Question: Does Faith or Religious Activity Improve Health?
Kaffinator gave us two questions in the comments section, which I am dealing with separately. One deals with health and religion, while the other deals with charity and religion.
Question 1:
If Kaff was correct in his fundamental premise, it may indeed be more ethical to promote churchgoing, regardless of its core truth value, simply to decrease pain and suffering. Unfortunately for all of us, no evidence of such magic exists.
Question 1:
Mr. Atheist, if you had your wish and all of the Christians in the United States suddenly joined you, the result would be that ... Many more people would experience depression and high blood pressure, placing a greater drain on the health-care system. Americans in general would suffer a massive loss in life expectancy. I'm sure I could go on.
So here is my question. What kind of warped morality would wish this upon a nation?
If Kaff was correct in his fundamental premise, it may indeed be more ethical to promote churchgoing, regardless of its core truth value, simply to decrease pain and suffering. Unfortunately for all of us, no evidence of such magic exists.
"A large US study found that religious folk had lower blood pressure, less depression and anxiety, stronger immune systems and generally cost the health-care system less than people who were less involved in religion." [link]
This has to be one of the most bankrupt studies I've ever read. Can anyone say, cum hoc, ergo propter hoc? you know, they say that those people who carry matches in their pocket tend to get lung cancer more, so we ought to speak out about carrying matches as a risk for cancer, right? [roll eyes]
Let's look at the abstract:
METHODS: A probability sample of 3,968 community-dwelling adults aged 64-101 years residing in the Piedmont of North Carolina was surveyed in 1986 as part of the Established Populations for the Epidemiologic Studies of the Elderly (EPESE) program of the National Institutes of Health. Attendance at religious services and a wide variety of sociodemographic and health variables were assessed at baseline. Vital status of members was then determined prospectively over the next 6 years (1986 1992). Time (days) to death or censoring in days was analyzed using a Cox proportional hazards regression model. RESULTS: During a median 6.3-year follow-up period, 1,777 subjects (29.7%) died. Of the subjects who attended religious services once a week or more in 1986 (frequent attenders), 22.9% died compared to 37.4% of those attending services less than once a week (infrequent attenders). The relative hazard (RH) of dying for frequent attenders was 46% less than for infrequent attenders (RH: 0.54, 95% CI 0.48-.0.61), an effect that was strongest in women (RH 0.51, CI 0.434).59) but also present in men (RH 0.63, 95% CI 0.52-0.75). When demographics, health conditions, social connections, and health practices were controlled, this effect remained significant for the entire sample (RH 0.72, 95% CI 0.64-.81), and for both women (RH 0.65, 95% CI 0.554-.76, p<.0001) and men (RH 0.83, 95% CI 0.69-1.00, p=.05). CONCLUSIONS: Older adults, particularly women, who attend religious services at least once a week appear to have a survival advantage over those attending services less frequently.
First, note the p-value = 5 for men, and less than 0.0001 for women, which immediately raises an intelligent person's eyebrows. The authors comment that males are much less likely to attend religious services, yet, this effect is least pronounced in males??
The p-value is a measure of statistical reliability of any correlative study. There should be no significant difference between the sexes if the variable studied is the causative factor. Second, note that they made no concession for AGE!. Think about this for a minute, if you are still attending church, whether 50 or 100, do you kind of think...you're in better health than the BEDRIDDEN friend of yours? Christian or not? 50 or 101? Well, it sounds good at first, and then, the more you think about it, people with arthritis of the hip won't die tomorrow, but can't attend services, while those with fine walkin' skills and Jeebus-lovin' skills still go to church, but have a bad heart, which pops on em at 50...hmmmm...
