Frequency of Attendance at Religious Services and Mortality in a U.S. National Cohort
Open accessAbstract
Objective Few nationally representative cohort studies have appeared on frequency of attendance at religious services and mortality. We test the hypothesis that > weekly attendance compared with nonattendance at religious services is associated with lower probability of future mortality in such a study.Methods Data were analyzed from a longitudinal follow-up study of 8450 American men and women age 40 years and older who were examined from 1988 to 1994 and followed an average of 8.5 years. Measurements at baseline included self-reported frequency of attendance at religious services, sociodemographics, and health, physical and biochemical measurements.Results Death during follow-up occurred in 2058. After adjusting for confounding by baseline sociodemographics and health status, the hazards ratios (95% confidence limits) were never 1.00 (reference); < weekly 0.89 (0.75-1.04), p = 0.15; weekly 0.82 (0.71-0.94) p = 0.005; and > weekly attenders 0.70 (0.59-0.83), p < 0.001. Mediators, including health behaviors and inflammation, explained part of the association.Conclusions In a nationwide cohort of Americans, predominantly Christians, analyses demonstrated a lower risk of death independent of confounders among those reporting religious attendance at least weekly compared to never. The association was substantially mediated by health behaviors and other risk factors.
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Of the 83 methodologically most rigorous smoking studies, 75 (90%) reported inverse relationships with R/S involvement.
“Of the 83 methodologically most rigorous studies, 75 (90%) reported inverse relationships with R/S involvement [213, 285–294].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [293]
Of the 37 methodologically most rigorous studies, 21 (57%) reported significant positive relationships between R/S and SRH.
“Of the 37 methodologically most rigorous studies, 21 (57%) reported significant positive relationships between R/S and SRH [503, 508–527], whereas three (8%) found the opposite [528–530].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [512]
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“While many studies of religious participation have sought to statistically control for respondents’ levels of nonreligious participation (e.g., Gillum et al. 2008; Musick, House, and Williams 2004; Strawbridge, Cohen, and Shema 2000; Strawbridge et al. 1997), jointly controlling for both types of…”
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Religious and Spiritual Beliefs in Stroke Rehabilitation
Giaquinto, S., Sarno, S., Dall’Armi, V., & Spiridigliozzi, C. (2010) · Clinical and Experimental Hypertension · doi:10.3109/10641960903443566 · Cited by 58 · see citing works
“[4] Gillum RF, King DE, Obisesan TO, Koenig HG.”
BackgroundMakridis, C. A., Johnson, B. R., & Koenig, H. G. (2020) · Journal for the Scientific Study of Religion · doi:10.1111/jssr.12700 · Cited by 57 · see citing works
Self-citationReligious Attendance and Biological Functioning
Hill, T. D., Rote, S. M., Ellison, C. G., & Burdette, A. M. (2014) · Journal of Aging and Health · doi:10.1177/0898264314529333 · Cited by 58 · see citing works
“…function, namely, blood pressure (Koenig et al., 1998; Krause et al., 2002; Maselko et al., 2007), and immune function, including CRP (Gillum et al., 2008; King et al., 2001; King et al., 2002), interleukin-6 (Koenig et al., 1997; Lutgendorf et al., 2004), and white blood cells (King…”
BackgroundMethodInfluentialHatala, A. R. (2013) · Journal of Spirituality in Mental Health · doi:10.1080/19349637.2013.776448 · Cited by 58 · see citing works
“…Idler et al., 2009); social integration and support (Idler, 2010; Krause, 2006; Oman & Thoresen, 2003); health behaviors (Enstrom & Breslow, 2008; Gillum et al., 2008; Strawbridge, Shema, Cohen, & Kaplan, 2001); a deeper meaning and purpose within illness experiences (Chen & Koening, 2006; Kaye…”
InfluentialReligious Participation and Mortality Risk in Mexico
Hill, T. D., Saenz, J. L., & Rote, S. M. (2018) · The Journals of Gerontology Series B · doi:10.1093/geronb/gby152 · Cited by 53 · see citing works
Religious Involvement, Health Status, and Mortality Risk
Hill, T. D., Burdette, A. M., & Idler, E. L. (2011) · Handbooks of sociology and social research · doi:10.1007/978-1-4419-7374-0_33 · Cited by 54 · see citing works
Hybels, C. F., George, L. K., Blazer, D. G., Pieper, C. F., Cohen, H. J., & Koenig, H. G. (2014) · Journal of Aging and Health · doi:10.1177/0898264314527479 · Cited by 50 · see citing works
“Inflammation, for example, has been shown to be a partial mediator in the 682 Journal of Aging and Health 26(4) longitudinal relationship between frequency of attendance at religious services and mortality in a nationally representative cohort of adults aged 40 years and older (Gillum et al., 2008).”
