Health behaviors are responsible for a substantial burden of poor health outcomes across the lifespan, including mental health disorders, diabetes, cardiovascular disease, and cancer. In children, unhealthy patterns of diet and physical activity are associated with higher rates of obesity, diabetes, depression, and asthma. Prior studies have demonstrated associations between family health behaviors, such as eating meals as a family and reading together regularly, and child health and developmental outcomes, including nutritional health, body mass index, language development, literacy, and behavior. While general adherence to recommended health behavior guidelines is low throughout the United States (U.S.), among low-income and marginalized racial and ethnic populations there is a concordance of the lowest rates of engagement in healthy behaviors and the highest prevalence of poor health outcomes.Thus, characterizing the individual and contextual factors that influence health behaviors, especially early in the life course, may thus prove constructive for initiatives aimed at reducing health disparities.
Resilience, defined as a person’s capacity to transform challenging or adverse experiences, sometimes described as sources of “toxic stress,” into manageable stress, is multifactorial, dynamic, and protective against many of the poor health outcomes that result from adversity.The concept of resilience as a mediator of health outcomes rejects the idea that unhealthy behaviors are the product of individual failures. Rather, health behaviors are influenced by larger social and structural factors, and resilience components can exist at multiple levels of a person’s social ecology, including at the individual, family, and community levels. Research has revealed an apparent reciprocal relationship between resilience and positive health behaviors, such that the two represent a positive feedback cycle contributing to health promotion.
Despite a strong conceptual linkage and the existing literature in multiple adult populations, the associations between resilience and health behaviors have not been well described in children. Studies in adolescents are largely limited to those with high rates of adverse childhood experiences (ACEs), but have shown consistent associations between higher individual resilience and physical activity, healthy diet, better sleep, and lower rates of substance use. Studies in younger children are similarly limited to specific subpopulations, resilience domains, and health behaviors. To our knowledge, there has yet to be a study assessing the associations between multiple resilience domains and multiple health behaviors in a general population of children. This study thus aims to advance the field by describing the relationships between three socio-ecological levels of resilience and six child and family health behaviors in a nationally representative sample of children. Understanding these relationships may help to provide conceptual evidence for the inclusion of resilience promotion efforts in health behavior interventions and vice versa.