OBJECTIVES Although previous research theorizes that cross-national variation in the relationship between family ties and health is due to nation-level differences in culture and policy/economics, no study has examined this theorization empirically. METHOD Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and the Organization for Economic Co-operation and Development (OECD), this study uses multilevel modeling to analyze individual-, nation-, and cross-level effects for 30,291 older adults in 14 nations. RESULTS Family ties to spouses/partners and parents are associated with better health, but ties to coresident children are associated with poorer health in certain contexts. Familistic culture and public pension spending have a weak but statistically significant moderating effect on the relationship between intergenerational family ties and health. DISCUSSION This article underscores the complexity of family and highlights the need for continued theorization and measurement at the nation level to promote older adults' health in diverse contexts.