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Hamm SI, Zimmer Z, Ofstedal MB. Linking Multi-Dimensional Religiosity in Childhood and Later Adulthood: Implications for Later Life Health. Res Aging 2024:1640275241267298. [PMID: 39089867 DOI: 10.1177/01640275241267298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
This study examines religiosity patterns across childhood and later adulthood and their associations with later-life health using an experimental module from the 2016 Health and Retirement Study (N = 1649; Mean Age = 64.0). Latent class analysis is used to categorize individuals by commonalities in religious attendance, religious identity, and spiritual identity. Cross-sectional and longitudinal associations are then explored using probable depression, disability, and mortality as health indicators. Results reveal complex patterns, often characterized by declining attendance and fluctuating identity. Relationships with health appear stronger in cross-sectional analyses, suggesting that some associations may be non-causal. Individuals with consistently strong religiosity show significantly better psychological health compared to their relatively non-religious counterparts. Moreover, the absence of religiosity in later adulthood is associated with an increased risk of mortality. Overall, the findings support the promotion of religiosity whilst acknowledging individual variations and highlighting the need for more individualistic approaches to the study of religion and health.
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Affiliation(s)
- Sara I Hamm
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, NS, Canada
| | - Zachary Zimmer
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, NS, Canada
| | - Mary Beth Ofstedal
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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2
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Prati G. Is religion beneficial for mental health? A 9-year longitudinal study. Int J Clin Health Psychol 2024; 24:100491. [PMID: 39220118 PMCID: PMC11365415 DOI: 10.1016/j.ijchp.2024.100491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/04/2024] [Indexed: 09/04/2024] Open
Abstract
Background/Objective This study aimed to investigate the within-person and between-person effects of religious variables on mental health and vice versa. Method Using a large sample of adults residing in Germany from the GESIS Panel study (N = 8146), the random intercept cross-lagged panel model was used. Data on six dimensions of religion (i.e., membership in a religious community; attendance at a place of worship; frequency of prayers; importance of religion in life; and participation in a religious organization) and three indicators of mental health (i.e., depression symptoms, happiness, and life satisfaction) were collected. Results The findings revealed that there is almost no evidence of lagged effects of religion on mental health and limited evidence regarding the role of mental health in influencing the dimensions of religion. Moreover, at the between-person level, there was some evidence of significant covariance between the trait-like components, indicating stable, trait-like differences between persons on religion and mental health. Conclusions The beneficial effect of religion on mental health may have been exaggerated in previous research.
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Affiliation(s)
- Gabriele Prati
- Department of Psychology, University of Bologna (Italy), Piazza Aldo Moro, 90, 47521 Cesena (FC), Italy
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3
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Halstead I, Heron J, Svob C, Joinson C. Maternal religiosity and adolescent mental health: A UK prospective cohort study. J Affect Disord 2024; 351:158-164. [PMID: 38281597 DOI: 10.1016/j.jad.2024.01.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Previous research has examined associations between parental religiosity and offspring mental health, but findings are inconsistent, and few studies have focused on late adolescence when mental health problems are more common. This study examines the prospective relationship between maternal religiosity and offspring mental health in late adolescence. METHODS We used data from the Avon Longitudinal Study of Parents and Children to examine the prospective association between latent classes of maternal religiosity (Highly Religious, Moderately Religious, Agnostic, Atheist) and self-reported mental health problems including common mental disorders, ICD 10 depression, depressive symptoms, generalised anxiety symptoms, self-harm acts, self-harm thoughts, and disordered eating outcomes at age 17-18 years (n = 7714). We used multivariable logistic regression analysis adjusted for maternal mental health, maternal adverse childhood experiences, and socioeconomic variables. RESULTS Compared with adolescent offspring of parents in the Agnostic class, offspring of the Atheist class had increased odds of depressive symptoms ((1.31[1.03,1.67]) and offspring of the Highly Religious class had increased odds of self-harm thoughts (1.43[1.04,1.97]). There was also weak evidence (95 % confidence intervals crossed the null) of increased odds of depression in the offspring of Moderately religious and Highly religious classes (1.26 [0.97,1.65], and 1.30 [0.99,1.70], respectively)) and self-harm acts in the offspring of the Highly religious class (1.31[0.98,1.74]). There was no evidence of associations with the disordered eating outcomes or generalised anxiety disorder symptoms. CONCLUSIONS We found evidence that adolescents whose mothers are Atheist, Moderately Religious, and Highly Religious are more likely to have depressive symptoms than those whose mothers are Agnostic. There was also evidence for an increased likelihood of self-harm (thoughts and acts) amongst adolescents of Highly Religious parents. Further research is needed to examine possible mechanisms that could explain these observed associations as well as a repetition of our analyses in a non-UK sample.
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Affiliation(s)
- Isaac Halstead
- The Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Connie Svob
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University; New York, NY, USA; Division of Child & Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Carol Joinson
- The Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
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Lindström M, Pirouzifard M. Religious service attendance and mortality: A population-based prospective cohort study in southern Sweden. SSM Popul Health 2023; 23:101492. [PMID: 37635991 PMCID: PMC10458674 DOI: 10.1016/j.ssmph.2023.101492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/30/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023] Open
Abstract
Aims The aim is to investigate associations between attendance in religious service during the past year and all-cause, cardiovascular (CVD), cancer and other cause mortality. Study design Prospective cohort study. Methods A public health survey with three reminders was sent to a stratified random sample of the adult 18-80 population in southernmost Sweden in 2008. The response rate was 54.1%, and 24,855 participants were included in this study. The cross-sectional baseline survey was connected to mortality data with 8.3-year follow-up. Analyses were conducted in Cox regression models. Results 13.9% had attended religious service at least once during the past year, and 86.1% had not attended. The group with religious attendance contained significantly higher proportions of women, high and medium position non-manual employees, participants born abroad, never alcohol consumers, respondents with high trust in others and respondents with high social participation. It also contained significantly lower proportions with low leisure-time physical activity (LTPA) and daily smokers. Religious service attendance during the past year was significantly associated with lower hazard rate ratios (HRRs) of all-cause mortality compared to non-attendance until social participation items were introduced in the final model. HRRs of CVD mortality were significantly lower for religious attendance in the multiple models until BMI and health-related behaviors were introduced. No significant results were observed for cancer and other cause mortality. Conclusions The results suggest that religious service attendance in a highly secularized country such as Sweden is significantly associated with lower all-cause mortality, which may be explained by a social network pathway in this highly secularized population.
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Affiliation(s)
- Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University, S-205 02, Malmö, Sweden
| | - Mirnabi Pirouzifard
- Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University, S-205 02, Malmö, Sweden
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Cupery T, Bush E, Turner RW, Sonnega A, Rosales T, Vissa K, Whitfield KE, Jackson JS, Weir D. Positive Effects of Religion and Social Ties on the Health of Former NFL Athletes. JOURNAL OF RELIGION AND HEALTH 2023; 62:1324-1342. [PMID: 34313910 DOI: 10.1007/s10943-021-01338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
This study explores the relationship between religious service attendance, social ties, and health among former NFL players, a population with relatively high levels of religious attendance who endure physically demanding occupations. Research shows that frequent religious service attenders tend to have better health, partly because of social connections formed through religious involvement. We analyzed a sample of 1029 former NFL players. Consistent with previous research, bivariate and multivariate OLS regression models show that frequent religious attenders have statistically significantly better self-rated health. However, this relationship is moderated by social ties. Respondents who scored lower on the social ties index exhibited a stronger significant relationship between frequent religious attendance and health; those scoring higher on the social ties index exhibited no relationship between frequent attendance and health. Future research should examine how benefits of religious attendance vary depending upon strength of social relationships.
