Religious Involvement and Mortality a Meta-analytic Review Health Psychology

ane There is a large and growing body of literature on the relationship between religious involvement and wellness outcomes. For the most function, religious involvement (due east.one thousand. church building attendance or church membership) is associated with better concrete and mental health and longer survival (George, Ellison and Larson, 2002). A meta-analysis of data from 42 studies from diverse populations constitute that religious involvement was significantly associated with lower mortality and the strength of the association was similar to that found for other psycho-social factors (McCullough et al., 2000). These studies take clarified the ways by which organized religion benefits health and divided them into four possible mechanisms: health practices, social back up, psychosocial resources and a sense of coherence or pregnant. The work of Hummer and his colleagues (Hummer et al., 1999) illustrates that social ties and behavioral factors mediate the relationship betwixt religious involvement and mortality.

2 Durkheim's seminal work on suicide (Durkheim, 1951) was among the first to advance the thesis that social support and integration are important factors affecting health status. This sociological insight has been confirmed by many investigators, including Waite and Lehrer (Waite and Lehrer, 2003) who recently reviewed the health benefits of both marriage and faith. In terms of faith, they cite a comprehensive torso of research that documents an association between religious interest and improved health status, including life expectancy. They note that religious affiliation may bear on health outcomes considering adherents to a faith have access to a network of people who may provide social resource, behavioral norms and instrumental support. Similarly, Jarvis and Northcott (Jarvis and Northcutt, 1987) indicate that people who attend church are more likely to be married, to be involved in a network of friendships, and to participate in social activities compared to those who do not attend services regularly. These attributes all work to improve the well being of individuals who have a religious attachment in relation to those lacking such an affiliation.

3 Wellness practices show the strongest associations on health outcomes when members of religions, that accept explicit prescriptions and proscriptions about health behaviors, are compared to others (George, Ellison and Larson, 2002). Studies of Seventh Day Adventists and members of the Church of Jesus Christ of Latter-twenty-four hour period Saints (LDS or Mormons), and Orthodox Jews have reported these findings. Observations from these studies show differences for the risks of cardiovascular disease, hypertension, stroke, numerous cancer sites, full general health status indicators, and overall and cause-specific mortality (Levin, 1994). For case, Enstrom (Enstrom, 1989) found agile LDS men had lower risks of cancer mortality than other Mormon men and had a life expectancy at birth that was more than six years longer than other U.South. white males. He likewise observed that couples committed to the LDS church building are more than likely to live longer.

four The exam of religion and bloodshed risks presents interesting issues because of endogamy and the fact that members of certain religions may take arisen from isolated populations. This means that, when examining the furnishings of religious affiliation on wellness, it is possible that any clan volition be a part of some shared genetic risk (e.k., Ashkenazi Jews and breast cancer) likewise equally the ecology influences affecting health due to the behavioral practices embraced by adherents to a specific religion. It is therefore important to examine the stability of a religion-wellness association over time since such as cess may reveal how socio-environmental factors direct alter bloodshed risks through time or through their interaction with underlying genetic susceptibilities.

5 The purpose of this article is to study how religious affiliation affects adult mortality risk. Our analyses focus on all-crusade mortality for adults who ally and survive to age 40 and will examine the differences betwixt active and inactive members of the LDS Church also every bit those who are not-LDS. Nosotros use an historical and longitudinal data set that allows us to follow prospectively individuals born during a seventy-twelvemonth period (1850-1919) from age 40 to their death or to the present. The vast bulk of studies investigating the association between faith and mortality have focused on contemporary U.S. populations using year-specific data that generate constructed cohort estimates of differential mortality. A strength of the analysis presented hither is our utilise of extinct (or most so) sex-specific cohorts. These cohorts span three key historical periods of time encompassing the demographic transition, thereby allowing u.s. to compare the strength of association between religion and mortality in the afar past compared to a more contemporary period.

