Literature on the American family that is pertinent to pediatrics is reviewed. Family characteristics considered include fertility, family structure, divorce, maternal employment and child care arrangements, family wealth and poverty, governmental assistance, and adolescent sexuality. Other topics of discussion include problematic effects of family transitions; poor black children as constituting a population that is at special risk; effects of maternal employment; sexual abuse allegations in divorce; convergence of abuse of children and women; effects of stress on children; pediatric social illness; homelessness; violence; and violent death. Future directions for practice, particularly the family support movement and the work and family movement, are considered. A total of 15 annotated references are provided. (RH)