Multigenerational health-related turning points and impact on health and social outcomes: a systematic review

Introduction: Some individuals over their life course will experience significant health-related events, such as a physical or mental illness, that can alter their life pathways or trajectories, known as “turning-point” events. This systematic review aimed to synthesize the evidence from population-based data collections for: (a) parent health-related turning point events and the impact of these events on offspring health and social outcomes; and (b) offspring health-related turning point events and the impact of these events on parent health and social outcomes. Method: A review of four databases (MEDLINE, CINAHL, PsycINFO, and Scopus) from January 1, 2010 to February 23, 2023 was conducted. Abstracts and full-text articles were screened by four reviewers and critically appraised. Results: Of 114 articles, 98 (86%) examined the effect of a parental health-related turning point on offspring, 11 (10%) examined the effect of an offspring turning point on parents, and five (4%) investigated bidirectional impacts of a turning point event. For parents and offspring, mental health disorders (50%), physical health (26%), and death (24%) were common turning point events examined. For parents and offspring, common health outcomes included mental disorders (n = 50), physical health (n = 11), substance use (n = 9), and death (n = 7), and common social outcomes included educational performance (n = 14), employment or income level (n = 7), and involvement of child protective services (n = 5). Discussion: The ability to disentangle relationships between turning point events and adverse health and social outcomes is required, as is the development of strategies to disrupt intergenerational disadvantage.