Mortality Differentials and Religion in the U.S.: Religious Affiliation and Attendance

Religion and survival among European older adults

There are several pathways through which religion can affect longevity. Previous research, predominately from North America, has shown decreased mortality risk for participants that attended religious services. This study aims to examine the association between religion and all-cause mortality in a large sample of older European adults, comparing religious affiliations, and using prayer frequency as well as frequency of participation in a religious organisation as measures of religiousness. To this end, a total of 16,062 participants from the Survey of Health Ageing and Retirement in Europe were employed for a survival analysis (median follow-up 11.3 years; 3790 recorded deaths). Following a religion was negatively associated with mortality regardless of demographic and socioeconomic factors (HR = 0.81; 95% CI 0.74-0.89). Large differences in the median survival of participants from different religious affiliations can be mostly attributed to demographic and socioeconomic factors. Both frequency of prayer and religious participation exhibited a significant positive dose-response relationship with survival despite adjustments, although the results for religious participation were more profound. Changes on the religiosity levels of the European population will require additional research on the subject in the future.

Religious affiliation and oral health-related quality of life: a cross-sectional study based on a nationally representative survey in Germany

BACKGROUND

Studies have shown an association between a person's religiosity, and physical as well as psychological, health status. However, results differ between certain religious affiliations. While good oral health is important for our overall health and wellbeing, research on religious affiliation and oral health status, specifically oral health-related quality of life (OHRQoL), is lacking. Thus, our aim was to investigate the association between religious affiliation and OHRQoL.

METHODS

A nationally representative online survey (n = 3,075 individuals) was conducted in August/September 2021. The mean age was 44.5 years (SD: 14.8 years, 18 to 70 years) and 51.1% of the individuals were female. OHRQoL was measured using the Oral Health Impact Profile (OHIP-G5). Religious affiliation served as key explanatory variable. Several covariates were included in regression analyses.

RESULTS

Regressions revealed that compared to individuals with no religious affiliation, individuals belonging to Christianity had poorer OHRQoL (β = 0.31, p < 0.01), individuals belonging to Islam had poorer OHRQoL (β = 2.62, p < 0.01) and individuals belonging to another religious affiliation also had poorer OHRQoL (β = 1.89, p < 0.01).

CONCLUSION

Our study demonstrated an association between religious affiliation and OHRQoL. Individuals with specific religious affiliations should be addressed to avoid low OHRQoL.

Shades of Black: Gendered Denominational Variation in Depression Symptoms Among Black Christians

Religion and spirituality (R/S) play a central role in shaping the contextual experiences of many Black people in the United States. Blacks are among the most religiously engaged groups in the country. Levels and types of religious engagement, however, can vary by subcategories such as gender or denominational affiliation. Although R/S involvement has been linked to improved mental health outcomes for Black people in general, it is unclear whether these benefits extend to all Black people who claim R/S affiliation irrespective of denomination and gender. Data from the National Survey of American Life (NSAL) sought to determine whether there are differences in the odds of reporting elevated depressive symptomology among African American and Black Caribbean Christian adults across denominational affiliation and gender. Initial logistic regression analysis found similar odds of elevated depressive symptoms across gender and denominational affiliation, but further analysis revealed the presence of a denomination by gender interaction. Specifically, there was a significantly larger gender gap in the odds of reporting elevated depression symptoms for Methodists than for Baptists and Catholics. In addition, Presbyterian women had lower odds of reporting elevated symptoms than Methodist women. This study's findings highlight the importance of examining denominational disparities among Black Christians, and suggest that denomination and gender may work in tandem to shape the R/S experiences and mental health outcomes of Black people in the United States.

Latent Profile Analysis to Survey Positive Mental Health and Well-Being: A Pilot Investigation Insight Tunisian Facebook Users

BACKGROUND

To examine mental health during COVID-19 peaks, lockdown, and times of curfew, many studies have used the LPA/LCA person-centered approach to uncover and explore unobserved groups. However, the majority of research has focused only on negative psychological concepts to explain mental health. In this paper, we take another perspective to explore mental health. In addition, the study focuses on a period of peak decline in the COVID-19 pandemic.