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Affiliation(s)
- Tim Cupery
- Department of Sociology, College of Social Sciences, California State University - Fresno, 534 N. Campus Dr. M/S SS97, Fresno, CA, 93740, USA.
| | - Evelyn Bush
- Department of Sociology and Anthropology, Fordham University, Dealy Hall 406D, 441 East Fordham Road, Bronx, NY, 10458, USA
| | - Robert W Turner
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, 2600 Virginia Ave NW T100, Washington, DC, 20037, USA
| | - Amanda Sonnega
- Survey Research Center of the Institute for Social Research, University of Michigan, P.O. Box 1248, Ann Arbor, MI, 48106, USA
| | - Teri Rosales
- Office of Diversity, Equity, and Inclusion, Office of the Provost, University of Michigan, 3050 Fleming Administration Building, 503 Thompson Street, Ann Arbor, MI, 48109, USA
| | - Kalpana Vissa
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, 2600 Virginia Ave NW T100, Washington, DC, 20037, USA
| | - Keith E Whitfield
- Psychology Department, Wayne State University, 5057 Woodward Ave., 7th Floor, Suite 7908, Detroit, MI, 48201, USA
| | - James S Jackson
- Department of Psychology, College of Literature, Sciences, and the Arts, University of Michigan, 1004 East Hall, 530 Church Street, Ann Arbor, 48109, USA
| | - David Weir
- Population Studies Center of the Institute for Social Research, University of Michigan, P. O. Box 1248, Ann Arbor, MI, 48106, USA
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Cowden RG, Nakamura JS, Chen ZJ, Case B, Kim ES, VanderWeele TJ. Identifying pathways to religious service attendance among older adults: A lagged exposure-wide analysis. PLoS One 2022; 17:e0278178. [PMID: 36445902 PMCID: PMC9707744 DOI: 10.1371/journal.pone.0278178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/12/2022] [Indexed: 12/02/2022] Open
Abstract
We used prospective data (spanning 8 years) from a national sample of older U.S. adults aged > 50 years (the Health and Retirement Study, N = 13,771) to evaluate potential factors that lead to subsequent religious service attendance. We applied a lagged exposure-wide epidemiologic design and evaluated 60 candidate predictors of regular subsequent religious service attendance. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. After rigorous adjustment for a rich set of potential confounders, we observed modest evidence that changes in some indices of physical health, psychological well-being, psychological distress, and social functioning predicted regular religious service attendance four years later. Our findings suggest that there may be opportunities to support more regular religious service attendance among older adults who positively self-identify with a religious/spiritual tradition (e.g., aid services for those with functional limitations, psychological interventions to increase hope), which could have downstream benefits for various dimensions of well-being in the later years of life.
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Affiliation(s)
- Richard G. Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Julia S. Nakamura
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Zhuo Job Chen
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC, United States of America
| | - Brendan Case
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
| | - Eric S. Kim
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Tyler J. VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Onyishi CN, Eseadi C, Ilechukwu LC, Okoro KN, Okolie CN, Egbule E, Asogwa E. Potential influences of religiosity and religious coping strategies on people with diabetes. World J Clin Cases 2022; 10:8816-8826. [PMID: 36157650 PMCID: PMC9477035 DOI: 10.12998/wjcc.v10.i25.8816] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes is a significant health issue that threatens patients’ overall wellbeing and quality of life. Critical public health concerns center on creating the best approach for diabetes management. Patients and caregivers have different approaches to diabetes management; however, this and the associated physiological, physical and mental health issues remain challenging. This review explores the potential influences of religiosity and religious coping strategies on people with diabetes. This study used a literature review approach to investigate how religiosity and religious coping strategies can influence the effective management of diabetes among patients. Based on the literature search, the researchers were able to identify and cite published papers that were analyzed using the descriptive-narrative analysis. An important goal of the descriptive-narrative analysis was to provide descriptions of the selected literature and take implications from the literature. The results of studies reviewed show some religious coping strategies for managing chronic diseases such as diabetes. The studies did establish a relationship between religiosity and diabetes management and suggest that religious coping strategies could positively impact the management of diabetes; however, they reported some adverse effects. Hence, we propose a pathway for the development of religion-oriented interventions and support framework for the management of diabetes.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | | | - Kingsley Nwannennaya Okoro
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Charles Nkem Okolie
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Emmanuel Egbule
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Emmanuel Asogwa
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
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Mckie AL, Gaida F. A scoping review of spirituality and religiosity in people who have had a kidney transplant. Nurs Open 2022; 9:2277-2288. [PMID: 35670228 PMCID: PMC9374409 DOI: 10.1002/nop2.1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To conduct a scoping review to discover what is known about the presence of spirituality and religiosity in people who have received a kidney transplant. DESIGN Using Arksey and O'Malley's five-stage framework, a scoping review of seven key databases was performed in June 2020. The scoping review follows the PRISMA extension for scoping review process. METHODS CINAHL, MEDLINE, Embase, OvidPsychINFO, JBI, Scopus and Cochrane databases were searched to identify original research, from which seven studies were identified with only four meeting the criteria. The search strategy focused on studies that were published between January 2000-May 2020. RESULTS In synthesizing the available research, two key areas of interest were identified within the included studies, (1) clinical outcomes (medical adherence, renal function and transplant-related outcomes) and (2) well-being outcomes (locus of control and coping).
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Affiliation(s)
- Amanda L. Mckie
- School of Nursing, Midwifery and Public HealthUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
- School of NursingGriffith UniversityGold CoastQueenslandAustralia
| | - Fellon Gaida
- School of Nursing, Midwifery and Public HealthUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
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Herold SC, Hvidt NC, Möller S, Christensen K, Ahrenfeldt LJ. Is Religiousness Associated with Better Lifestyle and Health Among Danes? Findings from SHARE. JOURNAL OF RELIGION AND HEALTH 2022; 61:1621-1640. [PMID: 32488829 DOI: 10.1007/s10943-020-01050-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Evidence of a possible association between religion and health in secular societies is sparse. We therefore conducted a nationwide study using data from 1596 Danes aged 50 + who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE) wave 1 (2004-2005) and were followed up between 2006 and 2015, to investigate the association between religiousness and health including a lifestyle index. Results from the longitudinal models adjusted for age and gender showed that being religiously educated by parents, taking part in a religious organization, and praying were factors associated with fewer risk factors of unhealthy lifestyle. Furthermore, being religiously educated was associated with lower odds of self-rated poor health and depressive symptoms. Results were overall consistent across the cross-sectional and longitudinal models and persisted after further adjustment for education and marital status. These findings provide support for a positive relationship between religiousness and health among Danes, particularly for those being religiously educated by their parents.
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Affiliation(s)
- Steffen Christensen Herold
- Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000, Odense, Denmark
| | - Sören Möller
- OPEN - Odense Patient Data Explorative Network, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark
| | - Kaare Christensen
- Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
- Department of Clinical Biochemistry, Odense University Hospital, 5000, Odense, Denmark
- Pharmacology and Department of Clinical Genetics, Odense University Hospital, 5000, Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark.
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Jokela M. Religiosity, Psychological Distress, and Well-Being: Evaluating Familial Confounding With Multicohort Sibling Data. Am J Epidemiol 2022; 191:584-590. [PMID: 34791015 PMCID: PMC8971076 DOI: 10.1093/aje/kwab276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 08/27/2021] [Accepted: 11/09/2021] [Indexed: 11/12/2022] Open
Abstract
Several studies have associated religiosity with better mental health, but these studies have only partially addressed the problem of confounding. The present study pooled data from multiple cohort studies with siblings to examine whether associations between religiosity and mental health are confounded by familial factors (i.e., shared family background and siblings' shared genetics). Data were collected between 1982 and 2017. Mental health was assessed with self-reported psychological distress (including depressive symptoms) and psychological well-being. Religious attendance was associated with lower psychological distress (standard-deviation difference between weekly vs. never attendance, B = -0.14, confidence interval (CI): -0.19, -0.09; n = 24,598 pairs), and this was attenuated by almost half in the sibling analysis (B = -0.08, CI: = -0.13, -0.04). Religious attendance was also related to higher well-being (B = 0.29, CI: = 0.14, 0.45; n = 3,728 pairs), and this estimate remained unchanged in sibling analysis. Results were similar for religiousness. The findings suggest that previous longitudinal studies may have overestimated the association between religiosity and psychological distress, as the sibling estimate was only one-third of the previously reported meta-analytical association (standardized correlation -0.03 vs. -0.08).
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Affiliation(s)
- Markus Jokela
- Correspondence to Prof. Markus Jokela, Department of Psychology and Logopedics, Haartmaninkatu 3, 00290 Helsinki, Finland (e-mail: )
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VanderWeele TJ, Balboni TA, Koh HK. Invited Commentary: Religious Service Attendance and Implications for Clinical Care, Community Participation, and Public Health. Am J Epidemiol 2022; 191:31-35. [PMID: 33977296 PMCID: PMC8751781 DOI: 10.1093/aje/kwab134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/17/2022] Open
Abstract
In this commentary, we review the evidence concerning associations between religious service attendance and subsequent health and wellbeing outcomes. The evidence base for a link between religious service attendance and health has increased substantially over the past 2 decades. The interpretation and implications of this research require careful consideration (Am J Epidemiol. 2022;191(1):20-30). It would be inappropriate to universally promote service attendance solely on the grounds of the associations with health. Nevertheless, a more nuanced approach, within both clinical care and public health, may be possible-one that encouraged participation in religious community for those who already positively self-identified with a religious or spiritual tradition and encouraged other forms of community participation for those who did not. Discussion is given to potential future research directions and the challenges and opportunities for promotion efforts by the public health community.
