We theorize that the social conditions surrounding the coronavirus disease 2019 (COVID-19) pandemic have the potential to increase the importance of families for health and widen existing inequalities. We suggest three primary tenets important for understanding families and health during COVID-19. First, risks of specific COVID-19 outcomes and other health problems are unevenly distributed across families. Second, how families impact health during the COVID-19 pandemic is conditional on public policies, organizational decisions, and concurrent events. Third, many health inequalities driven by racism, sexism, classism, and other oppressive societal forces are amplified during COVID-19, but the extent to which this is occurring is shaped by families and by the public policies, organizational decisions, and concurrent events that also impact families and health. As health disparities continue to emerge from this pandemic, we call on researchers and policymakers to pay attention to the multiple ways that families matter.