Written report population

6 The LDS Church was established in 1830 in the land of New York. In the years immediately post-obit, its members migrated and created settlements in Ohio, Missouri, Illinois and Iowa. The Mormons entered Table salt Lake Valley in 1847; this was the commencement of an organized migration between 1846 and 1870 when over threescore,000 pioneers and adherents of the LDS Church migrated from eastern and midwestern United States, too as from Western Europe, into the U.Due south. intermountain due west (Wahlquist, 1974). Past the 1880 census there were 143,963 residents enumerated in Utah Territory and the 1900 census enumerated 276,749 residents. The country of Utah was created in 1896. Over fourth dimension the LDS proportion of the population has varied from a peak in the initial settlement flow with about 97 pct in 1870 to lower levels of effectually 56 per centum in 1890 (Allen, 1989). About 70 percent of Utah's current two.iii million residents are members of the LDS Church.

7 We hypothesize that the health and longevity of active LDS members in relation to others individuals is partly due to their adherence to what is known as the "Give-and-take of Wisdom". The Word of Wisdom contains linguistic communication prohibiting the use of tobacco, alcohol or other stimulants (Alexander, 1996, 1981). The doctrine is attributed to a divine revelation to the founder of the LDS Church—Joseph Smith—in 1833; however, "(c)urrently available bear witness indicates that adherence to the Give-and-take of Wisdom in the nineteenth century was desultory" (Alexander, 1996). Emphasis on strict adherence to the Word of Wisdom appears to engagement from the early 20^th century. Church government agreed not to "fellowship" (catechumen to membership in the church) "anyone who operated or frequented saloons." (Alexander, 1996). Strict adherence may take remained somewhat problematic. In 1921 the Church building authorities decreed that strict adherence was required to proceeds access to an LDS Temple (Alexander, 1996).

8 Merrill'southward (Merrill, 2004) recent research highlights the benefits of following these behavioral factors. He concludes that a portion of the difference in college life expectancy among LDS and non-LDS is related lower apply of tobacco and that "(t)obacco-related deaths had a larger impact on the difference in life expectancy when conditioned on older ages because of the latency period often involved with tobacco-related diseases"(p. 78). However, this factor did not explain all of the difference in life expectancy between LDS and non-LDS members, clearly indicating that other factors associated with the LDS religion contributes to their greater life expectancy. A 2nd written report that focused on suicide among immature developed males in Utah compared different levels of affiliation with the LDS Church along with U.S. males in general. Active LDS men consistently had lower suicide rates for ages 20 through 34 while less agile and nonmembers had fluctuating and higher rates than all U.S. males (Hilton, Fellingham and Lyon, 2001). Enstrom (Enstrom, 1989) showed that mortality risks are significantly lower among agile male person members of the LDS Church building who concord major religious positions for a broad range of serious disease including cancer and cardiovascular disease in relation to U.S. men in general. Collectively, these findings are consistent with the hypothesis that health practices, social integration, and social support associated with religious involvement reduce the risk of a broad spectrum of adverse health outcomes.

9 The depth of commitment to religion is crucial in addressing behavioral versus familial effects. For example, siblings born into a faith are likely to share some genetic risk of illness/mortality. Suppose one of the siblings later rejects the faith merely the other does not. As well imagine that the sibling who is less religious fares poorly in relation to sibling who remains faithful to the faith. This would suggest that behavioral aspects associated with religious adherence are of import even in the presence of a shared genetic susceptibility. For these reasons, this analysis considers level of religious commitment and its effects on mortality take chances.

10 Much of our previous mortality and longevity research has emphasized the demand to include information on religious affiliation as a way to reduce the variability in social support and behavioral factors. In a study familial excess longevity (Kerber et al., 2001), affiliation with the LDS Church was found to exist associated with better survival past the age of 65 and used every bit a covariate to reduce possible confounding in a model of inheritance. Kerber found nearly ten to 20 per centum of the variability in backlog longevity could be heritable (Kerber et al., 2001). Similarly in analyzing the human relationship between reproductive behavior and developed longevity from an evolutionary biology approach, we (Smith, Mineau and Bean, 2002) controlled for the commitment to the LDS Church and found that bearing and rearing children does affect the mortality risks of mail-reproductive mothers and fathers.

