Living arrangement and coronary heart disease: the JPHC study.
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.
Ikeda
A
A
Department of Social and Environmental Medicine, Osaka University, Suita-shi, Japan.
Iso
H
H
Kawachi
I
I
Yamagishi
K
K
Inoue
M
M
Tsugane
S
S
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