This is a terrible study, and the follow-up researchers who cited this study agreed:
see Risk Factors, Confounding, and the Illusion of a Statistical Control, Psychosomatic Medicine, v66 i6 p868 (2001)
You apparently didn't read the follow-up study by the same authors, did you? See, this prelim was published in 1999, and when their methodology flaws were pointed out to them, they decided to go back and try again. Funnier still, the follow-up by the same authors admitted:
During a median 6.3-year follow-up period, 1,137 subjects (29.5%) died. Those reporting rarely to never participating in private religious activity had an increased relative hazard of dying over more frequent participants, but this hazard did not remain significant for the sample as a whole after adjustment for demographic and health variables. When the sample was divided into activity of daily living (ADL) impaired and unimpaired, the effect did not remain significant for the ADL impaired group after controlling for demographic variables (hazard ratio [RH] 1.11, 95% confidence interval [CI] 0.91–1.35). However, the increased hazard remained significant for the ADL unimpaired group even after controlling for demographic and health variables (RH 1.63, 95% CI 1.20–2.21), and this effect persisted despite controlling for numerous explanatory variables including health practices, social support, and other religious practices (RH 1.47, 95% CI 1.07–2.03).
In plain English, once these educated idiots realized their study was flawed, and went back and fixed the uncontrolled variables (comparing bedridden people who may or may not wish to go to church, and/or who may or may not have gone until becoming bedridden, at the age of 101, with a healthy 60 year old, is about the dumbest study I've ever seen), they found, guess what? That the activity of daily living was more important than anything else. Surprise surprise. So, whether grandma is out gardening or praising Jeebus in church, she, SHOCKER, is statistically more likely to be healthier than someone who does neither (often, because they can't). Man, whatta GD study, a real charlie foxtrot. In their own words, admitting this:
A study by Koenig and coworkers demonstrated that an ill, elderly population may not be able to overcome the force of impending mortality even when employing various behaviors that have been shown in healthy populations to correlate with extended survival (42 [this is the study that the BBC article you linked to cited]). It is possible that the relatively subtle effects of private religious activity are not sufficient to overcome the overwhelming force exerted on mortality by health decline to the point of ADL impairment. Thus, the milder effects of private religious activities on mortality are more detectable among those persons who are relatively healthy. Future studies may want to ask how long a person has been engaged in private religious activity, to determine if habits begun after the onset of ADL impairment are begun too late to show a survival benefit.
Beautiful, eh? If they're really bad off, Kaff, don't try to look for Jeebus' help. Also, never mind the social support and friendships and human networking that come with churchgoing, which often explains away the "milder effects", without invoking your Magic Man.
Swedish scientists studying an overview of these kinds of studies conclude:
Our analyses reveal that most domains of activities are associated with reduced mortality risk; however, in most instances the likelihood that healthier individuals tend to be more involved in activities serves as an effective explanation for these associations. [ie, if you're in good health, you're more active, be it religiously or otherwise, and that's why the ADL effect noted in your paper made the religious "protection" disappear...duh]
...Older men appear to benefit from participating in solitary but active pursuits, measured with an index that includes hobbies such as carpentry and gardening. This finding deserves a word of caution. Because respondents selected activities on the basis of their capacity to engage in them, we cannot be certain that existing differences in health between active and less active men are responsible for this finding....[note that these researchers are more thoughtful and clever than to commit the cum hoc, ergo propter hoc of your paper]...
Formal group involvement—organizational and religious activities—produces no longevity benefits, because their association with mortality is fully explained by the tendency of healthier respondents to be engaged in those activities. This "selection" hypothesis goes against the findings of other studies, particularly those that find religious attendance to be a robust predictor of mortality among elderly persons (Idler and Kasl 1992Citation; Koenig et al. 1999Citation; Oman and Reed 1998Citation). Interestingly, family contact does not predict mortality risk and is consequently omitted from our analysis. This finding is in line with earlier studies of oldest old persons in Sweden showing that family integration tends to have virtually no effect on various kinds of health outcomes of elderly persons. It is also consistent with the current Swedish welfare model that mandates the state, through public services, to assume the main responsibility for providing care needed by elderly persons (Parker 2000Citation; Szebehely 2000Citation)....
see The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56:S335-S342 (2001).