Utah Population Database

11 This bloodshed study draws upon the Utah Population Database (UPDB) for information on a range of demographic, family, and religious characteristics and their influences on the risk of bloodshed across time periods. The UPDB contains over seven million records. Information technology includes the genealogies of the founders of Utah and their Utah descendants. These records were computerized in the mid to late 1970s (Skolnick et al., 1979; Skolnick et al., 1981) and have been linked to other information sets, including birth and death certificates, cancer records, commuter license records, census records and records from the Social Security Death Alphabetize. The UPDB is the just such database in the U.s. and i of few such resource in the world.

12 These genealogical records originated as "Family unit Grouping Sheets" filled out by members of LDS Church. Records were selected from the Family History Library of the LDS Church in 1975-76 and again in 1978-79 and computerized (Bean, Mineau and Anderton, 1990). The criterion for selection was that one or more family members was built-in or died on the Mormon Pioneer Trail or in Utah. The purpose was to represent migrants to Utah and their Utah descendants. The genealogy records for early migrants and their families correspond nativity cohorts that date dorsum to about 1760. These 170,000 family unit group sheets (containing about 1.6 million individuals) have been linked across generations and, in some instances, the records comprehend as many as vii generations. While these records may be similar to those available on the web with FamilySearch or other publicly available genealogical databases, they are not the same database and have been maintained every bit a resource but for biomedical and health research.

13 The UPDB is a dynamic database and receives annual updates for Utah births, deaths, cancer records and driver license records. Several projects have computerized and linked older sets of vital records and these data are now part of the UPDB. The database now includes approximately 1.viii one thousand thousand Utah birth certificates from 1915-1921 and 1947-2002 and 666,878 death certificates from 1904-2002. Much of the value of this resource depends on the ability to friction match records on individuals from 2 or more data sets, known every bit record linking, and to create longitudinally linked data that are able to capture many events associated with an individual. These record linking activities provide quality control for demographic information and eliminate indistinguishable records in the genealogical data.

14 The Utah Resource for Genetic and Epidemiologic Research (RGE) at the University of Utah administers access to these data through a review process of the project proposal. The protection of privacy and confidentiality of individuals represented in these records has been negotiated with agreements between RGE and the data contributors. All research projects require approval from an Institutional Review Board and RGE Review Commission (Wylie and Mineau, 2003).

Previous Research Using UPDB

15 The representativeness of the genealogy file has been demonstrated in a variety of demographic studies on infant mortality (Lynch, Mineau and Anderton, 1985; Bean, Mineau and Anderton, 1990) and maternal mortality (Bardet et al., 1981) that have compared Utah rates and patterns to other populations. Other studies have analyzed fertility (Bean, Mineau and Anderton, 1990), birth spacing (Anderton and Bean, 1985), and widowhood (Mineau, 1988; Mineau, Smith and Edible bean, 2002). This population is biologically representative of a broad spectrum of the white U.S. population and is genetically like to other Northern European-derived populations. The population has a low inbreeding rate that is very similar to that of the U.South. white population due to a large founding population and high rates of immigration from a diverse grouping of outside populations (Jorde, 1989, 2001).

Clarification of data and methods

Expiry Information

xvi Death dates and places are available from the genealogy whether the death occurred in Utah or in other states/countries and are nearly consummate through the 1960s. Additional follow-up information comes from the Utah death certificates that are complete through 2002 or the Social Security Decease Index (SSDI) that are available through fall 2003. The death certificates provide information on deaths within Utah and the SSDI provides expiry dates and places that occur outside of Utah. Information on individuals who are even so living was adamant by a driver license or identification card that is issued through the Driver License Segmentation.

Religion Affiliation

17 The UPDB contains individual organized religion information relating to the LDS Church, specifically dates of baptism and endowment. These two formal religious rites define affiliation with the LDS Church. Baptism for children typically occurs at nigh age 8 and therefore does non imply a loftier degree of personal selection. Individuals who convert or select membership in the LDS Church may exist baptized at older ages. Regardless of the age at which baptism occurs, information technology is an essential prerequisite for the second, more formal religious rite, endowment. Endowments take identify in an LDS temple or during the xix ^th century in a Sealing House. Endowments occur for young men (and increasingly young women) when they are called to serve an LDS proselytizing mission. Endowments may as well occur at the fourth dimension of a temple wedlock or years subsequently a secular marriage as members secure admission to a temple. Regardless of the time or reason, an endowment implies a strong delivery to the LDS Church considering each person must exist certified by a religious authority. Their worthiness is evaluated during a personal interview to make up one's mind church omnipresence, payment of tithing, maintenance of the Give-and-take of Wisdom, and professed conventionalities in the theology of the LDS Church building.

