Objectives: 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. In this prospective cohort study, we sought to examine the impact of living arrangements on coronary heart disease incidence and mortality as well as all-cause mortality in a large prospective cohort of Japanese population.
Methods: We examined prospectively the association between living arrangement and risk of coronary heart disease incidence and mortality 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 coronary heart disease, 339 coronary heart disease deaths, and 6,255 all-cause deaths occurred between the baseline questionnaire (1990-1994) and the end of follow-up in January 2004.
Results: After adjustment of potentially confounding variables, women living in multi-generational households (living with spouse-children-parents; or spouse-parents) had 2.0 to 3.0-fold higher risk of coronary heart disease compared to women living with spouses only. Women living with spouses and children also had 2.1-fold higher risk of coronary heart disease incidence compared to married women living without children.
Conclusions: Women in a multi-generational family had a higher risk of coronary heart disease incidence, probably due to stress from multiple family roles.
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