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Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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3

Relationships

Key Findings

  • Young adulthood is a critical period for the formation of formal and informal romantic relationships that can have implications for the life course and many consequences for future mental and physical health and well-being.
  • Relationship patterns and trends vary by gender, race, ethnicity, and socioeconomic position. These variations can lead to health disparities and differing patterns of social and achievement role transitions across the life course.
  • Increasingly diverse levels of social networks that develop from family relations, romantic/sexual partners, peers, work, community, and educational institutions and other organizations have direct and indirect impacts on the health, safety, and well-being of young adults.
  • Delays in childbearing have been taking place at the population level, together with an increasing proportion of nonmarital births occurring within cohabitation and increases in multiple-partner births. These trends vary by race and socioeconomic position, with health consequences for children and young adult parents.
  • Changing demographic patterns of adult children are complex, and findings are mixed on the long-term implications of parental support for the development of young adults.
Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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  • Incarceration can impact relationship patterns and quality, family life, parenting, and children’s development.

This chapter considers the relationships that make up the social lives of young adults, which comprise many of the most salient contexts and developmental tasks of young adulthood and have profound consequences for future adult emotional, physical, and mental health (House et al., 1988; Schulenberg and Maggs, 2002; Umberson et al., 2010b). In childhood and early adolescence, family and peer relationships are the primary contexts in which emotional ties, social support, and social interactions take place (Furman et al., 1999). Throughout adolescence, developmental tasks include gaining autonomy from parents, bonding with peers, and exploring romantic interests. During the transition from adolescence into young adulthood, young people explore new lifestyles and experience diverse environments that expand their social relationships. Developmental tasks shift to renegotiating parent-child relationships, expanding networks of peers, and pursuing romantic connections (Furstenberg et al., 2005; Shanahan, 2000). The family of origin remains a central relationship context, but young adults experience growing and more diverse social networks of friends, peers, classmates, workmates, neighbors, community members, and sexual and romantic partners (Bucx and van Wel, 2008). Indeed, central to the life course of young adults is developing more permanent romantic relationships, forming their own families, and potentially becoming parents and forging relationships with their own children.

“Relationships can’t be built overnight. Young adults need to have someone they are generally able to engage with who can serve as a mentor within school or the neighborhood they live in.”*

The discussion in this chapter is guided by a socioecological framework that integrates three prominent theoretical perspectives on human development in general and the transition from adolescence into adulthood in particular (Lerner, 2006): life-course theory (Elder, 1998), human ecology (Bronfenbrenner and Morris, 1998), and systems-based developmental psychopathology (Sameroff, 2010). This framework encompasses several basic tenets that are woven into the discussion throughout this chapter:

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* Quotations are from members of the young adult advisory group during their discussions with the committee.

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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  • Healthy development is a product of dynamic transactions between the individual and his or her close relationships within safe, prosocial, and supportive contexts.
  • Individuals, their close relationships, and the transactions between them unfold over time within diverse social contexts.
  • Social contexts can range from the concrete proximate settings of daily life (e.g., peers, schools, communities) to more abstract and distal social systems and structures (e.g., media, legal, political, cultural).
  • The socially embedded role of relationships in healthy development can change dramatically across time and place.
  • Public policy and programmatic efforts aimed at serving individuals can use relationships and the contexts in which they are embedded as intervention points.

Although this socioecological framework applies to the full life course, it is particularly relevant to young adulthood, a time of dynamic change and diversity in social relationships and the contexts in which they occur.

This chapter examines in turn four broad areas of relationship development in the lives of young adults: social relationships, romantic relationships and union formation, the transition to parenthood, and intergenerational relationships. Within these areas, we examine trends and patterns of relationship development as they relate to the themes of young adulthood described in Chapter 2. Given the centrality of family relationships during young adulthood—both the creation of one’s own family through union formation and childbearing and intergenerational relationships—they are the primary focus of this chapter. We emphasize the protective nature of relationships; factors that inhibit or facilitate their development; and their link to health, safety, and well-being. We also examine the heterogeneity of these trends and patterns by gender, race, ethnicity, and socioeconomic position and the implications for disparities in health and achievement across the life course. In addition, we highlight topics in young adult relationships that have as yet received little research attention, as well as topics especially relevant to policies and programs that would improve the health, safety, and well-being of young adults. Chapter 9 includes a discussion of policies and programs for young adults who are parents.

“In transitioning from college to work, you have to fit yourself into a new community. It can be really challenging. It can be very isolating.”

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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SOCIAL RELATIONSHIPS

Social relationships are integral to physical and mental health and well-being. In contemporary societies, social relationships are articulated in the form of social networks (e.g., Simmel, 1950; Wasserman and Faust, 1994; Wellman and Berkowitz, 1997)—social structures that evolve out of dyadic relationships emerging from family relations, peership, friendship, work, groups, and organizations. It is within this web of affiliations that individuals self-actualize, and opportunities for and constraints on health and well-being present themselves.

Research suggests that a wide range of behaviors related to health and well-being develop and spread within networks. For example, research has shown that people are likely to be happier if they have close ties with happy people (Christakis and Fowler, 2009); by contrast, if people are depressed, their networks are more likely to be populated by depressed people (Rosenquist et al., 2010a). In addition, people closely connected within the same network tend to have similar health-related habits, such as smoking, alcohol drinking, and behaviors related to obesity (Rosenquist et al., 2010b). This similarity reflects a complex process by which individuals select networks and network members that share characteristics, attitudes, behaviors, and even genetic makeup within structural constraints often defined by socioeconomic position, race, ethnicity, and geography, and in which network influence is bidirectional (Boardman et al., 2012; Cohen-Cole and Fletcher, 2008).

Communication technologies expand the ability of people to preserve a variety of social ties and connect with a variety of networks. Media multiplexity theory builds on Granovetter’s (1973) work to posit that those in stronger relationships tend to use more media with greater frequency than those in weaker relationships, although media are also helpful in activating and maintaining connections with weaker but potentially helpful social ties (Haythornthwaite, 2005; Haythornthwaite and Wellman, 1998). This theory has enabled researchers to connect social media use to relational strength (Baym and Ledbetter, 2009; Ledbetter, 2009) and also to growth in network size and diversity (Hampton et al., 2011). In other words, if one thinks of networks as the everyday neighborhoods people occupy (Rainie and Wellman, 2012), social and mobile media make these neighborhoods more accessible and interconnect people beyond the confines of geographic proximity. Reflecting a general theme of this report, young adults are at

“Social media can be a tool to extend someone’s social network for good or bad.”

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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the forefront of this technological reshaping of social and interpersonal contexts.

Social and mobile media not only extend but also converge social networks, providing a rich sociocultural context for maintaining existing and cultivating new interpersonal relationships. Through this relational context, two main avenues for enhancing health and well-being present themselves: connection and expression.

Connection

The interconnected structure of social and mobile networks provides avenues for the sharing of information in ways that blend the potential of mass broadcasting with the immediacy of interpersonal conversation. This sociotechnical environment is enhanced by being constructed out of overlapping and interwoven social relations, weak or strong. People access a number of valuable resources through social relations, including information, advice, emotional support, and general forms of feedback (Baym, 2010), and social and mobile networks amplify potential points of social contact.

Not all points of contact have equal value for networked individuals. Social capital refers to the benefits that can be attained from the connections people maintain through their networks (Putnam, 2001). Depending on their nature, social ties are variably equipped to offer opportunities for different forms of social capital (Burt, 1992). Weak ties often work as “bridges,” connecting “otherwise disparate groups of individuals” and thus exposing them to heterogeneous groups and a wider and more diverse range of information (Ellison et al., 2011, p. 128; Granovetter, 1973). Strong ties, on the other hand, consist of close friends and family, lending themselves to bonding forms of social capital and therefore potentially being capable of offering more substantive forms of support. Social and mobile media make it easier for individuals to maintain a larger network of weak ties. They make ephemeral connections persistent, lower barriers to initial interaction, and help people seek both information and support from both weak and strong social ties (Baym, 2010; Boyd, 2014; Ellison et al., 2011; Humphreys, 2005, 2010; Quinn and Papacharissi, 2014).

“I have talked to people who say, ‘Oh, I know that person from Facebook,’ but they don’t talk to them.”

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

Expression

The sociotechnical environments resulting from the convergence of social and mobile networks invite people to connect further with others by disclosing information about themselves and their everyday lives. This form of self-disclosure has most recently been described as lifestreaming: “the ongoing sharing of personal information to a networked audience, the creation of a digital portrait of one’s actions and thoughts” (Marwick, 2013, p. 208). These daily exercises in self-disclosure, self-documentation, and self-representation are a way for people to frame and maintain a coherent story of who they are, where they have been, and where they are headed in the face of modern challenges that constantly require them to adjust their personal boundaries (Gergen, 1991; Giddens, 1991; Papacharissi, 2012; Rettberg, 2013).