18 Individuals who have records containing either baptism or endowment dates (simply not posthumously) are treated as affiliated with the LDS Church. Records in the genealogy that exercise not comprise these dates are classified as having less or no amalgamation with the LDS Church. Religious delivery is based on a nomenclature scheme developed by Mineau (Mineau, 1980) and Bean (Bean, Mineau and Anderton, 1990) using the timing of endowment. Individuals who have records containing endowment dates before age forty are treated as religiously committed to the LDS church; all others are less committed or non-LDS members. Three categories are used: 1) Active LDS are persons who were baptized and endowed before the age of twoscore (Females: N=85,117 or 53.2% of all females; Males: N=84,267 or 48.5% of all males). ii) Inactive LDS are persons who were baptized before the age of 40 just not endowed by age twoscore. They may have been endowed later or never endowed (Females: N=53,689 or 33.5% of all females; Males: N=58,869 or 33.9% of all males). 3) Non-LDS are persons with no information nearly baptism or endowment before age xl. These individuals have picayune or no amalgamation with the LDS Church; however, they may exist active members of other religious groups (Females: N=21,249 or 13.3% of all females; Males: N=30,463 or 17.half dozen% of all males).

19 We define converts to the LDS Church equally individuals who are endowed after historic period forty and are a subset of individuals who were initially classified every bit Inactive LDS or non-LDS. For females, xxx.6% (22,949 of 74,938) have an endowment appointment at 40 years of age or older while for men, this effigy is 21.2% (18,960 of 89,332).

Sample Selection

20 A sample was selected for individuals who accept complete data on all key variables necessary for the analysis. There are several eligibility criteria for inclusion into the final analysis sample. An individual's tape must contain complete birth and death dates. In instances where an individual is known to be live, it is too required that a appointment concluding known alive is available. Given the importance of categorizing individuals by their religious affiliation, information technology is necessary to accept data on baptism and endowment within the LDS Church. Endowment frequently occurs at the fourth dimension of marriage, specially for women. Consequently, we restricted the sample to include ever-married individuals merely. This restriction reduces the problem of categorizing an individual as inactive LDS (i.east., defective an endowment appointment) because they were single. As described to a higher place, persons who lack both baptism and endowment dates are classified as non-LDS. Persons who are inactive LDS are those who baptized just not endowed prior to age 40. Converts to the LDS religion were those with endowment dates after age 40.

21 Our focus is on adult mortality afterwards age 40 and then all individuals in the analysis are required to have survived to this age. This survival threshold was selected in large measure considering it represents an age by which the bulk of individuals have married. For those that marry, we are in a position to observe whether the individual has the requisite endowment dates needed to determine their religiosity.

22 The subjects' nascence years are also restricted to the years 1850 to 1919. This restriction was imposed because it represents, at the lower cease, an historical period following the establishment of the LDS Church in 1830 and initial Utah settlement in 1847. Individuals built-in in 1850 would be age 40 in 1890 and would have had access to religious facilities throughout the region where ceremonies could take place. We do not consider births past 1919 because nosotros wanted to observe mortality rates for as many years past age 40 equally possible. Accordingly, someone born in 1919 would accomplish age 40 in 1959 giving united states of america approximately 40 years of adult life-span later age 40 in which to observe mortality rates.

Analysis

23 Our sample, shown in Table 1, comprises 333,654 individuals, with female and male person sub-samples of 160,055 and 173,599, respectively. There are more males in this sample than females for at least 2 reasons. The first is related to differential bloodshed after marriage and before historic period forty. This results in the exclusion of female person deaths due to maternal mortality; for example, more women than men were excluded in the 1850-79 cohort because they died before age forty. The second reason is related to our criteria that we know either a death date or a verification of "living" status to be included in the sample. Women are excluded from the sample at a slightly higher rate than men, because nosotros may lack information on some women who remarry and have a dissimilar last proper name on their decease certificate, commuter license, or other records. This is particularly credible in the 1909-1919 cohort where the disproportion of men to women is the greatest.