OBJECTIVE

The present paper aim (a) empirically identifies different profiles among a cohort of Facebook users in Tunisia based on positive factors of mental health using a person-centered approach, (b) outline identified profiles across sociodemographic, internet use, and physical activity, and (c) establish predictors of these profiles.

METHODS

Cross-sectional data were collected through an online survey among 950 Facebook users were female (n = 499; 52.53%) and male (n = 451; 47.47) with an average age =31.30 ± 9.42. Subjects filled Arabic version of Satisfaction with Life Scale, Scale of Happiness (SWLS), Gratitude Questionnaire (GQ-6), International Physical Activity Questionnaire (IPAQ), and the Spirituel Well-Being Scale (SWBS).

RESULTS

The LPA results revealed three clusters. The first cluster (n = 489, 51,47%) contains individuals who have low scores on the positive psychology scales. The second cluster (n = 357, 37,58%) contained individuals with moderate positive psychology scores. However, a third cluster (n = 104, 10,95%) had high positive psychology scores. The selected variables in the model were put to a comparison test to ensure that the classification solution was adequate. Subsequently, the clusters were compared for the variables of socio-demographics, use of the internet for entertainment and physical activity, the results showed significant differences for gender (low mental well-being for the female gender), socio-economic level (low for the low-income class), and physical activity (low mental well-being for the non-exerciser). However, no significant differences were found for the variables age, location, and use of the Internet for entertainment.

CONCLUSION

Our results complement person-centered studies (LPA/LCA) related to the COVID-19 pandemic and can serve researchers and mental health practitioners in both diagnostic and intervention phases for the public. In addition, the GQ6 scale is a valid and reliable tool that can be administered to measure gratitude for culturally similar populations.

Denominational and Gender Differences in Hypertension Among African American Christian Young Adults

Hypertension, a major cardiovascular disease risk factor, is disproportionately prevalent among African American young adults. Religion and spirituality (R/S) have been studied for their potential effect on blood pressure (BP) outcomes. Despite their disproportionate hypertension risk and high levels of R/S engagement, limited research explores BP differences among religious African Americans. This study investigates whether denominational affiliation predicts within-group differences in odds of having hypertension among African American Christian young adults. Data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine hypertension differences between 1932 African American young adults based on self-reported religious denomination. Gender-separated logistic regressions included religious service attendance and coping measures, as well as personal characteristics and health behaviors to adjust for potential effects on BP. The odds of having hypertension were higher for Pentecostal women compared to Baptist and Catholic women. Hypertension odds for women who reported attending services more than once weekly were lower than those who never attended church. For women, frequent use of religious coping predicted higher odds of having hypertension than seldom or never using religious coping. R/S variables did not predict significant differences among men. The health benefits of R/S do not appear to be consistent within African American Christian young adults. Religion may be viewed as a source of BP risk and resilience, especially among African American young women.

Religion, Health, Social Capital and Place: The Role of the Religious, Social Processes and the Beneficial and Detrimental Effects on the Health and Wellbeing of Inhabitants in Deprived Neighbourhoods in Malta

This paper emphasises the important role that place has in determining how religious social processes operate and impact on health and wellbeing. It draws upon evidence through qualitative in-depth interviews with families (both parents and children) living in two deprived neighbourhoods in Malta, a 'traditional' and a 'modern' one. It emerged that religious faith and practices can generate normative and resource-based social capital which can positively impact on health and wellbeing. However, some individuals found this social capital constraining and this had detrimental effects on their wellbeing. The context, composition, history and norms of the place emerge as highly important. This study emphasises that religious social processes operate in a highly complex manner, and 'adherents' and 'disaffiliates' are likely to enjoy positive or negative health and wellbeing according to where they live and according to important persons living in the neighbourhood such as the parish priest. This study contributes to the research gap between religion, social capital and health and the complex, social processes that operate at the local level of place.

