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The current study primarily assesses uninsured, low-income patients (n = 125) in a primary care practice. Despite the knowledge that family relationships affect the management and outcomes of chronic illness, the rates of relational discord among primary care patients are unknown. Findings reveal that 54% of patients met criteria for problematic family functioning, while 40% of those in a romantic relationship reported relationship distress. In addition, 67% reported depression, 32% reported clinical levels of anxiety, and 33% at-risk alcohol use. Researchers used latent class analysis to explore characteristics of the sample, which revealed four classes. Comparisons with prior research with similar populations are made and implications for behavioral health providers working within primary care are discussed.