Tab. ane

Mortality and Religious Information for Individuals who Survived to Age 40 Specified for Males and Females and by Nascence Accomplice

Mortality and Religious Information for Individuals who Survived to Age 40 Specified for Males and Females and by Nascency Cohort

24 All of the survival models are estimated with Cox Proportional Hazard Models based on this sample. Other models accost the question about how religiosity affects the likelihood of reaching an avant-garde historic period or not. For these models, the issue variable is a dichotomous variable that equals cipher if you died before age 85 and equals one if you lot lived to historic period 85. Approximately 80% of the sample (all of whom survived to age 40) died before historic period 85. Appropriately, persons dying prior to age 85 are used as a standard comparing grouping for this set of analyses. We therefore code persons as zero for deaths occurring before age 85 and create 2 boosted dichotomous variables for longevity, whether you lot alive to historic period xc, and whether you lived to age 95. For these latter two variables ("living to age 90 versus dying before 85" and "living to age 95 versus dying before 85"), the sample size declines because of the intentional exclusion of individuals who died between the 2 threshold ages used to construct the variables. The sample sizes for analyses using these variables vary from one another by definition. The sample sizes for the outcomes for living to age 85, 90, and 95 are 199,619, 176,364, and 162,188, respectively.

Statistical Methods

25 Survival models for bloodshed past historic period xl were estimated using Cox proportional hazards (PH) regression models where the result is the adventure charge per unit for all-cause mortality. Several PH models are estimated to accost different aspects of the clan between religiosity and mortality. The starting time set up of models assesses how religiosity affects the mortality hazard charge per unit imposing the standard proportionality assumption that states that the furnishings of religiosity on mortality practise not change with age. A second class of models is estimated that relaxes this assumption to allow for the effects of religiosity to change with age (non-proportionality models). Finally, we consider models that provide for the effects of converting to the LDS Church after historic period 40 past allowing for a time-varying covariate that accounts for the ages after xl where an private was and was not a fellow member of the LDS Church.

26 The PH models focus on hazard rates just they exercise not show direct how religiosity affects survival to an advanced age. A fix of "exceptional survival" (ES) models provides estimates for such furnishings. We rely on logistic regressions to examine this discrete version of survival. The dependent variables here are binary that have on a value of 1 if they exceed a threshold historic period (live to at least 85, 90, or 95) and a value of zero if they did not live to historic period 85. Only persons born prior to 1900 are included in these analyses.

Results

27 The risks of bloodshed are significantly lower for active LDS members than for either in-active or not-LDS individuals (Table 2). The protective influences of being Mormon are found to be greater for men than for women. Among males, inactive and not-LDS members have most identical risks of bloodshed in relation to active church building members. For females, the benefits of being agile LDS are weaker (compared to males) but the largest difference is with non-LDS women.

Tab. 2

Effects of Religiosity and Fertility, by Gender, on Mortality Risks Based on Cox Proportional Hazards Models

Furnishings of Religiosity and Fertility, by Gender, on Mortality Risks Based on Cox Proportional Hazards Models

28 We take investigated whether the effects of religiosity may be confounded with fertility given that active Mormons have larger families (Mineau et al., 1984; Bean, Mineau and Anderton, 1990) and that increasing parity could affect bloodshed risks of parents (Smith Mineau, and Bean, 2002). We define parity as the number of children ever born to a couple. To address this possibility, we re-estimated our PH models using a sub-sample comprising persons who had complete parity data. Using this sub-sample, nosotros estimated two equations (2 for each gender): one with our prepare of religiosity codes and birth year as covariates and a second that added parity as a covariate. As shown in Table two, the statistical aligning for fertility had no appreciable influence on the estimated touch of religiosity on mortality risk.

29 The LDS Church has grown in myriad ways since its inception in 1830. These changes take generated conditions that could modify the style in which being Mormon affects health outcomes (e.one thousand., proscription of alcohol and tobacco, social safety cyberspace offered through church services). In Table 3, we find that the protective effects of being an agile LDS Church building member accept grown with fourth dimension. This tendency holds for men and women akin. The weaker effects of religiosity in the earliest accomplice may reflect the ubiquitous risks faced by everyone, risks that were more difficult to minimize through the deportment of religious involvement (east.g., nutrient shortages, infectious disease outbreaks) in relation to the risks more prevalent today (e.g., smoking).

