Regularly attending religious services associated with lower risk of deaths of despair, study finds

"Despair is something that can confront anyone dealing with severe difficulties or loss. While the term 'deaths of despair' was originally coined in the context of working class Americans struggling with unemployment, it is a phenomenon that is relevant more broadly, such as to the health care professionals in our study who may be struggling with excessive demands and burnout, or to anyone facing loss. As such, we need to look for important community resources that can protect against it," said Tyler VanderWeele, John L. Loeb and Frances Lehman Loeb Professor of Epidemiology at Harvard Chan School. VanderWeele is also director of the Human Flourishing Program and co-director of the Initiative on Health, Religion and Spirituality at Harvard University.

The study will be published online in JAMA Psychiatry on May 6, 2020.

Religion may be a social determinant of health, and previous research has shown that attending religious services may be associated with a lower risk of various factors related to despair, including heavy drinking, substance misuse, and suicidality.

For this study, researchers analyzed data from the Nurses' Health Study II on 66,492 women as well as data from the Health Professionals Follow-Up Study on 43,141 men. Among the women, there were 75 deaths from despair: 43 suicides, 20 deaths from poisoning, and 12 deaths from liver disease and cirrhosis. Among the men there were 306 deaths from despair: 197 suicides, 6 deaths from poisoning, and 103 deaths from liver diseases and cirrhosis.

After adjusting for numerous variables, the study showed that women who attended services at least once per week had a 68% lower risk of death from despair compared to those never attending services. Men who attended services at least once per week had 33% lower risk of death from despair.

The study authors noted that religious participation may serve as an important antidote to despair and an asset for sustaining a sense of hope and meaning. They also wrote that religion may be associated with strengthened psychosocial resilience by fostering a sense of peace and positive outlook, and promoting social connectedness.

"These results are perhaps especially striking amidst the present COVID-19 pandemic," said Ying Chen, research associate and data scientist at the Human Flourishing Program at Harvard's Institute for Quantitative Social Science, and first author of the paper. "They are striking in part because clinicians are facing such extreme work demands and difficult conditions, and in part because many religious services have been suspended. We need to think what might be done to extend help to those at risk for despair."

Other authors from Harvard Chan School include Howard Koh and Ichiro Kawachi. Michael Botticelli of the Grayken Center for Addiction at Boston Medical Center was also a co-author.