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DURHAM, N.C. - A study of nearly 4,000 elderly North
Carolinians has found that those who attended religious
services every week were 46 percent less likely to die over a
six-year period than people who attended less often or not at
all, according to researchers at Duke University Medical
Center.

After controlling for factors that could influence death
rates - such as medical illnesses, depression, social
connections, health practices and demographics - the frequent
religious attenders were still 28 percent less likely to die
than others in the study. The size of the effect was so strong
that it was equal to that of not smoking cigarettes, Duke
psychiatrist Dr. Harold Koenig said

Results of the study, funded by the National Institutes of
Mental Health, are published in the July/August issue of
Journal of Gerontology, medical
sciences edition. Koenig, lead author of the research
report, said it is the fourth major study published in the past
two years documenting a relationship between religious
attendance and longer survival.

"Participating in religious services is associated with
significant health benefits in elderly people, even when you
take into account the fact that religious people tend to start
out with better health practices and more social support,"
Koenig said.

The current findings build on a series of earlier studies at
Duke and elsewhere showing that religious people have lower
blood pressure, less depression and anxiety, stronger immune
systems and cost the health care system less than people who
are less religiously involved.

In the Duke study, researchers arrived at their conclusions
by analyzing data from a massive, 10-year research effort
funded by the National Institutes of Health. Called the
Established Populations for the Epidemiologic Studies of the
Elderly (EPESE), the study cataloged information on how older
North Carolinians age - everything from social practices to
religious behavior to eating and exercise habits.

Of the 1,177 subjects who died during the 6-year study
period, 22.9 percent were frequent church attenders compared to
37.4 percent who were infrequent attenders.

While researchers can't explain the association between
religious behavior and health, they say there is evidence that
religious participation benefits people through a number of
psychosocial, biological and behavioral pathways.

First, frequent religious service attenders reported having
larger social networks and hence experienced greater social
support than infrequent attenders, Koenig said. High levels of
social support have been linked to better mental health, and
they may also increase the likelihood that illnesses will be
detected by friends and family and thus treated more rapidly,
he said. Moreover, better mental health may confer protection
against a wide range of physical illnesses, from heart disease
to stroke, that have been linked to people with depression.

"In dozens of studies, depression has been shown to increase
the death rate from all causes," Koenig said. "So it stands to
reason that if religious participation fosters better mental
health, then death rates would be lower among this
population."

Second, the worship and adoration associated with religious
rituals may directly contribute to mental well-being by serving
as coping mechanisms for stressful events or physical illnesses
later in life, Koenig said. "Such positive feelings may
counteract stress and convey health effects, like enhanced
immune function, that go far beyond the prevention of
depression or other negative emotions," he said.

Third, said Koenig, people who cope better with life's ups
and downs appear to be less inclined to drink, smoke and engage
in other destructive health habits. Even at baseline
measurement in the current study, religious elderly people were
physically healthier and reported leading healthier lifestyles
than less frequent attenders.

But these factors were not sufficient to explain the
relationship between religious attendance and longer survival
found in the current study or others recently conducted around
the nation, Koenig said.

In one of the largest studies to date on the subject,
researchers at the University of California at Berkeley,
produced similar results in a 28-year study of 5,000 people
aged 21 to 65 years old. They found that people who attended
religious services at least once a week had a 23 percent lower
risk of dying over the study period than less frequent
attenders, even after controlling for health, social and
demographic factors.