Tab. 3

Effects of Religiosity, by Gender and Birth Cohort, on Mortality Risks Based on Cox Proportional Hazards Models. Panel A is for the Full Sample

Effects of Religiosity, by Gender and Nascence Accomplice, on Mortality Risks Based on Cox Proportional Hazards Models. Panel A is for the Total Sample

30 It is possible that members of the LDS Church may have lower mortality risks because they tend to have higher social standing and better access to resources that likewise have salutary effects in relation to non-LDS individuals. We therefore examined how religious affiliation affects the mortality hazard charge per unit after adjusting for the effects of socioeconomic condition (SES) as measured past occupation obtained from Utah decease certificates. Occupations were coded to the 1980 U.South. Demography categories and assigned a socioeconomic status score based on Nam and Powers (Nam and Powers 1983). Higher scores correspond occupations with greater socioeconomic status ranging from ane to 100. For men, SES is measured based on their own occupation while for women it is based on their husband'south occupation. Table 3 shows that for this subset of records, active members of the LDS Church are however plant to have lower mortality rates than inactive members and not-LDS before and after controlling for the influence of SES (Panels B and C in Table 3). The cohort of 1910-nineteen is excluded from these SES analyses because of a significant proportion still living.

31 Adult mortality risks change dramatically with historic period and and so it is useful to determine how religiosity affects these changing risks as individuals historic period. Tabular array iv shows that the greatest beneficial furnishings of being an agile Mormon occur during the middle years (40-49, 50-59) and steadily decline with advancing historic period. For instance, amid inactive LDS men the run a risk of dying between age 40 and 49 is 1.63 times greater than for active LDS men and amongst non-LDS men information technology is 1.70 times greater. For older ages (70+), the benefits of active interest in the LDS Church are about half what they were for those under age 60 indicating that religion has adulterate furnishings on forestalling bloodshed as chronic, degenerative disease become more prevalent.

Tab. 4

Age-Specific Effects of Religiosity and Later-Life Conversion, by Gender, on Bloodshed Risks Based on Cox Proportional Hazards Models

Age-Specific Effects of Religiosity and Later on-Life Conversion, by Gender, on Mortality Risks Based on Cox Proportional Hazards Models

32 Table 4 also shows that persons joining the LDS Church afterwards in life have dramatic reductions in mortality in relation to agile LDS members. This may reflect a greater adherence to the organized religion that translates into stronger health benefits. It is likewise possible that "belatedly converts" are not and so much converts only rather life-long members of the church who happened to marry belatedly in life, perchance demonstrating a resolve and depth of delivery to their organized religion that translated into lower mortality risks.

33 We elaborate on the findings further in Tabular array 5 by stratifying the sample by nascence cohort. These results are not surprising if we extend and combine the findings obtained from Table 3 and 4. The protective influences of beingness an active LDS member are greatest for the middle-aged and for those born in the most recent nascence accomplice. Indeed, amongst men, the mortality risks of inactive and non-LDS members are twice that of active members for the middle-aged in the final accomplice. We likewise meet an increasing benefit of joining the LDS church building over time.

Tab. 5

Age-Specific Effects of Religiosity and After-Life Conversion, by Gender and Nascence Cohort, on Mortality Risks Based on Cox Proportional Hazards Models

Age-Specific Effects of Religiosity and Later-Life Conversion, by Gender and Birth Cohort, on Mortality Risks Based on Cox Proportional Hazards Models

34 The exceptional survival models support the PH models in nearly every respect, every bit shown in Table 6. Active LDS Church members have a greater likelihood of reaching advanced ages than others and this benefit is greater for men than women. While these models assess these influences for only two birth cohorts, we observe again that the benefits of being an active Mormon are greater amidst more recent cohorts.

Tab. half-dozen

Effects of Religiosity, by Gender and Birth Cohort, on Infrequent Survival (Living to ages 85, 90, 95) Based on Logistic Regressions.

Effects of Religiosity, by Gender and Birth Cohort, on Exceptional Survival (Living to ages 85, ninety, 95) Based on Logistic Regressions.

