Attendance at Religious Services, Prayer, Religious Coping, and Religious/Spiritual Identity as Predictors of All-Cause Mortality in the Black Women's Health Study

Abstract

Previous longitudinal studies have consistently shown an association between attendance at religious services and lower all-cause mortality, but the literature on associations between other measures of religion and spirituality (R/S) and mortality is limited. We followed 36,613 respondents from the Black Women's Health Study from 2005 through December 31, 2013 to assess the associations between R/S and incident all-cause mortality using proportional hazards models. After control for numerous demographic and health covariates, together with other R/S variables, attending religious services several times per week was associated with a substantially lower mortality rate ratio (mortality rate ratio = 0.64, 95% confidence interval: 0.51, 0.80) relative to never attending services. Engaging in prayer several times per day was not associated with mortality after control for demographic and health covariates, but the association trended towards a higher mortality rate ratio when control was made for other R/S variables (for >2 times/day vs. weekly or less, mortality rate ratio = 1.28, 95% confidence interval: 0.99, 1.67; P-trend < 0.01). Religious coping and self-identification as a very religious/spiritual person were associated with lower mortality when adjustment was made only for age, but the association was attenuated when control was made for demographic and health covariates and was almost entirely eliminated when control was made for other R/S variables. The results indicate that service attendance was the strongest R/S predictor of mortality in this cohort.

Religion and health in Europe: cultures, countries, context

“…In their primary analyses (Table 2, Model 3), participation in religious organizations had point estimates for all associations in a protective direction, with more substantial evidence specifically for protective associations on for the global activity limitation index (OR=0.86, 95%CI:0.75,0.98) and on depression (OR=0.80, 95%CI:0.69,0.93). Second, there was little evidence that prayer, considered on its own, was associated with the various health outcomes, which likewise matches prior literature suggesting much weaker or null associations between private practice religious-spiritual measures and health [7,8]. …”

On the promotion of human flourishing

“…Although much of the literature is methodologically weak, there are now numerous well-designed longitudinal studies that suggest that regular religious service attendance is associated with greater longevity (105-110), a 30% lower incidence of depression (38,107,111), a fivefold lower rate of suicide (112), better survival from cancer, and numerous other outcomes (102,104). Importantly, the evidence suggests that it is attending religious services, rather than private practices or self-assessed spirituality or religiosity, that is most strongly predictive of health (106,113). It is the communal form of religious practice that appears to bring about better health outcomes.…”

New research directions on disparities in obesity and type 2 diabetes

“…84 Because certain psychosocial stressors (e.g., exposure to violence, low social position, and trauma) are disproportionately experienced by poor and minority communities in the United States, 85 investigating the underlying mechanisms through which such stressors operate to increase the risk of disease adds a critical piece of the puzzle in eliminating disparities in the burden of illness. 92,93 Religion and spirituality have emerged as potentially important sources of resiliency for minority and low-income communities, 94 and may be particularly important for African American and Hispanic/Latino communities who report higher levels of religious and spiritual beliefs and practices than White and Asian American populations. Human experiments show that both emotional and physical stressors trigger the central stress response and neuroendocrine systems, which can result in a cascade of hormonal changes linked to increased risk of obesity, metabolic syndrome, and poor glycemic control.…”

“…Mind-body stress-reduction interventions, such as the Relaxation Response Resiliency (3RP) Program or meditation, for example, have been shown to enhance the expression of genes associated with favorable energy metabolism, insulin secretion, and telomere maintenance; 90,91 and suggest a positive benefit for cardiovascular health and reducing blood glucose levels. 92,93 Religion and spirituality have emerged as potentially important sources of resiliency for minority and low-income communities, 94 and may be particularly important for African American and Hispanic/Latino communities who report higher levels of religious and spiritual beliefs and practices than White and Asian American populations. 95 In a recent national study of African American women in the United States; for example, those who used religion or spirituality to cope with stress were significantly less likely to develop hypertension, and this protective effect was greater among those with the highest levels of perceived stress.…”