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Affiliation(s)
- Tyler J VanderWeele
- Correspondence to Dr. Tyler J. VanderWeele, Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: )
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Rubenstein A, Koenig HG, Marin DB, Sharma V, Harpaz-Rotem I, Pietrzak RH. Religion, spirituality, and risk for incident posttraumatic stress disorder, suicidal ideation, and hazardous drinking in U.S. military veterans: A 7-year, nationally representative, prospective cohort study. J Affect Disord 2021; 295:1110-1117. [PMID: 34706422 DOI: 10.1016/j.jad.2021.08.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/23/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
While religion and spirituality (R/S) have been linked to positive mental health outcomes, most studies have employed cross-sectional designs, which do not allow one to evaluate the utility of R/S in predicting these outcomes. To address this gap, this study analyzed data from a 7-year nationally representative, prospective cohort study of U.S. military veterans to examine the effects of R/S on the development of incident mental health outcomes in this population. Specifically, we examined the association between organizational religious activity (ORA), non-organizational religious activity (NORA), and intrinsic religiosity (IR), and the risk of incident PTSD, suicidal ideation (SI), and hazardous drinking (HD). Multivariable logistic regression analyses revealed that ORA predicted a lower incidence of PTSD and SI; NORA a greater risk of developing HD; and IR a lower risk of developing HD. These results suggest that religion and spirituality, assessed in a nationally representative sample of military veterans, predict risk of developing PTSD, SI, and HD, over and above sociodemographic factors and perceived social support. Clinical implications and strategies for incorporating R/S into mental health assessment and interventions in this population are discussed.
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Affiliation(s)
- Arielle Rubenstein
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT.
| | - Harold G Koenig
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Deborah B Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Vanshdeep Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Does Participating in Religious Activities Have a Long-Term Effect on the Emotional/Mental Health of Immigrants in Canada? CANADIAN STUDIES IN POPULATION 2021. [DOI: 10.1007/s42650-021-00043-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol 2021; 49:2030-2040. [PMID: 32793951 PMCID: PMC7825951 DOI: 10.1093/ije/dyaa120] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Religious-service attendance has been linked with a lower risk of all-cause mortality, suicide and depression. Yet, its associations with other health and well-being outcomes remain less clear. METHODS Using longitudinal data from three large prospective cohorts in the USA, this study examined the association between religious-service attendance and a wide range of subsequent physical health, health behaviour, psychological distress and psychological well-being outcomes in separate cohorts of young, middle-aged and older adults. All analyses adjusted for socio-demographic characteristics, prior health status and prior values of the outcome variables whenever data were available. Bonferroni correction was used to correct for multiple testing. RESULTS Estimates combining data across cohorts suggest that, compared with those who never attended religious services, individuals who attended services at least once per week had a lower risk of all-cause mortality by 26% [95% confidence interval (CI): 0.65 to 0.84], heavy drinking by 34% (95% CI: 0.59 to 0.73) and current smoking by 29% (95% CI: 0.63 to 0.80). Service attendance was also inversely associated with a number of psychological-distress outcomes (i.e. depression, anxiety, hopelessness, loneliness) and was positively associated with psychosocial well-being outcomes (i.e. positive affect, life satisfaction, social integration, purpose in life), but was generally not associated with subsequent disease, such as hypertension, stroke, and heart disease. CONCLUSIONS Decisions on religious participation are generally not shaped principally by health. Nevertheless, for individuals who already hold religious beliefs, religious-service attendance may be a meaningful form of social integration that potentially relates to greater longevity, healthier behaviours, better mental health and greater psychosocial well-being.
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Affiliation(s)
- Ying Chen
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric S Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Van Herreweghe L, Van Lancker W. Re: Letter to the Editor of Public Health in response to 'Religiousness and depressive symptoms in Europeans: findings from the Survey of Health, Ageing, and Retirement in Europe'. Public Health 2020; 187:60-61. [PMID: 32919310 DOI: 10.1016/j.puhe.2020.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- L Van Herreweghe
- Centre for Sociological Research, Faculty of Social Sciences (KU Leuven), Centre for Sociological Research, Parkstraat 45 - bus 3601, 3000, Leuven, Belgium.
| | - W Van Lancker
- Centre for Sociological Research, Faculty of Social Sciences (KU Leuven), Centre for Sociological Research, Parkstraat 45 - bus 3601, 3000, Leuven, Belgium; Herman Deleeck Centre for Social Policy, Faculteit Sociale Wetenschappen, Universiteit Antwerpen, Sint-Jacobstraat 2, B-2000, Antwerpen, Belgium
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16
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Trajectories of Religious Change From Adolescence to Adulthood, and Demographic, Environmental, and Psychiatric Correlates. J Nerv Ment Dis 2020; 208:466-475. [PMID: 32053568 DOI: 10.1097/nmd.0000000000001154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Studies of religiosity and mental health largely characterize religiousness as stable over time. However, research shows that religiosity likely changes significantly with development. It is unclear whether associations of religiosity with mental health also change over the lifespan. Latent growth curves were created to quantify changes in multiple religious variables, identify associated psychosocial variables, and observe relationships between religiosity and mental health from adolescence to adulthood. Analyses used four waves of data from over 9000 subjects, from ages 12 to 34 years. Although religious service attendance decreased over time, the importance of religion increased and the frequency of prayer remained relatively stable. Baseline religiosity and changes over time were related to contextual variables including race, socioeconomic status, and peer substance use. Correlations with mental health varied over time. Religiosity should be conceptualized as multidimensional and dynamic; religion/health research should consider the impact of multiple psychosocial variables as well as bidirectional relationships with mental health.
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17
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Kawachi I. Invited Commentary: Religion as a Social Determinant of Health. Am J Epidemiol 2019; 189:1461-1463. [DOI: 10.1093/aje/kwz204] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 08/17/2019] [Accepted: 08/22/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
There is broad agreement that religion is a social determinant of health. In the article by Chen and VanderWeele (Am J Epidemiol. 2018;187(11):2355–2364), the authors took an outcome-wide approach to demonstrate associations between religious practices early in the life course (regular service attendance and prayer/mediation) and a wide range of health endpoints and behaviors later on. Is religion a panacea? The study adds to the evidence that religious practices are correlated with a broad swath of health outcomes. However, more work is needed to translate that evidence into practicable advice for individuals and for society. The following tasks remain. 1) We must sharpen our understanding of which elements of religious practices promote health. (Specifically, is it service attendance, prayer, or both? Could a nonreligious person achieve the same benefit via regular participation in a secular group, like a choir?). 2) We should improve our understanding of the different contexts in which religion is likely to have beneficial, as well as potentially harmful, effects.
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McClintock CH, Anderson M, Svob C, Wickramaratne P, Neugebauer R, Miller L, Weissman MM. Multidimensional understanding of religiosity/spirituality: relationship to major depression and familial risk. Psychol Med 2019; 49:2379-2388. [PMID: 30419987 PMCID: PMC6513730 DOI: 10.1017/s0033291718003276] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previous research has shown prospectively that religiosity/spirituality protects against depression, but these findings are commonly critiqued on two grounds, namely: (1) apparent religiosity/spirituality reflects merely an original absence of depression or elevated mood and (2) religiosity/spirituality too often is measured as a global construct. The current study investigates the relationship between depression and religiosity/spirituality by examining its multidimensional structural integrity. METHOD Confirmatory factor analyses with a previously observed cross-cultural factor structure of religiosity/spirituality variables were conducted on an independent sample, diagnostic and familial risk subgroups from this sample, and a subsample of the original cross-cultural sample. Linear regressions onto a previous diagnosis of major depressive disorder (MDD) 5 years prior to assess the potential attenuating impact of a previous depression was explored. RESULTS Across familial risk groups and clinical subgroups, each of the previously validated religiosity/spirituality domains was confirmed, namely: religious/spiritual commitment, contemplative practice, sense of interconnectedness, the experience of love, and altruistic engagement. Previous MDD diagnosis was associated with a lower religious/spiritual commitment among high-risk individuals, higher contemplation among low-risk individuals, and lower importance of religion or spirituality regardless of risk group. CONCLUSIONS Structural integrity was found across familial risk groups and diagnostic history for a multidimensional structure of religiosity/spirituality. Differential associations between a previous diagnosis of MDD and level of religiosity/spirituality across domains suggest a complex and interactive relation between depression, familial risk, and religiosity/spirituality. Accounting for an empirically valid, multidimensional understanding of religiosity/spirituality may advance research on mechanisms underlying the relationship between religiosity/spirituality and mental health.
