Work–Family Strain and Health Care For Children

  • Paul J. ChungEmail author
  • Katherine D. Vestal
  • Mark A. Schuster
Part of the National Symposium on Family Issues book series (NSFI)


Berkman and O’Donnell’s (Chap. 12) model of work–family strain ­provides a useful backdrop for an examination of family leave policies and parents of chronically ill children. About 15% of children in the USA are children with special health-care needs (CSHCN) (Bethell et al. Maternal and Child Health Journal 12:1–14, 2008), and their parents are at particularly high risk of employment instability and financial problems (Kuhlthau et al. Maternal and Child Health Journal 9:207–218, 2005; Looman et al. The Journal of Pediatric Health Care 23:117–125, 2009). Even the health-care needs of healthy children are substantial, and both the demands placed on parents of CSHCN and the destabilizing loss of control that their child’s illness generates create often unsustainable work–family strain. Until recently, however, US government work–family policies and programs were generally not designed to address the needs of employees with ill family members. In 1993, the federal Family and Medical Leave Act (FMLA) became the first federal law to do so. Because of FMLA’s limited reach, in 2004, California enacted the Paid Family Leave Insurance program, which has since been followed by a few similar programs in other states and by work on additional federal legislation. If strengthened, such programs have the potential to provide critical support for employed parents of CSHCN, as well as other employees with ill family members.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Paul J. Chung
    • 1
    • 2
    • 3
    Email author
  • Katherine D. Vestal
    • 4
  • Mark A. Schuster
    • 5
    • 4
    • 3
  1. 1.Department of Pediatrics, David Geffen School of Medicine and Mattel Children’s HospitalUniversity of CaliforniaLos AngelesUSA
  2. 2.Department of Health Policy and ManagementUCLA Fielding School of Public HealthLos AngelesUSA
  3. 3.RAND Health, The RAND CorporationSanta MonicaUSA
  4. 4.Division of General Pediatrics, Department of MedicineBoston Children’s HospitalBostonUSA
  5. 5.Department of PediatricsHarvard Medical SchoolBostonUSA

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