Attending religious services associated with lower risk of death in women

Frequently attending religious services was associated with a lower risk of death for women from all causes, cardiovascular disease and cancer, according to a new study published online by JAMA Internal Medicine.

Religious practice is common in the United States but the effects of religious practice on health are not clear.

Tyler J. VanderWeele, Ph.D., of the Harvard T.H. Chan School of Public, Boston, and coauthors used data from the Nurses' Health Study in an analysis examining attendance at religious services and subsequent death in women. Attendance at religious services was assessed in questionnaires from 1992 to 2012; data analysis was conducted from the 1996 questionnaire to 2012 for a 16-year follow-up.

Among 74,534 women at the 1996 study baseline with reported religious service attendance, 14,158 attended more than once a week, 30,401 attended once per week, 12,103 attended less than once per week and 17,872 never attended. Most of the study participants were Catholic or Protestant. Women who frequently attended religious services tended to have fewer depressive symptoms, were less likely to be current smothers and more likely to be married.

Among the 74,534 women, there were 13,537 deaths, including 2,721 from cardiovascular disease and 4,479 from cancer.

Women who attended religious services more than once per week had a 33 percent lower risk of death during the 16 years of follow-up compared with women who never attended religious services. Women who attended services weekly had a 26 percent lower risk and those who attended services less than weekly had a 13 percent lower risk, according to the results.

The study indicates women who attended religious services more than once a week had a 27 percent lower risk of death from cardiovascular disease and a 21 percent lower risk of death from cancer compared with women who never attended.

The authors note depressive symptoms, smoking, social support and optimism were potentially important mediators of the association between attending religious services and death.

However, the authors note limits in the generalizability of their results because the study mainly consisted of white Christians and the participants were nurses with similar socioeconomic status and who were health conscious. This observational study also cannot imply causality and the authors note that a randomized clinical trial of attendance at religious services is neither ethical nor feasible.

"Religion and spirituality may be an underappreciated resource that physicians could explore with their patients, as appropriate," the authors conclude.

Commentary: Empirical Studies about Attendance at Religious Services, Health

"In this issue of JAMA Internal Medicine, Li et al report a clear and moderately strong association between attendance at religious services and decreased mortality during a 16-year follow-up of a subgroup from the Nurses' Health Study. ... First, readers and investigators must, as do these authors, focus on the data, no more and no less, and not attempt to generalize beyond the evidence. ... So what can we learn from this study? In this well-designed secondary data analysis, attendance at religious services is clearly associated with lower risk of mortality. This finding should not be ignored but rather explored in more depth," writes Dan German Blazer, II, M.D., M.P.H., Ph.D., of Duke University Medical Center, Durham, N.C., in a related commentary.