The Differential Impact of Religion on Self-Reported Health Among Serbian Roma Women

The present paper offers an account of how self-reported health varies with religious affiliation and reproductive effort among Serbian Roma women. Data were collected in 2014-2018 in two Roma semi-urban settlements in central Serbia. The sample consisted of 177 Christian and 127 Muslim women, averaging 54 years of age. In addition to religious affiliation (Christianity/Islam), demographic data, reproductive histories, data on self-reported and children's health were collected, along with height and weight, and smoking status. Christian and Muslim Roma women differed significantly on a number of variables, with Muslim women reporting poorer health and higher reproductive effort. Among Roma women religion may be an important determinant of reproductive and fertility patterns, largely because it may have formed an important foundation upon which identity is based. This study adds to the literature on the cross-cultural relevance of the ways religion shapes reproductive behaviors for understanding the health variations of women from the same ethnic group who profess different religions.

"Thou Shalt not Smoke": Religion and smoking in a natural experiment of history

We provide a new identification strategy to analyse the implications of religious affiliation on unhealthful behaviour by focusing on the link between religiousness and smoking. Our quasi-experimental research design exploits the exogenous dramatic fall in religious affiliation that took place in East Germany after the post-war separation. Our conditional difference-in-differences estimates on data from the German Socio-Economic Panel (SOEP) for the period 1998-2006 indicate that individuals who are not affiliated to any religious denomination are consistently 13-19 percentage points more likely to smoke than are religious individuals. We interpret our results on the basis of a restraining effect of religious ethics on unhealthy behaviour, confirming the view that religion is a far-reaching vehicle for the enforcement of social norms.

Religiosity Dimensions and Disability-Free Life Expectancy in Taiwan

Objectives: Eight years of panel data are used to investigate the association between three dimensions of religiosity and total and disability-free life expectancy (TLE/DFLE) in Taiwan. Method: Data come from the 1999 "Taiwan Longitudinal Study on Aging" (TLSA; N = 4,440; Age 55+). Dimensions of religiosity are public, private, belief, and coping. Mortality is linked to a national database. Disability is activities of daily living (ADLs). TLE/DFLE estimates use the Stochastic Population Analysis for Complex Events (SPACE) software. Results: Those who engage in public and private religiosity live longer and more years disability-free than others, but proportion of life disability-free does not differ across levels of religiosity. Coping is less associated with TLE and DFLE. Coping however associates with more years disabled among men. Findings are robust to model specifications. Discussion: The way in which religiosity associates with health depends upon the definition. When it does associate, religiosity increases TLE and DFLE proportionately.

Religiosity and health: A global comparative study

The objective of this paper is to understand global connections between indicators of religiosity and health and how these differ cross-nationally. Data are from World Values Surveys (93 countries, N=121,770). Health is based on a self-assessed question about overall health. First, country-specific regressions are examined to determine the association separately in each country. Next, country-level variables and cross-level interactions are added to multilevel models to assess whether and how context affects health and religiosity slopes. Results indicate enormous variation in associations between religiosity and health across countries and religiosity indicators. Significant positive associations between all religiosity measures and health exist in only three countries (Georgia, South Africa, and USA); negative associations in only two (Slovenia and Tunisia). Macro-level variables explain some of this divergence. Greater participation in religious activity relates to better health in countries characterized as being religiously diverse. The importance in god and pondering life's meaning is more likely associated with better health in countries with low levels of the Human Development Index. Pondering life's meaning more likely associates with better health in countries that place more stringent restrictions on religious practice. Religiosity is less likely to be related to good health in communist and former communist countries of Asia and Eastern Europe. In conclusion, the association between religiosity and health is complex, being partly shaped by geopolitical and macro psychosocial contexts.

