Objective The purpose of this study was to examine the associations among community characteristics, family economic adversity, parents’ health beliefs, and parents’ and children’s health using cross-level mediation analyses. Methods Survey data were collected from a nationally representative sample of 1,337 families with children between 3 and 6 years nested within 45 Trinidad and Tobago community clusters. Results At the individual level, parents’ health belief of internality was a significant mediator between family economic adversity, adult health, and children’s health. In the cross-level mediation analyses, health belief of internality was a significant mediator between community health problems and children’s health. There were between-community variations in the relationship between adult health, health belief of powerful others, and children’s health. Conclusions There is strong evidence of the role of community and family influences on children’s health. Findings indicate the need to use a multilevel analytical approach in studies of children’s health.