The process of lifestreaming is relevant in the present context because it allows people to share stories about health and well-being and to present their own point of view—to tell their own story in their own terms. This potentially empowering act also allows people to affiliate with a particular culture, not just telling their own story but engaging with others and their stories in the process. The networking enabled by social and mobile media thus provides new places where relationships can evolve, while the stories shared through these networks afford connection that permits these relationships to flourish in supportive ways.

ROMANTIC RELATIONSHIPS AND UNION FORMATION

Young adulthood is a critical period in the formation of romantic unions. Young adults engage in a wide variety of romantic activities during their early 20s, but the nature of these activities has changed considerably over time. A century ago, most Americans in the young adult age range were already married; today, that is no longer the case (Sassler, 2010). Today, changes such as gender role fluctuations, birth control access, social capital for marriage and unions, and the importance attached to single-generation households in mainstream U.S. culture may be creating a new set of expectations and values relative to traditional romantic union pathways. Reflecting the theme of different pathways that runs throughout this report, the idea of a normative path to romantic union has increasingly come to seem unrealistic.

“There is a lot of pressure on young adults to be in relationships, and this is impacting their daily lives and mental health.”

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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Generally, romantic unions—which represent more significant and durable ties than dating—fall into two categories: formal and informal. Marriage is a formal union, defined by a government-sanctioned and legally binding contract. Cohabitation is the most common form of informal union, denoting couples in an intimate relationship who live together but are not legally married. Although cohabitation was long stigmatized as “living in sin,” it is now both common and widely accepted, such that most young Americans view it as a logical and expected step in the evolution of a relationship (Smock, 2000). As will be discussed shortly, same-sex unions could occur only in the context of cohabitation for most of U.S. history, as these unions were not legally recognized by the state. Today, moving from an informal to a formal union is now possible for same-sex couples, at least in some states (Hunter, 2012).

Despite the increased heterogeneity of the young adult population, efforts to disentangle racial and ethnic differences in this area are quite sparse. The majority of today’s young adults form formal or informal unions before turning 25, with higher rates for African American and Hispanic young adults (across levels of education) and lower rates for college students and graduates (across races/ethnicities). Early cohabitation patterns are strongly influenced by early sexual debut, school dropout, and early parenthood (Hofferth and Goldscheider, 2010). Family stability (e.g., married parents, parents with more than high school education) appears to decrease the chances of early cohabitation (Hofferth and Goldscheider, 2010). Nearly 50 percent of young adults in the United States have cohabited by the time they turn 25, while only about a quarter have married. Among those who marry by age 25, the overwhelming majority (three-fifths) cohabit first (Payne, 2011). Racial/ethnic minority young adults are somewhat less likely to fit this pattern (although most do) (63 percent of whites cohabited before marriage compared with 57 percent of African Americans and 53 percent of Hispanics); those with a General Educational Development (GED) credential most often cohabited before marriage (77 percent), while those with a bachelor’s degree or higher were least likely to cohabit before getting married (42 percent) (Payne, 2011). In other words, the modern style of union formation (cohabitation that may or may not be followed by marriage) tends to be less common in historically disadvantaged segments of the population (Payne, 2011).

These contemporary patterns are manifestations of much longer-term trends. Specifically, lower rates of marriage among young adults do not necessarily imply that marriage is becoming less common overall. Instead, they reflect a delay in marriage: young adults will get married eventually, but not during their early 20s. The median age at first marriage (the age by which half of the population has married) generally has increased over the last century. Today the median age is 29.4 for men and 27.4 for women

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

(U.S. Census Bureau, 2013). Thus the median age of marriage now falls outside of the 18-26 age range that is the focus of this report. Moreover, it is now older than the median age at first birth, meaning that on average, young adults become parents before marrying. They still form unions, just not formal unions, or at least not yet (Arroyo et al., 2013; Payne, 2012). The most common explanations for these trends are economic: American youth have high expectations for where they need to be economically before getting married but have more trouble getting there; in addition, getting to that point now requires greater investments in education and career development, especially among women, than was previously the case. Cultural explanations include an attitudinal shift away from the traditional exchange system of marriage toward women’s economic independence and two-career households (Settersten and Ray, 2010; Teachman et al., 2000).

Even as cohabitation becomes a normative part of young adult pathways, its meaning and role in the social lives of young adults differ widely, reflecting this report’s theme of population heterogeneity and diverse pathways. Family demographers Casper and Bianchi (2002) propose a basic typology of cohabitation that is not specific to young adulthood but is highly relevant to this period of the life course. Some young adults may cohabit as an alternative to marriage; they expect the relationship to endure but do not expect to make it legal—a marriage in all aspects but name. Another type of cohabitation is a precursor to marriage, a preliminary step on the road to getting married, almost like part of the engagement. A trial marriage is when a couple cohabits as practice, to explore whether they are compatible and whether marriage may make sense in the future. Finally, some young adults may use cohabitation as a form of coresidential dating—not wanting to get married but not wanting to be alone, so that they live together while dating without expecting that the arrangement will lead anywhere.

Although cohabitation as an alternative to marriage has a long tradition in Latin America (and, therefore, among Latin American immigrants in the United States) (see Frank and Wildsmith, 2005), it is relatively uncommon overall in this country. The other three types of cohabitation are much more common in the United States. The prevalence of these three types helps explain why cohabitation among Americans, including young adults, is a temporary state with a typical duration of about 1 year. Couples either move to marriage, decide that they are not marriage material, or just drift apart (Smock, 2000). In a comparison with dozens of other Western developed countries, Heuveline and Timberlake (2004) found that the most prototypically American form of cohabitation was akin to the alternative to singlehood as described above, a reflection of ample housing and widespread birth control in the United States, and indicative of short relationships without children.

As noted, same-sex couples often have been difficult to classify in terms

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

of marriage and cohabitation. Many same-sex couples (including young adults) lived together, but because of heterosexual definitions of legal marriage, one could not know whether they were more like a cohabiting couple (and if so, what type) or a married couple. Unlike opposite-sex couples, they had no choice in the matter (Gates, 2013). Over the past decade, some states began to recognize same-sex marriage legally, through either court decisions or legislative deliberations, and some states grant some marriage-like status to same-sex couples (e.g., civil unions). In June 2013, the U.S. Supreme Court rendered a decision in United States v. Windsor holding that the federal government is obligated to recognize any marriage granted by a state, regardless of whether it is between a same-sex or opposite-sex couple (Hunter, 2012).1

When same-sex marriage is legal, same-sex and opposite-sex couples tend to follow similar union formation (and dissolution) patterns (Hunter, 2012). How these dramatic legal changes will affect young adults is currently unknown. Given that young adulthood is an important period in union formation and that young adults are by far among Americans the most supportive of same-sex marriage (Dimock et al., 2013), this is an important topic for future research as more data on same-sex relationships become available.

The distinctions among formal and informal unions, same-sex or opposite-sex, are significant in light of the considerable evidence showing that romantic unions, especially formal unions, bring many benefits, including greater economic security, more social support, and better health. These patterns often are conditional on the duration of formal and informal unions throughout adulthood. Yet simply transitioning into a romantic partnership can have implications for the life course, as union formation itself can facilitate healthier and more prosocial behavior (Umberson et al., 2010b). Consistent with this report’s theme of social change and social network activities being concentrated in young adulthood, it is not surprising that union formation is increasingly taking place online. Popular dating sites need to be better understood as contexts for romantic partnerships, cohabitation, and even marriage (Kreager et al., 2014).

Union Formation and Health

One of the recurring themes of this report concerns the high stakes of pathways forged during young adulthood—a theme clearly evident when one considers how patterns of union formation shape lifelong health trajectories. Decades of research have documented the health benefits of marriage for men and women, including reduced health risk behaviors, improved

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1United States v. Windsor, 570 U.S. 12 (2013).

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

access to health insurance, and improved physical health and psychosocial well-being (Umberson and Montez, 2010; Waite, 1995; see the review and synthesis of research by Wood et al., 2007). Notable in this research is the attempt to disentangle health selection from the protective effects of marriage on health. Health selection occurs when underlying processes operate to increase the chances that healthier people enter marriage, leaving less healthy individuals unmarried or in cohabiting relationships. For example, observed differences in socioeconomic position and, in turn, better health are important selection factors that give individuals a higher probability of being married and of having better health over their life course (Goldman, 1993; Haas, 2006). On the other hand, marriage may have a causal protective effect, over and above health selection, that improves the health of married individuals (Hughes and Waite, 2002; Zhang and Hayward, 2006). In general, evidence indicates that both selection and protection operate in the health advantages of marriage, with protection effects being greater for men than for women (Goldman, 1993; Wood et al., 2007).

In comparison with effects of other role transitions, including parenthood and employment, marriage tends to be more predictive of greater health and decreased involvement with the justice system during early adulthood (Duncan et al., 2006; Sampson et al., 2006; Staff et al., 2010). Marriage is consistently associated with declines in alcohol and other drug use (Bachman et al., 2002; Duncan et al., 2006; Leonard and Eiden, 2007; Staff et al., 2010), although this effect is limited when both partners are heavy substance users (Merline et al., 2008). Criminal involvement also tends to decrease with marriage (Sampson et al., 2006).

