Health benefits of religion among Black and White older adults? Race, religiosity, and C-reactive protein

Highlights

• Investigates link between religion and C-reactive protein among US adults.

• Religious service attendance by Black adults is inversely related to CRP.

• Religion/health relationship is not confined to self-reported health.

Abstract

The study investigates potential health benefits of religiosity to protect against chronic inflammation associated with the risk of cardiovascular diseases. The study uses longitudinal data from a representative survey of adults 57–85 years old at the beginning of the National Social Life, Health, and Aging Project. Linear regression models were used to analyze the association between religiosity, as measured by affiliation, attendance, and having a clergy confidant, and logged values of C-reactive protein (CRP) concentration (mg/L). Although religious attendance was not related to CRP among the White respondents, attendance was associated with lower CRP—and change in CRP over time—among the Black respondents. There was no evidence that religious affiliation alone had any health benefit. The study provides evidence of the salutary effects of religious engagement on chronic inflammation among older adults, especially for Black Americans, which may be useful in reducing the prevalence of hypertension and cardiovascular disease.

Introduction

Is religion good, bad, or benign to health? This is a question that has long sparked scholarly interest. Freud and Marx generally viewed religion as a maladaptive response while Durkheim and James found that human–divine relations can benefit both the social order and personal well-being. Research on religion and health has proliferated during the last two decades: more than 2200 quantitative publications examine the conditions under which there may be a link between religion and various facets of physical or mental health (George et al., 2013, Koenig et al., 2001). Most of these studies report that religion is beneficial to one or more health indicators, but some studies reveal that religion may also lead to poorer health outcomes—and still other studies find no association. Religion and health are each rich concepts, and the evidence-based conclusions from the extant research depend largely upon which elements of the two phenomena are studied. The present study seeks to contribute to this literature along two axes.

First, given religion's role as a meaning system and its utility as a coping resource, it is logical that there are many studies of religion's effect on mental health and overall wellbeing. Even among the studies examining physical health, however, most rely on measures of self-reported health. Although self-reported measures are generally considered useful in a prognostic sense (Ferraro & Farmer, 1999), they are limited for explicating mechanisms for how social factors influence biological processes. Thus, a small but growing set of studies examine various biomarkers of health, which provide a window into preclinical risk of disease and the biological pathways by which religion may influence health.

Second, race is a notable and relatively understudied source of variability in how religion may be related to health. Organized religious affiliation and expression are patterned along racial and ethnic lines in many nations. Relatively few empirical studies of religion and physical health, however, systematically examine racial and ethnic variability in these relationships; many studies either do not analyze racial variability or simply adjust for race when testing the relationship between indicators of religion and physical health outcomes (for an exemplar examining health, see Steffen et al., 2001).

Black churches, however, are distinctive in the types of programs and services offered (Koch and Beckley, 2006), the sense of belonging among members (Martinez and Dougherty, 2013), and the religious experience cultivated to aid coping with adversity (Ellison et al., 2008). Perhaps greater attention to this variability will clarify who most benefits from (or is harmed by) religious participation. Evidence from previous research leads one to expect that Black people receive greater health benefits from their religious participation than is the case for White people (Krause, 2002). In addition, health disparities by race are substantial (LaVeist et al., 2011), calling for greater attention to the health needs of Black people (i.e., persons of African and Afro-Caribbean descent) and the role of religion to reduce such disparities. If the relationship between religion and health varies by race in the United States, the implications may be far reaching to other nations and religions.

Using a national sample of older Americans, we systematically examine Black/White differences in the relationship between several indicators of religion and a biomarker of chronic inflammation that is a precursor to several cardiovascular diseases. Across all age groups, Black men and women have higher rates of hypertension and heart disease mortality than their White counterparts (Centers for Disease Control and Prevention, 2014). As such, examining how religion may influence a biomarker that is highly predictive of heart disease is potentially significant for improving public health (Crimmins and Vasunilashorn, 2011).