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Affiliation(s)
- Clayton H. McClintock
- Spirituality Mind Body Institute, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York City, USA
| | - Micheline Anderson
- Spirituality Mind Body Institute, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York City, USA
| | - Connie Svob
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York City, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York City, USA
| | - Priya Wickramaratne
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York City, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York City, USA
| | - Richard Neugebauer
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York City, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York City, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, USA
| | - Lisa Miller
- Spirituality Mind Body Institute, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York City, USA
| | - Myrna M. Weissman
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York City, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York City, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, USA
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19
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Braam AW, Koenig HG. Religion, spirituality and depression in prospective studies: A systematic review. J Affect Disord 2019; 257:428-438. [PMID: 31326688 DOI: 10.1016/j.jad.2019.06.063] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/29/2019] [Accepted: 06/30/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Many empirical studies have shown inverse associations between measures of religiousness and spirituality (R/S) and depression. Although the majority of these studies is cross-sectional, a considerable number of prospective studies have also appeared. METHODS The current systematic review offers an overview of the major pattern of associations between the measures of R/S and depression / depressive symptoms in 152 prospective studies (until 2017). RESULTS With on average two R/S measures per study (excluding measures of religious struggle, treated separately), 49% reported at least one significant association between R/S and better course of depression, 41% showed a non-significant association, and 10% indicated an association with more depression or mixed results. The estimated strength of these associations was modest (d = -0.18). Of the studies that included religious struggle, 59% reported a significant association with more depression (d = +0.30). Especially among persons identified with psychiatric symptoms, R/S was significantly more often protective (d = -0.37). In younger samples and in samples of patients with medical illness, R/S was less often protective. Studies with more extensive adjustment for confounding variables showed significantly more often associations with less depression. Geographical differences in the findings were not present. LIMITATIONS Given the huge heterogeneity of studies (samples size, duration of follow-up), the current synthesis of evidence is only exploratory. CONCLUSION In about half of studies, R/S predicted a significant but modest decrease in depression over time. Further inquiry into bi-directional associations between religious struggle and (clinical) depression over time seems warranted.
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Affiliation(s)
- Arjan W Braam
- Department of Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands; Department of Emergency Psychiatry, Department of Residency Training, Altrecht Mental Health Care, Lange Nieuwstraat 119, 3512 PG Utrecht, The Netherlands.
| | - Harold G Koenig
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3400, Durham, NC 27710, USA; Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; School of Public Health, Ningxia Medical University, Yinchuan 750000, PR China.
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20
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Suh H, Hill TD, Koenig HG. Religious Attendance and Biological Risk: A National Longitudinal Study of Older Adults. JOURNAL OF RELIGION AND HEALTH 2019; 58:1188-1202. [PMID: 30334184 DOI: 10.1007/s10943-018-0721-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although several studies suggest that religious involvement is associated with healthier biological functioning in later life, most of this work is cross-sectional. We extend previous research by employing a longitudinal design. Our analysis of Health and Retirement Study (2006/2010) data suggests that older adults who attended religious services weekly or more in 2006 tend to exhibit fewer high-risk biomarkers in 2010 and greater reductions in allostatic load over the 4-year study period than respondents who attended yearly or not at all. These patterns persisted with adjustments for baseline allostatic load and a range of background variables.
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Affiliation(s)
- Hyungjun Suh
- School of Sociology, The University of Arizona, Social Sciences Building, Room 400, 1145 E. South Campus Drive, Tucson, AZ, 85721, USA
| | - Terrence D Hill
- School of Sociology, The University of Arizona, Social Sciences Building, Room 400, 1145 E. South Campus Drive, Tucson, AZ, 85721, USA.
| | - Harold G Koenig
- Departments of Psychiatry and Medicine, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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21
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Miller PK, Weller BE. Uncovering Profiles of Economic, Social, and Cultural Capital to Explore Depression Across Racial Groups. J Racial Ethn Health Disparities 2019; 6:1167-1181. [PMID: 31346966 DOI: 10.1007/s40615-019-00618-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/07/2019] [Accepted: 07/16/2019] [Indexed: 12/01/2022]
Abstract
Research exploring the association between socio-economic status (SES) and depression is limited by conceptualizations of SES and conflicting findings across racial groups. We broaden previous research by (1) reconceptualizing SES through the lens of Bourdieusian theory to identify profiles of economic, social, and cultural capital; (2) investigating whether these profiles differ for Black and white adults; and (3) exploring whether specific profiles of capital are associated with increased depression scores. This study analyzed secondary data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of US individuals. A sub-population of the sample was used, which was comprised of 4339 Black and white participants from wave IV. To address the study aims, we used the new three-step approach to conducting latent class analysis. We identified five profiles of capital, the composition of which varied by race. Compared to Blacks, whites were more likely to be in the "cultural-economic capital" (14% vs. 10%), "elevated overall capital" (35% vs. 14%), and "social-economic capital" (13% vs. 10%) profiles, whereas Blacks were more likely to be in the "limited overall capital" (35% vs. 16%) and "moderate economic capital" (32% vs 22%) profiles. Profiles differed in risk for depression; the "limited overall capital" profile had the highest depression scores, whereas the "elevated overall capital" profile had the lowest depression scores. This research has the potential to reduce health disparities, by providing policy makers and researchers with information that will allow them to target populations that are most at risk for depression.
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Affiliation(s)
- Paula K Miller
- Department of Sociology and Anthropology, Ohio University, 6 President St., Bentley Annex 162, Athens, OH, 45701, USA.
| | - Bridget E Weller
- School of Social Work, Western Michigan University, 1903 W. Michigan Ave., Kalamazoo, MI, 49008, USA
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22
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Orr J, Tobin K, Carey D, Kenny RA, McGarrigle C. Religious Attendance, Religious Importance, and the Pathways to Depressive Symptoms in Men and Women Aged 50 and Over Living in Ireland. Res Aging 2019; 41:891-911. [PMID: 31331248 DOI: 10.1177/0164027519860270] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to explore the relationship between religiosity and depressive symptoms longitudinally. METHOD We used four waves (2009-2016) of the Irish Longitudinal Study on Ageing (TILDA) to create growth curve models (GCM) of depressive symptoms and religious attendance/importance in a sample aged 50+ in Ireland and structural models to assess the longitudinal associations between religious attendance/importance and depressive symptoms. We tested whether this relationship was mediated by social connectedness. RESULTS GCM showed that higher religious attendance at baseline was associated with lower baseline depressive symptoms, while higher religious importance was associated with higher baseline depressive symptoms. Social connectedness partially mediated the baseline associations between religious attendance and lower depressive symptoms. There were no associations between religious factors and the development of depressive symptoms over time. DISCUSSION This study found that the relationship between religion and depressive symptoms is complex, and any protective effect was driven by religious attendance.
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Affiliation(s)
- Joanna Orr
- 1 The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Katy Tobin
- 1 The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.,2 Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Daniel Carey
- 1 The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- 1 The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.,3 Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Christine McGarrigle
- 1 The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
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23
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Van Herreweghe L, Van Lancker W. Is religiousness really helpful to reduce depressive symptoms at old age? A longitudinal study. PLoS One 2019; 14:e0218557. [PMID: 31269037 PMCID: PMC6609011 DOI: 10.1371/journal.pone.0218557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/04/2019] [Indexed: 12/03/2022] Open
Abstract
Background Higher levels of religiousness are associated with better mental health outcomes, but most of previous research is cross-sectional, failing to address issues of selection and reverse causation. Methods We assessed the longitudinal association between both public and private religiousness and depressive symptoms, drawing on data from 7,719 persons aged 65 and older of the Survey of Health, Ageing and Retirement in Europe (SHARE). Repeated measurements of different aspects of religiousness and depressive symptoms were used in random and fixed-effects models in order to assess the effect of changes in religious behavior on changes in depressive symptoms. Results Praying more than once a day was associated with more depressive symptoms (β = 0.150, 95% CI: 0.003, 0.298) relative to individuals who never pray, adjusted for socio-demographic characteristics, physical health covariates and history of depression, but the comparison with the fixed effects model suggests that this is the result of a selection effect. Participating weekly or more in a religious organization was associated with fewer depressive symptoms (β = -0.219, 95% CI: -0.344, -0.094), but this appeared to be spurious after taking due account of possible confounders (β = -0.092, 95% CI: -0.223, 0.038). Focusing on within-persons changes, we found that participating in religious organizations weekly or more was associated with more depressive symptoms (β = 0.275, 95% CI: 0.075, 0.475). Conclusion Our findings do not support that religious behavior, both public or private, may be beneficial for the mental health of older Europeans.