An exploratory study of knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke among women in Aleta Wondo, Ethiopia

BACKGROUND

By 2030, the Sub-Saharan African region is projected to be the epicenter of the tobacco epidemic. While smoking prevalence is currently low among women (< 2%), the prevalence among men (7.7% overall and up to 27% depending on region) makes exposure to secondhand smoke a pressing concern for women and children. To prevent the uptake of smoking among women and address tobacco-related risks, including secondhand smoke exposure, a greater understanding of women's related perceptions is needed. The purpose of this study was to explore Ethiopian women's knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke exposure, and the potential influence of contextual factors including; khat use, exposure to pro- and anti-tobacco messaging, and religious affiliation.

METHODS

A cross-sectional study using a systematic household sampling technique and an adapted interviewer-administered survey was conducted in Southern Ethiopia. The survey was administered to 353 women, 18-55 years of age, in Aleta Wondo town and surrounding districts between August-October 2014 (95.2% cooperation rate).

RESULTS

General awareness of harm associated with personal tobacco use and exposure to secondhand smoke was high (> 94%); however, specific knowledge of associated health-risks was limited. More than 96% perceived female tobacco use as socially unacceptable. At the same time, more than 70% were able to name potential benefits of using tobacco for both personal consumption and non-personal use. Respondents reported greater experimentation with khat versus tobacco and 73% reported that their religion significantly influenced their tobacco-related attitudes. Overall, there were higher reports of exposure to anti-tobacco (70%) versus pro-tobacco (49%) messaging, in the last 30 days.

CONCLUSIONS

The high level of awareness of health risks associated with tobacco use and SHS exposure and the high exposure to anti-tobacco messaging are community-level strengths that can proactively be built on to prevent the projected disease burden associated with tobacco. Findings have implications for the development of contextualized gender-specific tobacco control interventions, particularly in relation to the promotion of smoke-free homes.

An examination of the prospective association between religious service attendance and suicide: Explanatory factors and period effects

BACKGROUND

We addressed two unanswered questions from prior research, demonstrating a prospective association between frequent religious service attendance and decreased risk for suicide. First, we assessed whether religious service attendance conferred protection from suicide even after accounting for strength of religious affiliation. Second, we evaluated whether the relationship between religious service attendance and suicide was subject to period effects.

METHODS

Data were drawn from the 1978-2010 General Social Survey, a nationally representative study of 30,650 non-institutionalized, English-speaking American residents age 18 or older. Data were linked with the National Death Index through the end of 2014. We analyzed these data using moderated Cox proportional hazard analyses.

RESULTS

Religious affiliation had no relationship with suicide. Religious service attendance only had a protective effect against suicide death among those in later (2000-2010) rather than earlier (1998 and earlier) data collection periods.

LIMITATIONS

Secondary analysis of data limited the types of variables that were available.

CONCLUSIONS

The protective nature of religion is due more to participating in religious activities, such as attending religious services, than to having a strong religious affiliation, and this effect exists primarily in more recent data collection periods.

Does equality legislation reduce intergroup differences? Religious affiliation, socio-economic status and mortality in Scotland and Northern Ireland: A cohort study of 400,000 people

Religion frequently indicates membership of socio-ethnic groups with distinct health behaviours and mortality risk. Determining the extent to which interactions between groups contribute to variation in mortality is often challenging. We compared socio-economic status (SES) and mortality rates of Protestants and Catholics in Scotland and Northern Ireland, regions in which interactions between groups are profoundly different. Crucially, strong equality legislation has been in place for much longer and Catholics form a larger minority in Northern Ireland. Drawing linked Census returns and mortality records of 404,703 people from the Scottish and Northern Ireland Longitudinal Studies, we used Poisson regression to compare religious groups, estimating mortality rates and incidence rate ratios. We fitted age-adjusted and fully adjusted (for education, housing tenure, car access and social class) models. Catholics had lower SES than Protestants in both countries; the differential was larger in Scotland for education, housing tenure and car access but not social class. In Scotland, Catholics had increased age-adjusted mortality risk relative to Protestants but variation among groups was attenuated following adjustment for SES. Those reporting no religious affiliation were at similar mortality risk to Protestants. In Northern Ireland, there was no mortality differential between Catholics and Protestants either before or after adjustment. Men reporting no religious affiliation were at increased mortality risk but this differential was not evident among women. In Scotland, Catholics remained at greater socio-economic disadvantage relative to Protestants than in Northern Ireland and were also at a mortality disadvantage. This may be due to a lack of explicit equality legislation that has decreased inequality by religion in Northern Ireland during recent decades.

