, 1999; Bramlett & Blumberg, 2007; Dunifon & Kopko, 2011; Musil, Warner, McNamara, Rokoff, & Turek, 2008; Roberto, Dolbin- MacNab, & Finney, 2008) and in foster care (Simms, Dubowitz, & Szilagyi, 2000). Previous studies have not compared health outcomes of children living away from their parents to those of children in other family types.The Role of Health Insurance. One mechanism through which family structure might influence child health is through access to health insurance. Research suggests that health insurance does improve the health of vulnerable populations such as infants and children (Levy & Meltzer, 2008), due in part to linkages between health insurance coverage and access to primary and preventive care (C. …