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Affiliation(s)
- Lore Van Herreweghe
- Centre for Sociological Research, University of Leuven, Leuven, Belgium
- * E-mail:
| | - Wim Van Lancker
- Centre for Sociological Research, University of Leuven, Leuven, Belgium
- Herman Deleeck Centre for Social Policy, University of Antwerp, Antwerp, Belgium
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Chen Y, VanderWeele TJ. Associations of Religious Upbringing With Subsequent Health and Well-Being From Adolescence to Young Adulthood: An Outcome-Wide Analysis. Am J Epidemiol 2018; 187:2355-2364. [PMID: 30215663 PMCID: PMC6211237 DOI: 10.1093/aje/kwy142] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 06/29/2018] [Indexed: 12/28/2022] Open
Abstract
In the present study, we prospectively examined the associations of religious involvement in adolescence (including religious service attendance and prayer or meditation) with a wide array of psychological well-being, mental health, health behavior, physical health, and character strength outcomes in young adulthood. Longitudinal data from the Growing Up Today Study were analyzed using generalized estimating equations. Sample sizes ranged from 5,681 to 7,458, depending on outcome; the mean baseline age was 14.74 years, and there were 8–14 years of follow-up (1999 to either 2007, 2010, or 2013). Bonferroni correction was used to correct for multiple testing. All models were controlled for sociodemographic characteristics, maternal health, and prior values of the outcome variables whenever data were available. Compared with no attendance, at least weekly attendance of religious services was associated with greater life satisfaction and positive affect, a number of character strengths, lower probabilities of marijuana use and early sexual initiation, and fewer lifetime sexual partners. Analyses of prayer or meditation yielded similar results. Although decisions about religion are not shaped principally by health, encouraging service attendance and private practices in adolescents who already hold religious beliefs may be meaningful avenues of development and support, possibly leading to better health and well-being.
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Affiliation(s)
- Ying Chen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
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Biases Inherent in Studies of Coffee Consumption in Early Pregnancy and the Risks of Subsequent Events. Nutrients 2018; 10:nu10091152. [PMID: 30142937 PMCID: PMC6163788 DOI: 10.3390/nu10091152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/18/2018] [Accepted: 08/21/2018] [Indexed: 12/23/2022] Open
Abstract
Consumption of coffee by women early in their pregnancy has been viewed as potentially increasing the risk of miscarriage, low birth weight, and childhood leukemias. Many of these reports of epidemiologic studies have not acknowledged the potential biases inherent in studying the relationship between early-pregnancy-coffee consumption and subsequent events. I discuss five of these biases, recall bias, misclassification, residual confounding, reverse causation, and publication bias. Each might account for claims that attribute adversities to early-pregnancy-coffee consumption. To what extent these biases can be avoided remains to be determined. As a minimum, these biases need to be acknowledged wherever they might account for what is reported.
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26
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Methodological Issues in Nutritional Epidemiology Research—Sorting Through the Confusion. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0567-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Li S, Okereke OI, Chang SC, Kawachi I, VanderWeele TJ. Religious Service Attendance and Lower Depression Among Women-a Prospective Cohort Study. Ann Behav Med 2017; 50:876-884. [PMID: 27393076 DOI: 10.1007/s12160-016-9813-9] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Previous studies on the association between religious service attendance and depression have been mostly cross-sectional, subject to reverse causation, and did not account for the potential feedback between religious service attendance and depression. We prospectively evaluated evidence whether religious service attendance decreased risk of subsequent risk of depression and whether depression increased subsequent cessation of service attendance, while explicitly accounting for feedback with potential effects in both directions. METHOD We included a total of 48,984 US nurses who were participants of the Nurses' Health Study with mean age 58 years and who were followed up from 1996 to 2008. Religious service attendance was self-reported in 1992, 1996, 2000, and 2004. Depression was defined as self-reported physician-diagnosed clinical depression, regular anti-depressant use, or severe depressive symptoms. Multivariate logistic regression and marginal structural models were used to estimate the odds ratio of developing incident depression, adjusted for baseline religious service attendance, baseline depression, and time-varying covariates. RESULTS Compared with women who never attended services, women who had most frequent and recent religious service attendance had the lowest risk of developing depression (odds ratio [OR] = 0.71, 95 % confidence interval [CI] 0.62-0.82). Compared with women who were not depressed, women with depression were less likely to subsequently attend religious services once or more per week (OR = 0.74, 95 % CI 0.68-0.80). CONCLUSIONS In this study of US women, there is evidence that higher frequency of religious service attendance decreased the risk of incident depression and women with depression were less likely to subsequently attend services.
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Affiliation(s)
- Shanshan Li
- Departments of Nutrition, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA
| | - Olivia I Okereke
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Department of Psychiatry, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Shun-Chiao Chang
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, USA.
- Program on Integrative Knowledge and Human Flourishing, Harvard University, Cambridge, MA, 02138, USA.
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VanderWeele TJ. Religion and health in Europe: cultures, countries, context. Eur J Epidemiol 2017; 32:857-861. [PMID: 28884408 PMCID: PMC5681407 DOI: 10.1007/s10654-017-0310-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 09/02/2017] [Indexed: 01/31/2023]
Abstract
Much of the research on the relationships between religious participation and health comes from the United States. Studies in other geographic regions or cultural contexts is more sparse. Evidence presented by Ahrenfelt et al., and that from other research studies, is reviewed concerning the associations between religion and health within Europe and world-wide. The evidence within Europe suggests protective associations between various forms of religious participation and lower depression, lower mortality, and better self-rated health. Methodological challenges in such research are reviewed, and discussion is given as to whether a person-culture-fit explanation suffices to account for the existing data and to what other mechanisms might be operative.
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Affiliation(s)
- Tyler J VanderWeele
- Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
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29
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Ahrenfeldt LJ, Möller S, Andersen-Ranberg K, Vitved AR, Lindahl-Jacobsen R, Hvidt NC. Religiousness and health in Europe. Eur J Epidemiol 2017; 32:921-929. [PMID: 28840406 DOI: 10.1007/s10654-017-0296-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/17/2017] [Indexed: 11/25/2022]
Abstract
Recent research suggests that epidemiological forces in religion and health can have opposed effects. Using longitudinal data of people aged 50+ included in wave 1 (2004-2005) of the Survey of Health, Ageing and Retirement in Europe (SHARE), and followed up through waves 2 (2006-2007), 4 (2011) and 5 (2013), we examined two forms of religious internalization and their association with health. Multivariate logistic regressions were used to examine all associations. Taking part in a religious organization was associated with lower odds of GALI (global activity limitation index) (OR = 0.86, 95% CI 0.75, 0.98) and depressive symptoms 0.80 (95% CI 0.69, 0.93), whereas being religiously educated lowered odds of poor self-rated health (SRH) 0.81 (95% CI 0.70, 0.93) and long-term health problems 0.84 (95% CI 0.74, 0.95). The more religious had lower odds of limitations with activities of daily living 0.76 (95% CI 0.58, 0.99) and depressive symptoms 0.77 (95% CI 0.64, 0.92) than other respondents, and compared to people who only prayed and did not have organizational involvement, they had lower odds of poor SRH 0.71 (95% CI 0.52, 0.97) and depressive symptoms 0.66 (95% CI 0.50, 0.87). Conversely, people who only prayed had higher odds of depressive symptoms than non-religious people 1.46 (95% CI 1.15, 1.86). Our findings suggest two types of religiousness: 1. Restful religiousness (praying, taking part in a religious organization and being religiously educated), which is associated with good health, and 2. Crisis religiousness (praying without other religious activities), which is associated with poor health.
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Affiliation(s)
- Linda Juel Ahrenfeldt
- Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, 5000, Odense, Denmark.
- Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark.
| | - Sören Möller
- OPEN - Odense Patient data Explorative Network, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark
| | - Karen Andersen-Ranberg
- Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
| | - Astrid Roll Vitved
- Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, 5000, Odense, Denmark
- Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
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Holt CL, Roth DL, Huang J, Clark EM. Role of religious social support in longitudinal relationships between religiosity and health-related outcomes in African Americans. J Behav Med 2017; 41:62-73. [PMID: 28776192 DOI: 10.1007/s10865-017-9877-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/22/2017] [Indexed: 12/27/2022]
Abstract
This study tested a longitudinal model of religious social support as a potential mediator of the relationship between religious beliefs and behaviors, and multiple health-related outcomes (e.g., depressive symptoms, functioning, diet, alcohol use, cancer screening). A national probability sample of African Americans enrolled in the religion and health in African Americans study completed three waves of telephone interviews over a 5-year period (N = 766). Longitudinal structural equation models indicated that religious behaviors, but not beliefs, predicted the slowing of a modest overall decline in positive religious social support, while negative interactions with congregational members were stable. Positive religious support was associated with lower depressive symptoms and heavy drinking over time, while negative interaction predicted increases in depressive symptoms and decreases in emotional functioning. Positive religious support mediated the relationship between religious behaviors and depressive symptoms and heavy drinking. Findings have implications for mental health interventions in faith-based settings.