Discussion/Conclusion

35 This article is part of a series of studies using a unique database that provide the opportunity to explore major biodemographic too every bit social problems related to mortality and longevity. In order to clarify the social factors that may obscure genetic and biological factors determining longevity, these analyses are specifically designed to ascertain the caste to which a critical variable—religious affiliation—influences mortality risk in the Utah population.

36 At that place are several factors that can be used to explicate our observation that active LDS have lower mortality than inactive or non-LDS. Both the health practices that were officially mandated by the LDS Church and the social back up mechanism associated with church affiliation are more directly interpretable given our data sources and historical context. Because nosotros studied simply individuals who married, the systems of social support would be related more specifically to religious involvement that might be observed in other studies.

37 Some contemporary studies suggest that the protective effect of religious affiliation and bloodshed is stronger for women than men (Strawbridge and Cohen, 2000). Our results prove the opposite, that religious affiliation has stronger effects on developed bloodshed for men than women and that this is the case beyond all iii cohorts. We considered the possibility that fertility and its differential adverse effect on women (Smith, Mineau and Bean, 2002) might explain this finding, simply we accept rejected this machinery as a likely explanatory gene.

38 Another caption would be that agile LDS have college socioeconomic status and thus have admission to amend social conditions than others. Notwithstanding, our results bespeak that the positive effect of being active LDS and peculiarly a greater protective effect for men is not the result of the man's occupation.

39 A plausible alternative caption relates to the health practices amid active LDS members and others and how these differences vary by gender. During the primeval nativity cohorts, both LDS and non-LDS men were more alike than in relation to men today. This ascertainment is based on the fact the behaviors described in the Word of Wisdom were not institutionalized and thus were not adhered to as they are today. Accordingly, behaviors affecting wellness (e.g., tobacco and alcohol consumption) may accept been more normally practiced in LDS and not-LDS men alike in these early years. With the passage of time, the differences in the rates of these of import run a risk behaviors would have diverged resulting in rising relative health benefits among agile LDS men. Women, both Mormons and not-Mormons, were likely to have been more similar from the beginning because their rates of alcohol and tobacco consumption were low. Despite their low prevalence, active LDS women would accept engaged in them even less as the Give-and-take of Wisdom went from being a principle to a requirement (Alexander, 1981) starting around 1920. This would account for the increasing (albeit weaker) relative health benefits observed amidst active LDS women. It is also possible that the potential positive effects of being agile LDS are greater for men than women because of the greater social standing men have within the LDS Church building in relation to women.

xl Smoking may partially explain the difference betwixt active Mormons and others, especially for men, but even after statistical controls have been made for this confounder, agile LDS members still relish lower rates of mortality (Merrill, 2004). A probable caption for this protective effect, therefore, is the greater access to social back up and networks available to LDS members than others. This caption is consistent with other large-scale prospective studies of social back up and mortality. The Alameda County study was among the outset of such studies that demonstrated that those with few social ties (including the lack of church membership) had two to three times the risk of mortality than persons with many social contacts (Berkman and Syme, 1979). Our risk estimates are somewhat smaller than the Alameda report partly because our sample was restricted to ever-married persons, a data restriction that results in some minimum level of social integration for everyone in the sample. The bloodshed-social connection has since been demonstrated in a wide range of studies that agree with the general findings reported here. In that location is explicable variation in the consequence sizes given varying measures of social support/integration, length of follow-upwards, study design, and sample eligibility criteria (Business firm, Landis and Umberson, 1988) (Berkman and Glass, 2000).

41 An advantage of our analysis is that religiosity is measured before in life where initial health status would accept been excellent for most persons. We have as well restricted our sample to those who marry and survive to age 40, thereby enriching the sample with salubrious individuals. These features of our analysis greatly minimize the possibility that health condition affected religious participation (e.g., the good for you are better able to participate in church functions; or the ill are more than religiously active every bit they confront the prospects of their own mortality). And as indicated past George (George et al., 2002), the mediating consequence of factors such every bit health practices appear somewhat smaller in longitudinal studies compared to cross-sectional studies; even so, estimates based on longitudinal studies "are probable to exist more than accurate because at to the lowest degree part of the effects of social selection accept been excluded (p. 193)".

