Expired CME Article

Religious Involvement and Adult Mortality in the United States: Review and Perspective

Authors: Robert A. Hummer, PHD, Christopher G. Ellison, PHD, Richard G. Rogers, PHD, Benjamin E. Moulton, MA, Ron R. Romero, BA

Abstract

Objectives: The scientific community has recently taken a serious interest in the relation between religious involvement and adult mortality risk in the United States. We review this literature, highlighting key findings, limitations, and future challenges.


Methods: Literature from medicine, epidemiology, and the social sciences is included.


Results: Taken together, the existing research indicates that religious involvement is related to US adult mortality risks. The evidence is strongest for public religious attendance and across specific religious denominations. The evidence is weakest for private religious activity. The mechanisms by which religious involvement appear to influence mortality include aspects of social integration, social regulation, and psychological resources.


Conclusions: The religion-mortality literature has developed in both size and quality over the past decade. Fruitful avenues for continued research include the analysis of (1) more dimensions of religious involvement, including religious life histories; (2) population subgroups, including specific race/ethnic and socioeconomic populations; and (3) a richer set of social, psychologic, and behavioral mechanisms by which religion may be related to mortality.


Key Points


* A number of high-quality, population-based studies have shown an association between higher levels of public religious attendance and lower mortality risks among US adults.


* Key confounders, such as baseline health, have accounted for a relatively small portion of this association.


* Key hypothesized mechanisms for such a relation include increased levels of social support and integration, social regulation, and psychologic resources among more religiously active persons.


* Evidence is mixed at this point for an empiric relation between private religious activity and mortality.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Koenig HG, McCullough ME, Larson DB. Handbook of Religion and Health. Oxford, Oxford University, 2001.
 
2. Enstrom JE. Cancer mortality among Mormons. Am J Epidemiol 1975;36:825–841.
 
3. Gardner JW, Lyon JL. Cancer in Utah Mormon men by lay priesthood level. Am J Epidemiol1982;116:243–257.
 
4. Gardner JW, Lyon JL. Cancer in Utah Mormon women by church activity level. Am J Epidemiol1982;116:258–265.
 
5. Gardner JW, Sanborn J, Slattery M. Behavioral Factors explaining the low risk for cervical cancer in Utah Mormon women. Epidemiology 1995;6:187–189.
 
6. Hilton SC, Fellingham GW, Lyon JL. Suicide rates and religious commitment in young adult males in Utah. Am J Epidemiol 2002;155:413–419.
 
7. Phillips RL, Kuzman JW, Benson WL, et al. Influence of selection versus lifestyle on risk of fatal cancer and cardiovascular disease among Seventh-Day Adventist men. JAMA 1980;198:137–146.
 
8. Troyer H. Review of cancer among four religious sects: Evidence that life-styles are distinctive sets of risk factors. Soc Sci Med 1988;26:1007–1017.
 
9. Manton KG, Stallard E, Tolley HD. Limits to human life expectancy: Evidence, prospects, and implications. Pop Dev Rev 1991;17:603–637.
 
10. Goldstein S. Changes in Jewish mortality and survival. Soc Bio 1996;43:72–97.
 
11. Durkheim E. Suicide: A Study in Sociology. New York, Free Press, [1897] 1951.
 
12. Pescosolido B, Georgianna S. Durkheim, suicide, and religion: Toward a network theory of suicide.Am Soc Rev 1989;54:33–58.
 
13. Dwyer JW, Clarke LL, Miller MK. The effect of religious concentration and affiliation on county cancer mortality rates. J Health Soc Behav 1990;31:185–202.
 
14. Stark R, Bainbridge WS. Religion, Deviance, and Social Control. New York, Routledge, 1997.
 
15. Ellison CG, Burr JA, McCall P. Religious Homogeneity and metropolitan suicide rates. Soc Forces1996;76:273–299.
 
16. Ellison CG, Burr JA. The Effects of Religious Homogeneity on Metropolitan Crime Rates. Presented at Society for the Scientific Study of Religion and the Religious Research Association, Montreal, 1998.
 
17. Ellison CG, Burr JA, McCall P. the enduring puzzle of Southern homicide: Is regional religious culture the missing piece? Homicide Studies 2003;7:326–352.
 
18. McCullough ME, Larson DB, Hoyt WT, et al. Religious involvement and mortality: a meta-analytic review. Health Psychology 2000;19:211–222.
 
19. Hummer RA, Rogers RG, Nam CB, et al. Religious involvement and US adult mortality. Demography1999;36:273–285.
 
20. Musick MA, House JS, Williams DR. Attendance at religious services and mortality in a national sample. J Health Soc Behav 2004;16:198–213.
 
21. Strawbridge WJ, Cohen RD, Shema SJ, et al. Frequent attendance at religious services and mortality over 28 years. Am J Public Health 1997;87:957–961.
 
22. Oman D, Kurata JH, Strawbridge WJ, et al. Religious attendance and cause of death over 31 years.Int J Psychiatry Med 2002;32:69–89.
 
23. Oman D, Reed D. Religion and mortality among the community-dwelling elderly. Am J Public Health1998;88:1469–1475.
 
24. Koenig HG, Hays JC, Larson DB, et al. Does religious attendance prolong survival? A six-year follow-up study of 3,968 older adults. J Geronotol 1999;54A:M370–M377.
 
25. Rogers RG, Hummer RA, Nam CB. Living and Dying in the USA: Health, Behavioral, and Social Differentials of Adult Mortality. San Diego, Academic Press, 2000.
 
26. Hummer RA, Ellison CG, Donahue D, et al. Religious Involvement, Religious Denomination, and Adult Mortality Risk Among a Nationally Representative Cohort of Middle-Aged Adults. Presented at the Southern Demographic Association annual meeting, Miami, 2001.
 
