Thousands of studies have been conducted on religion/spirituality and health, and what constitutes “health” has ranged anywhere from depression to hypertension to cancer to mortality. Most of this research has been conducted in the U.S., typically on samples that are predominantly white and Christian. These studies have often found positive relationships between religion/spirituality and health or no relationship at all. However, in some cases, religion and spirituality have been linked with negative outcomes. Researchers have been able to demonstrate that when the relationship is positive it is often because religion and spirituality provide ways of coping with problems, and when it is negative it is often because of negative perceptions of the divine or negative experiences with others in their religion.
Prior to MASALA there were only two studies examining religion/spirituality and health among U.S. South Asians. Our team of researchers, in cooperation with scholars at Harvard Medical School, published three new papers looking at the associations between religion/spirituality and health in the MASALA study. These studies provide an important foundation for future work in the South Asian population.
The first study focused on religious group involvement, and looked at religious affiliation, religious attendance, participation in group prayer outside of religious services, giving and receiving love and support to and from fellow congregants, experiencing neglect by fellow congregants, and being criticized by fellow congregants. The second study examined private religious and spiritual practices and beliefs, which included frequency of prayer, yoga practice, belief in God/the divine, gratitude, non-theistic daily spiritual experiences (i.e., connections with the transcendent not specific to a religion or god), theistic daily spiritual experiences, feelings of closeness to God/the divine, positive religious coping (i.e., God/the divine provides comfort and support during times of stress), negative religious coping (i.e., feeling punished by God/the divine when things go wrong), religious and spiritual struggles (i.e., stress causes doubt about religious beliefs), and feelings of hope in God/the divine. The third short study looked at one variable: the degree to which people consider themselves to be religious or spiritual.
We examined four different health outcomes for each study: self-rated health (“rate your overall health on a scale of 1-5”), mental health (i.e., depressive symptoms), feelings of anxiety, and feelings of anger.
What did we find? First, for group religion, we found that Jains reported better self-rated health than Hindus and Muslims. Group prayer outside of religious services was associated with better self-rated health and mental health, along with lower anxiety and anger (these were strongest for regular participants). Giving and receiving love and care in the congregation was linked to better self-rated and mental health, along with lower anxiety. Congregational criticism was associated with higher anxiety and anger. Finally, religious service attendance was associated with higher levels of anxiety. Many of these results follow the patterns identified in other studies, largely indicating that participating in group religious practices is related to good health. Congregations provide places for friendship, acceptance, reinforcement of cultural norms and beliefs, and experiences of the transcendent. They also provide relationships that can lead to practical forms of material support, such as financial assistance in hard times or rides to the doctor.
One finding, however, was different than much of the existing literature: here, religious attendance was associated with increased anxiety rather than less anxiety. We suspect this could have something to do with something called “resource mobilization.” In short, when people experience distress they turn to religious sources of support to find help. This means it is possible that increased anxiety might lead to increased religious attendance (rather than the other way around). It is important to note that this finding could emerge since the largest group in the sample – Hindus – tended to report lower levels of attendance (which is expected given differences in organization and practice for this group). About 23% of Hindus attended religious services weekly or more, compared to 66% of Muslims. Evangelicals and Catholics examined in other studies had similar rates of attendance as Muslims. This reinforces the explanation that those who attend services less often sometimes turn to religious resources for support in times of distress.
The second study, which focused on individual (or private) religious and spiritual practices, had a number of interesting findings: yoga, gratitude, non-theistic spiritual experiences, closeness to God, and positive coping were associated with better self-rated health. Gratitude, non-theistic and theistic spiritual experiences, closeness to God, and positive coping were associated with better mental health; negative coping was associated with poorer mental health. Gratitude and non-theistic spiritual experiences were associated with less anxiety; negative coping and religious/spiritual struggles were associated with greater anxiety. Non-theistic spiritual experiences and gratitude were associated with less anger; negative coping and religious/spiritual struggles were associated with greater anger.
The most consistent of these variables was non-theistic daily spiritual experiences, which was beneficially associated with all four of the outcomes. This measure assesses the degree to which the individual lives in the moment and makes spiritual connections between themselves and the world around them. For example, one item states, “I experience a connection to all of life,” and another reads “I am touched by the beauty of creation.” Such “in-the-moment” presence appears strongly related to well-being, regardless of one’s religious affiliation, and we have found that the measure may be especially suited for examining Dharmic faiths (i.e., Hinduism, Jainism, Sikhism, and Buddhism). Many of the other results reflect positive associations for gratitude, yoga practice, and closeness to God/the divine, but negative associations for negative religious coping and religious/spiritual struggles.
Lastly, the third study examined how religious or spiritual people considered themselves to be. Interestingly, we found that being both “very” religious/spiritual or “not at all” religious/spiritual were associated with lower levels of anxiety and higher levels of self-rated health, whereas those identifying as “slightly” or “moderate” religious/spiritual reported higher levels of anxiety and lower levels of self-rated health. This pattern has been seen in a small number of studies of religion/spirituality and health.. Those who are very secure in their faith or those who have no faith at all often appear very similar in terms of health. It is those who are uncertain of their faith, however, those who are “somewhere in the middle” that tend to report worse health. This makes a good deal of sense, since experiences of doubt or frustration in one’s faith are likely to be associated with various forms of ill health, particularly poorer mental health. Of course, in most cases people don’t choose to believe or not believe in their faith for the sake of mental health, but this information provides some insight for religious adherents to examine themselves, their beliefs, and their practices, perhaps in conversation with family members or trusted spiritual advisers.
In summary, religious and spiritual beliefs and practices in the MASALA study appear to be associated with better health. However, these data are preliminary! The riches of the MASALA study will provide many more opportunities in the future to examine religion and spirituality, along with a host of other mental and physical health outcomes.