Beneficial health effects also are found for cohabitation, although to a limited degree. Research in Europe and Canada, where cohabitation has a longer history than in the United States, has found that single individuals report the lowest levels of health, while cohabiters’ self-reported health typically falls in the middle of that of married and single persons (Joung et al., 1995; Mastekaasa, 1994; Ren, 1997). Other Canadian research shows that a variety of physical health measures are improved equally for those who cohabit or marry compared with those who remain single (Wu et al., 2003), or are unaffected by entry into cohabitation (Wu and Hart, 2002). With respect to mental health in the United States, some research shows that it is not associated with cohabitation (Booth et al., 2008; Horwitz and White, 1998; Kim and McKenry, 2002; Lamb et al., 2003), some shows that it is similar for those who cohabit and marry (Ross, 1995), and some shows that cohabitation compared with marriage is associated with greater depression (Brown, 2000; Brown et al., 2005). Much of this prior research, however, suffers from limited health indicators and controls or small or unrepresentative samples, or is based on cross-sectional data or otherwise fails to account for selection effects, making it difficult to separate the effects of se-

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

lection into unions from the protective effects of union status. Furthermore, the broader societal context and prevalence of cohabitation have changed in the past few decades, suggesting that the meaning and health effects of cohabitation have changed as well, and may continue to do so.

Recent longitudinal research by Pollard and Harris (2013) examines a wide array of health indicators, including general health status, mental health, health behavior (regular physical exam, binge drinking, tobacco use, physical exercise), and body mass index among cohabiting versus married and single young adult men and women, controlling for health selection prior to union formation. Consistent with some of the previous research, the authors report mixed findings. They find that cohabitation does not benefit the health of young adult women who report poorer physical and mental health than married or single young adult women. Although cohabiting young adult women engage in less problem drinking behavior, they have lower levels of physical activity and more frequent use of tobacco than single adult women. Cohabiting young adult men experience more health benefits, with improved mental health and less problem drinking. Selection plays an important role in health differentials by union status. In general, young adults with worse mental health and poorer health behaviors appear to be selected into cohabitation compared with remaining single. Despite this selection, however, the protective effects of a union are the likely cause of any benefits found, especially for men. The presence of a cohabiting partner likely increases social support, benefiting the mental health of men in particular (Kessler and Cleary, 1980; Thoits, 1983).

THE TRANSITION TO PARENTHOOD

Parenthood has been a common role transition during young adulthood throughout U.S. history, but the age pattern and union context of childbearing have changed dramatically with the changes in union formation described above. Consonant with the delay in marriage has been a delay in childbearing at the population level. The average age at first childbearing has been increasing since the 1970s and currently stands at 26 for women and 28 for men (Martin et al., 2013; Mathews and Hamilton, 2009). While the 20s remain the peak years for childbearing, the rates of childbearing have been declining slightly for women aged 20-29 and increasing slightly for women over age 30, and teen childbearing rates have been declining since 1991 (Martin et al., 2013). What is most notable about childbearing among young adults is that it occurs predominantly outside of marriage.

With the increasing prevalence of cohabitation and delayed marriage—demographic trends concentrated among young adults—a growing proportion of births to young adults have been occurring outside of marriage. The trend in nonmarital childbearing among young adults is due in part

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

to couples delaying marriage but not delaying childbearing by an equal or greater number of years, and shows persistent racial, ethnic, and socioeconomic position gradients. The percentage of births that occur outside of marriage has increased for all young adults in America, although the rates by race and ethnicity still differ markedly. Among young adult women aged 20-24, blacks have the highest rate of nonmarital fertility (103.5 births per 1,000 unmarried black women), followed by Hispanics (96.5), whites (46.6), and Asians/Pacific Islanders (22.0) (Martin et al., 2013). Thus 88.2 percent of all births to black women aged 20-24 are outside of marriage, compared with 66.6 percent among Hispanic women, 54.8 percent among white women, 76.6 percent among American Indian/Alaska Native women, and 45.5 percent among Asian/Pacific Islander women in that age group (Martin et al., 2013).

In addition, young adults who bear children outside of marriage often are more disadvantaged, both before and after birth, in comparison with married young adults that have children. Compared with married young adult mothers, unmarried young adult mothers usually have lower incomes and education levels, and they are more likely to receive public assistance (Driscoll et al., 1999; Lichter et al., 2003; Mincieli et al., 2007; Smock and Greenland, 2010), and these patterns hold across race and ethnicity. Similarly, the majority of nonmarital births to young adults are reported to be unintended (Smock and Greenland 2010; Wildsmith et al., 2011). “Unintended births are those that, at the time of conception, were either mistimed (the mother wanted the pregnancy to occur earlier or later than it did) or unwanted (at that time or any time in the future)” (Wildsmith et al., 2011, p. 4). Estimates vary, but a recent study reviewing data from the Early Childhood Longitudinal Study-Birth Cohort found that while 20 percent of births to married women are reported to be unintended, this is the case for 65 percent of births to women who are not married or cohabiting with the child’s father and 50 percent of births to women who are cohabiting with the child’s father (Wildsmith et al., 2011). Note, however, that the “unintendedness” status of births is a subjective and typically retrospective assessment. Qualitative studies indicate that some women may report a birth as “unintended” when in fact they knowingly made no effort to avoid unintended pregnancy through the use of birth control (Edin and Kefalas, 2005). Thus survey estimates of unintended births may be overstated.

Another important trend in the transition to parenthood among young adults is the increasing proportion of nonmarital births that occur within cohabitation, which varies by race and ethnicity. Sixty-one percent of white and 65 percent of Hispanic nonmarital births occur among women who are cohabiting, while fewer than 30 percent of nonmarital births occur among cohabiting black women (Mincieli et al., 2007). Perhaps the most important

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

distinction in childbearing patterns by race and ethnicity is that births to young adult black women occur predominantly outside of unions.

In sum, patterns of the transition to parenthood vary by socioeconomic position (Ellwood and Jencks, 2001; Smock and Greenland, 2010). Many young adult couples are waiting to have children in order to follow career goals, and consequently, many have smaller families (Hines, 2008), but these women are primarily of higher socioeconomic position, with higher levels of education and eventual income. Young adults of higher socioeconomic position from all racial and ethnic groups delay childbearing until their late 20s or 30s (Sassler and Cunningham, 2008; Smock and Greenland, 2010). Young adults who are making the transition to parenthood tend to come from a lower socioeconomic background, with fewer years of completed education and lower potential household income. Young adults of lower socioeconomic position tend to have children early in young adulthood (i.e., before the average age of first childbearing in America), and most of their births occur outside of marriage. Both quantitative and qualitative research has documented this pattern of delaying marriage but not delaying childbearing (Edin and Kefalas, 2005; Gibson-Davis et al., 2005; Smock and Greenland, 2010; Sweeney, 2002). Because racial and ethnic minority women tend to come from lower socioeconomic backgrounds and face higher risks of poverty, rates of early, nonmarital, and unintended childbearing are higher for black and Hispanic women, but the primary driver of early childbearing patterns in young adulthood remains socioeconomic position.

Explanations for this pattern of childbearing among young adult women of low socioeconomic position include the low opportunity costs associated with childbearing (i.e., because employment and career opportunities are lower for these women, they do not suffer a loss of opportunities due to childbearing) and a lack of marriageable men, together with the increasing economic independence of women and deteriorating economic fortunes of men in their occupational and economic stratum (Edin and Kefalas, 2005; Oppenheimer, 2003; Wilson, 1987). Another important factor behind the rise in nonmarital childbearing at all socioeconomic levels is the dramatic shift in attitudes toward women’s roles in the workplace and family, including increasing acceptance of working mothers and single-mother families (Casper and Bianchi, 2002; Edin and Kefalas, 2005).

Multiple-Partner Fertility

Another trend that varies by race and socioeconomic position is the dramatic increase in the number of women having multiple-partner births, a phenomenon termed multiple-partner fertility (MPF). This phenomenon underscores two major themes of this report: population diversity (i.e.,

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

group differences in the prevalence of MPF) and intergenerational connections (i.e., family influences on MPF and its implications for children). Having children by more than one partner is an overlooked yet important component of family formation and family structure. According to Guzzo and Furstenberg (2007), the phenomenon is fairly common among low-income individuals and differs remarkably by race. Based on national survey data, the rate of MPF is nearly 7 percent for black women aged 19-25, more than twice the rate for white or Hispanic women. MPF is seen most commonly among those who are young and unmarried at first birth and have conflicted and weak relationships with current or previous partners. Switching to another partner and having additional children in that relationship often is prompted by the hope of improving prospects for having a stable relationship. Women following such relationship trajectories frequently experience depression and substance use, which increases the likelihood that their partners will raise their own biological children solo because of the destabilizing factors in their relationships with the mothers of their children.

