Religion and health: public health research and practice.

Research examining the relationships between religion and the health of individuals and populations has become increasingly visible in the social, behavioral, and health sciences. Systematic programs of research investigate religious phenomena within the context of coherent theoretical and conceptual frameworks that describe the causes and consequences of religious involvement for health outcomes. Recent research has validated the multidimensional aspects of religious involvement and investigated how religious factors operate through various biobehavioral and psychosocial constructs to affect health status through proposed mechanisms that link religion and health. Methodological and analytical advances in the field permit the development of more complex models of religion's effects, in keeping with proposed theoretical explanations. Investigations of religion and health have ethical and practical implications that should be addressed by the lay public, health professionals, the research community, and the clergy. Future research directions point to promising new areas of investigation that could bridge the constructs of religion and health.

Mental health services in faith communities: the role of clergy in black churches.

A small but growing literature recognizes the varied roles that clergy play in identifying and addressing mental health needs in their congregations. Although the role of the clergy in mental health services delivery has not been studied extensively, a few investigations have attempted a systematic examination of this area. This article examines the research, highlighting available information with regard to the process by which mental health needs are identified and addressed by faith communities. Areas and issues where additional information is needed also are discussed. Other topics addressed include client characteristics and factors associated with the use of ministers for personal problems, the role of ministers in mental health services delivery, factors related to the development of church-based programs and service delivery systems, and models that link churches and formal services agencies. A concluding section describes barriers to and constraints against effective partnerships between churches, formal services agencies, and the broader practice of social work.

Public health and health education in faith communities.

This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

Religion, health, and psychological well-being in older adults: findings from three national surveys.

This study examines the impact of religious involvement on health status and psychological well-being using data on older adults from three national probability surveys: the Myth and Reality of Aging (N = 2,797), the Quality of American Life (N = 1,209), and Americans' Changing Lives (N = 1,669) studies. Constructs are measured by single items and indices that vary across data sets. A proposed theoretical model specifies direct effects of religiosity on health and well-being and indirect effects on well-being through health. Analyses consist of structural-equation modeling of confirmed measurement models using weighted least squares estimation in LISREL 8.03. The model is analyzed first as specified and is then rerun controlling for the effects of six exogenous constructs: age, gender, race, marital status, education, and geographical region. Findings reveal excellent overall fit in all three samples and the presence of statistically significant religious effects, notably positive net effects of organizational religiosity, in all three samples. These results build on those of prior studies based mostly on samples limited regionally or methodologically or to particular racial or ethnic groups. This study also underscores the value of replicated secondary data analysis as a strategy for gerontologists seeking to confirm or examine a given structural model. Finally, an agenda is proposed for future research in this area.

Religious effects on health status and life satisfaction among black Americans.

This study tests a theoretical model linking religiosity, health status, and life satisfaction using data from the National Survey of Black Americans, a nationally representative sample of Blacks at least 18 years old. Findings reveal statistically significant effects for organizational religiosity on both health and life satisfaction, for nonorganizational religiosity on health, and for subjective religiosity on life satisfaction. Analyses of structural invariance reveal a good overall fit for the model across three age cohorts (< or = 30, 31-54, > or = 55) and confirm that assuming age-invariance of structural parameters does not significantly detract from overall fit. In addition, after controlling for the effects of several sociodemographic correlates of religiosity, health, and well-being, organizational religiosity maintains a strong, significant effect on life satisfaction. These findings suggest that the association between religion and well-being is consistent over the life course and not simply an artifact of the confounding of measures of organizational religiosity and health status.

Race and gender differences in religiosity among older adults: findings from four national surveys.

Using data from four national surveys, this article presents findings on racial and gender differences in religiosity among older adults. Surveys include the second Quality of American Life study, the Myth and Reality of Aging study, wave one of Americans' Changing Lives, and the 1987 sample of the General Social Survey. These four data sources collectively include a broad range of items which tap the constructs of organizational, nonorganizational, and subjective religiosity. In all four studies, and for most indicators, results revealed significant racial and gender differences which consistently withstood controlling for sociodemographic effects, including age, education, marital status, family income, region, urbanicity, and subjective health.

Antecedents and dimensions of religious involvement among older black adults.

