The role of the family in the health of its members is critical from birth to death. This review focuses on the aging family, recognizing that the family is one of the earliest and longest lasting contexts influencing health. In particular, we emphasize the changing demographics of the family including the increased numbers of older family members and the decreased number of children. We consider how best to adapt to the changing family so that its critical role in maintaining individual and public health can be retained and enhanced. We begin by highlighting the importance of taking both a life span and life course perspective, recognizing that individuals develop and change over their lifetime. At the same time, they are members of groups and organizations, which shape their life course. We next consider the dramatically changing demographics of the population generally and within families specifically. We reflect on how these changes impact public health both positively and negatively, taking into account the potential of the family as a resource and a risk factor. We next consider five life course epidemiological models of health: the immediate effects model, the social trajectory model, the cumulative biological model, the sensitive period or latency model and the physiological effects of trajectory model. We explicitly consider the relevance of these models for the family and its aging members. Finally, we highlight what we consider the most important implications of these issues for the health and well-being of older adults and families in an aging society.