Role of Religiosity in the Lives of the Low-Income Population: A Comprehensive Review of the Evidence. Findings Specific to the Low-Income Population

07/10/2009

  1. Does religiosity/spirituality exert a protective effect reducing substance use outcomes?

Table 6-1 highlights the findings from the eight studies that conducted analyses exploring the effects of religiosity or spirituality on substance use outcomes. Overall, findings from these eight studies are mixed; therefore, there is not enough evidence to draw conclusions about the direction of the effects of religiosity on substance use in the low-income population.

Overall, findings from these eight studies are mixed; therefore, there is not enough evidence to draw conclusions about the direction of the effects of religiosity on substance use in the low-income population.

Three of the studies find that religiosity/spirituality have a positive or protective effect on reducing substance use outcomes. In the Sanchez et al. (2008) study, religiosity is viewed as having an important role in primary prevention. One group of study participants indicated that religiosity is the primary way that they keep away from initiating drug use, whereas others attributed religiosity as a secondary or tertiary protective factor. This group of study participants believed that religion helped them to quit using drugs or contributed to a drastic reduction in substance use. The second study (Johnson, 2008) provides empirical support for how harmful environmental influences can be lessened by a youths individual religious commitment. The third study (Hill & McCullough, 2008) finds that religious involvement protects adherents from high levels of intoxication. In fact, not only does religious attendance lead to a lower level of intoxication among low-income urban women, religious attendance is also associated with a sustained lower level of intoxication for 2 years.

Two of the studies find no statistically significant positive or protective impact for religiosity/spirituality on substance use outcomes. However, one of these studies (Weiss et al., 2008) examines multiple substance use outcomes and reveals inconclusive findings for one of the three outcomes.

Table 6-1.
Associations between Religiosity and Substance Use Outcomes
Substance Use Outcomes Association with Religiosity
Positive or Protective Association
Prevention of initial use of drugs (Sanchez et al., 2008) Religiosity is the second protective factor most cited by study participants.
Adolescent use of illicit drugs
(Johnson, 2008)
Individual religious commitment reduces the effects of perceived neighborhood disorder on adolescent use of illicit drugs.
The beneficial effect of individual religious commitment is independent of social and family bonding variables.
The beneficial effect of individual religious commitment on teen drug use becomes stronger the older a teenager gets.
Religiously committed adolescents from bad neighborhood are less likely to use illicit drugs than those with low levels of religious commitment from good neighborhoods.
Level of intoxication
(Hill & McCullough, 2008)
Religious involvement is associated with lower levels of intoxication and lower levels of sustained intoxication over 2 years among low-income women
No statistically significant association
Alcohol and drug addiction severity
(Arevalo et al., 2008)
The association between spirituality and alcohol and drug addiction severity is not significant.
Heavy drinking
(Weiss et al., 2008)
Religious intentionality (measured by how strongly beliefs of religious group influences behavior) worship attendance and religious self-perception are unrelated to heavy drinking.
Heavy crack use
(Weiss et al., 2008)
Religious intentionality, worship attendance, and religious self-perception are unrelated to heavy crack use.
Inconclusive findings
Alcohol and hard drug use
(Schensul & Burkholder, 2005)
Lower religiosity is associated with more frequent alcohol use, and higher religiosity is associated with more frequent hard drug use.
Drug use and drug selling
(Johnson et al., 2000)
Church attendance is associated with decreased drug use and drug selling; however, religiosity is not associated with drug use and drug selling.
Smoking and substance use during pregnancy
(Jesse et al., 2006)
Women with low levels of religiosity are more likely to smoke during pregnancy; however, the association between religiosity and substance use during pregnancy is not significant.
Reuse of needles/syringes
(Weiss et al., 2008)
Religious intentionality is significantly associated with reuse of needles/syringes among heroin injectors, but worship attendance and religious self-perception are unrelated to reuse of needles/syringes.

Inconclusive findings are revealed in four studies. Religiosity has both a buffering and risk-enhancing effect, and a positive and null effect on substance use in these studies. In the Schensul & Burkholder (2005) study, religiosity protects against alcohol use but enhances risk in the use of hard drugs. Research conducted by Johnson, Larson, Li, and Lang (2000) finds a positive association between church attendance and decreased drug use and drug selling; however, when the same study explores religious salience, it finds that this construct is not associated with drug use and drug selling. Similarly, Jesse, Graham, and Swanson (2006) find that low levels of religiosity are associated with an increased likelihood of smoking during pregnancy; however, the association between religiosity and substance use during pregnancy is not significant. The last study (Weiss et al., 2008) finds that heroin injectors who reported that the beliefs of their religious groups strongly influenced their behaviors were protected from increased reuse of needles/syringes. Worship attendance and religious self-perception are not related to reuse of needles, and none of the religious dimensions used in this study (religious intentionality, worship attendance, and religious self-perception) are related to other substance use behaviors common to heroin injectors, such as heavy alcohol use and daily crack use.

2. What role does religiosity play in drug use interventions or drug treatment?

Two studies explored the role of religiosity within the context of a drug use intervention and drug use treatment paradigm. One study focuses on the role of religiosity on a smoking cessation intervention, and the second study focuses on religiosity and seeking drug use treatment (see Table 6-2). Religiosity does not predict or mediate the relationship between the smoking cessation intervention and actual smoking cessation. Religiosity was more positively associated with seeking drug treatment. The Spence, Wallisch, & Smith (2007) research focused on Hispanic residents living in the U.S./Mexican border area. One community, termed colonias, has a deficit of protective factors compared with other border communities in terms of having a lower socioeconomic status and lacking community institutions. Despite the general deficits in protective factors, religiosity appeared to be an important factor in acknowledging the need for and seeking drug treatment.

Table 6-2.
Effects of the Importance of Religiosity on Drug Treatment
Substance Use Outcome Role of religiosity
Drug Use Intervention
Smoking cessation
(Andrews et al., 2007)
Religiosity does not predict or mediate the relationship between the intervention and smoking cessation.
Drug Use Treatment
Drug treatment seeking behaviors
(Spence et al., 2007)
In socially isolated rural communities, higher religiosity is related to greater drug treatment seeking.
Severity of need for drug treatment
(Spence et al., 2007)
In socially isolated rural communities, low religiosity is related to greater severity of need for drug treatment.

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