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

07/10/2009

Although there are only a small number of qualitative research studies that focus on religion and health care treatment and services in the low-income population, these studies highlight the positive role that religion can play in helping families engage in positive health behaviors and treatment regimens. One study of asthma treatment decisions finds that low-income Puerto Rican families use spiritually based folk remedies such as prayer to saints (Espiritismo) during times of stress. These practices supplement medical treatment routines administered to children that are closely managed by parents (Pachter, Cloutier, & Bernstein, 1995). The authors conclude that the spiritual and medical treatments do not interfere with each other.

Also, two studies highlight the positive role that religion can play in comforting economically vulnerable individuals when thinking about end-of-life decisions (Born, Greiner, Sylvia, Butler, & Ahluwalia, 2004; Tarzian, Neal, & ONeil, 2005). Religious and spiritual influences are apparent when focus group participants discuss end-of-life decisions, and these beliefs appear to provide positive coping mechanisms. The influence of religious beliefs does not seem to push people in specific directions about their preferred treatments. As Tarzian et al. (2005) note, homeless individuals interviewed appear to have a range of preferences about end-of-life care, and many seem to be making decisions in the moment and abiding by Gods messages (p. 41).

One study highlights the potential for positive and negative effects of religion in promoting screening and treatment of sexually transmitted infections (STIs). Lichenstein (2003) reports that in a sample of patients, college students, and community health clinic workers, which included a sizable low-income population, about half reported that religion promoted STI stigma that could create a barrier to treatment, while the other half believed that positive moral messages could help prevention. Patients in the study sample viewed religion as a treatment barrier while community health workers had the opposite view of religion. The differing perspectives about the effects of religion on treatment behavior highlight some of the communication difficulties between providers and patients about religion.

The qualitative research studies also highlight factors that influence treatment decisions that are not generally considered in the quantitative empirical research literature. These factors include family of origin religious beliefs and treatment practices, potential stigma of treatment, the role of folk remedies, and perceived discrimination from health care providers. Adequately controlling for these determinants of health outcomes that are also likely to be correlated with religious beliefs and practices can increase the precision of the estimated associations between religiosity and mental and physical health outcomes.

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