BackgroundSelf-citationThe Impact of Spirituality on Health
Tabei, S. Z., Zarei, N., & Joulaei, H. (2016) · Shiraz E-Medical Journal · doi:10.17795/semj39053 · Cited by 51 · see citing works
Religiosity and telomere length: One step forward, one step back
VanderWeele, T. J., & Shields, A. E. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.06.038 · Cited by 47 · see citing works
Church Attendance and Mobility Limitation Among Black and White Men With Prostate Cancer
Bruce, M. A., Bowie, J. V., Beech, B. M., Norris, K. C., LaVeist, T. A., Howard, D. L., & Thorpe, R. J. (2021) · American Journal of Men s Health · doi:10.1177/1557988321993560 · Cited by 47 · see citing works
“Participation in organized religious services have been linked to hope, resilience, stress mitigation, and enhanced longevity (Bruce et al., 2017, 2020; Bruce & Thorpe, 2019; Chen et al, 2020; Gillum et al., 2008; Kim & VanderWeele, 2019; Koenig et al., 2012; Krause, 1997; Li et al., 2016).”
BackgroundInfluentialThe Complex Association Between Religious Activities and Functional Limitations in Older Adults
Hybels, C. F., Blazer, D. G., George, L. K., & Koenig, H. G. (2012) · The Gerontologist · doi:10.1093/geront/gnr156 · Cited by 49 · see citing works
Self-citationThe Etiology of Stability and Change in Religious Values and Religious Attendance
Button, T. M. M., Stallings, M. C., Rhee, S. H., Corley, R. P., & Hewitt, J. K. (2010) · Behavior Genetics · doi:10.1007/s10519-010-9388-3 · Cited by 46 · see citing works
“Furthermore, religiosity or, more specifically, religious attendance, has also been shown to be associated with lower rates of premature mortality (Gillum et al. 2008; McCullough et al. 2000; Musick et al. 2004) and a positive general well-being (Maselko and Kubzansky 2006; Moreira-Almeida et al.”
Masters, K. S., & Hooker, S. A. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0030813 · Cited by 45 · see citing works
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United on Sunday: The effects of secular rituals on social bonding and affect
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“We dichotomized religious attendance in this manner because prior research suggests that most Americans in midlife and old age attend a religious service at least weekly (71).”
MethodMasters, K. S., & Knestel, A. (2011) · International Journal for the Psychology of Religion · doi:10.1080/10508619.2011.532450 · Cited by 28 · see citing works
Religious and Spiritual Biomarkers in Both Health and Disease
Kharitonov, S. A. (2012) · Religions · doi:10.3390/rel3020467 · Cited by 32 · see citing works
“The association did not differ by gender or ethnicity [39].”
BackgroundPerceptions of Longevity and Successful Aging in Very Old Adults
Cherry, K. E., Marks, L. D., Benedetto, T., Sullivan, M. C., & Barker, A. (2013) · Journal of Religion Spirituality & Aging · doi:10.1080/15528030.2013.765368 · Cited by 28 · see citing works
Religion and Adult Mortality: Group- and Individual-Level Perspectives
Idler, E. L. (2011) · International handbooks of population · doi:10.1007/978-90-481-9996-9_17 · Cited by 27 · see citing works
Borders, T. F., Curran, G. M., Mattox, R., & Booth, B. M. (2010) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2010.71.136 · Cited by 26 · see citing works
“A large body of research has shown that frequent religious-service attendance protects against mortality (Bagiella et al., 2005; Gillum et al., 2008; Musick et al., 2004; Oman and Reed, 1998; Strawbridge et al., 1997), the incidence of chronic physical health conditions, such as hypertension…”
BackgroundCheadle, A. C. D., & Schetter, C. D. (2017) · Social and Personality Psychology Compass · doi:10.1111/spc3.12299 · Cited by 26 · see citing works
Spiritual Health and Outcomes in Muslim ICU Patients: A Nationwide Cross-Sectional Study
Bashar, F. R., Vahedian‐Azimi, A., Salesi, M., Hajiesmaeili, M., Shojaei, S., Farzanegan, B., Goharani, R., Madani, S. J., Moghaddam, K. G., Hatamian, S., et al. (2018) · Journal of Religion and Health · doi:10.1007/s10943-017-0543-5 · Cited by 27 · see citing works
“In several large-scale studies, less frequent religious attendance (Hummer et al. 2004; Gillum et al. 2008) and participation (Lutgendorf et al.”