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Affiliation(s)
- Cheryl L Holt
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, 1234W School of Public Health Building (255), College Park, MD, 20742, USA.
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jin Huang
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eddie M Clark
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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Holt CL, Roth DL, Huang J, Park CL, Clark EM. Longitudinal effects of religious involvement on religious coping and health behaviors in a national sample of African Americans. Soc Sci Med 2017. [PMID: 28645040 DOI: 10.1016/j.socscimed.2017.06.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Many studies have examined associations between religious involvement and health, linking various dimensions of religion with a range of physical health outcomes and often hypothesizing influences on health behaviors. However, far fewer studies have examined explanatory mechanisms of the religion-health connection, and most have overwhelmingly relied on cross-sectional analyses. Given the relatively high levels of religious involvement among African Americans and the important role that religious coping styles may play in health, the present study tested a longitudinal model of religious coping as a potential mediator of a multidimensional religious involvement construct (beliefs; behaviors) on multiple health behaviors (e.g., diet, physical activity, alcohol use, cancer screening). A national probability sample of African Americans was enrolled in the RHIAA (Religion and Health In African Americans) study and three waves of telephone interviews were conducted over a 5-year period (N = 565). Measurement models were fit followed by longitudinal structural models. Positive religious coping decreased modestly over time in the sample, but these reductions were attenuated for participants with stronger religious beliefs and behaviors. Decreases in negative religious coping were negligible and were not associated with either religious beliefs or religious behaviors. Religious coping was not associated with change in any of the health behaviors over time, precluding the possibility of a longitudinal mediational effect. Thus, mediation observed in previous cross-sectional analyses was not confirmed in this more rigorous longitudinal model over a 5-year period. However, findings do point to the role that religious beliefs have in protecting against declines in positive religious coping over time, which may have implications for pastoral counseling and other faith-based interventions.
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Affiliation(s)
- Cheryl L Holt
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, United States.
| | - David L Roth
- Johns Hopkins University, Center on Aging and Health, United States
| | - Jin Huang
- Johns Hopkins University, Center on Aging and Health, United States
| | - Crystal L Park
- University of Connecticut, Department of Psychological Sciences, United States
| | - Eddie M Clark
- Saint Louis University, Department of Psychology, United States
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Astrup A, Pedersen CB, Mok PL, Carr MJ, Webb RT. Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood. J Affect Disord 2017; 208:582-589. [PMID: 27802894 PMCID: PMC5754328 DOI: 10.1016/j.jad.2016.10.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/07/2016] [Accepted: 10/22/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Experience of child-parent separation predicts adverse outcomes in later life. We conducted a detailed epidemiological examination of this complex relationship by modelling an array of separation scenarios and trajectories and subsequent risk of self-harm. METHODS This cohort study examined persons born in Denmark during 1971-1997. We measured child-parent separations each year from birth to 15th birthday via complete residential address records in the Civil Registration System. Self-harm episodes between 15th birthday and early middle age were ascertained through linkage to psychiatric and general hospital registers. Incidence rate ratios (IRRs) from Poisson regression models were estimated against a reference category of individuals not separated from their parents. RESULTS All exposure models examined indicated an association with raised self-harm risk. For example, large elevations in risk were observed in relation to separation from both parents at 15th birthday (IRR 5.50, 95% CI 5.25-5.77), experiencing five or more changes in child-parent separation status (IRR 5.24, CI 4.88-5.63), and having a shorter duration of familial cohesion during upbringing. There was no significant evidence for varying strength of association according to child's gender. LIMITATIONS Measuring child-parent separation according to differential residential addresses took no account of the reason for or circumstances of these separations. CONCLUSIONS These novel findings suggest that self-harm prevention initiatives should be tailored toward exposed persons who remain psychologically distressed into adulthood. These high-risk subgroups include individuals with little experience of familial cohesion during their upbringing, those with the most complicated trajectories who lived through multiple child-parent separation transitions, and those separated from both parents during early adolescence.
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Affiliation(s)
- Aske Astrup
- National Centre for Register-Based Research, Aarhus University, Denmark
| | - Carsten B. Pedersen
- National Centre for Register-Based Research, Aarhus University, Denmark,Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
| | - Pearl L.H. Mok
- Centre for Mental Health and Safety, The University of Manchester, United Kingdom
| | - Matthew J. Carr
- Centre for Mental Health and Safety, The University of Manchester, United Kingdom
| | - Roger T. Webb
- Centre for Mental Health and Safety, The University of Manchester, United Kingdom,Corresponding author.
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VanderWeele TJ, Jackson JW, Li S. Causal inference and longitudinal data: a case study of religion and mental health. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1457-1466. [PMID: 27631394 DOI: 10.1007/s00127-016-1281-9] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/28/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE We provide an introduction to causal inference with longitudinal data and discuss the complexities of analysis and interpretation when exposures can vary over time. METHODS We consider what types of causal questions can be addressed with the standard regression-based analyses and what types of covariate control and control for the prior values of outcome and exposure must be made to reason about causal effects. We also consider newer classes of causal models, including marginal structural models, that can assess questions of the joint effects of time-varying exposures and can take into account feedback between the exposure and outcome over time. Such feedback renders cross-sectional data ineffective for drawing inferences about causation. RESULTS The challenges are illustrated by analyses concerning potential effects of religious service attendance on depression, in which there may in fact be effects in both directions with service attendance preventing the subsequent depression, but depression itself leading to lower levels of the subsequent religious service attendance. CONCLUSIONS Longitudinal designs, with careful control for prior exposures, outcomes, and confounders, and suitable methodology, will strengthen research on mental health, religion and health, and in the biomedical and social sciences generally.
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Affiliation(s)
- Tyler J VanderWeele
- Department of Epidemiology, Harvard Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. .,Department of Biostatistics, Harvard Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - John W Jackson
- Department of Epidemiology, Harvard Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Shanshan Li
- Department of Epidemiology, Harvard Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Webb RT, Pedersen CB, Mok PLH. Adverse Outcomes to Early Middle Age Linked With Childhood Residential Mobility. Am J Prev Med 2016; 51:291-300. [PMID: 27288289 PMCID: PMC4982753 DOI: 10.1016/j.amepre.2016.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/31/2016] [Accepted: 04/19/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Links between childhood residential mobility and multiple adverse outcomes through to maturity, and effect modification of these associations by familial SES, are incompletely understood. METHODS A national cohort of people born in Denmark in 1971-1997 were followed from their 15th birthdays until their early forties (N=1,475,030). Residential moves during each age year between birth and age 14 years were examined, with follow-up to 2013. Incidence rate ratios for attempted suicide, violent criminality, psychiatric illness, substance misuse, and natural and unnatural deaths were estimated. The analyses were conducted during 2014-2015. RESULTS Elevated risks were observed for all examined outcomes, with excess risk seen among those exposed to multiple versus single relocations in a year. Risks grew incrementally with increasing age of exposure to mobility. For violent offending, attempted suicide, substance misuse, and unnatural death, sharp spikes in risk linked with multiple relocations in a year during early/mid-adolescence were found. With attempted suicide and violent offending, the primary outcomes, a distinct risk gradient was observed with increasing age at exposure across the socioeconomic spectrum. CONCLUSIONS The links between childhood residential mobility and negative outcomes in later life appear widespread across multiple endpoints, with elevation in risk being particularly marked if frequent residential change occurs during early/mid-adolescence. Heightened vigilance is indicated for relocated adolescents and their families, with a view to preventing longer-term adverse outcomes in this population among all socioeconomic groups. Risk management will require close cooperation among multiple public agencies, particularly child, adolescent, and adult mental health services.