Let's end with the discussion by your papers' authors:
In this study we found that private religious activities provided a protective effect against mortality for an elderly population free of functional impairment, even after controlling for numerous covariates; no such effect persisted in the ADL impaired group. To our knowledge, this is the first study to document a possible protective effect for private religious activity on mortality in a large community-dwelling population. Whereas studies of organizational religious activity (ORA) and mortality have shown a positive correlation (4)(5)(6)(7)(8)(9), this study demonstrates protection via nonorganizational religious activity (NORA), at least for those who practice NORA before the onset of impairment in ADLs.
BUA-HA-HA-HA...good stuff! I think I'll thus avoid church and stay busy in the garden, and then when I get impaired, I'll send my wife to church to ensure her survival, but flip a coin to determine whether or not it will confer benefit for me to go, ah hell, who am I kidding? I'll keep working in the garden, it's good for us that God cursed the ground, eh?
see
Does Private Religious Activity Prolong Survival? A Six-Year Follow-up Study of 3,851 Older Adults, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, v55, m400 (2000) [follow-up by your authors]
See also:
Physicians and Patient Spirituality: Professional Boundaries, Competency, and Ethics
Roles of Religious Involvement and Social Support in the Risk of Colon Cancer among Blacks and Whites
Religion, spirituality, and medicine [Sloan, 1999 Lancet]
Religion, Spirituality & Medicine [Richard Sloan's follow-up, the lead author of a recent article in the prestigious medical journal Lancet cautioning physicians not to prescribe religion as medicine. This study was published prior to the Duke study in 1999]
"Linking religious activities and better health outcomes can be harmful to patients, who already must confront age-old folk wisdom that illness is due to their own moral failure. Within any individual religion, are the more devout adherents 'better' people, more deserving of health than others? If evidence showed health advantages of some religious denominations over others, should physicians be guided by this evidence to counsel conversion? Attempts to link religious and spiritual activities to health are reminiscent of the now discredited research suggesting that different ethnic groups show differing levels of moral probity, intelligence, or other measures of social worth. Since all human beings, devout or profane, ultimately will succumb to illness, we wish to avoid the additional burden of guilt for moral failure to those whose physical health fails before our own."
The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population. [Pain patients' religious and spiritual beliefs appear different than the general population (e.g. pain patients feel less desire to reduce pain in the world and feel more abandoned by God). Hierarchical multiple regression analyses revealed significant associations between components of religion/spirituality and physical and mental health. Private religious practice (e.g. prayer, meditation, consumption of religious media) was inversely related to physical health outcomes, indicating that those who were experiencing worse physical health were more likely to engage in private religious activities, perhaps as a way to cope with their poor health. Forgiveness, negative religious coping, daily spiritual experiences, religious support, and self-rankings of religious/spiritual intensity significantly predicted mental health status. Religion/spirituality was unrelated to pain intensity and life interference due to pain]
Spirituality in health: the role of spirituality in critical care
Analysis of Lancet article, by FFRF
Reality check
Huh, whattya know? Maybe your "facts" are a little off? Maybe the fact that longevitiy studies and infant mortality studies and teen pregnancy and abortion rates and murder rates were ALL directly correlated to increased religiosity in western democracies never caught your attention? Well, let me help you out:
Cross-National Correlations of Quantifiable Societal Health with Popular Religiosity and Secularism in the Prosperous Democracies
Whattya know? The countries with the highest number of atheists just so happen to have lower murder rates, teen pregnancies, abortions, infant mortality, and longer longevity. Maybe you should do some reading ;)
Some "pro-religious" sources [older]:
Science & Theology News
Religion, Spirituality, and Medicine: How Are They Related and What Does it Mean? [by Koenig, author of flawed study, 2001]
Religious Involvement, Spirituality, and Medicine: Implications for Clinical Practice [Mueller, 2001]
Note that Mueller was the lead author of the recent study confirming that intercessory prayer does nothing:
Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer [April 2006]
What kind of sick morality would put false hope in the heads of many? Worse still, confirmed by Mueller's recent study, those people who knew they were being prayed for did worse than those who weren't prayed for at all. Perhaps it's the problem of linking morality with health? Perhaps you don't know any better. Perhaps those who derived their sick morality from a God who kills babies [cf 1 Sam 15:3, Num 31] can't see the problem in foisting false hopes and lies on others for the sake of propping up this god's popularity?
