Religion and health: an assessment of causality, interaction, feedback, and mechanisms
Abstract. A large literature has suggested that religious service attendance is associated with better mental and physical health. Two major questions that have emerged from these studies are: (i) is the relationship causal? and (ii) if so, what are the mechanisms? We present analyses using data from the Nurses Health Study, with repeated measures of religious service attendance, health outcomes, and time-varying confounders, to address these questions with respect to mortality, depression, and suicide as outcomes. Marginal structural models are employed to address issues of potential feedback and reverse causation; methods from causal mediation analysis are used to assess mechanisms; sensitivity analysis techniques are used to assess the robustness of conclusions to potential unmeasured confounding. Potential interaction between service attendance and either race or Protestant vs. Catholic affiliation are assessed. Discussion is given to the relation of these results to the observations in Durkheim's work Suicide, potential implication for social policy, and the needs and challenges for future research in this area.