摘要：Objectives. We examined the relationship between burden of providing care to non-ill children and grandchildren and incidence of coronary heart disease (CHD) among women. Methods. A prospective cohort study was conducted as part of the Nurses’ Health Study among 54 412 women aged 46 to 71 years who were registered nurses. Women answered questions about their child care responsibilities. Results. We documented 321 incident cases of CHD during 4 years of follow-up. Multivariate analyses showed that caring for non-ill children 21 hours or more per week and caring for non-ill grandchildren 9 hours or more per week (vs no caregiving) were associated with an increased risk of CHD (relative risks were 1.59 and 1.55, respectively). Conclusions. High levels of care provision to grandchildren (and possibly children) may increase the risk of CHD among women. Almost all women provide care to their own children, and a growing number of grandmothers provide care to their grandchildren. According to recent data, 14.5% of American grandmothers have raised a grandchild for 6 months or more. 1 Although studies have been conducted investigating health consequences among individuals who provide care to ill children and grandchildren, few studies have examined the health consequences for caregivers of looking after non-ill children. Most studies of caregiving provided to grandchildren have been limited to grandparents whose adult children are mentally ill, incarcerated, dead, or divorced. Among such grandparents, assuming primary responsibility for rearing grandchildren has been linked to depression, insomnia, hypertension, diabetes, functional health limitations, and declines in self-rated health. 2– 8 Researchers conducting other qualitative studies have noted the tendency among grandparents with caregiving responsibilities to delay seeking help for their own health problems. 9– 11 In the present prospective study, we examined the association between caregiving responsibilities (for non-ill children and non-ill grandchildren) and the incidence of coronary heart disease (CHD) in a cohort of middle-aged and older women.
