Mediators of the Association Between Religious Service Attendance and Mortality

Abstract

Mounting evidence consistently shows associations between religious service attendance and reduced risk of mortality; yet research identifying mediators remains limited. Using prospective data from the Health and Retirement Study (2006-2014; n=5,200), we evaluated a range of potential mediators. After robust control for confounders (demographic, health, health behaviors, and social factors), among positive psychological factors, we observed mediation through increased life satisfaction (5.27% ; P=<.001) and possibly positive affect (1.52%; P=.06)—but not optimism, mastery, or purpose. Among dimensions of psychological distress, we observed mediation through reductions in hopelessness (1.92%; P=.01), trait anger (1.98%; P=.03), state anger (2.23%; P=.03), and possibly loneliness (1.21%; P=.06), but not cynical hostility or negative affect, and some evidence that increased anxiety (−3.61%; P=.008) and possibly depressive symptoms (−1.14%; P=.05) increased odds of mortality. Among social factors we observed mediation through contact with friends (10.73%; P=.005), but not living with a spouse, contact with children, or other family. Among health behaviors we observed mediation through exercise (5.38%; P=<.001), negative mediation through alcohol frequency (−2.55%; P=.03) and possibly body mass index (−2.34%; P=.08), but not smoking. These results highlight a range of mediators that may underlie the association between religious service attendance and reduced risk of mortality.