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Merck Manual

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The Changing Structures of Families

The Changing Structures of Families

Although most people picture a traditional family as a married man and woman and their biologic children, this has not been the case for many years. For example, a family may consist of a single parent, a gay couple, or unrelated adults who live and raise children together.

Divorce forces many children into single-parent families or blended families created by adults living together or remarrying. About 33% of children are born to single mothers, and about 10% of children are born to single teenage mothers. Many children are raised by grandparents or other relatives. Over 1 million children live with adoptive parents (see Adoption).

Even traditional families have changed. Often both parents work outside the home, requiring many children to receive regular care outside of the family setting (see Child Care). Because of school and career commitments, many couples postpone having children until their 30s and even 40s. Changing cultural expectations have resulted in fathers spending increasing amounts of time raising children.

Conflicts develop in every family, but healthy families are strong enough to resolve conflicts or thrive despite them. Whatever their makeup, healthy families provide children with a sense of belonging and meet children's physical, emotional, developmental, and spiritual needs. Members of healthy families express emotion and support for each other in ways consistent within their own culture and family traditions.