Manlove and colleagues (2008) contend that the combination of increased marital dissolution and nonmarital fertility may contribute to the rising rates of MPF and that the phenomenon may become even more prevalent in the future, “fostering intergenerational trends in disadvantage and in disconnected families” (p. 547). Anderson (1999) has suggested that high rates of uncommitted sexual relationships in disadvantaged communities may be caused by a shortage of financial opportunities.

Another important issue in understanding the complexities of MPF families is the extent to which women bearing children with romantic partners who have additional children by other women influences childrearing and parenting patterns. Burton and Hardaway (2012) pose the question of whether such women serve as “other-mothers” to the children of their current or past romantic partners. Other-mothering has a long-standing tradition in African American and Latino families. Findings from Burton and Hardaway’s study of low-income women reveal that the majority of MPF women were overwhelmed with the day-to-day management of their own households; very few were serving as other-mothers. Alarmingly, half of the women had been medically diagnosed with depression and/or anxiety, often associated with their contentious relationships with romantic partners and the lack of resources from the biological father(s) of their children. Many of the women sought new partners or continued relationships with former partners knowing that the men had children with multiple women. Additional research is needed to inform practice and policies aimed at meeting the mental health and parenting needs of women involved in MPF, including enhancing their ability to manage relational stress and conflict with their romantic partners.

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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Because of the increasing rate of MPF and the potential negative consequences for children, research also is needed to identify ways of encouraging fathers to support their children from concurrent or previous relationships. Doing so will require programs and policies that facilitate school completion so as to increase employment, and perhaps diversion programs that reduce incarceration to increase men’s marriage potential. Finally, in light of the declining birth rate among teenagers and rising nonmarital birth rates among young adults in their 20s, efforts designed to reduce nonmarital and unintended pregnancies previously targeting teenagers need to be expanded to include young adult men and women.

Childbearing and Health

The consequences of nonmarital fertility for the health of children have received considerable research attention. Most of the research on the health of unmarried mothers comes from European settings where single mothers report worse health than married or cohabiting mothers (e.g., Elstad, 1996; Shouls et al., 1999; Westin and Westerling, 2006). Other research on representative U.S. samples has examined the health consequences of nonmarital childbearing among women in mid-life (age 40) (Williams et al., 2011) and the long-term consequences among elderly women in their 60s and 70s (Henretta, 2007). Likewise, research examining the birth and health outcomes of children born to never-married mothers finds greater risks to their health and well-being compared with children born to married mothers (e.g., Albrecht et al., 1994; Bennett, 1992; Bennett et al., 1994; Chomitz et al., 1995; Williams et al., 2013). However, there is less research on the consequences for the young adult mothers and absent fathers.

The large literature on marriage and health described above is relevant, however, to the health consequences of nonmarital fertility among young adult mothers. Health operates as an important selection factor associated with nonmarital fertility, if only through the process of nonmarriage, but more importantly because relationship and childbearing decisions often are made jointly (Edin and Kefalas, 2005; Musick, 2007; Upchurch et al., 2002). As noted above, despite the increasing prevalence of nonmarital childbearing in the mainstream young adult population, there remain significant differences by socioeconomic position, with nonmarital childbearing being more common among women with lower levels of education and income and disadvantaged parental backgrounds (Lichter and Qian, 2008; Lichter et al., 1992). These selection differences are correlated with health prior to nonmarital childbearing and matter for the health consequences of nonmarital fertility. Thus, preconception and preunion health is an important factor in understanding how a nonmarital birth is related to the subsequent health of a young adult mother. Recent research by Wagner

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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and Harris (2014) taking preconception and preunion health into account finds an additional negative health impact among women who have births outside of marriage, especially those who are not in cohabiting or highly committed relationships. Although research has yet to uncover the mechanisms through which this additional health disadvantage operates, the stress experienced by single mothers and the disadvantaged environments in which nonmarital births occur are likely explanations (Williams et al., 2011). As with the health effects of cohabitation, however, the broader societal context and prevalence of nonmarital fertility have changed in recent decades, suggesting that the significance and health effects of such births for both parents and children have changed. Multicohort research therefore is needed to examine historical variation in the effects of nonmarital fertility.

Young Adult Parents

Given the contexts in which young adults experience childbearing, as described above, it is not surprising that research has focused on the number of challenges they face as they become parents. Reflecting one of the themes of this report—that the stakes of young adulthood are high—pathways that include childbearing have profound consequences for the health and well-being of young adults and their families (Amato, 2005; Demo and Cox, 2000; Gibson-Davis, 2008; Haveman et al., 2001). While those consequences include both costs and benefits, the balance of research finds that having children is more costly than rewarding for young adults in terms of economic security, daily stress, social relationships, and psychological well-being (Nomaguchi and Milkie, 2003; Thomas and Sawhill, 2005; Umberson et al., 2010a). However, this general finding is dependent on the gender and marital status of the young adult (Umberson and Williams, 1999). In particular, women and the unmarried tend to experience greater risks of low family income and poverty, and as a result, greater distress and lower psychological well-being relative to men or married young adults. Unmarried young adult mothers living alone and raising young children lack economic, social, and emotional resources and face the challenges of providing for their family and parenting young children alone.

Grandparents can play important roles in helping their young adult children with childrearing. Over the past several decades, a growing number of grandparents have been taking care of grandchildren. In 2010, approximately 10 percent of children (7.5 million) were living with a grandparent, and 4.9 million of them lived in the grandparent’s home (U.S. Census Bureau, 2010). Fully 82 percent of such households are three-generation households; in the remainder, neither of the grandchild’s parents is in the household (Wilson, 2012). Caregiving by coresident grandparents occurs disproportionately among families who are poor and among racial/

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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ethnic minorities (Wilson, 2012). When the parents are absent, grandparents act as “surrogate parents” and role models, supporting and guiding their grandchildren’s development and imparting cultural and family values (Burton, 1992). Empirical findings show that caregiving can be beneficial for the grandparents, the young adult parents, and the grandchildren. It also can improve the developmental outcomes of children raised by poor single parents, most of whom are young (Burton, 1992; Dunifon and Kowaleski-Jones, 2007; Hayslip and Kaminski, 2005). On the other hand, in many cases, caregiving grandparents—African American grandmothers in particular—report physical, mental, and financial burdens associated with caregiving (Fuller Thomson, 2000). Further, a significant proportion of grandparents experience stress-related health problems that they believe contributed to the onset of various chronic illnesses (e.g., diabetes, hypertension) (Burt, 1992).

A wealth of data has documented the increased risks of economic insecurity and poverty associated with single motherhood, and nonmarital childbearing in particular, in young adulthood (e.g., Ellwood and Jencks, 2001; Garfinkel and McLanahan, 1986; McLanahan and Sandefur, 1994). Children create substantial demands on parents’ time and physical and emotional energy, but these demands generally take a greater toll on parents’ well-being when economic security, social resources, and emotional support are lacking. Marriage tends to increase family economic stability, emotional well-being, and psychological health, which in turn lead to higher-quality relationships and positive parenting behaviors (Brown and Booth, 1996; Lerman, 2002; Nock, 1995). Cohabitation provides some of these resources, but the lack of institutionalization of expectations, norms, and legal supports for parenting, as well as the shorter duration and instability of such unions, makes this union context less beneficial to the well-being of young adult parents (Cherlin, 2004; Manning et al., 2004).

The overload all parents experience from combining family responsibilities with employment and job responsibilities and having to find child care is particularly stressful in the context of family poverty and/or single motherhood (Gibson-Davis, 2008; Umberson et al., 2010a). The lack of a partner’s potential resources and of social networks within the world of work further isolates poor and low-educated single mothers in particular. The stressors experienced by these young adults as a consequence of being uneducated and having limited skills with which to obtain gainful employment not only inhibit their ability to support themselves but also affect their children. Raising children in poverty diminishes parents’ ability to meet the basic needs of their children while producing multiple strains for both parents and children that can have long-lasting consequences.

These strains often manifest through harsh and inconsistent parenting, elevated family conflict and violence, and depleted emotional energy.

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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The chronic stress associated with facing the daily difficulties of economic insecurity and providing and caring for children erodes mothers’ physical and mental health, undermining effective parenting and connections with the extended family that might provide some support (Avison et al., 2007; Evenson and Simon, 2005). The stress experienced by disconnected parents also is heightened by living in crowded, substandard housing, often located in high-crime and socially disorganized neighborhoods. Krieger and Higgins (2002) characterize housing as one of the determinants of health, with poor living conditions being linked with anxiety; depression; psychological distress, including irritability; and social intolerance. Children who reside in poor housing are at increased risk for numerous health problems, such as respiratory infections, asthma, lead poisoning, and injuries (Krieger and Higgins, 2002).

The risks faced by young adults who become parents and their children require policy attention and program intervention. However, interventions can be effective only if the causes of early and nonmarital childbearing and its consequences are identified. Research aimed at understanding the elevated risks to young adult and child functioning among unmarried parents and poor families has identified two major explanations: selection and structural constraints (Biblarz and Raftery, 1999; Gibson-Davis, 2008).