This study proposed and tested a measurement model of religiosity among a sample of older (55 years of age and above) Black Americans. This model incorporates three correlated dimensions of religious involvement, termed organizational, nonorganizational, and subjective religiosity. Findings indicate that the proposed model provides a good fit to the data, is preferable to other alternative models, and exhibits convergent validity with respect to exogenous or antecedent variables (age, gender, marital status, income, education, urbanicity, and region) known to predict religious involvement. In addition, these antecedents exhibit stronger effects on subjective religiosity than on the two more behavioral dimensions of religiosity. Interpretation of these status-group differences in religiosity focuses on socialization experiences and social environment factors which may promote a religious world-view.

Extended family networks of older black adults.

The correlates of three characteristics of familial networks (i.e., residential proximity, family affection, and family contact) were examined among a national sample of older Black Americans. Overall, the findings indicated high levels of interaction and strong emotional bonds between older Black adults and their extended families. While the oldest respondents were less likely to reside near immediate family and other relatives, there were no age differences in levels of contact and emotional closeness. Having an adult child and proximity of relatives facilitated the emotional and social integration of older Black adults in family networks.

Nonorganizational religious participation among elderly black adults.

This study investigated rates of participation in nonorganizational religious activities of elderly Black adults. Four indicators of participation were examined: reading religious materials, watching or listening to religious programs, prayer, and requests for prayer. Demographic, religious denomination, and health disability factors influenced participation in these behaviors. The findings were discussed for their implications for the development of a multidimensional conceptualization of religiosity.

Sociodemographic and environmental correlates of racial socialization by black parents.

The present study focused on the content and practice of racial socialization by black parents. Sociodemographic correlates of patterns of racial socialization were examined using data from a national probability sample of 2,107 respondents (National Study of Black Americans). Multivariate analysis revealed that gender, age, marital status, region, and racial composition of neighborhood predicted whether or not black parents imparted racial socialization messages to their children. Black parents envision racial socialization as involving several components, including messages regarding their experience as minority group members, themes emphasizing individual character and goals, and information related to black cultural heritage. The findings highlighted the critical importance of sociodemographic and environmental influences on the socialization process. Implications for future research on racial socialization are discussed.

Age differences in religious participation among black adults.

Age differences in level of religious participation were examined using data from the National Survey of Black Americans (N = 2107). Seven indicators of organizational, nonorganizational, and attitudinal forms of religious involvement were examined. For women, age was positively associated with each of the religiosity measures; among men, requests for prayer from others was the only indicator for which age was not a significant predictor. The findings are discussed in relation to previous work on age and religious participation.

Subjective well-being evaluations among older black Americans.

The causal relations among social status and resource, health, and stress factors, and a single-item measure of subjective well-being (i.e., happiness) were examined among a national sample of 581 Black adults aged 55 years and over. Results indicated that although social status and resource factors had a limited impact on happiness ratings, these measures were important in predicting intermediate factors related to health status and satisfaction and stress. Happiness was directly influenced by stress and reported satisfaction with health, whereas the effect of health disability was mediated by stress and health satisfaction. The findings suggest that certain groups of older Blacks (i.e., relatively younger, widowed, and separated) may be at specific risk for diminished well-being. However, adverse health and life conditions, which are determined by status and resources, represent circumstances that further jeopardize the well-being of older Black adults.

Aged blacks' choices for an informal helper network.

Research on the support networks of impaired elderly adults suggests that membership in sociodemographic subgroups influences use of specific informal helpers. This study explored the relationships of sociodemographic, health, and family factors to informal helper choice among a nationally representative sample (N = 581) of older (55 years and above) blacks (National Survey of Black Americans). Nine categories of helpers were examined: spouse, son, daughter, father, mother, brother, sister, friend, and neighbor. Logistic regression analyses revealed that marital status is important in selecting the categories of sister, friend, and neighbor. Presence of children decreased the likelihood that siblings and friends would be chosen. Perceived family closeness facilitated the selection of siblings but inhibited the choice of friends. Regional differences suggest a greater likelihood of selecting the categories of sister, friend, and neighbor among Southern residents.

Size and composition of the informal helper networks of elderly blacks.

Research on the informal support networks of older persons recognizes that network size and composition (i.e., family vs. nonkin) may have important consequences for care. Factors that determine these aspects of networks among older blacks, however, have not been explored systematically. The present study examined the relationship of a group of sociodemographic, health, family, and availability factors to the size and composition of the informal support network. The data were taken from the National Survey of Black Americans and constitute a nationally representative sample (N = 581) of older blacks (55 years and older). The results for several of the sociodemographic factors (i.e., sex and marital status) are consistent with previous work. Regional differences in network dimensions, however, suggest new areas of inquiry. The findings underscore the importance of availability and family factors in support relationships and the relative ineffectiveness of health factors as predictors of network size and composition.