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Living arrangement and coronary heart disease: the JPHC study
  1. A Ikeda1,2,
  2. H Iso1,
  3. I Kawachi2,
  4. K Yamagishi3,4,
  5. M Inoue5,
  6. S Tsugane5,
  7. for the JPHC Study Group
  1. 1
    Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
  2. 2
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
  3. 3
    Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences and Institute of Community Medicine, University of Tsukuba, Ibaraki, Japan
  4. 4
    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
  5. 5
    Epidemiology and Prevention Division, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan
  1. Professor H Iso, Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University. 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; iso{at}


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.

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  • Competing interests: None declared.

  • Funding: This study was supported by Grants-in-aid for Cancer Research and for the Third Term Comprehensive Ten-Year Strategy for Cancer Control from the Ministry of Health, Labour and Welfare of Japan.

  • Ethics approval: Ethics committee approval obtained.