Spirituality, religiosity, aging and health in global perspective: A review

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.

Leaving my religion: Understanding the relationship between religious disaffiliation, health, and well-being

Religious disaffiliation-leaving the religious tradition in which one was raised for no religious affiliation in adulthood-has become more common in recent years, though few studies have examined its consequences for the health and well-being of individuals. We use an innovative approach, comparing the health and subjective well-being of religious disaffiliates to those who remain affiliated using pooled General Social Survey samples from 1973 through 2012. We find that religious disaffiliates experience poorer health and lower well-being than those consistently affiliated and those who are consistently unaffiliated. We also demonstrate that the disadvantage for those who leave religious traditions is completely mediated by the frequency of church attendance, as disaffiliates attend church less often. Our results point to the importance of the social processes surrounding religious disaffiliation and emphasize the role of dynamics in the relationship between religious affiliation and health.

An 81-year-old woman with chronic illnesses and a strong faith

Mrs. Smith is an 81-year-old woman who has several medical problems. Despite these problems, however, her faith and spirituality strength give her the strength and determination to move forward in life. She stresses that, "My faith helps me cope with my illnesses." This article describes Mrs. Smith's roller coaster life and how faith, prayer, and hope have allowed her to continue to press forward. She interprets pain and illnesses as challenges, not obstacles. Her physician who has been treating her for about 20 years indicates that she has continued to have multiple chronic health issues and has maintained an incredibly positive spirit, particularly when traditional medicine has failed to make a difference. Spiritual care is being increasingly documented as an important component of whole person medicine. For some, religiosity and spirituality are important aspects of patient-provider relationship. God, faith, and hope are essential factors to Mrs. Smith who uses spirituality and religion daily to cope with her chronic illnesses.

Religious Affiliation, Religious Service Attendance, and Mortality

Very few studies have examined the effects of both religious affiliation and religiosity on mortality at the same time, and studies employing multiple dimensions of religiosity other than religious attendance are rare. Using the newly created General Social Survey-National Death Index data, our report contributes to the religion and mortality literature by examining religious affiliation and religiosity at the same time. Compared to Mainline Protestants, Catholics, Jews, and other religious groups have lower risk of death, but Black Protestants, Evangelical Protestants, and even those with no religious affiliation are not different from Mainline Protestants. While our study is consistent with previous findings that religious attendance leads to a reduction in mortality, we did not find other religious measures, such as strength of religious affiliation, frequency of praying, belief in an afterlife, and belief in God to be associated with mortality. We also find interaction effects between religious affiliation and attendance. The lowest mortality of Jews and other religious groups is more apparent for those with lower religious attendance. Thus, our result may emphasize the need for other research to focus on the effects of religious group and religious attendance on mortality at the same time.

Santa Clara Strength of Religious Faith Questionnaire: psychometric analysis in older adults

OBJECTIVES

To assist researchers and clinicians considering using the Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ) with older-adult samples, the current study analyzed the psychometrics of SCSRFQ scores in two older-adult samples.

METHOD

Adults of age 55 or older who had formerly participated in studies of cognitive-behavioral therapy for anxiety and/or depression were recruited to complete questionnaires. In Study 1 (N = 66), the authors assessed the relations between the SCSRFQ and other measures of religiousness/spirituality, mental health, and demographic variables, using bivariate correlations and nonparametric tests. In Study 2 (N = 223), the authors also conducted confirmatory and exploratory factor analyses of the SCSRFQ, as well as an item response theory analysis.

