Multigenerational family structure in Japanese society: impacts on stress and health behaviors among women and men.

Rapid population aging in Japan has led to rising demands for informal care giving. Traditionally, care giving for aging parents has fallen disproportionately on the shoulders of women living in multigenerational households. However, rising labor force participation by Japanese women, declining marriage and fertility rates, and women's changing expectations have combined to produce unprecedented strains on traditional multigenerational households where care giving to elders traditionally takes place. In this paper, we explored gender-specific relationships between family structure, stress and worries, and health behaviors, using linked data from two national surveys conducted in Japan: the 1995 Comprehensive Survey of the Living Conditions of People on Health and Welfare, and the 1995 National Nutrition Survey. We found that women in multigenerational households reported more care-giving worries, and also less future health and financial worries. Living with parents was associated with protective health behaviors (less smoking, less heavy drinking), but also more sedentary behavior among women, while men in "sandwich" families (i.e., living with both parents and children) reported heavier smoking. The association of family structure and health behavior was not mediated by worries. Living alone was associated with worse health for women. These findings suggest gender-specific patterns of worries and health behaviors that reflect both the health-protecting and health-damaging effects of living in multigenerational households. Copyright 2003 Elsevier Ltd.