The project studied how multigenerational households—those with grandparents, parents, and children living under one roof—managed COVID-19 risk and care during the pandemic. While these arrangements offer cultural and economic benefits, they also made families more vulnerable to infection due to close living quarters, caregiving responsibilities, and the presence of essential workers.

We aimed to understand how families managed these risks in real-world conditions, especially when public health recommendations like masking, isolating, or testing were difficult to follow due to limited space, caregiving roles, or the need to keep working.

To do this, we conducted in-depth interviews with 68 multigenerational households in Los Angeles County, focusing on Latino and Asian families. We asked how they made decisions about safety, caregiving, and sharing resources—particularly when someone in the home got sick or needed to leave for work.

Key Findings

1. Families created internal systems for managing risk.
Families didn’t simply follow public health guidance. Instead, they developed their own strategies to balance safety and care. They prioritized protection for those most at risk—typically elders or those with medical conditions—and expected others to take on more exposure, such as going to work or providing care.

We call this a "hierarchy of risk"—a household-specific way of identifying who is most vulnerable and who takes on risk to protect others. Based on this, families also developed a "hierarchy of care and concern," or an informal caregiving plan based on household roles and obligations. Mothers and eldest daughters were often expected to care for sick family members, even at personal risk. Breadwinners were usually shielded so they could keep working. These strategies reflect how families navigated difficult trade-offs between health, caregiving, and survival.

2. CDC guidelines were adapted to fit household realities.

• Masking was common—even indoors when someone was sick—but became a source of tension when mandates ended or visitors arrived.
• Testing helped families feel secure, but concerns over cost, access, and test accuracy created confusion.
• Isolation depended on home layout. Some families rearranged sleeping spaces, converted garages, or used outdoor areas or hotels when needed.
• Vaccination was widely accepted. Initial hesitation was often due to fear of side effects or missing work, but most members ultimately got vaccinated out of concern for elders or to meet work, school, or travel requirements.

3. The home was both a source of safety and constraint.
Space and layout mattered. Families with extra bathrooms or rooms could isolate more effectively. Others had to be more resourceful and often relied on support from extended kin. These findings show how housing inequality directly affects health vulnerability.

Intellectual Merit

This project contributes to anthropology and related fields by expanding the household production of health framework to a crisis context. Traditionally used to study everyday illness and caregiving, we adapted this model to examine how families make rapid, high-stakes decisions during a pandemic. The concepts of "hierarchies of risk" and "hierarchies of care and concern" offer useful tools for understanding household-level decision-making, particularly in situations where risk, caregiving, and economic pressures are deeply intertwined. These insights are relevant to public health, sociology, urban studies, and policy research.

Broader Impacts

Public Health:
The findings show that families make health decisions together, not in isolation. Public health messages and strategies must reflect the realities of multigenerational households and their caregiving structures.

Social Equity:
Multigenerational living is common among low-income, immigrant, and communities of color—groups disproportionately affected by COVID-19. Our findings highlight both their heightened vulnerabilities and their resilience. These insights can inform more equitable emergency response, housing, and healthcare policies.

Education and Workforce Development:
We trained undergraduate students in anthropological research methods and in public communication through a podcast series. Most students were first-generation college students from underrepresented communities. Many had personal experience with multigenerational households, which informed their work and helped build trust with participants. Students presented findings at conferences and gained hands-on experience in research, storytelling, and science communication.

This project highlights the importance of recognizing and supporting diverse family structures in public health planning. Multigenerational households are not unusual or outdated—they are central to how many families live, care, and survive, especially during crises.

By documenting these households’ experiences, this project offers valuable insights for future public health planning, emergency preparedness, and communication. It also demonstrates how students, especially those from the communities being studied, can contribute meaningfully to research when given the tools and opportunity to do so.

Last Modified: 08/11/2025
Modified by: Amy Dao