Sunday, November 23, 2008



Religious Feelings Associated with Women's Lengthier Survival

By John Gever
NEW YORK, 23 nov 2008--Expressions of religious feeling by participants in the Women's Health Initiative translated into a greater likelihood of survival during the study, researchers here said.
Post-menopausal women who, at study baseline, reported certain types of religious feeling had hazard ratios for all-cause mortality of 0.80 to 0.89 (P<0.05) with a mean 7.7 years of follow-up, reported Eliezer Schnall, Ph.D., of Yeshiva University, and colleagues online in Psychology and Health.
But these expressions of religious feeling did not affect mortality or morbidity associated with coronary heart disease, the researchers said.
In fact, some models showed positive associations between religiosity and cardiac illness and death, they said.
It was not the first study to connect religious attachments to reduced mortality, but with more than 92,000 participants in the Women's Health Initiative, it may be the largest.
And like those earlier studies, this one shed little light on exactly how religious feelings may forestall death.
"In an effort to assess which pathways may be relevant to the decreased mortality found for those with religious affiliation and more frequent religious service attendance, causes of death were compared across groups," Dr. Schnall and colleagues wrote. "However, no significant differences were found."
They concluded that the protective effect of religious attachment seems real, but the reasons for it are still not understood.
At baseline in the study, women were asked whether they had a religious affiliation; how frequently they attended worship services; and whether religion provided a great deal of strength and comfort, a little, or none.
The hazard ratios for all-cause death during follow-up associated with these variables, relative to participants expressing the lowest level of religious attachment, were:
Having a religious affiliation: HR 0.84 (95% CI 0.75 to 0.93)
Attending services less than weekly: HR 0.85 (95% CI 0.79 to 0.92)
Attending services weekly: HR 0.80 (95% CI 0.75 to 0.86)
Attending services more often than weekly: HR 0.80 (95% CI 0.73 to 0.87)
Religion provides a little comfort: HR 0.95 (95% CI 0.86 to 1.05)
Religion provides a great deal of comfort: HR 0.89 (95% CI 0.82 to 0.98)
These hazard ratios reflected adjustments for age, ethnicity, income, education, body mass index, and current morbidities.
The apparent benefits of deriving substantial strength and comfort from religion disappeared when the researchers also controlled for smoking and alcohol consumption.
And having a religious affiliation was no longer a protective factor when these health behaviors and psychosocial variables, such as self-reported social support and life satisfaction, were included in the analysis.
But the protective effect of attendance at religious services at least weekly remained significant in these enhanced models, with hazard ratios of 0.87 to 0.90 (P<0.05).
About 5,900 of the study participants died during follow-up, excluding the first year. Of these, 425 deaths were among those who did not identify themselves as having a particular religion.
A seemingly disproportionate number of those deaths were from cancer -- 47.1% compared with 42.4% of deaths in the religiously affiliated, although the difference did not reach statistical significance.
But coronary heart disease accounted for only 9.9% of deaths among the religiously unaffiliated versus 13.2% of those who said they had a religion.
Religious affiliation correlated with overall cardiac morbidity and mortality with a hazard ratio of 1.46 (95% CI 1.22 to 1.75).
The raw numbers also suggested that cardiac disease and death was increased with religious service attendance and the degree of strength and comfort provided by religion, with hazard ratios of up to 1.49.
The statistical significance of these associations largely vanished when other variables were factored in -- but in many cases just barely, with the lower limit of 95% confidence intervals at 0.97 to 0.99 for the resulting hazard ratios.
Again, Dr. Schnall and colleagues were at a loss to explain why religious attachment might increase cardiac disease risks.
They noted that their results could have differed if they had longer follow-up or used other measures of religious feeling.
They also said their study's focus on post-menopausal women limited its interpretation for men and younger women.
The Women's Health Initiative was funded by the National Heart, Lung, and Blood Institute. External funding for this analysis was not reported.
No potential conflicts of interest were reported.

Primary source: Psychology and HealthSource reference:Schnall E, et al. "The relationship between religion and cardiovascular outcomes and all-cause mortality in the Women's Health Initiative Observational Study" Psychol Health 2008; DOI: 10.1080/08870440802311322.

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