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Affiliation(s)
- Roger T Webb
- Centre for Mental Health and Safety, University of Manchester, Manchester, England.
| | - Carsten B Pedersen
- Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark; National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Pearl L H Mok
- Centre for Mental Health and Safety, University of Manchester, Manchester, England
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VanderWeele TJ, Li S, Tsai AC, Kawachi I. Association Between Religious Service Attendance and Lower Suicide Rates Among US Women. JAMA Psychiatry 2016; 73:845-51. [PMID: 27367927 PMCID: PMC7228478 DOI: 10.1001/jamapsychiatry.2016.1243] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Previous studies have linked suicide risk with religious participation, but the majority have used ecologic, cross-sectional, or case-control data. OBJECTIVE To examine the longitudinal association between religious service attendance and suicide and the joint associations of suicide with service attendance and religious affiliation. DESIGN, SETTING, AND PARTICIPANTS We evaluated associations between religious service attendance and suicide from 1996 through June 2010 in a large, long-term prospective cohort, the Nurses' Health Study, in an analysis that included 89 708 women. Religious service attendance was self-reported in 1992 and 1996. Data analysis was conducted from 1996 through 2010. MAIN OUTCOMES AND MEASURES Cox proportional hazards regression models were used to examine the association between religious service attendance and suicide, adjusting for demographic covariates, lifestyle factors, medical history, depressive symptoms, and social integration measures. We performed sensitivity analyses to examine the influence of unmeasured confounding. RESULTS Among 89 708 women aged 30 to 55 years who participated in the Nurses' Health Study, attendance at religious services once per week or more was associated with an approximately 5-fold lower rate of suicide compared with never attending religious services (hazard ratio, 0.16; 95% CI, 0.06-0.46). Service attendance once or more per week vs less frequent attendance was associated with a hazard ratio of 0.05 (95% CI, 0.006-0.48) for Catholics but only 0.34 (95% CI, 0.10-1.10) for Protestants (P = .05 for heterogeneity). Results were robust in sensitivity analysis and to exclusions of persons who were previously depressed or had a history of cancer or cardiovascular disease. There was evidence that social integration, depressive symptoms, and alcohol consumption partially mediated the association among those occasionally attending services, but not for those attending frequently. CONCLUSIONS AND RELEVANCE In this cohort of US women, frequent religious service attendance was associated with a significantly lower rate of suicide.
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Affiliation(s)
- Tyler J. VanderWeele
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States.,Department of Biostatistics, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
| | - Shanshan Li
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
| | - Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.,Harvard Center for Population and Development Studies, 9 Bow St, Cambridge, MA 02138, United States.,Mbarara University of Science and Technology, Mbarara, Uganda
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
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Banta JE, McKinney O. Faith-Based Hospitals and Variation in Psychiatric Inpatient Length of Stay in California, 2002-2011. JOURNAL OF RELIGION AND HEALTH 2016; 55:787-802. [PMID: 26718346 DOI: 10.1007/s10943-015-0175-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We examined current treatment patterns at faith-based hospitals. Psychiatric discharges from all community-based hospitals in California were obtained for 2002-2011 and a Behavioral Model of Health Services Utilization approach used to study hospital religious affiliation and length of stay (LOS). During 10 years there were 1,976,893 psychiatric inpatient discharges, of which 14.3% were from faith-based nonprofit hospitals (eighteen Catholic, seven Seventh-day Adventist, and one Jewish hospital). Modest differences in patient characteristics and shorter LOS (7.5 vs. 8.3 days) were observed between faith-based and other hospitals. Multivariable negative binomial regression found shorter LOS at faith-based nonprofit hospitals (coefficient = -0.1169, p < 0.001, Wald χ (2) = 55) and greater LOS at all nonprofits (coefficient = 1.5909, p < 0.001, Wald χ (2) = 2755) as compared to local government-controlled hospitals. Faith-based hospitals provide a substantial and consistent amount of psychiatric care in California and may have slightly lower LOS after adjusting for patient and other hospital characteristics.
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Affiliation(s)
- Jim E Banta
- Loma Linda University School of Public Health, 24951 North Circle Drive, Loma Linda, CA, 92350, USA.
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Roth DL, Usher T, Clark EM, Holt CL. Religious Involvement and Health over Time: Predictive Effects in a National Sample of African Americans. JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION 2016; 55:417-424. [PMID: 28502992 PMCID: PMC5423663 DOI: 10.1111/jssr.12269] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this study, two telephone interviews that assessed both religious involvement and health-related quality of life were conducted approximately 2.5 years apart in a national sample of 290 African Americans. Religious involvement was assessed with an instrument that measured both personal religious beliefs (e.g., having a personal relationship with God) and more public religious behaviors (e.g., attending church services). Health-related quality of life was measured with version 2 of the Medical Outcomes Study 12-item short form (SF-12v2). Structural equation models indicated that higher religious beliefs at baseline predicted better physical and mental health 2.5 years later. Higher religious behaviors at baseline contributed smaller, complementary suppression effects. Physical and mental health indicators from the SF-12v2 at baseline did not predict changes in either religious beliefs or religious behaviors over time. These findings indicate that, for African Americans, personal religious beliefs lead to beneficial health effects over time, whereas individual differences in health do not appear to predict changes in religious involvement.
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Affiliation(s)
- David L Roth
- Center on Aging and Health, Johns Hopkins University
| | - Therri Usher
- Center on Aging and Health, Johns Hopkins University
| | | | - Cheryl L Holt
- Department of Behavioral and Community Health, University of Maryland
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Zimmer Z, Jagger C, Chiu CT, Ofstedal MB, Rojo F, Saito Y. Spirituality, religiosity, aging and health in global perspective: A review. SSM Popul Health 2016; 2:373-381. [PMID: 29349154 PMCID: PMC5758000 DOI: 10.1016/j.ssmph.2016.04.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 11/26/2022] Open
Abstract
Persistent population aging worldwide is focusing attention on modifiable factors that can improve later life health. There is evidence that religiosity and spirituality are among such factors. Older people tend to have high rates of involvement in religious and/or spiritual endeavors and it is possible that population aging will be associated with increasing prevalence of religious and spiritual activity worldwide. Despite increasing research on religiosity, spirituality and health among older persons, population aging worldwide suggests the need for a globally integrated approach. As a step toward this, we review a subset of the literature on the impact of religiosity and spirituality on health in later life. We find that much of this has looked at the relationship between religiosity/spirituality and longevity as well as physical and mental health. Mechanisms include social support, health behaviors, stress and psychosocial factors. We identify a number of gaps in current knowledge. Many previous studies have taken place in the U.S. and Europe. Much data is cross-sectional, limiting ability to make causal inference. Religiosity and spirituality can be difficult to define and distinguish and the two concepts are often considered together, though on balance religiosity has received more attention than spirituality. The latter may however be equally important. Although there is evidence that religiosity is associated with longer life and better physical and mental health, these outcomes have been investigated separately rather than together such as in measures of health expectancy. In conclusion, there is a need for a unified and nuanced approach to understanding how religiosity and spirituality impact on health and longevity within a context of global aging, in particular whether they result in longer healthy life rather than just longer life.
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Affiliation(s)
- Zachary Zimmer
- University of California, San Francisco, USA.,Mount Saint Vincent University, Canada
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O'Reilly D, Rosato M. Religion and the risk of suicide: longitudinal study of over 1 million people. Br J Psychiatry 2015; 206:466-70. [PMID: 25698765 DOI: 10.1192/bjp.bp.113.128694] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 09/26/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Durkheim's seminal historical study demonstrated that religious affiliation reduces suicide risk, but it is unclear whether this protective effect persists in modern, more secular societies. AIMS To examine suicide risk according to Christian religious affiliation and by inference to examine underlying mechanisms for suicide risk. If church attendance is important, risk should be lowest for Roman Catholics and highest for those with no religion; if religiosity is important, then 'conservative' Christians should fare best. METHOD A 9-year study followed 1 106 104 people aged 16-74 years at the 2001 UK census, using Cox proportional hazards models adjusted for census-based cohort attributes. RESULTS In fully adjusted models analysing 1119 cases of suicide, Roman Catholics, Protestants and those professing no religion recorded similar risks. The risk associated with conservative Christians was lower than that for Catholics (HR = 0.71, 95% CI 0.52-0.97). CONCLUSIONS The relationship between religious affiliation and suicide established by Durkheim may not pertain in societies where suicide rates are highest at younger ages. Risks are similar for those with and without a religious affiliation, and Catholics (who traditionally are characterised by higher levels of church attendance) do not demonstrate lower risk of suicide. However, religious affiliation is a poor measure of religiosity, except for a small group of conservative Christians, although their lower risk of suicide may be attributable to factors such as lower risk behaviour and alcohol consumption.
