Dataset Information

Religious service attendance, divorce, and remarriage among U.S. nurses in mid and late life.

ABSTRACT: Prior research has suggested religious participation can promote marital satisfaction and stability. However, current literature has mainly focused on early life divorce, and used cross-sectional data, leaving open the question of the directionality of effects. We evaluated the prospective associations between service attendance and marital stability in mid and late life considering either 1) divorce or separation; or 2) remarriage, as separate outcomes. Data were drawn from the Nurses' Health Study, a large prospective cohort study that consisted of US female nurses in their 50s at study enrollment, with repeated measures of service attendance and marital status over 14 years of follow-up from 1996-2010. During follow up, among 66,444 initially married nurses who were mainly Christians, frequent service attendance was associated with 50% lower risk of divorce (95% CI: 32%, 63%), and 52% lower risk of either divorce or separation (95%CI: 37%, 63%). Among initially divorced or separated women, frequent service attendance was not associated with subsequent likelihood of remarriage; however, among widowed women, women who attended services frequently had 49% increased likelihood of remarriage (95% CI: 13%, 97%) compared to those women who did not. The study provides evidence that in this cohort of US nurses, frequent service attendance is associated with lower risk of becoming divorced in mid- and late- life, and increased likelihood of remarriage among widowed nurses, but not among divorced or separated nurses.

SUBMITTER: Li S

PROVIDER: S-EPMC6277070 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Religious service attendance, divorce, and remarriage among U.S. nurses in mid and late life.

Li Shanshan S Kubzansky Laura D LD VanderWeele Tyler J TJ

PloS one 20181203 12

Prior research has suggested religious participation can promote marital satisfaction and stability. However, current literature has mainly focused on early life divorce, and used cross-sectional data, leaving open the question of the directionality of effects. We evaluated the prospective associations between service attendance and marital stability in mid and late life considering either 1) divorce or separation; or 2) remarriage, as separate outcomes. Data were drawn from the Nurses' Health S ...[more]

PMID: 30507933

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Project description:ImportanceStudies on the association between attendance at religious services and mortality often have been limited by inadequate methods for reverse causation, inability to assess effects over time, and limited information on mediators and cause-specific mortality.ObjectiveTo evaluate associations between attendance at religious services and subsequent mortality in women.Design, setting, and participantsAttendance at religious services was assessed from the first questionnaire in 1992 through June 2012, by a self-reported question asked of 74 534 women in the Nurses' Health Study who were free of cardiovascular disease and cancer at baseline. Data analysis was conducted from return of the 1996 questionnaire through June 2012.Main outcomes and measuresCox proportional hazards regression model and marginal structural models with time-varying covariates were used to examine the association of attendance at religious services with all-cause and cause-specific mortality. We adjusted for a wide range of demographic covariates, lifestyle factors, and medical history measured repeatedly during the follow-up, and performed sensitivity analyses to examine the influence of potential unmeasured and residual confounding.ResultsAmong the 74 534 women participants, there were 13 537 deaths, including 2721 owing to cardiovascular deaths and 4479 owing to cancer deaths. After multivariable adjustment for major lifestyle factors, risk factors, and attendance at religious services in 1992, attending a religious service more than once per week was associated with 33% lower all-cause mortality compared with women who had never attended religious services (hazard ratio, 0.67; 95% CI, 0.62-0.71; P < .001 for trend). Comparing women who attended religious services more than once per week with those who never attend, the hazard ratio for cardiovascular mortality was 0.73 (95% CI, 0.62-0.85; P < .001 for trend) and for cancer mortality was 0.79 (95% CI, 0.70-0.89; P < .001 for trend). Results were robust in sensitivity analysis. Depressive symptoms, smoking, social support, and optimism were potentially important mediators, although the overall proportion of the association between attendance at religious services and mortality was moderate (eg, social support explained 23% of the effect [P = .003], depressive symptoms explained 11% [P < .001], smoking explained 22% [P < .001], and optimism explained 9% [P < .001]).Conclusions and relevanceFrequent attendance at religious services was associated with significantly lower risk of all-cause, cardiovascular, and cancer mortality among women. Religion and spirituality may be an underappreciated resource that physicians could explore with their patients, as appropriate.

