Long-term trends in family level contribution to mortality – Finland 1990-2000

BACKGROUND: Family is among the most relevant sociodemographic factors influencing the health and well-being of individuals. However, the general contribution of the family context to premature adult mortality is seldom measured, and possible changes in this effect over time have not been quantified in previous studies. METHODS: The study is based on individual-level register data on the total Finnish population aged 30 years and over. We estimate two-level Weibull survival models with individuals nested in families for six five-year periods between 1990 and 2020 to assess the degree to which the family context contributes to individual differences in mortality. The median hazard ratio (MHR) is used as a summary measure of this general contextual effect. We assess trends separately by sex and age categories and broad cause of death groups, as well as adjust for different individual- and family-level sociodemographic characteristics. RESULTS: The preliminary results show that the contribution of the family level to individual mortality risk is substantial. The family effect shows an increasing trend over three decades and is largest among younger individuals aged 30-49. CONCLUSIONS: The overall relevance of the family context to mortality is considerable and has grown over time. From a public health perspective, policy and interventions should place more importance on family-level influences on health. KEY MESSAGES: • The family context and whom you live with are increasingly important for health and mortality. • Family-oriented health care and services that consider family-level influences should be developed further.