Does Religious Activity Distinguish the Mortality Experiences of Older Taiwanese? An Analysis Using Eighteen Years of Follow-Up Data

  • Zachary ZimmerEmail author
  • Chi-Tsun Chiu
  • Yasuhiko Saito
  • Yu-Hsuan Lin
  • Mary Beth Ofstedal
  • Carol Jagger
Original Paper


This paper extends investigation of religiosity and longevity to Taiwan using a 1989 survey: N = 3849, aged 60+, with 18 years of follow-up. Religious activity is measured as worship and performance of rituals. A Gompertz regression, adjusted and non-adjusted for covariates and mediating factors, shows the hazard of dying is lower for the religiously active versus the non-active. Transformed into life table functions, a 60-year-old religiously active Taiwanese female lives more than 1 year longer than her non-religious counterpart, ceteris paribus. Mainland Chinese migrants are examined carefully because of unique religious and health characteristics. They live longer, but the religiosity gap is similar.


Taiwan Religion Mainlander Mortality Worship 



Funding for this research has been provided by the John Templeton Foundation, Award No. 57521. The lead author acknowledges funding from the Social Sciences and Humanities Research Council of Canada through their Canada Research Chairs Program.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The research reported in this paper complies with ethical standards: IRB No. 15-17165, Reference No. 152120, Human Research Protection Program, Committee on Human Research, University of California, San Francisco.