RESULTS

The SCSRFQ was moderately to highly positively correlated with all measures of religiousness/spirituality. Relations with mental health were weak and differed across samples. Ethnic minorities scored higher than White participants on the SCSRFQ, but only in Study 2. Factor analyses showed that a single-factor model fit the SCSRFQ best. According to item response theory analysis, SCSRFQ items discriminated well between participants with low-to-moderate levels of the construct but provided little information at higher levels.

CONCLUSION

Although the SCSRFQ scores had adequate psychometric characteristics, the measure's usefulness may be limited in samples of older adults.

Religion and selected health behaviors among Latinos in Texas

Though research has shown that religion provides a protective influence with respect to a number of health-related outcomes, little work has examined its influence on patterns of alcohol (especially binge drinking) and tobacco consumption among Latinos in Texas. Thus, we used a probability sample of Texas adults to test this relationship via logistic regression. Our results revealed that clear distinctions emerge on the basis of both denomination and frequency of attendance. Specifically, Protestants who regularly attend religious services are significantly more likely to be abstainers and to have never smoked, while those with no religious affiliation exhibit relatively unfavorable risk profiles. These findings persist despite a range of socio-demographic controls. Our study supports the assertion that religion may serve as an important protective influence on risky health behaviors.

An integrative research review of instruments measuring religious involvement: implications for nursing research with African Americans

BACKGROUND AND PURPOSE

Many instruments in which religious involvement is measured often (a) contain unclear, poorly developed constructs; (b) lack methodological rigor in scale development; and (c) contain language and content culturally incongruent with the religious experiences of diverse ethnic groups. The primary aims of this review were to (a) synthesize the research on instruments designed to measure religious involvement, (b) evaluate the methodological quality of instruments that measure religious involvement, and (c) examine these instruments for conceptual congruency with African American religious involvement.

METHODS

An updated integrative research review method guided the process (Whittemore & Knafl, 2005).

RESULTS

152 articles were reviewed and 23 articles retrieved. Only 3 retained instruments were developed under methodologically rigorous conditions. All 3 instruments were congruent with a conceptual model of African American religious involvement.

CONCLUSIONS

The Fetzer Multidimensional Measure of Religious Involvement and Spirituality (FMMRS; Idler et al., 2003) was found to have favorable characteristics. Further examination and psychometric testing is warranted to determine its acceptability, readability, and cultural sensitivity in an African American population.

High mortality, violence and crime in alcohol dependents: 5 years after seeking treatment in a Brazilian underprivileged suburban community

OBJECTIVE

To investigate the results of alcohol-related consequences in an underprivileged area of São Paulo.

METHOD

One hundred and ninety one adult patients who sought alcohol treatment in 2002 were reassessed in 2007 regarding alcohol use and involvement with crime. The interview consisted of demographic questions and questionnaires assessing alcohol dependence and pattern of alcohol use. Risk and protective factors and involvement with crime were further explored. RESULTS High mortality rate (16.9%, n = 41) was found in this sample and 97.4% were identified as being severe alcohol dependents. The sample consisted of a homogeneous group, average age of 42, 81.9% male, 57.5% black, 52.2% unemployed and 100% of low socioeconomic status. Individuals ageing 35 or younger, not engaged in religious activities and with intense alcohol consumption in the last month had 2.7 times more chance on committing crimes (95% CI = [1.22; 5.93] p = 0.014). Subjects who consumed alcohol in the last month also had a 4.1 greater chance of becoming involved in crime (95% CI = [1.2; 14.24] p = 0.024).

CONCLUSION

Alcohol dependence within an underprivileged community was associated with high rates of crime and mortality. Religious affiliation was negatively associated with delinquent behavior.