Role of Religiosity in the Lives of the Low-Income Population: A Comprehensive Review of the Evidence. General Mental Health

07/10/2009

In terms of overall ratings of mental health, four out of five studies find a statistically significant positive association between more frequent participation in religious organizational activities (church attendance and other activities in places of worship) and better mental health outcomes. Nonorganizational religiosity, measured by higher levels of individuals spiritual and religious beliefs, also has a statistically significant positive association with individuals self-reported mental health.

Table 5-1.
Summary of Religiosity and Mental Health Findings in the Low-Income Population
Study Sample Key Control Variables1 Measure of Religiosity2 Effect
Depression3
Aranda, 2008 Convenience sample 230 older Latinos in hospital in Los Angeles Stress, social support, functional limits Church attendance -
Prayer Null
Jesse & Swanson, 2007 Convenience sample 324 pregnant women at prenatal clinic in the Southeast Abuse, stress, social support, satisfaction with support SPS4 +
JAREL5 Null
Jesse et al., 2005 Convenience sample 130 pregnant women at prenatal clinic in the Midwest Abuse, stress, social support, Medicaid receipt, health risk behaviors SPS4 Null
JAREL5 +
Dyeson, 2000 Convenience sample 286 chronically ill elders receiving home health services in Texas Health status, financial resources, perceptions of caregiving Index: prayer, read religious material, watch or listen to religious programs Direct: Null
Indirect: -
Garrison et al., 2004 Convenience sample 131 single mothers, living in rural areas in 8 states who receive public benefits (TANF, WIC, etc.) Demographics only Index: strength and support from God, prayer helps me, importance of seeking Gods guidance
Index: church attendance
-   -
Kalil et al., 2001 Random sample of 580 single mothers who are first-time welfare recipients in Maryland Multiple measures of stressors and social support Church attendance -
van Olphen et al., 2003 Random sample of 679 African American women in east side of Detroit Physical functioning, church social support Church member
Importance of faith
Church attendance

Prayer

-
Null
Direct: -
Indirect: Null
Direct: -
Indirect: -
Mental Health Inventory6
Gore et al., 2005 277 men with prostate cancer in free treatment program in CA Cancer stage, ratings of physical health FACIT-sp7 +
Romero et al., 2004 Convenience sample 81 women treated for breast cancer at county hospital in Houston Quality of life, self-forgiving attitude Rating of how spiritual/religious one considers oneself +
Friedman et al., 2005 Convenience sample 58 women 40 and over receiving home health care in Texas None Belong to church, congregation or religious group and when last active +
Franzini et al., 2005 Multistage probability sample of 3203 individuals in 13 low-income communities in Houston Motivation to participate in religious organization, perceived racism, trust, personal opportunity, social support, victimization Organizational: church attendance, other activities in place of worship
Nonorganizational: prayer, importance of religious or spiritual beliefs in daily life and as a source of meaning in life
+   -
Franzini & Fernandez-Esquer, 2004 Subsample of 1,745 Mexican-origin respondents from the sample above Factors above except motivation Index: church attendance, other activities in place of worship Null
Suicide Attempt
Meadows et al., 2005 200 African American women who experienced intimate partner violence receiving care at urban hospital Spousal abuse, protective factors such as social support, self-efficacy, hopefulness SWBS8 Index of protective factors including spirituality

Null

-

Anglin et al., 2005 200 African American women and men seeking medical or psychiatric care at urban hospital Homeless status, suicide acceptability RWB subscale9

-

Psychological Distress
Prado et al., 2004 Convenience sample 252 HIV-positive African American mothers in S. Florida Stress, social support, coping styles Index: church attendance, religious and spiritual activities, read religious materials, prayer or meditation

Direct: Null
Indirect: -

Psychological Adaptation
Simoni et al., 2002 Convenience sample 230 African Americans and Puerto Ricans with HIV/AIDS in New York City Social support, coping strategies Church membership
Church attendance
Spirituality
Spirituality-based coping10

Null
Null
+
+

Post-traumatic Stress Disorder (PTSD)
Bradley et al., 2005 Convenience sample 134 African American women with history of interpersonal violence receiving care at urban hospital Coping strategies, self-esteem, abuse, and trauma Positive religious coping
Negative religious coping

Null

+

  1. Includes independent variables other than basic demographics (race, age, marital status, gender, region)
  2. Includes single-item measures unless indicated.
  3. Includes multi-item depression scales.
  4. SPS = Spirituality Perception Scale  10 items including spirituality measures such as frequency of discussion of spiritual matters and feelings of closeness to God or a higher power.
  5. JAREL spirituality scale  3 items including how often attend religious services, how important is religious services, how often would you attend if able.
  6. Mental health indicators include: Mental Health Inventory (MHI-5)  emotional well-being, SF-12/36 health-related quality of life (social/family and emotional well-being), MCS = mental component summary.
  7. FACIT = Functional Assessment of Chronic Illness Therapy scale  spirituality subscale is a 12-item survey measure including measures such as sense of purpose in life and comfort from spiritual beliefs.
  8. SWBS = Spiritual Well-being Scale comprised of 13 attitudes  ranging from spirituality provides sense of hope to prayer.
  9. RWB subscale = Religious Well-being  10 items measuring the degree to which individuals report a satisfactory relationship with God.
  10. Spirituality-based coping  prayed or other spiritual activities, found new faith, mediated or used relaxation or visualization to solve problem.

Notably, one study that includes measures of both organizational and nonorganizational religiosity points to the potential differential effects of religiosity depending on type of measurement and whether the study sample is drawn from a community or a hospital or clinic setting. In this study, organizational religiosity has a significant positive association with good mental health outcomes while nonorganizational religiosity has a significant negative association (Franzini et al., 2005). In a separate study, these authors find a statistically insignificant association between organizational religiosity and mental health for individuals of Mexican origin (Franzini & Fernandez-Esquer, 2004). Because this study draws on a community sample of residents from low-income neighborhoods rather than a clinical sample, it may be that the effects of religiosity and spirituality are strong and positive for overall mental health when low-income individuals are facing serious health conditions such as cancer or chronic diseases in patient samples, but community samples show weaker effects.

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