Who Takes the Kids to the Doctor? The Family Health Load

Someone chooses the children's doctor. Someone books the appointments, remembers what the doctor said, fills the prescription, gives the medicine on time, and notices that the rash is spreading or the cough hasn't cleared. Someone tracks the vaccinations, the dentist, the eye tests and the allergy that means one snack can never be in the house. And when a child is too sick for school, someone stays home.

Of everything on a household's list, health carries a particular weight, because a missed appointment or a forgotten dose isn't just an inconvenience.

What the numbers say

The health research organization KFF asked American adults about this in its 2020 Women's Health Survey, which included more than 3,600 women and more than 1,100 men aged eighteen to sixty-four.

• Around two thirds or more of mothers said they were usually the one who chose the children's doctor, took them to appointments and made sure follow-up care happened. Fewer than one in five fathers said the same.
• When children were too sick for school or childcare, 61% of mothers said they usually stayed home, compared with 9% of fathers.
• 45% of fathers said this was shared equally. Only 25% of mothers said so.
• Among mothers who missed work to care for a sick child, nearly half weren't paid for it. Among lower-income mothers, three quarters lost pay.

The survey was American, taken during the pandemic, and based on what people reported. It still fits everything else I found. And look at that third line: the same arrangement looks equal from one side and unequal from the other. I wrote about that gap in You Think It's Fair. She Doesn't.

Why health is hard to hand over

A child's medical history builds up over years. The parent who has been to every appointment knows what was tried and what the doctor worried about two years ago. A parent who goes without that history may not be able to answer the doctor's questions.

Noticing early signals, a child who is quieter than usual or rubbing an ear, comes from being responsible. The parent who isn't responsible may simply not see them.

And there's fear. Most tasks can be done imperfectly without harm. A missed allergy can't.

One composite from the book: a mother has managed her son's asthma since he was three. When her husband offers to take over the clinic visits, she writes him a page of notes, texts him during the appointment and rings the clinic afterwards. It takes a year before she trusts him with it. What changes her mind is a winter night when she's away and their son has a bad attack. Her husband handles it calmly and correctly, and calls her afterwards to say it's under control.

How to share it safely

• Move it gradually: routine check-ups first, then follow-ups, then any chronic condition.
• Keep a written record that travels with the child, not only in one parent's memory.
• Use the clinic's online portal so both parents see the same information.
• Ask who is keeping track of the health of the person who manages everyone else's. She is often the one postponing her own appointments.

More in The Calendar and What Is the Mental Load?. This is chapter eleven of The Work Nobody Sees.

Questions people ask

Who usually stays home when a child is sick?

In KFF's 2020 Women's Health Survey, 61% of mothers said they usually stayed home with a sick child, compared with 9% of fathers.

Why is the family health load hard to share?

Because medical history builds up over years, early warning signs are noticed by the responsible parent, and mistakes can have serious consequences.

How can parents share children's health care?

Hand it over gradually, keep a written record that travels with the child, and use shared online patient portals so both parents see the same information.