This has to be one of the most bankrupt studies I've ever read. Can anyone say, cum hoc, ergo propter hoc? you know, they say that those people who carry matches in their pocket tend to get lung cancer more, so we ought to speak out about carrying matches as a risk for cancer, right? [roll eyes]
Let's look at the abstract:
METHODS: A probability sample of 3,968 community-dwelling adults aged 64-101 years residing in the Piedmont of North Carolina was surveyed in 1986 as part of the Established Populations for the Epidemiologic Studies of the Elderly (EPESE) program of the National Institutes of Health. Attendance at religious services and a wide variety of sociodemographic and health variables were assessed at baseline. Vital status of members was then determined prospectively over the next 6 years (1986 1992). Time (days) to death or censoring in days was analyzed using a Cox proportional hazards regression model. RESULTS: During a median 6.3-year follow-up period, 1,777 subjects (29.7%) died. Of the subjects who attended religious services once a week or more in 1986 (frequent attenders), 22.9% died compared to 37.4% of those attending services less than once a week (infrequent attenders). The relative hazard (RH) of dying for frequent attenders was 46% less than for infrequent attenders (RH: 0.54, 95% CI 0.48-.0.61), an effect that was strongest in women (RH 0.51, CI 0.434).59) but also present in men (RH 0.63, 95% CI 0.52-0.75). When demographics, health conditions, social connections, and health practices were controlled, this effect remained significant for the entire sample (RH 0.72, 95% CI 0.64-.81), and for both women (RH 0.65, 95% CI 0.554-.76, p<.0001) and men (RH 0.83, 95% CI 0.69-1.00, p=.05). CONCLUSIONS: Older adults, particularly women, who attend religious services at least once a week appear to have a survival advantage over those attending services less frequently.
First, note the p-value = 5 for men, and less than 0.0001 for women, which immediately raises an intelligent person's eyebrows. The authors comment that males are much less likely to attend religious services, yet, this effect is least pronounced in males??
The p-value is a measure of statistical reliability of any correlative study. There should be no significant difference between the sexes if the variable studied is the causative factor. Second, note that they made no concession for AGE!. Think about this for a minute, if you are still attending church, whether 50 or 100, do you kind of think...you're in better health than the BEDRIDDEN friend of yours? Christian or not? 50 or 101? Well, it sounds good at first, and then, the more you think about it, people with arthritis of the hip won't die tomorrow, but can't attend services, while those with fine walkin' skills and Jeebus-lovin' skills still go to church, but have a bad heart, which pops on em at 50...hmmmm...
This is a terrible study, and the follow-up researchers who cited this study agreed:
see Risk Factors, Confounding, and the Illusion of a Statistical Control, Psychosomatic Medicine, v66 i6 p868 (2001)
You apparently didn't read the follow-up study by the same authors, did you? See, this prelim was published in 1999, and when their methodology flaws were pointed out to them, they decided to go back and try again. Funnier still, the follow-up by the same authors admitted:
During a median 6.3-year follow-up period, 1,137 subjects (29.5%) died. Those reporting rarely to never participating in private religious activity had an increased relative hazard of dying over more frequent participants, but this hazard did not remain significant for the sample as a whole after adjustment for demographic and health variables. When the sample was divided into activity of daily living (ADL) impaired and unimpaired, the effect did not remain significant for the ADL impaired group after controlling for demographic variables (hazard ratio [RH] 1.11, 95% confidence interval [CI] 0.91–1.35). However, the increased hazard remained significant for the ADL unimpaired group even after controlling for demographic and health variables (RH 1.63, 95% CI 1.20–2.21), and this effect persisted despite controlling for numerous explanatory variables including health practices, social support, and other religious practices (RH 1.47, 95% CI 1.07–2.03).