The preponderance of this research examines selection efforts. This evidence indicates that the poorer outcomes of young adult parents and their children are due to preexisting differences in family background (primarily lower socioeconomic position) compared with those who do not become parents in young adulthood and delay both marriage and childbearing (Oesterle, 2013). For example, Amato and Kane (2011) found that college-bound women who delayed family formation rated their health higher, were less depressed, and had higher self-esteem in their mid-20s compared with single mothers, who ranked the lowest on all of these measures; however, these same differences were evident in adolescence before the women followed divergent pathways into young adulthood. This evidence suggests that the disadvantaged outcomes experienced by young adult parents are due more to their disadvantaged backgrounds in childhood and adolescence than to the process of becoming a parent in young adulthood.

There is some evidence that having limited social, economic, and emotional resources undermines parenting behaviors, as well as parents’ health and well-being. For example, the lack of a spouse or partner reduces such resources for single mothers, as well as the social capital associated with the father’s extended family (McLanahan and Sandefur, 1994). However, research examining parenting styles and parent-child relationships by family structure has not found significant differences in positive engagement, harsh parenting behaviors, or parental aggravation among married, cohabiting, and single mothers once preexisting differences in family background and

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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adolescent well-being are taken into account (Gibson-Davis, 2008), thus further supporting the importance of selection factors.

In sum, social stratification in the United States tends to reinforce disadvantaged pathways by which young adults enter parenthood, cope with the stressors of work and family, and parent the next generation of children. Early exposure to adversities among the children of these disadvantaged young parents disrupts brain development; impedes learning; and increases the likelihood of low academic performance, repeated grades, school disengagement, and early dropout from school—a cycle that is repeated as those who experience these adversities have children. The problems associated with growing up in a hazardous environment are compounded as individuals attempt to manage their life circumstances. Specifically, feeling helpless, hopeless, distressed, anxious, depressed, and unable to change one’s life course may lead to maladaptive coping strategies (e.g., alcohol/substance use, risky sexual practices) (Murry et al., 2013).

Two-Generation Programs: Saving a Generation of At-Risk Children by Investing in Their Young Parents

Various programs targeting either young mothers or their children have failed to yield the desired results (Chase-Lansdale and Brooks-Gunn, 2014). A promising policy trend therefore involves investing in both generations at the same time—an approach that reflects the theme of this report of connecting generations. The ultimate goal of this investment is to move the young adult onto a pathway that leads to self-sufficiency and economic independence. Programs currently being designed with this goal explicitly target low-income parents and their children. “For children, two-generation programs can include health and education services such as home visiting, early childhood education, and interventions for those exposed to trauma. Services for parents can involve parenting, literacy, learning the English language, earning a General Educational Development (GED) credential, obtaining a postsecondary education, receiving treatment for mental health problems, and receiving counseling aimed at preventing child abuse and domestic violence, as well as case management and workforce development” (Chase-Lansdale and Brooks-Gunn, 2014, p. 14).

Two-generation programs are not new. The two-generation concept was fundamental to the launch of Head Start in 1965. In the early 1990s, the Foundation for Child Development described two-generation programs that involved two strategies: embedding some self-sufficiency programs for parents in early childhood education programs and adding child care to education and employment services for parents (Smith, 1995). Other two-generation programs in the 1980s and 1990s were focused on adolescent mothers on welfare. Their main goal was to promote life skills, high school

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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graduation or GED attainment, employment, and reductions in long-term welfare use (Zaslow et al., 2002). A few services for children also were provided—mainly child care, with little attention to its quality. Although these early two-generation programs took a fresh approach to the problems of both young parents and children in low-income families, the impetus to expand such programs was lost because several large demonstration programs for adolescent mothers yielded disappointing results (e.g., Duncan and Magnuson, 2004; Granger and Cytron, 1999; Moore and Brooks-Gunn, 2002), and because work-first policies instituted through welfare reform began to dominate the human capital focus for poor young parents (Shaw et al., 2005).

The mid-2000s saw a resurgence of interest in two-generation programs, led primarily by foundation support and initiatives. For example, The Bill & Melinda Gates Foundation launched an ambitious postsecondary education program for low-income students in 2008; the Foundation for Child Development added a two-generation component to its PreK3rd initiative; the Annie E. Casey Foundation launched an initiative to expand and study implementation strategies for two-generation human capital interventions (see Box 3-1); the W.K. Kellogg Foundation is foster-

BOX 3-1
Examples of Two-Generation Programs

The Annie E. Casey Foundation has an initiative to strengthen programs that link family economic success with high-quality early childhood education for children (Murrell, 2012). The strategy for this initiative is to identify barriers to the implementation of two-generation programs while working with programs that combine parent and child services in order to develop creative ways of improving implementation. The foundation has funded the implementation of programs at four sites (the Community Action Project [CAP] of Tulsa, the Atlanta Partnership, the Educational Alliance, and the Garrett County Community Action Committee). Two of these sites are discussed below. An evaluation will focus on the challenges and best practices in the implementation of two-generation programs, as well as short-term parent and child indicators (Chase-Lansdale and Brooks-Gunn, 2014).

CareerAdvance®, a program of CAP Tulsa, is the first fully operating two-generation sectoral training program in the United States. It is an education and training program in the health care sector (nursing and medical technology) for parents of young children enrolled in CAP Tulsa’s early childhood education centers. The health care profession was identified as a source of family-supporting wages in Tulsa. In partnership with community colleges, CareerAdvance offers a sequence of programs that enable participants to obtain a certificate so they can enter the workplace with a credential; participants also can return for further advancement. Partnerships are maintained with a range of organizations—including community colleges, employers, public schools, GED and English as a second

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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language programs, and the Tulsa Workforce Board—that implement the workforce intermediary approach. Innovations include GED preparation that is specific to health care terms and concepts, and a number of support components including career coaches, financial incentives, and peer group meetings. The program is tuition free and covers all expenses. A quasi-experimental evaluation of CareerAdvance, begun in 2010, will continue until 2015. The evaluation is using a mixed-methods longitudinal design that compares participants in CareerAdvance with a matched group of families in which the children are enrolled in CAP Tulsa’s early childhood education centers, but the parents are not enrolled in CareerAdvance.

The Annie E. Casey Foundation’s Atlanta Partnership merges adult and child programs and comprises the foundation’s Atlanta Civic Site, the Sheltering Arms Early Learning and Resource Center, an elementary school, and the Center for Working Families. These programs have achieved national recognition and are located on the same campus in Atlanta. The Center for Working Families, for example, “provides a combination of comprehensive education and workforce development services, as well as coaching and leadership training, in one location so residents can compete in the workforce. The two-generation program specifically targets parents of children in Sheltering Arms” (Chase-Lansdale and Brooks-Gunn, 2014, p. 32). An implementation study and a short-term outcomes study are in progress.

In addition to these programs, the Annie E. Casey Foundation, together with the Open Society, Kresge, Paul Allen, and Kellogg Foundations, as well as the National Institutes of Health and the Department of Health and Human Services, funded the Urban Institute’s launch of a Housing Opportunity and Services Together (HOST) program in Chicago and Portland, Oregon. HOST is a whole-family or dual-generations program that establishes partnerships with various community organizations and coordinates services and programs for parents and children in public and mixed-income housing. The program uses a case management approach to prepare families in low-income neighborhoods to overcome barriers to self-sufficiency. At the parent level, the focus is on pathways to completing education and training that will lead to certification and employment. Career services and life skills development, as well as programs and services addressing both physical and mental health concerns, also are available. At the child level, programs and services are designed to promote academic success and school completion and to reduce risky behaviors. Programs also target family-level improvements, with emphasis on connecting young adults to support networks and relationships through neighborhood organizations. Preliminary findings show great promise, as case managers are reporting fewer lease violations, higher employment rates, increased civic engagement among residents, and improvement in youth school and extracurricular activities, and some families have begun saving to purchase a home or start a business. The overall goal is to utilize housing as a platform for addressing numerous challenges that confront the most vulnerable residents by bridging public housing authorities, private developers, and federal policy makers (Scott et al., 2013).

The promise shown by these initiatives suggests the need for more funding to expand the offerings of evidence-based two-generation interventions.

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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ing innovative family engagement programs; and the Aspen Institute has established a broad two-generation investment in policy, practice, research philanthropy, and the media (Two Generations, One Future). These initiatives have a renewed and explicit focus on promoting the human capital of low-income parents and children in the same program. For parents, education and training go beyond adult basic education and obtaining a GED to include postsecondary education and certification, thus responding to the rising need for credentials and skills in a service-oriented and technological workplace and preparing parents for jobs that will lead to family-supporting wages. These programs also capitalize on new directions in job training by including “workforce intermediaries” (discussed below). For children, the programs reflect the evidence that high-quality childhood education centers can have significant short- and long-term benefits. The current two-generation approach also has expanded to encompass the full range of low-income families, not just those on welfare or teen parents.

