Does religious involvement affect mortality in low-income Americans? A prospective cohort study

ObjectiveThis study aimed to evaluate the impacts of various forms of religious involvement, beyond individual socioeconomic status, lifestyle factors, emotional well-being and social support, on all-cause and cause-specific mortality in socioeconomic disadvantaged neighbourhoods.DesignThis is a prospective cohort study conducted from 2002 through 2015.SettingsThis study included underserved populations in the Southeastern USA.ParticipantsA total of nearly 85 000 participants, primarily low-income American adults, were enrolled. Eligible participants were aged 40–79 years at enrolment, spoke English and were not under treatment for cancer within the prior year.ResultsWe found that those who attended religious service attendance >1/week had 8% reduction in all-cause death and 15% reduction in cancer death relative to those who never attended. This association was substantially attenuated by depression score, social support, and socioeconomic and lifestyle covariates, and further attenuated by other forms of religious involvement. This association with all-cause mortality was found being stronger among those with higher socioeconomic status or healthier lifestyle behaviours.ConclusionOur results indicate that the association between religious services attendance >1/week and lower mortality was moderate but robust, and could be attenuated and modified by socioeconomic or lifestyle factors in this large prospective cohort study of underserved populations in the Southeastern USA.

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Social Integration, Social Support, and All-Cause, Cardiovascular Disease and Cause-Specific Mortality: A Prospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091498 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1498 ◽

Cited By ~ 1

Author(s):

Jinke Tan ◽

Yafeng Wang

Keyword(s):

Social Support ◽

Cardiovascular Disease ◽

Socioeconomic Status ◽

Cohort Study ◽

Social Integration ◽

Social Relationships ◽

Prospective Cohort Study ◽

Mortality Risk ◽

Prospective Cohort ◽

All Cause Mortality

Social relationships are associated with all-cause mortality. Substantial uncertainties remain, however, for the associations of social relationships with mortality from subtypes of cardiovascular disease (CVD) and major non-vascular diseases. This prospective cohort study estimated mortality risks according to social support and social integration utilizing a nationally representative sample of 29,179 adults ages 18 years and older. Cox proportional hazards regression models were employed. Social integration, but not social support was associated with all-cause mortality risk. For CVD mortality, social integration predicted a 33% lower risk (HR = 0.67, 95% CI = 0.53–0.86). The results were similar in magnitude for heart disease mortality. Participants with the highest social integration level had a 53%, 30%, and 47% decreased mortality risk of diabetes, Alzheimer’s disease, and chronic lower respiratory diseases (CLRD) than those with the lowest level. These social integration associations were linear and consistent across baseline age, sex and socioeconomic status. We did not observe an association of social integration with the risk of cancer mortality. Our findings support the linear association of social integration but not social support with mortality from a range of major chronic diseases in the US adult population, independent of socioeconomic status (SES), behavioral risk factors, and health status.

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