Defining family in family medicine: perceived family vs household structure in an urban black population.

This paper explores two hypotheses: first, that household structure, the people who live in one's household, and perceived family, the people one considers members of one's family, are different entities among urban black pregnant women; and second, that the perceived family is a stronger predictor of social, psychological, and health outcomes than is household structure. The study data are from the first interview of a prospective study of a consecutive sample of 140 black pregnant women patients of a Cleveland, Ohio, university hospital family practice center. The study hypotheses are supported: household structure and perceived family differ in their size and the inclusion or exclusion of members of the family of origin and the father of the baby. Household structure is strongly correlated with demographic variables such as age, socioeconomic status, and household income, whereas perceived family is less strongly associated with these measures. Perceived family, but not household structure, is associated with family functioning, measures of psychological status, worries about household change, and better family and parental relationships during the woman's childhood.