Most two-generation programs are still in the pilot stages, exploring various innovations, but the theory behind these initiatives suggests and their leaders strongly believe that two-generation programs will be more effective than single-generation programs (Chase-Lansdale and Brooks-Gunn, 2014). There are two primary reasons for this optimism. First, designers of intensive education and training programs for parents are situating their programs in organizations where the children are—in high-quality early-childhood education centers and prekindergarten programs. This collocation strategy promotes social capital and networking among parents, children, teachers, program leaders, and family support staff (Small, 2009). As parents see their children thriving and learning, they are more motivated to improve their own education and economic standing and tend to be more committed to and persistent in their education and training programs. Second, the early-childhood education centers have become key partners that serve as workforce intermediaries for low-income parents (an approach called “sectoral training”). This approach entails bringing together employers and workers and private and public funding streams. In essence, low-income parents are linked directly to partners such as employers and community colleges that offer peer support, coaching, and other services (King et al., 2009).

INTERGENERATIONAL RELATIONSHIPS

The changes discussed thus far in social relationships, union formation, and the transition to parenthood among young adults have been occurring in the context of another notable change: the delays in leaving home and the return to the parental home of adult children.

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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Living Arrangements Among Young Adults

Even as the social maturation of children is occurring more rapidly than in previous generations as a result of the increased influence of television and the Internet, “many young adults are seeking to capture their lost childhoods” by delaying the uptake of responsibilities and milestones commonly associated with the transition into adulthood (Hines, 2008, p. 20). Hines (2008) coined the terms “rejuveniles” or “kidults” for these young adults. The former are those who have left home and returned to live with their parents, while the latter have never left.

Studies have shown that patterns of leaving and returning home among young adults are complex. For example, early home leaving is more common among children growing up in low-income families and those with personal or family problems. Delayed home leaving is seldom related to relationship quality but usually is economically linked, in particular the consequence of continued financial dependency of adult children (Ward and Spitze, 2007). Delayed leaving has been associated with positive outcomes, such as prolonged access to financial and network support from parents that provides social capital young adults would not be able to attain on their own (Swartz, 2009). Further, delayed home leavers have substantially higher educational attainment at every level through college graduation. Those whose home leaving is facilitated by military service also fare well compared with those leaving home early to enter marriage or cohabit (White and Lacy, 1997).

A notable difference between delayed and early home leaving is that parents report feeling less emotionally close to children who have left home and view independent-living children as less supportive than those remaining at home. What appears to be key to continued parent-adult child connections is the quality of the relationship during adolescence and into adulthood, the social role milestones of adult children, and time engaged in interactional activities (Aquilino, 1997).

Adult children who return home to live with their parents are often called “boomerangers” (Hines, 2008, p. 20). These children frequently have more negative relations with parents before leaving compared with those who never leave. Returning home is a common response to the economic needs of adult children, regardless of the prior relationship quality.

Intergenerational Relationship Quality, Social Support, and Parenting

Young adults can be both children and parents at the same time, so they represent a major connector of family generations—a theme of this report. Their relationships with parents and children, however, evolve over time, and what happens during young adulthood is a critical window into

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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their social trajectories across the life course—another important theme of the report. Studies designed to understand the nature and context of multigenerational families focus in several areas. One area of focus is the pathways through which affective ties and instrumental support between adult children and parents are sustained across generations (Rossi, 1990). Another focus links intergenerational inequalities in the United States to differential transference of skills and socioeconomic resources from parents to children (Behrman et al., 1995; Lee, 1998). Still another area of focus is whether romantic relationship formation, stability, and satisfaction, as well as parenting patterns, are transmitted across generations. Before summarizing relevant research studies, we emphasize that longitudinal studies following respondents from childhood to older ages are rare. Consequently, while this field of research has greatly expanded in recent years, it has yielded insufficient data with which to draw conclusions about the transmission of family patterns across generations (Elder et al., 1986).

Close, positive, and supportive family relationships during childhood and adolescence make key contributions to development and psychological adjustment. For example, families that are highly stressed and conflicted tend to rely on coercive control as a management strategy in the home (Fosco et al., 2012). This environment often creates anger and resentment among youth that not only disrupt and undermine their development but may cause them to seek support from nonconforming peers, do poorly in school, and engage in risky behaviors (Fosco et al., 2012). Conversely, growing up in a warm and socially connected family creates a sense of security, comfort, and safety. Such youth are more likely to seek advice, guidance, and support from their parents when confronted with stressful or demanding life circumstances, which in turn may offer opportunities to develop proactive coping behaviors.

Fosco and colleagues (2012) contend that a supportive, warm family environment serves a critical role in children’s development and mastery of skills needed to respond to demands they encounter, which in turn promotes overall well-being and decreases their vulnerability to emotional distress and aggressive behavior. These proactive adaptive coping behaviors and emotional management skills have been characterized as “effortful control” (Derryberry and Reed, 2002; Eisenberg et al., 2009). The protective nature of effortful control per se has not been studied beyond adolescence, with the exception of Fosco and colleagues (2012). Their longitudinal, developmental study of a diverse sample of 17-year-old adolescents and their parents over a 6-year period yielded several important findings. First, the parent-adolescent relationship plays a pivotal role in the maintenance of effortful control, with implications for adolescents’ development and adjustment as they transition into young adulthood. Second, adaptive coping, or exercising control to manage emotions and behaviors, increases one’s capacity to

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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navigate pressure associated with deviant peer affiliations (Goodnight et al., 2006) as youth transition from adolescence to young adulthood (Rueda et al., 2011; Silk et al., 2003). Third, effortful control appears to be protective in multiple domains of young adult development necessary to prepare for and adapt to adult social roles (O’Connor et al., 2011), and reduces the likelihood of psychological maladjustment (Côté et al., 2010) and the risk of psychopathology (Clements and Bailey, 2010).

One of the major limitations of research on parent-child relationships is that studies often are based on data obtained from particular parent-child dyads instead of examining patterns across multiple parent-child relationships. Further, studies of parents’ interactions with children over the life course are quite rare. To fill this gap, Ward and colleagues (2009) examined the relationships of middle-aged parents with multiple adult children, including adult stepchildren. They found that having more children was associated with more positive relationships but also lower-quality relationships and less contact with at least one child. Relational patterns differed by gender and the presence of stepchildren in the household. In terms of gender, mothers compared with fathers reported more positive and better-quality relationships and more contact with their biological adult children. Mothers compared with fathers reported more problematic relationships with adult stepchildren. Better health outcomes were associated with positive relationships between parents and adult children, but frequency of contact was not a contributing factor to overall health. This finding, in particular, warrants further exploration.

Balancing Parental Support and Autonomy

Recent years have seen increased interest in the long-term implications of parental support for young adults’ development. Fingerman and colleagues (2012) examine the extent to which parents’ intense support promotes or hampers positive adjustment and development in their children. Their findings are mixed. Both the intensely supportive parents and their young adult children perceived the support as “too much.” Yet the children also reported better psychological adjustment and life satisfaction compared with their counterparts who received less frequent and intense support from their parents.

Providing instrumental support that extends into adulthood may create ambivalent feelings in families and may strain parent-child relationships (Connidis and McMullin, 2002). Specifically, having a dependent adult child runs counter to U.S. society’s notion of individualism and to the life-course norms and expectations that parents may have for their adult children. In addition, a lack of reciprocity between parents and adult children may strain their relationship (Fingerman et al., 2012). Parents

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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may perceive their grown children as needing too much support. Intensely supportive parents in particular tend to report greater financial and emotional strain, poorer life satisfaction, and less satisfaction with overall well-being compared with parents providing less support to their grown children (Fingerman et al., 2012). This issue may be especially important as parents of young adults age and their health deteriorates.

“Some parents are very sheltering and aren’t okay with their kids making mistakes, and I see many kids in college who are not able to cope with things very well. There are some things young adults just have to learn themselves.”

While intergenerational families are an important source of support for young adults, the prolonged direct transmission of support by aging family members to the younger generation is shifting two major developmental, life-course patterns—extending the parenting years and delaying the transition of adult children to the assumption of adult social roles and responsibilities. Future research is needed to understand more clearly the developmental and life-course consequences of these changes across generations, using longitudinal data to document how these relationships fare over time.

Evidence on the effects of parental support on relationships between young adults and their parents comes primarily from research on white, middle-class parents (Furstenberg, 2010; Goldscheider et al., 2001). However, there is some evidence that middle-class and more affluent minorities are following the same patterns (Lareau, 2004; Settersten and Ray, 2010). What is clear now is that differential access to family capital and the older generation’s aggregated resources and investments is increasing disparities and inequalities among young adults. While many young adults get some financial support from their family, young adults receive approximately 70 percent more material assistance when their parents are in the top 25 percent of the income distribution compared with their young adult counterparts whose families are in the bottom 25 percent (Schoeni and Ross, 2005). Young adults from families of higher socioeconomic position are more likely to receive assistance from their parents to purchase a home or advance their education, which in turn influences their subsequent standard of living and ability to become self-sufficient (Semyonov and Lewin-Epstein, 2001).

