Families are foundational social units through which health risks, protection, values, and resources are transmitted. Yet family structures are not static. Declining fertility, delayed parenthood, increased life expectancy, urbanisation, migration, and changing gender norms have transformed households across the globe.

This chapter explores trends such as single-parent families, dual-income households, multigenerational living, ageing populations, and shifting caregiving roles. It considers how these structural shifts influence child development, mental health, elder care, reproductive patterns, and economic security.

Public health must adapt to these demographic realities. Policies surrounding childcare, parental leave, elder support, social protection, and gender equity become not peripheral social debates, but central determinants of population health.

The family is understood not nostalgically, but structurally - as a dynamic institution shaping health across the life course.

Key Takeaways

* Family structures are evolving globally due to demographic and social transition.

* Ageing populations and reduced fertility alter dependency ratios and caregiving demands.

* Gender role shifts influence labour participation, parenting, and health behaviours.

* Single-parent and multigenerational households face distinct health and economic pressures.

* Migration reshapes family composition and support systems.

* Social protection policies play a critical role in buffering family-level health risks.

* Public health must respond to demographic change, not assume static social structures.

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