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Affiliation(s)
- Dermot O'Reilly
- Dermot O'Reilly, MD, Centre for Public Health, Queen's University, Belfast; Michael Rosato, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, Derry, Northern Ireland, UK
| | - Michael Rosato
- Dermot O'Reilly, MD, Centre for Public Health, Queen's University, Belfast; Michael Rosato, PhD, Bamford Centre for Mental Health and Wellbeing, Ulster University, Derry, Northern Ireland, UK
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The efficacy of religious service attendance in reducing depressive symptoms. Soc Psychiatry Psychiatr Epidemiol 2014; 49:911-8. [PMID: 24178134 DOI: 10.1007/s00127-013-0785-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To examine whether religiosity may help people ward off depression, we investigated the association between religious service attendance and depressive symptom scores in a community-based 30-year follow-up longitudinal study. METHODS This study used data on 754 subjects followed over 30 years and evaluated at four time points. Linear mixed effects models were used to assess the association between religious service attendance and depressive symptoms development; frequency of attendance and age also were used as predictors. Demographic factors, life-time trauma, family socioeconomic status, and recent negative events were considered as control variables. RESULTS Depressive symptom scores were reduced by an average of 0.518 units (95 % CI from -0.855 to -0.180, p < 0.005) each year in subjects who attended religious services as compared with subjects who did not. The more frequent the religious service attendance, the stronger the influence on depressive symptoms when compared with non-attendance. Yearly, monthly, and weekly religious service attendance reduced depression scores by 0.474 (95 % CI from -0.841 to -0.106, p < 0.01), 0.495 (95 % CI from -0.933 to -0.057, p < 0.05) and 0.634 (95 % CI from -1.056 to -0.212, p < 0.005) units on average, respectively, when compared with non-attendance after controlling for other covariates. CONCLUSION Religious service attendance may reduce depressive symptoms significantly, with more frequent attendance having an increasingly greater impact on symptom reduction in this 30-year community-based longitudinal study.
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Martinez P, Lien L, Landheim A, Kowal P, Clausen T. Quality of life and social engagement of alcohol abstainers and users among older adults in South Africa. BMC Public Health 2014; 14:316. [PMID: 24708736 PMCID: PMC4234309 DOI: 10.1186/1471-2458-14-316] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 04/02/2014] [Indexed: 11/10/2022] Open
Abstract
Background The literature from developed countries suggests a relationship between alcohol use and quality of life and social engagement, where harmful drinkers have lower quality of life and less social engagement. Despite the high rates of harmful alcohol use in South Africa, little is known about the association between drinking pattern and quality of life and social engagement in this context. We aimed to determine if quality of life and social engagement varied across different drinking patterns among older South African adults, contributed to drinking pattern when controlling for socio-demographic factors, and varied differentially between genders. Methods This is a secondary analysis of data from the Survey on Global Ageing and Adult Health (SAGE). Alcohol use was measured as self-reports of use over the previous seven days, and we constructed gender-specific alcohol variables. The WHO Quality of Life-scale was used to measure quality of life, and social engagement was measured by frequency of participation in social activities. We used ANOVA to observe differences in quality of life and social engagement scores across drinking patterns, and regression models were used to identify factors independently associated with drinking pattern. Results There were 2572 (84.4%) lifetime abstainers, and 475 (15.6%) persons who had a drink in the last 7 days. In bivariate analysis, quality of life was lowest among at risk drinking men compared to abstainers (OR = 0.21, p = 0.02), although this association was not significant in adjusted analysis. Social engagement did not vary statistically significantly across the drinking patterns in the total sample or within gender. Conclusions Quality of life and social engagement were not independently associated with drinking pattern among older adults in South Africa in this sample. In order to better understand their alcohol use, further exploratory research is warranted to identify other potentially relevant subjective factors of alcohol use among older adults in South Africa.
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Affiliation(s)
- Priscilla Martinez
- Norwegian Center for Addiction Research, University of Oslo, Oslo, Norway.
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Balbuena L, Baetz M, Bowen R. Religious attendance after elevated depressive symptoms: is selection bias at work? PeerJ 2014; 2:e311. [PMID: 24688885 PMCID: PMC3961168 DOI: 10.7717/peerj.311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/26/2014] [Indexed: 11/20/2022] Open
Abstract
In an attempt to determine if selection bias could be a reason that religious attendance and depression are related, the predictive value of elevated depressive symptoms for a decrease in future attendance at religious services was examined in a longitudinal panel of 1,673 Dutch adults. Religious attendance was assessed yearly over five years using the single question, “how often do you attend religious gatherings nowadays?” Depressive symptoms were assessed four times within the first year using the Depression subscale of the Brief Symptom Inventory. Logistic regression models of change in attendance were created, stratifying by baseline attendance status. Attenders who developed elevated symptoms were less likely to subsequently decrease their attendance (relative risk ratio: 0.55, 95% CI [0.38–0.79]) relative to baseline as compared to those without elevated symptoms. This inverse association remained significant after controlling for health and demographic covariates, and when using multiply imputed data to account for attrition. Non-attenders were unlikely to start attending after elevated depressive symptoms. This study provides counter evidence against previous findings that church attenders are a self-selected healthier group.
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Affiliation(s)
- Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Marilyn Baetz
- Department of Psychiatry, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Rudy Bowen
- Department of Psychiatry, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
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Cruwys T, Dingle GA, Haslam C, Haslam SA, Jetten J, Morton TA. Social group memberships protect against future depression, alleviate depression symptoms and prevent depression relapse. Soc Sci Med 2013; 98:179-86. [PMID: 24331897 DOI: 10.1016/j.socscimed.2013.09.013] [Citation(s) in RCA: 290] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 09/04/2013] [Accepted: 09/16/2013] [Indexed: 11/27/2022]
Abstract
A growing body of research suggests that a lack of social connectedness is strongly related to current depression and increases vulnerability to future depression. However, few studies speak to the potential benefits of fostering social connectedness among persons already depressed or to the protective properties of this for future depression trajectories. We suggest that this may be in part because connectedness tends to be understood in terms of (difficult to establish) ties to specific individuals rather than ties to social groups. The current study addresses these issues by using population data to demonstrate that the number of groups that a person belongs to is a strong predictor of subsequent depression (such that fewer groups predicts more depression), and that the unfolding benefits of social group memberships are stronger among individuals who are depressed than among those who are non-depressed. These analyses control for initial group memberships, initial depression, age, gender, socioeconomic status, subjective health status, relationship status and ethnicity, and were examined both proximally (across 2 years, N = 5055) and distally (across 4 years, N = 4087). Depressed respondents with no group memberships who joined one group reduced their risk of depression relapse by 24%; if they joined three groups their risk of relapse reduced by 63%. Together this evidence suggests that membership of social groups is both protective against developing depression and curative of existing depression. The implications of these results for public health and primary health interventions are discussed.
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Affiliation(s)
- Tegan Cruwys
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
| | - Genevieve A Dingle
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
| | - Catherine Haslam
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
| | - S Alexander Haslam
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
| | - Jolanda Jetten
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
| | - Thomas A Morton
- School of Psychology, University of Exeter, Exeter, United Kingdom.
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Balbuena L, Baetz M, Bowen R. Religious attendance, spirituality, and major depression in Canada: a 14-year follow-up study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:225-32. [PMID: 23547646 DOI: 10.1177/070674371305800408] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Although there have been numerous studies on the relation of religion or spirituality and major depression, few used a longitudinal, nationally representative sample. Our study sought to examine the effect of religious attendance, self-declared importance of spiritual values, and self-identification as a spiritual person on major depression. METHOD Data coming from 8 waves (1994 to 2008) of the longitudinal Canadian National Population Health Survey were used. People (n = 12 583) who were not depressed at baseline (1994) were followed during 14 years. Depression at each cycle was assessed using the Composite International Interview-Short Form for Major Depression. Weibull proportional hazards regression was used to model longitudinal risk of depression, with religious attendance or spirituality as a predictor. RESULTS At baseline, monthly religious attenders tended to be older, female, and married, compared with occasional and nonattenders. The Weibull regression model revealed a 22% lower risk of depression for monthly attenders (hazard ratio 0.78, 95% CI 0.63 to 0.95), compared with nonattenders, after controlling for age, household income, family and personal history of depression, marital status, education, and perceived social support. Neither self-reported importance of spiritual values nor identification as a spiritual person was related to major depressive episodes. CONCLUSION Attending religious services at least monthly has a protective effect against major depression.
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Affiliation(s)
- Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan
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Vanderweele TJ. Re: "Religious service attendance and major depression: a case of reverse causality?". Am J Epidemiol 2013; 177:275-6. [PMID: 23292958 DOI: 10.1093/aje/kws415] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Maselko J, Meador K. Two of the Authors Reply. Am J Epidemiol 2013. [DOI: 10.1093/aje/kws418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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