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.

Duke Scholars

Author Vance Garrison Fowler Jr. Medicine, Infectious Diseases

Author Gordon Ralph Corey Medicine, Infectious Diseases

Author Vivian Hou Chu Medicine, Infectious Diseases

Author Daniel John Sexton Medicine, Infectious Diseases