BackgroundHuman Capital and the Supply of Religion
Engelberg, J., Fisman, R. J., Hartzell, J. C., & Parsons, C. A. (2016) · The Review of Economics and Statistics · doi:10.1162/rest_a_00582 · Cited by 23 · see citing works
Religion and the Use of Complementary and Alternative Medicine (CAM) Among Cardiac Patients
Nicdao, E. G., & Ai, A. L. (2013) · Journal of Religion and Health · doi:10.1007/s10943-013-9681-6 · Cited by 23 · see citing works
Shields, A. E., & Balboni, T. A. (2020) · BMC Public Health · doi:10.1186/s12889-020-08854-8 · Cited by 21 · see citing works
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“Greater frequency of attendance at religious services has been linked to beneficial health behaviors and a lower risk of mortality (Gillum et al., 2008).”
BackgroundReligiousness, Health, and Depression in Older Adults from a Brazilian Military Setting
Lucchetti, G., Lucchetti, A. L. G., Peres, M. F. P., Moreira‐Almeida, A., & Koenig, H. G. (2012) · ISRN Psychiatry · doi:10.5402/2012/940747 · Cited by 20 · see citing works
“Nevertheless, this profile is different from US studies in which there is a Protestant majority [18].”
BackgroundSelf-citationCausal effects of religious service attendance?
VanderWeele, T. J. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1434-5 · Cited by 20 · see citing works
Health and Biological Functioning
Hill, T. D., Bradshaw, M., & Burdette, A. M. (2016) · Handbooks of sociology and social research · doi:10.1007/978-3-319-31395-5_2 · Cited by 18 · see citing works
“…Hill et al. 2014 ; Koenig et al. 1998 ; Krause et al. 2002 ; Maselko et al. 2007 ), c-reactive protein (Das and Nairn 2016 ; Ferraro and Kim 2014 ; Gillum et al. 2008 ; Hill et al. 2014 ; King et al. 2001 , 2002 ), interleukin-6 (Koenig et al. 1997 ; Lutgendorf et al. 2004 ), white blood cells…”
BackgroundResultInfluentialAttachment and Spiritual Coping: Theory and Practice With Older Adults
Pickard, J. G., & Nelson-Becker, H. B. (2011) · Journal of Spirituality in Mental Health · doi:10.1080/19349637.2011.565239 · Cited by 17 · see citing works
Religious service attendance and mortality among older Black men
Bruce, M. A., Beech, B. M., Kermah, D., Bailey, S., Phillips, N., Jones, H. P., Bowie, J. V., Heitman, E., Norris, K. C., Whitfield, K. E., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0273806 · Cited by 16 · see citing works
“The responses ranging from 0 to 1095 times a year were divided by 12 and classified into three categories, never attended, attended three or fewer times per month, and attended one or more times per week [27,28].”
BackgroundReligious activity, life expectancy, and disability-free life expectancy in Taiwan
Hidajat, M. M., Zimmer, Z., Saito, Y., & Lin, H.-S. (2013) · European Journal of Ageing · doi:10.1007/s10433-013-0273-9 · Cited by 16 · see citing works
Health Promoting Habits of People Who Pray for Their Health
Harrigan, J. T. (2009) · Journal of Religion and Health · doi:10.1007/s10943-009-9293-3 · Cited by 16 · see citing works
Patient perception of disease control and psychological distress
Mazzotti, E., Sebastiani, C., & Marchetti (2012) · Cancer Management and Research · doi:10.2147/cmar.s35060 · Cited by 16 · see citing works
Jaoude, J. A., Obeïd, S., Malaeb, D. N., Sakr, F., Dabbous, M., Khatib, S. E., Hallit, S. R., Fekih‐Romdhane, F., & Hallit, R. R. (2024) · BMC Psychology · doi:10.1186/s40359-024-01942-z · Cited by 17 · see citing works
“Because religiosity is commonly used as an indicator of population health, involving mental health [17]* has a significant and crucial influence on the way individuals perceive and understand death [11].”
BackgroundCancer family caregiver depression: are religion‐related variables important?