Project description:IMPORTANCE:Previous studies have linked suicide risk with religious participation, but the majority have used ecologic, cross-sectional, or case-control data. OBJECTIVE:To examine the longitudinal association between religious service attendance and suicide and the joint associations of suicide with service attendance and religious affiliation. DESIGN, SETTING, AND PARTICIPANTS:We evaluated associations between religious service attendance and suicide from 1996 through June 2010 in a large, long-term prospective cohort, the Nurses' Health Study, in an analysis that included 89?708 women. Religious service attendance was self-reported in 1992 and 1996. Data analysis was conducted from 1996 through 2010. MAIN OUTCOMES AND MEASURES:Cox proportional hazards regression models were used to examine the association between religious service attendance and suicide, adjusting for demographic covariates, lifestyle factors, medical history, depressive symptoms, and social integration measures. We performed sensitivity analyses to examine the influence of unmeasured confounding. RESULTS:Among 89?708 women aged 30 to 55 years who participated in the Nurses' Health Study, attendance at religious services once per week or more was associated with an approximately 5-fold lower rate of suicide compared with never attending religious services (hazard ratio, 0.16; 95% CI, 0.06-0.46). Service attendance once or more per week vs less frequent attendance was associated with a hazard ratio of 0.05 (95% CI, 0.006-0.48) for Catholics but only 0.34 (95% CI, 0.10-1.10) for Protestants (P?=?.05 for heterogeneity). Results were robust in sensitivity analysis and to exclusions of persons who were previously depressed or had a history of cancer or cardiovascular disease. There was evidence that social integration, depressive symptoms, and alcohol consumption partially mediated the association among those occasionally attending services, but not for those attending frequently. CONCLUSIONS AND RELEVANCE:In this cohort of US women, frequent religious service attendance was associated with a significantly lower rate of suicide.

Project description:ImportanceThe increase in deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) has been identified as a public health crisis. The antecedents associated with these deaths have, however, seldom been investigated empirically.ObjectiveTo prospectively examine the association between religious service attendance and deaths from despair.Design, setting, and participantsThis population-based cohort study used data extracted from self-reported questionnaires and medical records of 66 492 female registered nurses who participated in the Nurses' Health Study II (NHSII) from 2001 through 2017 and 43 141 male health care professionals (eg, dentist, pharmacist, optometrist, osteopath, podiatrist, and veterinarian) who participated in the Health Professionals Follow-up Study (HPFS) from 1988 through 2014. Data on causes of death were obtained from death certificates and medical records. Data analysis was conducted from September 2, 2018, to July 14, 2019.ExposureReligious service attendance was self-reported at study baseline in response to the question, "How often do you go to religious meetings or services?"Main outcomes and measuresDeaths from despair, defined specifically as deaths from suicide, unintentional poisoning by alcohol or drug overdose, and chronic liver diseases and cirrhosis. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) of deaths from despair by religious service attendance at study baseline, with adjustment for baseline sociodemographic characteristics, lifestyle factors, psychological distress, medical history, and other aspects of social integration.ResultsAmong the 66 492 female participants in NHSII (mean [SD] age, 46.33 [4.66] years), 75 incident deaths from despair were identified (during 1 039 465 person-years of follow-up). Among the 43 141 male participants in HPFS (mean [SD] age, 55.12 [9.53] years), there were 306 incident deaths from despair (during 973 736 person-years of follow-up). In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week had a 68% lower hazard (HR, 0.32; 95% CI, 0.16-0.62) of death from despair in NHSII and a 33% lower hazard (HR, 0.67; 95% CI, 0.48-0.94) of death from despair in HPFS.Conclusions and relevanceThe findings suggest that religious service attendance is associated with a lower risk of death from despair among health care professionals. These results may be important in understanding trends in deaths from despair in the general population.

Project description:Cannabis use and disorders (CUD) are influenced by multiple genetic variants of small effect and by the psychosocial environment. However, this information has not been effectively incorporated into studies of gene-environment interaction (GxE). Polygenic risk scores (PRS) that aggregate the effects of genetic variants can aid in identifying the links between genetic risk and psychosocial factors. Using data from the Pasman et al. GWAS of cannabis use (meta-analysis of data from the International Cannabis Consortium and UK Biobank), we constructed PRS in the Collaborative Study on the Genetics of Alcoholism (COGA) participants of European (N: 7591) and African (N: 3359) ancestry. The primary analyses included only individuals of European ancestry, reflecting the ancestral composition of the discovery GWAS from which the PRS was derived. Secondary analyses included the African ancestry sample. Associations of PRS with cannabis use and DSM-5 CUD symptom count (CUDsx) and interactions with trauma exposure and frequency of religious service attendance were examined. Models were adjusted for sex, birth cohort, genotype array, and ancestry. Robustness models were adjusted for cross-term interactions. Higher PRS were associated with a greater likelihood of cannabis use and with CUDsx among participants of European ancestry (p < 0.05 and p < 0.1 thresholds, respectively). PRS only influenced cannabis use among those exposed to trauma (R2: 0.011 among the trauma exposed vs. R2: 0.002 in unexposed). PRS less consistently influenced cannabis use among those who attend religious services less frequently; PRS × religious service attendance effects were attenuated when cross-term interactions with ancestry and sex were included in the model. Polygenic liability to cannabis use was related to cannabis use and, less robustly, progression to symptoms of CUD. This study provides the first evidence of PRS × trauma for cannabis use and demonstrates that ignoring important aspects of the psychosocial environment may mask genetic influences on polygenic traits.

Dataset Information

Religious service attendance, divorce, and remarriage among U.S. nurses in mid and late life.

Publications

Religious service attendance, divorce, and remarriage among U.S. nurses in mid and late life.

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