The social determinants of health framework has brought a recognition of the primary importance of social forces in determining population health. Research using this framework to understand the health and mortality impact of social, economic, and political conditions, however, has rarely included religious institutions and ties. We investigate a well-measured set of social and economic determinants along with several measures of religious participation as predictors of adult mortality. Respondents (N = 18,370) aged 50 and older to the Health and Retirement Study were interviewed in 2004 and followed for all-cause mortality to 2014. Exposure variables were religious attendance, importance, and affiliation. Other social determinants of health included gender, race/ethnicity, education, household income, and net worth measured at baseline. Confounders included physical and mental health. Health behaviors and social ties were included as potential explanatory variables. Cox proportional hazards regressions were adjusted for complex sample design. After adjustment for confounders, attendance at religious services had a dose-response relationship with mortality, such that respondents who attended frequently had a 40% lower hazard of mortality (HR = 0.60, 95% CI 0.53-0.68) compared with those who never attended. Those for whom religion was "very important" had a 4% higher hazard (HR = 1.04, 95% CI 1.01-1.07); religious affiliation was not associated with risk of mortality. Higher income and net worth were associated with a reduced hazard of mortality as were female gender, Latino ethnicity, and native birth. Religious participation is multi-faceted and shows both lower and higher hazards of mortality in an adult US sample in the context of a comprehensive set of other social and economic determinants of health.
by
Richard A. Powell;
Linda Emanuel;
George Handzo;
John Lantos;
Laura B. Dunn;
Ellen Idler;
Diane J. Wilkie;
Kevin Massey;
William T. Summerfelt;
Marilyn J. D. Barnes;
Tammie Quest;
Allison Kestenbaum;
Karen Steinhauser;
George Fitchett;
Angelika Zollfrank;
Annette K. Olsen;
Tracy A. Balboni;
Dane Sommer
Background: Despite recognition of the centrality of professional board-certified chaplains (BCC) in palliative care, the discipline has little research to guide its practices. To help address this limitation, HealthCare Chaplaincy Network funded six proposals in which BCCs worked collaboratively with established researchers. Recognizing the importance of interdisciplinary collaboration in the development of a new field, this paper reports on an exploratory study of project members' reflections over time on the benefits and challenges of conducting inter-disciplinary spiritual care research. Methods: Data collection occurred in two stages. Stage 1 entailed two independent, self-reflective focus groups, organized by professional discipline, mid-way through the site projects. Stage 2 entailed end-of-project site reports and a conference questionnaire. Results: Eighteen professionals participated in the group discussions. Stage 1: researchers perceived chaplains as eager workers passionately committed to their patients and to research, and identified challenges faced by chaplains in learning to conduct research. Chaplains perceived researchers as passionate about their work, were concerned research might uncover negative findings for their profession, and sensed they used a dissimilar paradigm from their research colleagues regarding the 'ways of relating' to knowledge and understanding. Stage 2: researchers and chaplains noted important changes they ascribed to the interdisciplinary collaboration that were classified into six domains of cultural and philosophical understanding: respect; learning; discovery; creativity; fruitful partnerships; and learning needs. Conclusions: Chaplains and researchers initially expressed divergent perspectives on the research collaborations. During the projects' lifespans, these differences were acknowledged and addressed. Mutual appreciation for each discipline's strengths and contributions to inter-professional dialogue emerged.
Religious responses to COVID-19 as portrayed in a major news source raise the issue of conflict or cooperation between religious bodies and public health authorities. We compared articles in the New York Times relating to religion and COVID-19 with the COVID-19 statements posted on 63 faith-based organizations’ web sites, and with the guidance documents published by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) specifically for religious bodies. We used computational text analysis to identify and compare sentiments and topics in the three bodies of text. Sentiment analysis showed consistent positive values for faith-based organizations’ texts throughout the period. The initial negative sentiment of religion—COVID-19 coverage in the New York Times rose over the period and eventually converged with the consistently positive sentiment of faith-based documents. In our topic modelling analysis, rank order and regression analysis showed that topic prevalence was similar in the faith-based and public health sources, and both showed statistically significant differences from the New York Times. We conclude that there is evidence of both narratives and counter-narratives, and that these showed demonstrable shifts over time. Text analysis of public documents shows alignment of the interests of public health and religious bodies, which can be discerned for the benefit of communities if parties are trusted and religious messages are consistent with public health communications.