In plain English, once these educated idiots realized their study was flawed, and went back and fixed the uncontrolled variables (comparing bedridden people who may or may not wish to go to church, and/or who may or may not have gone until becoming bedridden, at the age of 101, with a healthy 60 year old, is about the dumbest study I've ever seen), they found, guess what? That the activity of daily living was more important than anything else. Surprise surprise. So, whether grandma is out gardening or praising Jeebus in church, she, SHOCKER, is statistically more likely to be healthier than someone who does neither (often, because they can't). Man, whatta GD study, a real charlie foxtrot. In their own words, admitting this:
A study by Koenig and coworkers demonstrated that an ill, elderly population may not be able to overcome the force of impending mortality even when employing various behaviors that have been shown in healthy populations to correlate with extended survival (42 [this is the study that the BBC article you linked to cited]). It is possible that the relatively subtle effects of private religious activity are not sufficient to overcome the overwhelming force exerted on mortality by health decline to the point of ADL impairment. Thus, the milder effects of private religious activities on mortality are more detectable among those persons who are relatively healthy. Future studies may want to ask how long a person has been engaged in private religious activity, to determine if habits begun after the onset of ADL impairment are begun too late to show a survival benefit.
Beautiful, eh? If they're really bad off, Kaff, don't try to look for Jeebus' help. Also, never mind the social support and friendships and human networking that come with churchgoing, which often explains away the "milder effects", without invoking your Magic Man.
Swedish scientists studying an overview of these kinds of studies conclude:
Our analyses reveal that most domains of activities are associated with reduced mortality risk; however, in most instances the likelihood that healthier individuals tend to be more involved in activities serves as an effective explanation for these associations. [ie, if you're in good health, you're more active, be it religiously or otherwise, and that's why the ADL effect noted in your paper made the religious "protection" disappear...duh]
...Older men appear to benefit from participating in solitary but active pursuits, measured with an index that includes hobbies such as carpentry and gardening. This finding deserves a word of caution. Because respondents selected activities on the basis of their capacity to engage in them, we cannot be certain that existing differences in health between active and less active men are responsible for this finding....[note that these researchers are more thoughtful and clever than to commit the cum hoc, ergo propter hoc of your paper]...
Formal group involvement—organizational and religious activities—produces no longevity benefits, because their association with mortality is fully explained by the tendency of healthier respondents to be engaged in those activities. This "selection" hypothesis goes against the findings of other studies, particularly those that find religious attendance to be a robust predictor of mortality among elderly persons (Idler and Kasl 1992Citation; Koenig et al. 1999Citation; Oman and Reed 1998Citation). Interestingly, family contact does not predict mortality risk and is consequently omitted from our analysis. This finding is in line with earlier studies of oldest old persons in Sweden showing that family integration tends to have virtually no effect on various kinds of health outcomes of elderly persons. It is also consistent with the current Swedish welfare model that mandates the state, through public services, to assume the main responsibility for providing care needed by elderly persons (Parker 2000Citation; Szebehely 2000Citation)....
see The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56:S335-S342 (2001).
Let's end with the discussion by your papers' authors:
In this study we found that private religious activities provided a protective effect against mortality for an elderly population free of functional impairment, even after controlling for numerous covariates; no such effect persisted in the ADL impaired group. To our knowledge, this is the first study to document a possible protective effect for private religious activity on mortality in a large community-dwelling population. Whereas studies of organizational religious activity (ORA) and mortality have shown a positive correlation (4)(5)(6)(7)(8)(9), this study demonstrates protection via nonorganizational religious activity (NORA), at least for those who practice NORA before the onset of impairment in ADLs.
BUA-HA-HA-HA...good stuff! I think I'll thus avoid church and stay busy in the garden, and then when I get impaired, I'll send my wife to church to ensure her survival, but flip a coin to determine whether or not it will confer benefit for me to go, ah hell, who am I kidding? I'll keep working in the garden, it's good for us that God cursed the ground, eh?
see
Does Private Religious Activity Prolong Survival? A Six-Year Follow-up Study of 3,851 Older Adults, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, v55, m400 (2000) [follow-up by your authors]
See also:
Physicians and Patient Spirituality: Professional Boundaries, Competency, and Ethics
Roles of Religious Involvement and Social Support in the Risk of Colon Cancer among Blacks and Whites
Religion, spirituality, and medicine [Sloan, 1999 Lancet]
Religion, Spirituality & Medicine [Richard Sloan's follow-up, the lead author of a recent article in the prestigious medical journal Lancet cautioning physicians not to prescribe religion as medicine. This study was published prior to the Duke study in 1999]
"Linking religious activities and better health outcomes can be harmful to patients, who already must confront age-old folk wisdom that illness is due to their own moral failure. Within any individual religion, are the more devout adherents 'better' people, more deserving of health than others? If evidence showed health advantages of some religious denominations over others, should physicians be guided by this evidence to counsel conversion? Attempts to link religious and spiritual activities to health are reminiscent of the now discredited research suggesting that different ethnic groups show differing levels of moral probity, intelligence, or other measures of social worth. Since all human beings, devout or profane, ultimately will succumb to illness, we wish to avoid the additional burden of guilt for moral failure to those whose physical health fails before our own."
The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population. [Pain patients' religious and spiritual beliefs appear different than the general population (e.g. pain patients feel less desire to reduce pain in the world and feel more abandoned by God). Hierarchical multiple regression analyses revealed significant associations between components of religion/spirituality and physical and mental health. Private religious practice (e.g. prayer, meditation, consumption of religious media) was inversely related to physical health outcomes, indicating that those who were experiencing worse physical health were more likely to engage in private religious activities, perhaps as a way to cope with their poor health. Forgiveness, negative religious coping, daily spiritual experiences, religious support, and self-rankings of religious/spiritual intensity significantly predicted mental health status. Religion/spirituality was unrelated to pain intensity and life interference due to pain]
Spirituality in health: the role of spirituality in critical care
Analysis of Lancet article, by FFRF
Reality check
Huh, whattya know? Maybe your "facts" are a little off? Maybe the fact that longevitiy studies and infant mortality studies and teen pregnancy and abortion rates and murder rates were ALL directly correlated to increased religiosity in western democracies never caught your attention? Well, let me help you out:
Cross-National Correlations of Quantifiable Societal Health with Popular Religiosity and Secularism in the Prosperous Democracies
Whattya know? The countries with the highest number of atheists just so happen to have lower murder rates, teen pregnancies, abortions, infant mortality, and longer longevity. Maybe you should do some reading ;)
Some "pro-religious" sources [older]:
Science & Theology News
Religion, Spirituality, and Medicine: How Are They Related and What Does it Mean? [by Koenig, author of flawed study, 2001]
Religious Involvement, Spirituality, and Medicine: Implications for Clinical Practice [Mueller, 2001]
Note that Mueller was the lead author of the recent study confirming that intercessory prayer does nothing:
Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer [April 2006]
What kind of sick morality would put false hope in the heads of many? Worse still, confirmed by Mueller's recent study, those people who knew they were being prayed for did worse than those who weren't prayed for at all. Perhaps it's the problem of linking morality with health? Perhaps you don't know any better. Perhaps those who derived their sick morality from a God who kills babies [cf 1 Sam 15:3, Num 31] can't see the problem in foisting false hopes and lies on others for the sake of propping up this god's popularity?