  1. Argue, A., Johnson, D. R., & White, L. K. (1999). Age and religiosity: Evidence from a three-wave panel analysis. Journal for the Scientific Study of Religion, 38(3), 423–435.CrossRefGoogle Scholar
  2. Bono, G., & McCullough, M. E. (2004). Religion, forgiveness, and adjustment in older adulthood. In K. W. Schaie, N. Krause, & A. Booth (Eds.), Religious influences on health and well-being in the elderly (pp. 163–186). New York: Springer.Google Scholar
  3. Chang, M.-C., & Hermalin, A. I. (1989). 1989 Survey of health and living status of the elderly in Taiwan: Questionnaire and survey design. In Comparative study of the elderly in four Asian countries, Research Report No. 1. Ann Arbor, MI: The University of Michigan.Google Scholar
  4. Chida, Y., Steptoe, A., & Powell, L. H. (2009). Religiosity/spirituality and mortality. Psychotherapy and Psychosomatics, 78(2), 81–90.CrossRefGoogle Scholar
  5. Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564–570.CrossRefGoogle Scholar
  6. Ellison, C. G., & Levin, J. S. (1998). The relgion-health connection: Evidence, theory, and future directions. Health Education and Behaviors, 25(6), 700–720.CrossRefGoogle Scholar
  7. George, L. K., Ellison, C. G., & Larson, D. B. (2002). Explaining the relationships between religious involvement and health. Psychological Inquiry, 13(3), 190–200.CrossRefGoogle Scholar
  8. Hermalin, A. I. (2002). The well-being of the elderly in Asia: A four-country comparative study. Ann Arbor: The University of Michigan Press.CrossRefGoogle Scholar
  9. Hidajat, M., Zimmer, Z., Saito, Y., & Lin, H.-S. (2013). Religious activity, life expectancy, and disability-free life expectancy in Taiwan. European Journal of Ageing, 10(3), 1–8. Scholar
  10. Hill, T. D., Angel, J. L., Ellison, C. G., & Angel, R. J. (2005). Religious attendance and mortality: An 8-year follow-up of older Mexican Americans. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60(2), 102–109.CrossRefGoogle Scholar
  11. Hill, T. D., Ellison, C. G., Burdette, A. M., & Musick, M. A. (2007). Religious involvement and healthy lifestyles: Evidence from the survey of Texas adults. Annals of Behavioral Medicine, 34(2), 217–222.CrossRefGoogle Scholar
  12. Hummer, R. A. (2005). Commentary: Understanding religious involvement and mortality risk in the United States: Comment on Bagiella, Hong, and Sloan. International Journal of Epidemiology, 34(2), 452–453.CrossRefGoogle Scholar
  13. Hummer, R. A., Benjamins, M. R., Ellison, C. G., & Rogers, R. G. (2010). Religious involvement and mortality risk among pre-retirement aged US adults. In C. G. Ellison & R. A. Hummer (Eds.), Religion, families, and health: Population-based research in the United States (pp. 273–291). New Brunswick, NJ: Rutgers University Press.Google Scholar
  14. Hummer, R. A., Rogers, R. G., Nam, C. B., & Ellison, C. G. (1999). Religious involvement and US adult mortality. Demography, 36(2), 273–285.CrossRefGoogle Scholar
  15. Idler, E. L., Musick, M. A., Ellison, C. G., George, L. K., Krause, N., Ory, M. G., et al. (2003). Measuring multiple dimensions of religion and spirituality for health research: Conceptual background and findings from the 1998 General Social Survey. Research on Aging, 25(4), 327–365.CrossRefGoogle Scholar
  16. Iwasaki, M., Otani, T., Sunaga, R., Miyazaki, H., Xiao, L., Wang, N., et al. (2002). Social networks and mortality based on the Komo-Ise cohort study in Japan. International Journal of Epidemiology, 31(6), 1208.CrossRefGoogle Scholar
  17. Kinsella, K., & Phillips, D. R. (2005). Global aging: The challenge of success. Population Bulletin, 60(1), 1–40.Google Scholar
  18. Koch, C. (2013). The brain of Buddha. Scientific American Mind, 24(3), 28–31.CrossRefGoogle Scholar
  19. Koenig, H. G. (2001). Religion, spirituality, and medicine: How are they related and what does it mean? Mayo Clinic Proceedings, 76(12), 1189–1191.CrossRefGoogle Scholar
  20. Koenig, H. G. (2013). Is religion good for your health? The effects of religion on physical and mental health. New York: Routledge.Google Scholar
  21. Krause, N. (2002). Church-based social support and health in old age exploring variations by Race. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(6), S332–S347.CrossRefGoogle Scholar
  22. Krause, N., & Booth, A. (2004). Religious influences on health and well-being in the elderly. New York: Springer.Google Scholar
  23. Krause, N., & Hayward, D. R. (2014). Hostility, religious involvement, gratitude and self-rated health in late life. Research on Aging, 36(6), 731–752.CrossRefGoogle Scholar
  24. Lawler-Row, K. A., & Elliott, J. (2009). The role of religious activity and spirituality in the health and well-being of older adults. Journal of Health Psychology, 14(1), 43.CrossRefGoogle Scholar
  25. Ledesma, D., & Kumano, H. (2009). Mindfulness-based stress reduction and cancer: A meta-analysis. Psycho-Oncology, 18(6), 571–579.CrossRefGoogle Scholar
  26. Levin, J. S., & Chatters, L. M. (2008). Religion, aging, and health: Historical perspectives, current trends, and future directions: Public health. Journal of Religion, Spirituality & Aging, 20(1–2), 153–172.CrossRefGoogle Scholar
