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Religious Involvement and Mortality Risk among PreRetirement Aged U.S. Adults Robert A. Hummer Popul

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Title: Religious Involvement and Mortality Risk among PreRetirement Aged U.S. Adults Robert A. Hummer Popul


1
Religious Involvement and MortalityRisk among
Pre-Retirement Aged U.S. AdultsRobert A.
HummerPopulation Research Center andDepartment
of Sociology,University of Texas at Austin
Presentation prepared for Heritage Foundation
Conference on Religion and Health, December 3,
2008
2
Acknowledgements and Citation
  • Co-Authors Maureen R. Benjamins, Christopher G.
    Ellison, Richard G. Rogers
  • This paper will appear as Chapter 14 in the
    upcoming volume entitled Religion, Families, and
    Health Population-Based Research in the United
    States, edited by C.E. Ellison and R.A. Hummer.
    Rutgers University Press, 2009.

3
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5
PREVIOUS LITERATURE, I
  • Handbook of Religion and Health (Koenig et al.,
    2001, Oxford University Press) provides
    comprehensive summary and assessment of the
    literature.
  • 1200 studies over the 20th century 400 of which
    are theoretical/review
  • Many of the studies are cross-sectional, have
    poor religion measures, and lack appropriate
    controls others, methodologically very weak
  • Many are at the ecological level (e.g., county)
    level
  • Many are of limited geographic areas, specific
    denominational groups
  • To date, only 3 studies focusing on religious
    involvement and mortality risk among individuals
    at the national level in the United States
  • Few national-level data sets that will allow such
    investigation!

6
Previous Literature, II
  • Hummer et al. (1999) in Demography
  • Graded association between religious
    attendance and adult mortality risk in U.S.
  • No statistically significant differences in
    the association across demographic groups
  • NHIS data from 1987, mortality links through
    1995
  • Ages 18-99 at baseline

7
Previous Literature, III
  • Ellison et al. (2000) in Research on Aging
  • Among African Americans, strong and pervasive
    risk of non-attendance on mortality among
    different demographic subgroups
  • Associations stronger and graded among younger
    (lt55 at baseline) adults association somewhat
    weaker and only only non-attenders among older
    (55 at baseline) adults
  • Also used NHIS data from 1987 linked to mortality
    risk through 1995
  • Ages 18-99 at baseline

8
Previous Literature, IV
  • Musick et al. (2004), Journal of Health and
    Social Behavior
  • Strong association between non-attendance and
    adult mortality riskbut not graded (no
    differences between infrequent and frequent
    attenders). Other religion measures not related
    to mortality risk.
  • Much stronger relationship between attendance
    and mortality risk among younger (lt60 at
    baseline) adults than among older (60 at
    baseline) adults.
  • Americans Changing Lives dataset from 1986
    mortality links through 1994
  • Ages 25 and above

9
GUIDING RESEARCH QUESTIONS
  • What is the relationship between religious
    involvement and adult mortality risk among a
    specific birth cohort (1931-1941, ages 51-61 at
    baseline) of individuals in the United States?
  • Is this relationship influenced by controls for
    demographic, health, socioeconomic, and
    behavioral factors?
  • Does the religion-mortality relationship among
    this cohort vary by sex, race/ethnicity,
    education level, and marital status?

10
Why Focus on This Age Range?
  • Previous evidence suggests that the
    religion-mortality relationship may be quite
    strong among younger adults (at least in a
    relative sense)
  • Much literature in this area focuses on the
    elderly
  • Deaths in this age range are clearly premature in
    the context of current U.S. life expectancy

11
CONCEPTUAL FRAMEWORK
Stress
Health Factors
Demographic Factors
Survival Or Die (Probability)
Social Support/Integration
Religious Involvement
Health Behavior
Socioeconomic Factors
Psychological Factors
Health Care
12
DATA
  • Large, nationally-representative health surveys
    of U.S. adults
  • Health and Retirement Study original cohort
    (1992), individuals born 1931-1941 (ages 51-61 at
    baseline)
  • N 9,423, with 834 identified as dying during
    follow-up
  • Data includes information on religious
    involvement and important correlates
  • Statistically linked to death information from
    the National Death Index (NDI) and through
    follow-up interviews with spouses or other family
    member contacts
  • HRS individuals statistically followed for
    mortality risk for 8 years

13
Key Variables, I
  • Religious Attendance
  • Frequent (usually once per week or more 35.3
    of sample) 6.0 died during follow-up
  • Infrequent (usually less than once per week
    36.7 of sample) 7.7 died during follow-up
  • Never (very infrequent or never 28.1 of
    sample) 11.1 died during follow-up

14
Key Variables, II
  • Demographic Controls Age, Gender,
    Race/Ethnicity, Region, Religious Denomination
  • Socioeconomic Controls Education, Marital Status
  • Health Controls Self-Rated Health, Activity
    Limitations
  • Behavioral Factors Smoking, Drinking, Exercise

15
HAZARD RATIOS ESTIMATING THE RELATIONSHIP BETWEEN
RELIGIOUS VARIABLES AND SUBSEQUENT MORTALITY
RISK, U.S. ADULTS, AGE 51-61, 1992
16
Supplementary Analysis, NHIS-LMF (Rogers,
Krueger, Hummer Chapter 15 in forthcoming RUP
Volume)
  • NHIS Cancer Risk Factor Supplement from 1987,
    with mortality follow-up through end of 2002
  • Ages 45-64 at baseline
  • N 4,906 individuals, 1,041 of whom were
    identified as dying during follow-up
  • Follow-up exclusively through linkages to the
    National Death Index

17
Hazard Ratios of Mortality, NHIS-LMF (Ages 45-64
at Baseline)
  • Model 1 Model 2 Model 3
  • Attendance (gt1 week)
  • Never 1.73 1.43 1.35
  • Less than once/week 1.27
    1.29 1.21
  • Once per week 0.97 1.02 1.00
  • Controls Demog Demog, Demog,
  • SES, Soc, SES, Soc,
  • Behavior Behavior,
  • Health

18
Conclusions
  • Strong association between religious attendance
    and mortality risk among middle-aged U.S. adults
  • Non-attenders particularly stand out (31-34
    higher mortality risk than frequent attenders, in
    most completely specified models) upwards of 60
    higher risk in less completely specified models
  • Moderate-to-modestly higher mortality (depending
    on model specification) among less frequent
    attenders, compared with frequent attenders
  • No national-level evidence that the
    attendance-mortality relationship varies by
    gender, race/ethnicity, educational level, or
    marital status among this age range of
    individuals in the 1931-1941 birth cohort

19
CONTINUED CRITIQUES AND NEED FOR RESEARCH
  • Literature has relied very heavily on
    self-reported public attendance as a measure of
    religious involvement. Substantial data needs
  • Religious life histories
  • Cross-national evidence
  • Second, some have criticized the quality of
    empirical work in the religion-health and
    religion-mortality areas, focusing on
  • The lack of appropriate controls for confounders
    (selection into religious attendance/involvement
    still a very important concern)
  • Perception of inconsistent findings
  • Third, even greater attention to population
    subgroups needed
  • By race/ethnicity, socioeconomic status, birth
    cohort, etc
  • Fourth, better measurement of mediators needed
  • Fifth, more attention to cause of death warranted
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