Williams, A.-L., Dixon, J. K., Feinn, R., & McCorkle, R. C. (2014) · Psycho-Oncology · doi:10.1002/pon.3647 · Cited by 15 · see citing works
Importancia de los aspectos espirituales y religiosos en la atención de pacientes quirúrgicos
CANTEROS, M. A. F. (2016) · Revista de Cirugía · doi:10.1016/j.rchic.2016.03.011 · Cited by 15 · see citing works
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Religious and Spiritual Issues in DSM-5: Matters of the Mind and Searching of the Soul
Chandler, E. N. (2012) · Issues in Mental Health Nursing · doi:10.3109/01612840.2012.704130 · Cited by 14 · see citing works
Fluidity of Faith: Predictors of Religion in a Longitudinal Sample of Chinese Adults
Francis‐Tan, A., & Tian, F. F. (2021) · Journal for the Scientific Study of Religion · doi:10.1111/jssr.12764 · Cited by 13 · see citing works
Ai, A. L., & Carretta, H. J. (2020) · International Journal of Behavioral Medicine · doi:10.1007/s12529-020-09915-3 · Cited by 13 · see citing works
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Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0001 · Cited by 11 · see citing works
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Religion Benefiting Brain Tumour Patients: A Qualitative Study
Ravishankar, N., & Bernstein, M. (2014) · Journal of Religion and Health · doi:10.1007/s10943-014-9895-2 · Cited by 10 · see citing works
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“A study among 85,000 low-income Americans demonstrated an association between weekly religious attendance, an 8% reduction in all-cause mortality, and a 15% reduction in cancer death compared to those who never attended services.(22) Increased spirituality was also associated with improved mortality and decreased hosp…”
BackgroundToward a translational epidemiology of religion: Challenges and applications
Levin, J. (2022) · Annals of Epidemiology · doi:10.1016/j.annepidem.2022.08.053 · Cited by 10 · see citing works
Does religious involvement affect mortality in low-income Americans? A prospective cohort study
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Cigarette Smoking and Correlates Among Ultra-Orthodox Jewish Males
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“…a large body of literature has shown promising associations between frequent religious participation and better cardiovascular health as well as decreased Extended author information available on the last page of the article mortality risk among African American adults [26, 27, 28, 29, 30, 31, 32].”
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Physical health in a Canadian Old Order Mennonite community
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Religion and survival among European older adults
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“…attendance and mortality in predominately (or exclusively) Christian samples (Ahrenfeldt et al. 2023; Bagiella et al. 2005; Bruce et al. 2022; Gillum et al. 2008; Hill et al. 2005; Hummer et al. 1999; Idler et al. 2017; Kim et al. 2015; La Cour et al. 2006; Li et al. 2016; Musick et al.…”
BackgroundAssociation between Religion and Health in China: Using Propensity Score Matching Method
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“In western countries, the religions are congregational and the effects of church attendance on health may be mediated in part by a healthy lifestyle, social cohesion or mitigating stress (Koenig 2012; Bruce et al. 2017; Gillum et al. 2008; Holt et al. 2017).”
BackgroundLindström, M., & Pirouzifard, M. (2023) · SSM - Population Health · doi:10.1016/j.ssmph.2023.101492 · Cited by 5 · see citing works
“Previous international studies have investigated associations between religious service attendance/religious involvement and mortality finding significant associations between religious service attendance and/or religious involvement and lower all-cause mortality (Chida et al., 2009; Gillum et al., 2008; Hummer et al.…”
Background(Un)holy Smokes? Religion and Traditional and E-Cigarette Use in the United States
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Driving Status and Religious Service Attendance among Older Americans
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- Authors
- Gillum, R. F., King, D. E., Obisesan, T. O., & Koenig, H. G.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Medical University of South Carolina (US)
- Howard University (US)
- Duke University (US)
- Corresponding author
- Gillum, R.F.
- Venue
- Annals of Epidemiology
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 18
- Issue
- 2
- Pages
- 124-129
- ISSN
- 1047-2797 (ISSN-L)
- PMC
- PMC2659561
- OpenAlex
- W2093838162
- Cited by
- 176
- References
- 50
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 46 · 2022: 5 · 2021: 10 · 2020: 10 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 9 · 2015: 4 · 2014: 9 · 2013: 12 · 2012: 9
- FWCI
- 10.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (AG00980, K23AG000980)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Sociology and Political Science › Religion and Society Interactions
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- religious service attendance, mortality, religiosity, health behavior, inflammation, mediation, older adults
- MeSH terms
- Adult, Female, Humans, Longitudinal Studies, Male, Middle Aged, Mortality, Religion, United States, Cohort Studies, Spirituality
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