Recent research suggests that epidemiological forces in religion and health can have opposed effects. Using longitudinal data of people aged 50+ included in wave 1 (2004–2005) of the Survey of Health, Ageing and Retirement in Europe (SHARE), and followed up through waves 2 (2006–2007), 4 (2011) and 5 (2013), we examined two forms of religious internalization and their association with health. Multivariate logistic regressions were used to examine all associations. Taking part in a religious organization was associated with lower odds of GALI (global activity limitation index) (OR = 0.86, 95% CI 0.75, 0.98) and depressive symptoms 0.80 (95% CI 0.69, 0.93), whereas being religiously educated lowered odds of poor self-rated health (SRH) 0.81 (95% CI 0.70, 0.93) and long-term health problems 0.84 (95% CI 0.74, 0.95). The more religious had lower odds of limitations with activities of daily living 0.76 (95% CI 0.58, 0.99) and depressive symptoms 0.77 (95% CI 0.64, 0.92) than other respondents, and compared to people who only prayed and did not have organizational involvement, they had lower odds of poor SRH 0.71 (95% CI 0.52, 0.97) and depressive symptoms 0.66 (95% CI 0.50, 0.87). Conversely, people who only prayed had higher odds of depressive symptoms than non-religious people 1.46 (95% CI 1.15, 1.86). Our findings suggest two types of religiousness: 1. Restful religiousness (praying, taking part in a religious organization and being religiously educated), which is associated with good health, and 2. Crisis religiousness (praying without other religious activities), which is associated with poor health.
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Koenig HG. Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry. 2012;2012:278730. doi:10.5402/2012/278730.
Koenig HG, King DE, Carson VB. Handbook of Religion and Health. Oxford: Oxford University Press; 2012.
Chida Y, Steptoe A, Powell LH. Religiosity/spirituality and mortality. A systematic quantitative review. Psychother Psychosom. 2009;78(2):81–90. doi:10.1159/000190791.
McCullough ME, Hoyt WT, Larson DB, Koenig HG, Thoresen C. Religious involvement and mortality: a meta-analytic review. Health Psychol. 2000;19(3):211–22.
O. Harrison M, Koenig HG, Hays JC, Eme-Akwari AG, Pargament KI. The epidemiology of religious coping: a review of recent literature. Int Rev Psychiatry. 2001;13(2):86–93. doi:10.1080/09540260124356.
Pargament KI, Ensing DS, Falgout K, Olsen H, Reilly B, Van Haitsma K, et al. God help me:(I): religious coping efforts as predictors of the outcomes to significant negative life events. Am J Commun Psychol. 1990;18(6):793–824.
Pargament KI, Olsen H, Reilly B, Falgout K, Ensing DS, Van Haitsma K. God help me (II): the relationship of religious orientations to religious coping with negative life events. J Sci Study Relig. 1992;31(4):504–13.
AbdAleati NS, Mohd Zaharim N, Mydin YO. Religiousness and Mental Health: Systematic Review Study. J Relig Health. 2016;55(6):1929–37. doi:10.1007/s10943-014-9896-1.
Arnes SM, Kleiven M, Olstad R, Fonnebo V. Religious affiliation and mental health–is there a connection? health survey in Finnmark 1990. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke. 1996;116(30):3598–601.
Whitfield W. Religion and mental health. Int J Psychiatr Nurs Res. 1999;5(2):553.
Swinton J, Pattison S. Spirituality. Come all ye faithful. Health Serv J. 2001;111(5786):24–5.
Thygesen LC, Dalton SO, Johansen C, Ross L, Kessing LV, Hvidt NC. Psychiatric disease incidence among Danish seventh-day adventists and Baptists. Soc Psychiatry Psychiatr Epidemiol. 2013;48(10):1583–90. doi:10.1007/s00127-013-0669-z.
Pargament KI. The Psychology of Religion and Coping: Theory, Research, Practice. New York: The Guildford Press; 1997.
Pargament KI, Kennell J, Hathaway W, Grevengoed N, Newman J, Jones W. Religion and the problem-solving process: three styles of coping. J Sci Study Relig. 1988;27(1):90.
Pargament KI, Smith BW, Koenig HG, Perez L. Patterns of positive and negative religious coping with major life stressors. J Sci Study Relig. 1998;37(4):710–24. doi:10.2307/1388152.
Hvidt NC, Hvidtjorn D, Christensen K, Nielsen JB, Sondergaard J. Faith moves mountains-mountains move faith: two opposite epidemiological forces in research on religion and health. J Relig Health. 2016;. doi:10.1007/s10943-016-0300-1.
Ryan RM, Rigby S, King K. Two types of religious internalization and their relations to religious orientations and mental health. J Pers Soc Psychol. 1993;65(3):586.
Ferraro KF, Kelley-Moore JA. Religious consolation among men and women: do healthproblems spur seeking? J Sci Study Relig. 2000;39(2):220–34. doi:10.1111/0021-8294.00017.
Ferraro KF, Kelley-Moore JA. Religious seeking among affiliates and non-affiliates: do mental and physical health problems spur religious coping? Rev Relig Res. 2001;42(3):229–51. doi:10.2307/3512568.
Blalock HM, editor. Causal Models in the Social Sciences. New York: Aldine Transactions; 1985.
Elsass PM, Veiga JF. Acculturation in acquired organizations: a force-field perspective. Hum Relat. 1994;47(4):431–53. doi:10.1177/001872679404700404.