42 Our results based on the UPDB and active members of the LDS Church suggest that exceptional life expectancies tin can be achieved at a population level under very positive health conditions accompanied with high levels of social integration. The exceptional longevity of active LDS members has been noted by others in the give-and-take of the upper limits of homo longevity. Mormons are likely to exist closer to some theoretical maximum than the larger U.Southward. population and life expectancy among agile LDS members may well represent a target for longevity that might be achievable in other populations. From a public health prospective, this report adds to the body of literature that seeks to empathize the mechanisms that promote better health outcomes as well every bit those associated with maximizing longevity (Manton, Stallard, and Tolley, 1991).

43 ADH_id270113725X_pu2004-02s_sa06_art06_img007.jpg

Fig. 1

Survival Curves for Males who Survived to Age twoscore by Birth Accomplice

Fig. 1

Survival Curves for Males who Survived to Historic period forty by Nascence Cohort

Fig. 2

Survival Curves for Females who Survived to Age 40 past Birth Cohort

Fig. 2

Survival Curves for Females who Survived to Historic period 40 by Birth Cohort

ACKNOWLEDGEMENT

Nosotros wish to thank the Full-blooded and Population Resources funded by the Huntsman Cancer Foundation, University of Utah for providing the information and valuable computing support. The work was supported past NIH grant AG13748 (Kinship and Socio-demographic Determinants of Bloodshed) and NIH grant AG022095 (The Utah Study of Fertility, Longevity and Crumbling). In addition, we wish to admit the contributions of Alison Fraser and Diana Lane Reed in enabling access to data and support of the projection.

L'objectif de l'article est de préciser annotate 50'appartenance religieuse modifie le risque de décès. La base of operations de données de la population de l'Utah est ici utilisée afin d'étudier la mortalité générale d'un échantillon d'hommes et de femmes mariés qui ont survécu à leur quarantième anniversaire. Les individus appartiennent aux générations 1850-1919, ils sont suivis pendant toute leur vie et se situent à 50'époque de la transition démographique. Les membres actifs de 50'Église des Mormons présentent une mortalité inférieure à celle des membres non actifs ou des non-Mormons, différence qui se maintient si l'on tient compte des hiérarchies socio-économiques. Les écarts sont plus forts cascade les âges médians et pour les générations nées le plus récemment. L'appartenance à l'Église mormone est aussi plus discriminante pour les hommes que pour les femmes. Ces observations empiriques confirment le rôle des pratiques de santé et du soutien social dans les liens entre l'appointment religieux et la plus faible mortalité.

The purpose of this study is to understand how religious affiliation affects bloodshed risk. The Utah Population Database is used to examine all-cause mortality for a set of married men and women who survived to age twoscore. Individuals in selected birth cohorts (1850-1919) are observed across their lifetime and span the period of the demographic transition. We find active members of the Church of Jesus Christ of Latter-twenty-four hours Saints (LDS or Mormon) take lower bloodshed than those who are inactive or non-LDS in all cohorts and this relationship remains afterward decision-making for socioeconomic status. The protective influences of being an active member of the LDS Church are greatest for the middle-anile and for those born in the more than contempo nativity accomplice. Our results bear witness that religious affiliation has stronger effects on developed mortality for men rather than women. These observations are consistent with explanations of health practices and social support factors that accept been posited to sympathise the positive relationship between religious involvement and mortality outcome.

Study population
1. Utah Population Database
2. Previous Research Using UPDB
Description of data and methods
1. Decease Information
2. Religion Affiliation
3. Sample Selection
4. Assay
5. Statistical Methods
Results
Discussion/Determination

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Geraldine P. MINEAU Ph.D^a

^a Department of Oncological Sciences and Huntsman Cancer Plant,
University of Utah,
2000 Circumvolve of Promise,
Common salt Lake City,
Utah 84112.

Ken R. SMITH Ph.D^b

^b Department of Family and Consumer Studies and Huntsman Cancer Constitute,
University of Utah,
Salt Lake Urban center,
Utah.

Lee L. BEAN Ph.D^c

^c Department of Folklore,
University of Utah,
Salt Lake City,
Utah

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