ABSTRACT
BACKGROUND: Suicide and alcohol use disorders (AUD) have high public health and economic costs. We investigate the relationship between religious features that are external to the individual (hereafter, contextual religiosity) and individuals' risk of AUD and suicidal thoughts. METHODS: Data are from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions (analytic Nâ¯=â¯34,326). Regression analysis assessed whether contextual (i.e., Geographic state) religiosity and membership rates of Catholics and the three major Protestant traditions, are associated with DSM-IV AUD risk in the past 12 months and suicidal thoughts since last interview, controlling for individual and state-level covariates. In a secondary analysis, we test for interactions between individual race/ethnicity and contextual religiosity on the outcomes since prior work suggested differences by race and individual religiosity. RESULTS: Some contextual religious variables were significantly associated with AUD risk but not suicidal thoughts. Individuals living in a state with higher membership rates of Evangelical Protestant had higher AUD risk (Adjusted Relative Risk [ARR]=1.27, 95%CI=1.08-1.49). Individuals living in states with higher membership rates of Historically Black Protestant had a lower risk of AUD (ARR=0.83, 95% CI=0.72-0.96). The interaction between individual race and contextual-level religious variables on the outcomes were not significant. LIMITATIONS: NESARC is an observational cross-sectional so causality between religiosity and the outcomes cannot be established. CONCLUSIONS: The risk of AUD among individuals varies depending on the religious membership rates among Protestant groups within their geographic state of residence. Contextual religiosity may impact AUD risk above and beyond one's individual religiosity.