George LK, Ellison CG, Larson DB. Explaining the relationships between religious involvement and health. Psychol Inq. 2002;13(3):190–200.
Wink P, Ciciolla L, Dillon M, Tracy A. Religiousness, spiritual seeking, and personality: findings from a longitudinal study. J Pers. 2007;75(5):1051–70. doi:10.1111/j.1467-6494.2007.00466.x.
Pargament KI. The bitter and the sweet: an evaluation of the costs and benefits of religiousness. Psychol Inq. 2002;13(3):168–81.
Borsch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, et al. Data resource profile: the survey of health, ageing and retirement in Europe (SHARE). Int J Epidemiol. 2013;42(4):992–1001. doi:10.1093/ije/dyt088.
UNESCO. International standard classification of education—ISCED 1997, Re-edition (2006). http://www.uis.unesco.org.
Jagger C, Gillies C, Cambois E, Van Oyen H, Nusselder W, Robine JM. The global activity limitation index measured function and disability similarly across European countries. J Clin Epidemiol. 2010;63(8):892–9. doi:10.1016/j.jclinepi.2009.11.002.
Castro-Costa E, Dewey M, Stewart R, Banerjee S, Huppert F, Mendonca-Lima C, et al. Ascertaining late-life depressive symptoms in Europe: an evaluation of the survey version of the EURO-D scale in 10 nations. The SHARE project. Int J Method Psychiatr Res. 2008;17(1):12–29. doi:10.1002/mpr.236.
Croezen S, Avendano M, Burdorf A, van Lenthe FJ. Social participation and depression in old age: a fixed-effects analysis in 10 European countries. Am J Epidemiol. 2015;182(2):168–76. doi:10.1093/aje/kwv015.
Nicholson A, Rose R, Bobak M. Association between attendance at religious services and self-reported health in 22 European countries. Soc Sci Med. (1982). 2009;69(4):519–28. doi:10.1016/j.socscimed.2009.06.024.
Park NS, Klemmack DL, Roff LL, Parker MW, Koenig HG, Sawyer P, et al. Religiousness and longitudinal trajectories in elders’ functional status. Res Aging. 2008;30(3):279–98. doi:10.1177/0164027507313001.
Norton MC, Singh A, Skoog I, Corcoran C, Tschanz JT, Zandi PP, et al. Church attendance and new episodes of major depression in a community study of older adults: the cache county study. J Gerontol B Psychol Sci Soc Sci. 2008;63(3):P129–37.
Di Gessa G, Grundy E. The relationship between active ageing and health using longitudinal data from Denmark, France, Italy and England. J Epidemiol Commun Health. 2014;68(3):261–7. doi:10.1136/jech-2013-202820.
Balbuena L, Baetz M, Bowen R. Religious attendance, spirituality, and major depression in Canada: a 14-year follow-up study. Can J Psychiatry Revue Can de Psychiatr. 2013;58(4):225–32. doi:10.1177/070674371305800408.
Li S, Okereke OI, Chang SC, Kawachi I, VanderWeele TJ. Religious service attendance and lower depression among women-a prospective Cohort study. Ann Behav Med. 2016;50(6):876–84. doi:10.1007/s12160-016-9813-9.
Strawbridge WJ, Shema SJ, Cohen RD, Kaplan GA. Religious attendance increases survival by improving and maintaining good health behaviors, mental health, and social relationships. Ann Behav Med. 2001;23(1):68–74. doi:10.1207/s15324796abm2301_1.
Koenig HG. Religion and remission of depression in medical inpatients with heart failure/pulmonary disease. J Nerv Ment Dis. 2007;195(5):389–95. doi:10.1097/NMD.0b013e31802f58e3.
Lucette A, Ironson G, Pargament KI, Krause N. Spirituality and religiousness are associated with fewer depressive symptoms in individuals with medical conditions. Psychosomatics. 2016;57(5):505–13. doi:10.1016/j.psym.2016.03.005.
VanderWeele TJ, Jackson JW, Li S. Causal inference and longitudinal data: a case study of religion and mental health. Soc Psychiatry Psychiatr Epidemiol. 2016;51(11):1457–66. doi:10.1007/s00127-016-1281-9.
Maselko J, Hayward RD, Hanlon A, Buka S, Meador K. Religious service attendance and major depression: a case of reverse causality? Am J Epidemiol. 2012;175(6):576–83. doi:10.1093/aje/kwr349.
Vanderweele TJ. Re: “Religious service attendance and major depression: a case of reverse causality?”. Am J Epidemiol. 2013;177(3):275–6. doi:10.1093/aje/kws415.
Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13:145–57. doi:10.1007/s10433-016-0367-2.
This article uses data from SHARE waves 1 (2004–2005), 2 (2006–2007), 4 (2011) and 5 (2013). The SHARE data collection has been primarily funded by the European Commission through the 5th framework programme (project QLK6-CT-2001-00360). Additional funding came from the US National Institute on Ageing (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, Y1-AG-4553-01 and OGHA 04-064). Further support from the European Commission through the 6th framework programme (projects SHARE-I3, RII-CT-2006-062193, and COMPARE, CIT5-CT-2005-028857) is gratefully acknowledged. For methodological details, see Börsch-Supan et al. (2013).
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Ahrenfeldt, L.J., Möller, S., Andersen-Ranberg, K. et al. Religiousness and health in Europe. Eur J Epidemiol 32, 921–929 (2017). https://doi.org/10.1007/s10654-017-0296-1
- Activity limitations
- Self-rated health