Under current law in most states, parents have no formal legal obligation to provide financial support to their children once the children reach the age of majority unless they have disabilities that preclude gainful employment (NCSL, 2014a,c). Even without a legal obligation to do so,

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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however, many parents in intact families do provide continuing support within their means, especially for the costs of higher education (Settersten and Ray, 2010). By contrast, it is well established that divorced or separated parents provide less support, even for higher education, than married parents with similar incomes (López Turley and Desmond, 2011). Moreover, postmajority assistance for children of divorced or separated parents is provided more often by mothers than by fathers (Emery, 2013). Even fathers who are legally obligated to provide support while their child is a minor often do not continue to do so after the child reaches the age of majority unless they have entered into a binding agreement or are under a judicial order to assist with college expenses in those jurisdictions that authorize such orders (Wallerstein and Lewis, 2004). No state currently authorizes a judicial order for financial support other than college expenses once a child reaches the age of majority (NCSL, 2014b). The net result is that the burden of supporting young adults in families with divorced or separated parents falls disproportionately on mothers, and young adult children of divorced or separated parents typically have lower rates of attending and graduating from college than young adult children of married parents of similar means (Emery, 2013; Ginther and Pollak, 2004). Goldfarb (2014) proposes that child support orders covering educational expenses as well as other types of financial support be made more broadly available for young adults who are over the age of majority. State legislatures could consider whether current laws governing support obligations for divorced or separated parents need to be modified to take adequate account of the rising costs of higher education and the other financial challenges faced by many young adults over the age of majority.

Young adults’ access to family resources until they can support themselves financially may be especially important in light of the social and economic challenges currently confronting young adults. It is important to acknowledge, however, that access to family financial support is not available to all young adults. For this reason, it is not surprising that stark differences are seen in the developmental trajectories of young adults based on whether their families can afford them this luxury. A large proportion of young adults grow up in families that cannot (Wickrama et al., 2012), and they are particularly vulnerable to becoming disconnected. Such young adults also are more likely to experience diminished life opportunities that have long-term consequences for their ability to become self-sufficient. This pattern occurs among many racial/ethnic minorities, but most notably among African Americans.

Compared with other racial/ethnic groups, African American young adults have consistently lower earnings and assets at every level of education, a situation that has changed little since the civil rights movement (Murry and Li, 2014). In contrast, young adult Asian Americans and

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×

Cuban Americans attain higher incomes, assets, and job quality relative to Caucasians irrespective of community and family characteristics (Wickrama et al., 2012). Wickrama and colleagues (2012) attribute these differential patterns to the high aspirations, fields of employment and education, family support, and immigrant status that collectively constitute high human capital for these ethnic minorities. Nonetheless, that economic and employment disparities persist for African Americans, regardless of family income, parental education, or community context, suggests that these differences may be attributable in part to systematic discrimination experienced by this population (Brody et al., 2006).

Transmission of Parenting Practices Across Generations

Studies examining the transmission of parenting practices across generations have just begun to illuminate the mechanisms through which those practices are internalized, carried forward, and reactivated in later generations by adult children who become parents (Kohn et al., 1986). Findings from intergenerational studies of the transmission of both parenting practices and externalizing behavior across generations are mixed (Bailey et al., 2009). Thus, the extent to which parenting patterns are transmitted across multiple generations is an issue requiring additional longitudinal research.

“There is a need to take into consideration how various cultures impact families. For example, my parents didn’t go through school or college, so they thought I would just get a job at the end of high school.”

A developing line of research demonstrates that constructive parenting can influence parenting over three generations to promote socioemotional development (Kerr et al., 2009). Two hypotheses have been proposed to explain this phenomenon. The modeling hypothesis contends that adult children imitate their own parents’ behavior and practices, and views the transmission as a psychological process of internalizing and subsequently engaging in familiar behavior when similar circumstances arise. The second hypothesis posits reworking or compensatory transmission processes whereby adult children attempt to modify and improve the parenting of their own children so as not to repeat dysfunctional patterns they experienced with their own parents (Gaunt and Bassi, 2012; Guzzo, 2011). Findings from a national survey of two-generation families revealed that men who described their fathers as warm were more likely to model their own parenting after their father and perceived themselves as good parents (Hofferth et al., 2012).

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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Men who reported being raised by harsh fathers were more likely to rework their fathers’ parenting strategies so as to utilize positive parenting practices, and likewise perceived themselves as good parents. Those whose fathers were perceived to be uninvolved, neither warm nor harsh, struggled most as parents and were less able to develop parenting approaches that worked effectively with their own children (Hofferth et al., 2012). Future research is needed to understand the role of fathering in the transmission of parenting dynamics. In addition, while fathering programs often target those perceived to be “at risk,” consideration needs to be given to recruiting all fathers.

Other studies examining the transmission of constructive parenting across generations have found only modest intergenerational continuity (Chen and Kaplan, 2001). When continuity is observed, it appears to occur through interpersonal relationships and social interactions that facilitate opportunities to model the behavior. Whereas Simons and colleagues (1993) found that modeling was the strongest predictor of intergenerational transmission of constructive parenting, young adults’ perception of their upbringing did not affect their subsequent reports of their own parenting practices in middle adulthood. Further, studies have shown that parental education, poverty, and family structure are not strong predictors of the transmission of constructive parenting across generations (Chen and Kaplan, 2001; Kohn et al., 1986).

Another line of research attempts to extend the notion of modeling of parenting behaviors to the development of social skills that promote good parenting. Children who are exposed to positive parenting are socialized to have successful interpersonal relationships that range from relationships with peers to relationships with their own children (Furman et al., 2002; Shaffer et al., 2009). Social skills are sustained by cognitive representations of positive, stable, trusting relationships. Peers may contribute to the development of social skills and the capabilities to form and maintain relationships. Developing social competence in relationships with peers may in turn contribute to improved parenting skills and parent-child relationships. Further, Ehrensaft and colleagues (2011) found that observing one’s own parents’ socioemotional and relationship functioning may be important in predicting parenting patterns across generations.

Parenting and Incarceration

Incarceration in the United States has continued to increase. As of 2012, 1 in every 108 adults was incarcerated, and an estimated 1 in 50 adults were on probation or parole (Glaze and Herberman, 2013). Among males in 2012, African Americans were 6 times and Hispanics 2.5 times more likely than whites to be incarcerated, and 18- to 19-year-old African

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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Americans were approximately 9.5 times more likely to be incarcerated than their white counterparts (Carson and Golinelli, 2013). It is worth noting that most of those incarcerated are parents (more than 1.7 million children under 18 had a parent in prison in 2007). The majority of incarcerated parents are males (744,200 male versus 65,500 female inmates in 2007) of low socioeconomic position, and many of those men (46 percent) are African American (Glaze and Maruschak, 2008). Among inmates aged 25-34, 64 percent in state prisons and 74.1 percent in federal prisons have minor children, compared with 44.1 percent in state prisons and 45.8 percent in federal prisons under age 24 (Glaze and Maruschak, 2008).

While incarcerated fathers are embedded in social networks that include their family of origin, relatives, romantic partners, children, and friends, studies examining this population focus primarily on the incarcerated individuals. Yet incarceration makes families fragile, and diminishes the financial resources and well-being of intimate partners/wives and children who are left behind.

Arditti and colleagues (2003) contend that having an incarcerated family member has detrimental social, economic, and health consequences for children and other family members. Many families feel personal shame and experience marginalization and stigma associated with the incarceration. To manage and cope with the shame, a code of silence or conspiracy of silence may be created in families whereby mothers hide a father’s incarceration from their children. Arditti and colleagues (2003) note that while most families of incarcerated fathers were suffering economically prior to the incarceration, they became even more vulnerable afterwards. The imprisonment not only created physical and emotional distance between mothers and their incarcerated partners but also increased parental strain, emotional stress, and concerns about children’s loss of contact and involvement with their incarcerated parent. Being incarcerated is consistently associated with disrupted and damaged romantic relationships, often resulting from stigma associated with having a partner who is incarcerated and problems that emerge from time spent apart (Apel et al., 2010; Lopoo and Western, 2005; Massoglia et al., 2011). Reentering family life under these conditions can exacerbate instability in an already unstable romantic relationship and may negatively impact fathers’ involvement with their children. This inability to engage with their children may lead in turn not only to long-term desertion but also to reduced contact with other relatives (Massoglia et al., 2011), creating a disconnect between the individual and important social support systems. Thus, imprisonment has a corrosive effect on families, contributes to relational breakups, exacerbates preexisting behavioral and psychological problems in children, and adds to the economic and relational deficits of children and families that were already struggling prior to the father’s incarceration (Comfort, 2007; Lewis et al., 2007).

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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Because of the increased number of incarcerated parents, many fatherhood initiatives have been implemented in recent years to reconnect incarcerated fathers with their children and families; many parenting programs have been implemented in prisons. However, few such programs have been evaluated, and those that have yielded mixed results (Cabrera and Peters, 2000; Martinson and Nightingale, 2008). Although fatherhood intervention programs for incarcerated men may be effective, only four such programs were considered effective according to a recent review (Bronte-Tinkew et al., 2008). There is as yet no evidence suggesting what characteristics contribute to a program’s overall success, and few programs found to be effective have been replicated (Bronte-Tinkew et al., 2008; Loper and Tuerk, 2006).

