title: Living arrangement and coronary heart disease: the JPHC study.
abstract: BACKGROUND
  Previous studies have suggested that living in a multi-generational household (a type of family structure prevalent in Japan) confers mixed health benefits and stresses, especially for women who report such living arrangements.
  
  
  OBJECTIVE
  To examine, in a prospective cohort study, the impact of living arrangements on the incidence of coronary heart disease (CHD) and mortality as well as all-cause mortality in a large prospective cohort of the Japanese population.
  
  
  METHODS
  The association between living arrangements and risk of CHD and mortality was examined prospectively within a cohort of 90 987 Japanese women and men aged 40-69 years, free of prior diagnosis of cancer and cardiovascular disease. A total of 671 cases of newly diagnosed CHD, 339 CHD deaths and 6255 all-cause deaths occurred between the baseline questionnaire (1990-4) and the end of follow-up in January 2004.
  
  
  RESULTS
  After adjustment for potentially confounding variables, women living in multi-generational households (ie, with spouse-children-parents; or spouse-parents) had a two- to threefold higher risk of CHD than women living with spouses only. Women living with spouses and children also had a 2.1-fold higher risk of CHD incidence compared with married women living without children.
  
  
  CONCLUSIONS
  Women in a multi-generational family had a higher risk of CHD, probably due to stress from multiple family roles.
authors.affiliation: Department of Social and Environmental Medicine, Osaka University, Suita-shi, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ikeda
authors.forename: H
authors.initials: H
authors.lastname: Iso
authors.forename: I
authors.initials: I
authors.lastname: Kawachi
authors.forename: K
authors.initials: K
authors.lastname: Yamagishi
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.forename: S
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics; D012306:Risk; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology