Religion and Health 195
A recent prospective study of 3,968 community-dwelling older adults from the Pied-
mont region of North Carolina (Koenig, Hays, Larson, George, Cohen, McCullough,
Meador, and Blazer 1999) yielded evidence that frequency of attendance at religious ser-
vices was related to significantly reduced hazard of dying over the six-year study period.
After controlling for potential sociodemographic and health-related confounds, Koenig
et al. found that the relative hazard of dying for frequent attenders of religious services
remained relatively low (for women, RH=.51, CI=0.43–0.59; for men, RH=.63, CI=
0.52–0.75). After adjusting the association for explanatory variables such as social sup-
port and health behaviors (including cigarette smoking, alcohol consumption, and
body mass index), the religion-mortality association became appreciably weaker (for
women, RH=0.65, CI=0.55–0.76; for men, RH=0.83, CI=0.69–1.00). These re-
sults indicate that being involved in public religious activity – namely, attendance at
religious services – was associated with a reduction in mortality. Part of this association
was attributable to potential confounds (e.g., gender, ethnicity, education, number
of health conditions, self-rated health), and part was attributable to the influence of
church attendance on well-established risk factors for early death.
In what is perhaps the most far-reaching study on religion and mortality to date,
Hummer, Rogers, Nam, and Ellison (1999) followed a nationally representative sample
of over twenty-one thousand adults from 1987 to 1995. In 1987, respondents com-
pleted a single-item measure of frequency of attendance at religious services, along with
a variety of other measures to assess demographics, socioeconomic status, health, social
ties, and health behaviors. Hummer and his colleagues found that frequent religious
attendance was positively related to length of life. People of both sexes who attended
religious services more than once per week were estimated to live for 62.9 years beyond
age twenty. For those who attended once per week, life expectancy beyond age twenty
was 61.9 years. For those who attended less than once per week, life expectancy beyond
age twenty was 59.7 years. Finally, for those who reported never attending religious ser-
vices, the life expectancy beyond age twenty was 55.3 years. This represents a 7.6-year
survival differential between the frequent attenders and the nonattenders.
After controlling for a variety of potential confounds and mediators that could ex-
plain the association of religious involvement and longevity (including age, gender,
health, social status, social support, cigarette smoking, alcohol use, and body mass in-
dex), people who frequently attended religious services still appeared to survive longer
than did those who did not attend. Indeed, people who reported never attending re-
ligious services had an 87 percent higher risk of dying during the follow-up period
than did people who attended religious service more than once per week. People who
attended religious services, but less frequently than “more than once per week” also
experienced longer survival than did those who did not attend.
Because Hummer et al. (1999) worked with such a large data set, they were able
to explore the association of religious involvement with death from specific causes in-
cluding circulatory diseases, cancer, respiratory diseases, diabetes, infectious diseases,
external causes, and all other causes. Religious attendance was associated with lower
hazard of death from most causes, including circulatory diseases, respiratory diseases,
diabetes, infectious diseases, and external causes. One notable exception was that reli-
gious attendance did not appear to be related to a reduced risk of dying from cancer.
When demographics, health, socioeconomic status, social ties, and health behaviors
were controlled, most of these survival differences became statistically nonsignificant,