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Church attendance, allostatic load and mortality in middle aged adults

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  • Marino A Bruce
  • David Martins
  • Kenrik Duru
  • Bettina M Beech
  • Mario Sims
  • Nina Harawa
  • Roberto Vargas
  • Dulcie Kermah
  • Susanne B Nicholas
  • Arleen Brown
  • Keith C Norris

Abstract

Importance: Religiosity has been associated with positive health outcomes. Hypothesized pathways for this association include religious practices, such as church attendance, that result in reduced stress. Objective: The objective of this study was to examine the relationship between religiosity (church attendance), allostatic load (AL) (a physiologic measure of stress) and all-cause mortality in middle-aged adults. Design, setting and participants: Data for this study are from NHANES III (1988–1994). The analytic sample (n = 5449) was restricted to adult participants, who were between 40–65 years of age at the time of interview, had values for at least 9 out of 10 clinical/biologic markers used to derive AL, and had complete information on church attendance. Main outcomes and measures: The primary outcomes were AL and mortality. AL was derived from values for metabolic, cardiovascular, and nutritional/inflammatory clinical/biologic markers. Mortality was derived from a probabilistic algorithm matching the NHANES III Linked Mortality File to the National Death Index through December 31, 2006, providing up to 18 years follow-up. The primary predictor variable was baseline report of church attendance over the past 12 months. Cox proportional hazard logistic regression models contained key covariates including socioeconomic status, self-rated health, co-morbid medical conditions, social support, healthy eating, physical activity, and alcohol intake. Results: Churchgoers (at least once a year) comprised 64.0% of the study cohort (n = 3782). Non-churchgoers had significantly higher overall mean AL scores and higher prevalence of high-risk values for 3 of the 10 markers of AL than did churchgoers. In bivariate analyses non-churchgoers, compared to churchgoers, had higher odds of an AL score 2–3 (OR 1.24; 95% CI 1.01, 1.50) or ≥4 (OR 1.38; 95% CI 1.11, 1.71) compared to AL score of 0–1. More frequent churchgoers (more than once a week) had a 55% reduction of all-cause mortality risk compared with non-churchgoers. (HR 0.45, CI 0.24–0.85) in the fully adjusted model that included AL. Conclusions and relevance: We found a significant association between church attendance and mortality among middle-aged adults after full adjustments. AL, a measure of stress, only partially explained differences in mortality between church and non-church attendees. These findings suggest a potential independent effect of church attendance on mortality.

Suggested Citation

  • Marino A Bruce & David Martins & Kenrik Duru & Bettina M Beech & Mario Sims & Nina Harawa & Roberto Vargas & Dulcie Kermah & Susanne B Nicholas & Arleen Brown & Keith C Norris, 2017. "Church attendance, allostatic load and mortality in middle aged adults," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0177618
    DOI: 10.1371/journal.pone.0177618
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    References listed on IDEAS

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    1. Buck, Anna C. & Williams, David R. & Musick, Marc A. & Sternthal, Michelle J., 2009. "An examination of the relationship between multiple dimensions of religiosity, blood pressure, and hypertension," Social Science & Medicine, Elsevier, vol. 68(2), pages 314-322, January.
    2. Ferraro, Kenneth F. & Kim, Seoyoun, 2014. "Health benefits of religion among Black and White older adults? Race, religiosity, and C-reactive protein," Social Science & Medicine, Elsevier, vol. 120(C), pages 92-99.
    3. Geronimus, A.T. & Hicken, M. & Keene, D. & Bound, J., 2006. ""Weathering" and age patterns of allostatic load scores among blacks and whites in the United States," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 826-833.
    4. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
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    1. Marino A. Bruce & Kia Skrine Jeffers & Jan King Robinson & Keith C. Norris, 2018. "Contemplative Practices: A Strategy to Improve Health and Reduce Disparities," IJERPH, MDPI, vol. 15(10), pages 1-9, October.
    2. Marino A. Bruce & Roland J. Thorpe & Dulcie Kermah & Jenny Shen & Susanne B. Nicholas & Bettina M. Beech & Delphine S. Tuot & Elaine Ku & Amy D. Waterman & Kenrik Duru & Arleen Brown & Keith C. Norris, 2021. "Religious Service Attendance and Mortality among Adults in the United States with Chronic Kidney Disease," IJERPH, MDPI, vol. 18(24), pages 1-14, December.

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