Is Being Religious Really Good for you? What Recent Scientific Studies Reveal David R. Williams, Ph.D., MPH, M.Div. Departments of Sociology & Epidemiology & Institute for Social Research University of Michigan Spirituality & Health Conference 2005 Adventist Health Professionals
Forgiveness and Health - I Participants recalled a particular person who had mistreated, offended or hurt them. Then they were instructed via a computer to actively imagine unforgiving and forgiving responses toward the offender 8 times by following: (1) a script that had them rehearse the hurt and harbor a grudge, and (2) a script that had them empathize with the offender and grant forgiveness. Physiologic measures were monitored Witvliet et al. 2001
Forgiveness and Health - II An unforgiving response was adversely related to sympathetic nervous system and cardiovascular functioning. During the unforgiving versus the forgiving response participants: -felt more negative, aroused, angry and sad -had greater brow tension(measured by electromyograms, EMG) -had higher skin conductance level (SCL), heart rate and mean arterial pressure. Witvliet et al. 2001
Religiousness Among AIDS/HIV Patients In a study of 279 HIV/AIDS-infected people, long-term survival was significantly related to all four dimensions of religiosity measured in the Ironson/Woods Spirituality/ Religiousness (SR) Index: faith in God, religious activity, sense of peace, and compassion toward others. Long-term survival was also positively related to frequency of prayer and inversely associated with judgmental attitude. Additionally, religiousness was positively associated with reduced distress, more hope, social support, health behaviors, and lower cortisol levels. Ironson et al. 2002
Illness Prevention: Domestic Violence • Men who regularly attend religious services are one-third as likely to abuse. • Abuse by men or women is reduced for regular attenders even when controlling for unemployment or educational differences. Ellison CG, et al. Are there religious variations in domestic violence? J Fam Issues 1999; 20(1):87-113.
Illness Prevention:Domestic Violence • Theologically conservative men married to more liberal women twice as likely to abuse than if married to conservative spouses. • Study highlighted: Religion may patter in positive and negative ways for the risk of violence. Violence research seldom includes religious variables. • Ellison CG, et al. Are there religious variations in domestic violence? • J Fam Issues 1999; 20(1):87-113.
Improving Rehabilitation Outcomes:Reducing Criminal Recidivism 400 prison inmates were followed for one year after their release: • 200 = At least monthly Bible studies • 200 = No Bible studies One year follow-up: • 14% of Bible study participants had returned to prison • 41% of non-participants had returned to prison Johnson et al. Justice Quarterly 1997;14:145-166
Religious Belief and Mental Health Analyses of data from a community sample of 1,139 adults in the Detroit Area Study found that belief in eternal life was positively associated with psychological well-being (but unrelated to psychological distress). This association remained significant after adjustments for other religious variables, demographic factors, stressors, social support and self-esteem and mastery. Ellison et al. 2001
Buffering Effect (Belief) • In the 1995 Detroit Area Study, a strong belief in eternal life: • Reduced the negative effects of some stressors (chronic health problems and financial problems) on psychological well-being, but not on distress. • Reduced the negative effects of work-related stress on psychological distress, but not on well-being. Ellison et al. 2001
Summary: Religion & Depression A recent meta analysis of 147 studies that examined the association between religiousness and depressive symptoms concluded that higher levels of religious involvement was associated with fewer symptoms of depression. Although the association was robust, it was modest in size. Although the associations were not moderated by gender, age, or ethnicity, the association was stronger for studies of persons under stress. An extrinsic religious orientation and negative religious coping was associated with elevated symptoms of depression. Smith, McCullough, & Poll 2003, Psychological Bulletin
Attendance and Physical Health A review of the epidemiological research which used a measure of frequency of religious attendance found: - 81% showed benefit - 15% were neutral • 4% showed harm • Levin JS, Vanderpool HY. Is frequent religious attendance really conducive to better health?: toward an epidemiology of religion. Social Science and Medicine 1987; 24:589-600.
Attendance and Life Expectancy In a national sample of over 21,000 adults followed over 8 years, attendance is associated with mortality in a graded manner. People who never attend have 1.9 times the risk of death of people who attend more than once a week. The association exists for most causes of death. At age 20 persons who attend more than once a week live 7.5 years longer than those who never attend. For blacks, the difference was 13.7 years. Hurmmer,Rogers, Nam & Ellison 1999
Religious Attendance and Mortality Attendance was associated with a 30-35 percent reduced risk of death over a 7.5 year follow-up period in a national study of 3,617 adults . The effect was stronger for persons under age 60 than for those over 60. This association remained robust after adjusting for many potential confounding and mediating variables (demographic and SES factors, baseline health, health practices, private religious activity, social support, religious beliefs & worldviews, fatalism, neuroticism, extraversion, self-esteem, self-efficacy and depression). Musick, House & Williams, 2004
Religion and Adolescent Risk Behavior • Religious high school seniors are less likely than their non-religious peers to • Carry a weapon (gun, knife, club) to school • Get into fights or hurt someone • Drive after drinking • Ride with driver who had been drinking • Smoke cigarettes • Engage in binge drinking (5 or more drinks in a row) • Use marijuana • Religious seniors were more likely to • Wear seat belts • Eat breakfast, green vegetables and fruit • Get regular exercise • Sleep at least 7 hours per night Wallace and Forman 1998; Monitoring the Future Study
Risk Taking (Australia) A study of 954 Australian Year 11 and 12 students identified 26 activities of varying degrees of riskiness or dangerousness, including injecting heroin, sharing needles, binge drinking, smoking cigarettes, and speeding in cars. Overall, high levels of moderate risk taking were found across the sample. Church-going youth had lower levels of risk- taking than the rest of the sample. Abbott-Chapman and Denholm 2001