Longitudinal research is needed to document the intergenerational patterns and consequences of incarceration in families, such as the extent to which parents’ criminality and incarceration influence their children’s behavior and adjustment over time. Further, more work is needed to document ways in which criminal justice policies and practices impact family functioning, including parents’ abilities to fulfill their roles as mothers and fathers and a father’s sense of familial obligations (Hairston, 2009).

CONCLUSIONS AND RECOMMENDATION

The developmental and social contexts of young adult relationships in contemporary American society have changed dramatically relative to earlier generations of young adults. Advances in communication and social media have had a profound impact on the context, access, and interactions of social relationships and social networks among young adults. More advanced educational credentials and job skills are needed for successful employment trajectories in the predominantly service-oriented and high-tech occupations of the 21st century. Those who come from advantaged family backgrounds can meet these demands by investing in their education and career development and delaying marriage and childbearing to their late 20s and early 30s, enabling them to achieve greater employment, family, and financial stability into adulthood. Those from economically disadvantaged backgrounds may need to curtail their education and tend to work at low-skilled jobs, choosing instead, or by default, to initiate their family pathways in young adulthood by having children outside of marriage or in cohabiting relationships.

The stakes for these pathway choices in young adulthood are high, with consequences for health, safety, and well-being. Those who initiate the family pathway with early, nonmarital, unintended childbearing or multiple-partner fertility experience greater stress, less social and economic support from a committed spouse or partner and extended family, precari-

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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ous economic circumstances, and poor physical and mental health. Those who invest in the education and career development pathway and delay family formation beyond young adulthood tend to experience more family and work supports, greater financial security—or at least the promise of financial security—greater family and employment stability, and better physical and mental health. Some health advantages and disadvantages precede these diverging pathways, as those from backgrounds of higher socioeconomic position have better health in childhood and adolescence, which leads to more options for young adult pathways involving relationships, education, employment, and stable and supportive contexts for family formation and, in turn, health.

“The media needs to emphasize the positive aspects of young adults instead of the negatives. This impacts how young adults think about themselves and see themselves in society.”

In young adulthood, increasingly diverse social networks develop from family relations, romantic/sexual partners, peers, work, community, and educational institutions and other organizations. Although most young people are immersed in these social networks, many feel isolated, without the human contact or individual support needed to cope with psychological and emotional problems common to this life stage. One of the committee’s young adult consultants poignantly told us of how alone and desperate she felt in dealing with mental illness, not knowing where to turn for help despite multiple connections to peer, family, and community networks. Intergenerational relations can serve as vital sources of resources and support, especially for young parents, but the changing demographic patterns of adult children are complex, and the long-term implications of parental support for the development of young adults can be mixed. As detailed throughout this chapter, moreover, relationship patterns and trends vary by gender, race/ethnicity, and socioeconomic position, which can lead to health disparities and differing patterns of social and achievement role transitions across the life course. Social relationships, union formation, the transition to parenthood, and intergenerational relationships have direct and indirect impacts on the health, safety, and well-being of young adults.

There have been many debates about the role of government programs and policies aimed at strengthening relationships and parenting, and a variety of initiatives with this aim have been implemented. Some evidence suggests that marriage programs can reduce conflict and increase parenting and communication skills, marital happiness, and stability (Fagan et al., 2002). Likewise, some interventions designed to improve the transition

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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into parenthood have had positive effects on parents and their relationships, such as increasing self-esteem, marital satisfaction, and stability (Cowan and Cowan, 1995, 2000). A few programs have shown enhanced development in children as well (Cowan and Cowan, 1995, 2000). Such initiatives, however, have traditionally focused on married couples in favorable socioeconomic and relationship circumstances (Cowan and Cowan, 1995), and have not always addressed issues relevant to low-income individuals. Some programs have been created for the latter individuals, but they have not yet been assessed (Dion, 2005; Roulet, 2009). The fatherhood initiatives discussed above are an exception to this general pattern; they target diverse audiences and provide a wide variety of services.

While some programs designed to strengthen relationships and marriage and help families have shown positive effects, moreover, many have had small or no effects. The Healthy Marriage Initiative, for example, launched in 2002, established several national efforts aimed at encouraging or supporting marriage. One of these was the Building Strong Families program, which was designed to promote relationships between couples with a new baby or about to have a child and to help those desiring marriage to achieve it (Brown, 2010; Roulet, 2009). An evaluation of this program, which followed more than 4,000 couples, found that it did not succeed in improving the couples’ relationship or the quality of coparenting or in enhancing father involvement (Wood et al., 2014). No difference in major outcomes was found between the control and program couples in eight sites (Donahue et al., 2010). In fact, in one of the sites, the program had modest negative effects on some of the outcomes, including lower coparenting quality, less father involvement, and more severe domestic violence (Donahue et al., 2010). On the other hand, in another site, the program did have positive effects on African American couples with respect to reduced infidelity, family violence, and destructive behaviors and enhanced coparenting and ability to manage conflict.

In sum, social, romantic, and family relationships are central to the lives of young adults. And young adulthood clearly is a period entailing some of the highest rates of disadvantage-defining risks, including nonmarital, unintended childbearing and multiple-partner fertility; poverty and material hardship; incarceration; alienation and loss of extended family support; social isolation; and social and economic disconnection. However, existing social policy research does not provide a sufficient evidence base for extensive policy recommendations in this area. Mechanisms linking marriage, socioeconomic position, and child outcomes still are not fully understood, and several programs are being evaluated to determine whether they can facilitate healthy relationships and marriage (Brown, 2010). Overall, most programs and initiatives that have been evaluated have shown small, inconsistent, or no effects. This may be because of the substantial diversity in

Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
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relationship development, contexts, and statuses during young adulthood, as documented in this chapter. Young adulthood is a fluid period, and thus far there is insufficient evidence to show what works in fortifying and supporting young adult relationships and for whom these programs work. Our review of existing research on the social lives of young adults revealed a number of areas in which the development of such policies and programs would benefit from more research, as highlighted throughout this chapter.

The results of evaluations of the two-generation programs discussed in this chapter are promising and could be monitored closely, with successful programs being expanded to new sites. Findings from recent two-generation programs implemented as part of early-childhood interventions show potential for enhancing the outcomes experienced by young adults. It is important for two-generation programs to value the parents as individuals in addition to the vital role the programs play in relation to the children. Accordingly, the committee makes the following recommendation:

Recommendation 3-1: In funding the implementation and evaluation of two-generation programs, philanthropic funders and federal government agencies should actively monitor the outcomes of the young parent participants in addition to early childhood outcomes. Doing so would be valuable for programs that target primarily health and well-being (such as home visiting programs), as well as those that target primarily human capital development.

Our findings also suggest a number of additional intervention points and possible directions for policy makers for such policies and programs:

  • Socially isolated young adults are more likely than their peers to be disconnected from systems that can serve as key sources of support for health care, parenting, or early-childhood development. Research is needed to understand how social media could be used to identify potential vulnerabilities of these young adults, including mental illness and depression, and respond with interventions that can reduce their vulnerabilities, increase their social integration, and link them to needed resources and contexts for support.
  • Rising rates of incarceration among young adults have destabilized intergenerational family patterns, which may suggest the need for more concerted efforts to devise rehabilitation programs. The U.S. Department of Health and Human Services and the U.S. Department of Justice could follow up on the report of the Federal Interagency Working Group for Children of Incarcerated Parents (2013) to improve efforts in the following areas: (1) ensure that prison visiting conditions are sensitive to the needs of children;
Suggested Citation:"3 Relationships." Institute of Medicine and National Research Council. 2015. Investing in the Health and Well-Being of Young Adults. Washington, DC: The National Academies Press. doi: 10.17226/18869.
×
  • (2) give incarcerated parents opportunities to improve their parenting capacities; (3) facilitate parents’ involvement in their children’s schooling during incarceration; and (4) provide appropriate services for improving parenting skills during reentry.

  • As many young people delay or are thwarted in making a successful and stable transition to adulthood, the parents of young adults continue carrying out their parenting roles and serving as sources of support. This changing nature of parenting young adults has implications for privacy laws under the Health Insurance Portability and Accountability Act of 1996; eligibility for programs; and the straining of economic, social, and emotional resources across generations.
  • Shoring up the economic circumstances of at-risk families can help promote entry into the education and career development pathway over the early family formation pathway in young adulthood. As discussed in Chapter 4, for disadvantaged youth who cannot meet demands for increased educational credentials and high-tech job skills, vocational training can help open up alternative pathways into adulthood that provide the economic security needed to form families within stable, committed relationships.

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Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large.

Investing in The Health and Well-Being of Young Adults describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. Investing in The Health and Well-Being of Young Adults makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions.

What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. Investing in The Health and Well-Being of Young Adults will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.

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