摘要：Objectives. To review the contribution of the Nurses’ Health Studies (NHS) on factors that influence mental and physical health. Methods. Narrative review of all published articles using data from the NHS, the NHS II, and the Growing Up Today Study focusing on mental health conditions (e.g., depression, posttraumatic stress disorder, anxiety) and psychosocial resources and stressors (e.g., job strain, interpersonal violence, social relationships, sexual orientation) between 1990 and 2016. Results. Studies have considered a broad array of determinants (e.g., genes, biomarkers, air pollution) and consequent behavioral and disease-related outcomes (e.g., body weight, smoking, cardiometabolic diseases, cancer, autism). Findings suggest anxiety, posttraumatic stress disorder, childhood violence, caregiver burden, and job insecurity may increase the risk of coronary heart disease and diabetes, whereas findings with cancer are mixed. This work directly affects public health actions, as demonstrated by recent inclusion of a gender expression measure in state surveys. Conclusions. The NHS cohorts have produced novel and influential research on the interplay of psychological and social factors with health. Psychological and social variables are important contributors to the maintenance or decline of physical and mental health. The Nurses’ Health Study (NHS; 121 700 nurses aged 30–55 years in 1976) first biennial questionnaires gathered data on sociodemographic characteristics, contraceptive methods, medical conditions, nutrition, and health-relevant behaviors. Starting in 1988, measures of psychosocial factors were incorporated. Similarly, the Nurses’ Health Study II (NHS II; 116 430 nurses aged 25–42 years in 1989) included psychosocial factors on questionnaires starting in 1993. In the Growing Up Today Study (GUTS; 16 882 children aged 9–14 years), offspring of NHS II participants completed items on medical conditions, lifestyle, self-perception, and sexuality since 1996. The expressed interest of the nurses and emerging research suggesting an important interplay between psychological, social, and biological processes motivated the assessment of psychosocial variables. 1–4 Nearly 150 articles targeting psychological or social factors that examined these cohorts’ data have been published to date. Prevalence rates of psychiatric conditions (e.g., anxiety, depression) and psychosocial stressors (e.g., sexual minorities and violence in adulthood) observed among NHS participants are generally comparable to those of the general population. Most studies used the prospective research design, but cross-sectional, retrospective, or case–control studies were also published. Studies adjust for similar covariates, including demographics (e.g., age, education), health and medical factors (e.g., medical conditions, menopausal status, medication, body mass index ), and lifestyle (e.g., tobacco and alcohol use, diet and exercise) as potential mediators or confounders. Medical conditions are either self-reported (e.g., hypertension), self-reported and validated by blinded physician (e.g., cancer), or extracted by blinded physicians from patient records (e.g., stroke). Deaths are reported by next of kin or postal authorities or found in a search of the National Death Index. Most studies assess the risk of disease onset or mortality (using hazard ratios [HRs], odds ratios [ORs], prevalence ratios [PRs], or relative risks [RRs]), and some examine changes over time (e.g., of behaviors). We have presented published research that examined the NHS cohorts as we considered determinants of psychiatric conditions or psychosocial risk factors in relation to health. We gathered studies through PubMed and PsycInfo, and lead researchers of the NHS cohorts reviewed the list to ensure completeness. For the sake of parsimony, we have described only a few studies; a comprehensive report of all articles is available in a supplement to the online version of this article at http://www.ajph.org (Table A: psychiatric conditions; Table B: psychosocial resources and stressors). Because of space constraints, we have included factors with more limited findings (socioeconomic status, job strain, caregiving) in the tables only.