27. Boardman JD, Hummer RA, Rogers RG, et al. Religious Involvement and Mortality among Elders in the United States. Res Aging 2005 (in press).
 
28. Ellison CG, Hummer RA, Cormier S, et al. Religious involvement and mortality risk among African American adults. Res Aging 2000;22:630–667.
 
29. Bryant S, Rakowski W. Predictors of mortality among elderly African Americans. Res Aging1992;14:50–67.
 
30. Helm H, Hays JC, Flint E, et al. Does private religious activity prolong survival? A six-year follow-up study of 3,851 older adults. J Gerontol Med Sci 2000;55a:400–405.
 
31. Krause N. Stressors in highly valued roles, religious coping, and mortality. Psychol Aging1998;13:242–255.
 
32. Oxman TE, Freedman DH, Manheimer E. Lack of social participation or religious strength and comfort as risk factors after cardiac surgery in the elderly. Psychosom Med 1995;57:5–15.
 
33. Koenig HG, Larson DB, Hays JC, et al. Religion and survival of 1010 hospitalized veterans. J Relig Health 1998;37:15–29.
 
34. Pargament KI, Koenig HG, Tarakeshewar N, et al. Religious struggle as a predictor of mortality.Arch Inter Med 2001;161:1881–1885.
 
35. Idler EL, Musick MA, Ellison CG, et al. Measuring multiple dimensions of religion and spirituality for health research. J Gerontol Soc Sc 2003;25:327–365.
 
36. Vakharia M, Hummer RA. Religion and Mortality Risk Among Highly Educated Individuals in the United States. Presented at the Southern Demographic Association annual meeting, Miami, 2001.
 
37. Ellison CG, Levin JS. The religion-health connection: Evidence, theory, and future directions. Health Educ Behav 1998;25:700–720.
 
38. Waite LJ, Lehrer EL. The benefits from marriage and religion in the United States: A comparative analysis. Pop Dev Rev 2003;29:255–276.
 
39. Jarvis GK, Northcott HC. Religion and differences in morbidity and mortality. Soc Sci Med1987;25:813–824.
 
40. Taylor RJ, Chatters LM. Church based informal support among elderly blacks. Gerontology1986;26:637–642.
 
41. Ellison CG, George LK. Religious involvement, social ties, and social support in a southeastern community. J Sci Study Relig 1994;33:46–60.
 
42. George L, Ellison C. Psychosocial Mediators of the Relationship Between Religious Involvement and Health: State of the Evidence and Future Directions. Presented at the Workshop on Spirituality, Religion, and Health, National Institutes on Health, Bethesda, MD, 1999.
 
43. House JS, Landis KR, Umberson D. Social relationships and health. Science 1988;241:540–545.
 
44. Levin JS. Investigating the epidemiologic effects of religious experience: Findings, explanations, and barriers, in Levin JS (ed): Religion in Aging and Health: Theoretical Foundations and Methodological Frontiers. Thousand Oaks, CA: Sage, 1994, pp 3–17.
 
45. Levin JS. Religion and health: Is there an association, is it valid, and is it casual? Soc Sci Med1994;38:1475–1482.
 
46. Ott P. John Wesley on health as wholeness. J Relig Health 1991;30:43–58.
 
47. Benjamins M, Brown C. Religion and preventative care utilization among the elderly. Soc Sci Med (in press) 2004.
 
48. Ellison CG. Religion, the life stress paradigm, and the study of depression, in Levin JS (ed): Religion in Aging and Health: Theoretical Foundations and Methodological Frontiers Thousand Oaks, CA: Sage, 1994, pp 78–124.
 
49. Kark JD, Shemi G, Friedlander Y, et al. Does religion promote health? Mortality in secular vs religious kibbutzim in Israel. Am J Pub Health 1996;86:341–346.
 
50. Krause N. Religious meaning and subjective well-being in late life. J Gerontol Series B2003;58:S160–S170.
 
51. Pargament KI. The Psychology of Religion and Coping: Theory, Research, Practice. New York, Guilford, 1997.
 
52. Anson J, Anson O. Thank God it’s Friday: The weekly cycle of mortality in Israel. Pop Research Pol Rev 2000;19:143–154.
 
53. Idler EL, Kasl S. Religion, disability, depression, and the timing of death. Am J Soc 1992;97:1052–1079.
 
54. Idler EL, Kasl S. Religion among disabled and non-disabled persons, II: Attendance at religious services as a predictor of the course of disability. J Gerontol Soc Sci 1997;52B:S306–S316.
 
55. Comstock GW, Partridge KB. Church attendance and health. J Chron Dis 1972;665–672.
 
56. Comstock GW, Tonascia JA. Education and mortality in Washington County, Maryland. J Health Soc Behav 1977;18:54–61.
 
57. Ellison CG. Bringing religion back in: the life stress process and the study of depression [dissertation]. Durham, NC: Duke University.
 
58. Hoffman JP. Religion and problem gambling in the US. Rev Relig Res 2000;41:488–509.
 
59. Sloan RP, Bagiella E, VandeCreek L, et al. Should physicians prescribe religious activities? N Engl J Med 2000;342:1913–1916.
 
60. Sloan RP, Bagiella E. Claims about religious involvement and health outcomes. Ann Behav Med2002;24:14–21.
 
61. Sloan RP, Bagiella E, Powell T. Religion, spirituality, and medicine. Lancet 1999;353:664–667.
 
62. Koenig HG, Idler E, Kasl S, et al. Religion, spirituality, and medicine: A rebuttal to skeptics. Int J Psychiatry Med 1999;29:123–131.
 
63. Weaver AJ, Flannelly, KJ, Stone HW, et al. Spirituality, health, and CAM: Current controversies.Alter Ther Health Med 2003;9:42–46.