Physiological Effects of Meditative Prayer Eight male meditation teachers performed Yoga Nidra relaxation meditation (relaxed state in which the mind ‘withdraws’ from wishing to act) while undergoing PET scans. During this meditation-induced change of consciousness, dopamine release increased by 65%. This is the 1st en vivo evidence for the regulation of conscious states at a synaptic level Kjaer et al. 2002
Meditation Among Cancer Patients 59 breast and prostate cancer patients were enrolled in an 8-week program that incorporated relaxation, meditation, yoga, and daily home practice. Program participation was associated with decreased symptoms of stress, improved sleep patterns, and improved quality of life. Participants also exhibited a change in cancer-related cytokine production, resulting in a shift from an immune profile associated with depressive symptoms to a more normal immune profile. Carlson et al. 2003; 2004
Are Religious People Nice? A national study in the U.S. found that more religious participants (reading religious materials, watching or listening to religious programs, attendance) were rated by the interviewers as: -More enjoyable to interview -More open(less suspicious) -More friendly -Less hostile -Less bored and more interested in the interview Ellison 1992
Good Samaritans: Beliefs vs. Actions Study of the relationship between religion beliefs and providing help in an emergency. -Belief in the accuracy of the Bible unrelated to helping behavior. -Frequency of church attendance and prayer had no effect on helping behavior. Religion does not necessarily translate into moral development. Annis 1976
Religion’s Negative Effects • Used to justify hatred, aggression, prejudice • Judgmental, alienating and exclusive • May be restricting and limiting, rather than freeing • May induce excessive guilt (not enough “faith”) • May encourage magical thinking, sacrifice of intellect • May be used instead of medical care • Failure to seek prenatal, obstetrical, and other medical care • Failure to vaccinate children • Stopping of medication to demonstrate faith
The Harmfulness of Faith Healing • Study sample: 172 children who died (1975-95) • a) after parents refused medical care • b) preferred faith healing alone • Study results: 140 (81%) died from conditions with excellent long-term survival (e.g. Dehydration, diabetes, measles, pneumonia, appendicitis) with medical care. • 59 prenatal & newborn died, 58 from conditions with excellent long-term survival following medical care. • Asser SM, Swan R. Child fatalities from religion-motivated medical neglect. • Pediatrics 1998;101(4)625-629.
Religious Struggle and Mortality Among Medically Ill In a longitudinal cohort study of 596 medically ill patients aged 55 or older, religious struggle was associated with greater risk of mortality. Specifically, patients who reported that they ‘wondered whether God had abandoned me;’ ‘questioned God’s love for me;’ ‘decided that the devil made it happen’; had a 19% to 28% increase in risk of dying during the 2-year follow-up period. Pargament et al. 2001
Religion & Weight • Religiosity and religious attendance are positively associated with BMI • Most observed relationships are independent of SES • Relationships partly explained by other health behaviors, especially smoking
Obesity: A Challenge • Obesity, at any time during adulthood, heightens health problems. • Many religions do a disservice to their adherents by trivializing obesity as health risk. • Obesity reduces the health benefits of spirituality.
Religious Profile (Australia) 25% Attend Church monthly or more often 61% Believe in God, other than just sometimes 67% Pray, including only praying occasionally Peach 2003; Data from the 1980s
Spirituality in Australia One third of Australian adults say their desire for a spiritual life is very important or the most important principle guiding their lives. An additional third say it is ‘important’ Women value spirituality more than men Education is positively related to valuing spirituality Only 30% of those who value spirituality attend religious services monthly or more 40% of those who value spirituality are Christians (believe Bible; view Jesus as divine). They pray but the majority feel that attending a church is not necessary Christian Research Association: Spirituality; Australian Community Survey
Religious and Spiritual: Profile • Spiritual and religious adults attended services, prayed, meditated, read the Bible and had more daily spiritual experiences than any other group. They were less distressed and less mistrusting than the religious-only group, but they (and the religious only group) had high levels of intolerance. • The Spiritual only group were politically liberal, tolerant of diverse points of view and unwilling to claim a denominational affiliation. Shahabi et al. 2002; 1998 General Social Survey
Patient Need (Australia) A study of the spiritual attitudes and needs of 79 psychiatric patients in NSW found that: • 79% rated rated spirituality as very important. • 67% said their spirituality helped them cope with their psychological pain. • 82% thought their therapists should be aware of their spiritual beliefs and needs. • 69% reported that therapists should consider the patients’ spiritual needs in their psychological treatment. D’Souza 2002
Implications of the Research for Clinical Care: Minimalist Recommendations (Idler) • Health care institutions should facilitate inpatients’usual religious observances. • Health care providers should be aware of patients’ religiously-motivatedtreatment preferences, particularly for patients at the end of life. • Physicians and other health care workers should make appropriatereferrals to hospital chaplainsand/or local religious congregations. • Physicians should recommendreturn to usual religiousactivitiesfollowing bereavement or illness. • Religious congregations have the primary responsibility in caring for the spiritual well-being of their members.
Religion and Stress • A national telephone survey conducted three to five days after the September 11 attacks revealed that in coping with this tragedy: • 98% talked with others about their feelings • 90% turned to prayer, religion, or spiritual feeling • 60% participated in public or group activities • 36% donated money or did volunteer work • Analyses of a New Haven sample of 938 adults found that in response to stress, prayer increased but church attendance declined Schuster et al. 2001; Lindenthal et al. 1970
The Weight of the Evidence • Over the last century 1200+ studies have examined the religion health relationship • Conducted by hundreds of investigators at different institutions in the U.S. and elsewhere • The majority show a positive association between religion and physical and mental health, Few find no association and even fewer a negative relationship • They are not perfect but the consistency of the association is impressive Koenig, McCullough & Larson 2001