Role of Religiosity in the Lives of the Low-Income Population: A Comprehensive Review of the Evidence. Cancer Screening

07/10/2009

Based on the results of four studies, there are no statistically significant direct effects of frequency of church attendance, religious affiliation, general religious beliefs, and specific health-related religious beliefs on cancer screening use, including mammograms and pap smears for low-income women.

Based on the results of four studies, there are no statistically significant direct effects of frequency of church attendance, religious affiliation, general religious beliefs, and specific health-related religious beliefs on cancer screening use, including mammograms and pap smears for low-income women. Notably, one study measures health services such as mammograms and pap smears based on insurance claims data, while the other study uses self-reported measures, and both find a null effect. Table 5-3 highlights these findings.

Although these studies find no significant direct effects of religiosity on the likelihood of receiving cancer screening, one study conducts subgroup analysis and finds that church attendance increases the likelihood of pap smears in at-risk groups in a community sample of low-income African American women (Aaron et al., 2003). At-risk groups include women who are uninsured and who have two or more chronic health conditions. This study does not control for any potential mediating factors; therefore, church attendance could be a proxy for church-based social support. This study does find a direct effect of religiosity on use of preventive health services other than cancer screening. More frequent church attendance increases the likelihood of dental visits and blood pressure measurement.

Table 5-3.
Summary of Religiosity and Cancer Screening and Reproductive Health Findings in the Low-Income Population
Study Sample Key Control Variable Constructs1 Dependent Variable Measure of Religiosity2 Effect
Paskett et al., 1999 Random sample panel of 290 women over 40 in low-income housing in one North Carolina county Screening in the past year, social organization, moral support, insurance Breast and cervical-cancer screening (pap smear, mammogram) between time 1 and time 2 Church member
Attendance
Denomination
Five items on religiosity3
Null effects for all 3 religion measures for both tests
Husaini et al., 2001 Group level intervention study of 364 African American women over 40 Social support, family history, education program, health beliefs, insurance Mammogram status obtained last year, obtained between wave 1 and 2 and no mammogram Two-item scale frequency of church attendance and other church activities

Null

Aaron et al., 2003 2196 adults in low-income, African American neighborhood Comorbid conditions, insurance, regular source of care Dental visits,
blood pressure,
pap smear,
mammogram
Two-item scale ever attend church and how often

+
+
Null
Null

Katz et al., 2008 Randomized trial, 851 women over 40 who had not received a mammogram in the past year in a rural county. ROSE project Treatment, insurance, smoking Mammogram in the past year (medical record) 12 months after enrollment Religious affiliation
Frequency of church attendance
Spirituality4

Null

Null

Null

Romo et al., 2004 297 Latino women receiving care at two university reproductive health clinics in southeast Texas Language, foreign born, contraception and birth history Unwillingness to use emergency contraception (EC) Roman Catholicism
Church attendance
Religious morality5

Null

Null

+

  1. Includes independent variables other than basic demographics (race, age, marital status, gender, region).
  2. Includes single-item measures unless indicated.
  3. Respondents were asked if they agreed or disagreed with the following questions: (1) "If God wants me to have cancer, it's His will"; (2) "God is my doctor"; (3) "God gives doctors wisdom and skill to heal"; (4) "God wants us to help ourselves"; and (5) "I need to be in good health to do God's work."
  4. Frequency with which women asked God for help, the proximity of their relationship to God, and the extent to which their life had a religious purpose, were used to assess spirituality.
  5. EC is morally wrong, my church disapproves, it is against my religion, it interferes with Gods will.

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