  27. Levin, J. S., Taylor, R. J., & Chatters, L. M. (1994). Race and gender differences in religiosity among older adults: Findings from four national surveys. Journal of Gerontology, 49(3), S137–S145.CrossRefGoogle Scholar
  28. Liu, E. Y., Schieman, S., & Jang, S. J. (2011). Religiousness, spirituality, and psychological distress in Taiwan. Review of Religious Research, 53(2), 137–159.CrossRefGoogle Scholar
  29. Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Sciences, 12(4), 163–169.CrossRefGoogle Scholar
  30. Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099–1104.CrossRefGoogle Scholar
  31. Mineau, G., Smith, K. R., & Bean, L. (2004). Adult mortality risks and religious affiliation. Paper presented at the Annales de démographie historique.Google Scholar
  32. Moreira-Almeida, A. (2013). Religion and health: The more we know the more we need to know. World Psychiatry, 12(1), 37–38.CrossRefGoogle Scholar
  33. Neugarten, B. L., Havighurst, R. J., & Tobin, S. S. (1961). The measurement of life satisfaction. Journal of Gerontology, 16, 134–143.CrossRefGoogle Scholar
  34. Nicholson, A., Rose, R., & Bobak, M. (2010). Associations between different dimensions of religious involvement and self-rated health in diverse European populations. Health Psychology, 29(2), 227–235.CrossRefGoogle Scholar
  35. Penninx, B. W., Van Tilburg, T., Kriegsman, D. M., Deeg, D. J., Boeke, A. J. P., & van Eijk, J. T. M. (1997). Effects of social support and personal coping resources on mortality in older age: The Longitudinal Aging Study Amsterdam. American Journal of Epidemiology, 146(6), 510–519.CrossRefGoogle Scholar
  36. Phillips, R. L. (1975). Role of life-style and dietary habits in risk of cancer among seventh-day adventists. Cancer Research, 35(11), 3513–3522.PubMedGoogle Scholar
  37. Pirutinsky, S., Rosmarin, D. H., Holt, C. L., Feldman, R. H., Caplan, L. S., Midlarsky, E., et al. (2011). Does social support mediate the moderating effect of intrinsic religiosity on the relationship between physical health and depressive symptoms among Jews? Journal of Behavioral Medicine, 34(6), 489–496.CrossRefGoogle Scholar
  38. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.CrossRefGoogle Scholar
  39. Seybold, K. S., & Hill, P. C. (2001). The role of religion and spirituality in mental and physical health. Current Directions in Psychological Science, 10(1), 21–24.CrossRefGoogle Scholar
  40. Strawbridge, W. J., Shema, S. J., Cohen, R. D., & Kaplan, G. A. (2001). Religious attendance increases survival by improving and maintaining good health behaviors, mental health, and social relationships. Annals of Behavioral Medicine, 23(1), 68–74.CrossRefGoogle Scholar
  41. UNFPA, & HelpAge International. (2012). Ageing in the twenty-first century: A celebration and a challenge. New York: United Nations Population Fund and Help Age International.Google Scholar
  42. United Nations. (2016). World population prospects: The 2016 revision. New York: United Nations.CrossRefGoogle Scholar
  43. Yeager, D. M., Glei, D. A., Au, M., Lin, H.-S., Sloan, R. P., & Weinstein, M. (2006). Religious involvement and health outcomes among older persons in Taiwan. Social Science and Medicine, 63(8), 2228–2241.CrossRefGoogle Scholar
  44. Zhang, W. (2008). Religious participation and mortality risk among the oldest old in China. Journal of Gerontology: Social Sciences, 63(5), 293–297.CrossRefGoogle Scholar
  45. Zimmer, Z., Jagger, C., Chiu, C.-T., Ofstedal, M. B., Rojo, F., & Saito, Y. (2016). Spirituality, religiosity, aging and health in global perspective: A review. SSM-Population Health, 2(December), 373–381.CrossRefGoogle Scholar
  46. Zimmer, Z., Martin, L. G., & Lin, H.-S. (2005). Determinants of old-age mortality in Taiwan. Social Science and Medicine, 60(2), 457–470.CrossRefGoogle Scholar
  47. Zimmer, Z., Rojo, F., Ofstedal, M. B., Chiu, C. T., Saito, Y., & Jagger, C. (2019). Religiosity and health: A global comparative study. Social Science & Medicine: Population Health, 7(April), 1–9.Google Scholar
  48. Zuckerman, D. M., Kasl, S. V., & Ostfeld, A. M. (1984). Psychosocial predictors of mortality among the elderly poor. American Journal of Epidemiology, 119(3), 410–423.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Zachary Zimmer
    • 1
    Email author
  • Chi-Tsun Chiu
    • 2
  • Yasuhiko Saito
    • 3
  • Yu-Hsuan Lin
    • 4
  • Mary Beth Ofstedal
    • 5
  • Carol Jagger
    • 6
  1. 1.Department of Family Studies and Gerontology, Global Ageing and Community InitiativeMount Saint Vincent UniversityHalifaxCanada
  2. 2.Institute of European and American StudiesAcademia SinicaTaipeiTaiwan
  3. 3.Population Research InstituteNihon UniversityTokyoJapan
  4. 4.Surveillance and Research DivisionTaiwan Ministry of Health and WelfareTaichungTaiwan
  5. 5.Institute of Social ResearchUniversity of MichiganAnn ArborUSA
  6. 6.Institute for AgeingNewcastle UniversityNewcastleUK

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