Abstracts – 1990s
The body-mind revolution of the past four decades has had considerable impact on biomedical science, health research, and the practice of medicine. This psychosomatic approach, however, is not so much the “new paradigm” that is often heralded, as rather a transitionary perspective to a more comprehensive worldview that is beginning to emerge in biomedical discourse. The science and medicine of the 21st Century will be informed by a body-mind-spirit perspective that acknowledges the influence of God or Spirit on the functioning of the physical vehicle and its subtle emanations and fields. Such a theosomatic medicine will be a real new paradigm which promises to transform the practice of medicine, the content of biomedical research, and our understanding of disease prevention, health, and healing.
CONTEXT: Evidence synthesized from social epidemiology, psychophysiology, and behavioral medicine suggests that religiousness may represent a significant correlate of absorption, a construct for which few if any psychosocial determinants have been identified.
OBJECTIVE: To examine the association between absorption and intrinsic and extrinsic religiousness.
PARTICIPANTS: 83 respondents of a self-administered survey of adult survivors of cancer or other life-threatening diseases, recruited from participants in a pilot study of psychosocial factors related to recovery from illness.
MAIN MEASURES: Tellegen Absorption Scale and Religious Orientation Scale.
RESULTS: Absorption, as assessed by the Tellegen Absorption Scale, was positively and significantly associated with intrinsic religiousness, as measured by the Religious Orientation Scale. Predominantly intrinsic subjects had absorption scores at least 20% higher than did predominantly extrinsic, proreligious, or nonreligious subjects.
DISCUSSION: Prior research has found that absorption and hypnotizability have psychophysiological correlates, and that religiousness shows protective effects against morbidity and mortality. In light of this work, the present findings suggest that certain religious cognitions, emotions, or experiences may generate an internally focused state that enhances health and attenuates disease through self-soothing psychophysiological mechanisms.
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.
This panel study explores the effects of eight measures of religious involvement on three indicators of well-being in a national probability sample of African Americans. Religious measures include religious attendance, church membership, church activity, reading religious books, listening to religious TV/radio, prayer, asking for prayer, and subjective religiosity. Well-being indicators include single-item measures of life satisfaction and happiness, and a 10-item version of the RAND Mental Health Index (MHI), a scale assessing psychological distress. Using data from multiple waves of the National Survey of Black Americans, religious effects on well-being are examined both cross-sectionally at each wave and longitudinally across waves. Findings reveal strong, statistically significant, and consistent religious effects on well-being contemporaneously within each wave, which withstand controlling for the effects of health and seven sociodemographic variables. Longitudinal religious effects on well-being are present bivariately, but disappear after controlling for the effects of baseline well-being, lagged religious involvement, and health. The meaning and interpretation of contemporaneous as opposed to longitudinal religious effects on well-being are discussed.
This study examines differences by age cohort in (a) the frequency of prayer, (b) racial and gender variation in prayer, and (c) religious and sociodemographic correlates of prayer. Analyses are conducted across four age cohorts (18-30, 31-40, 41-60, >61) using data from the 1988 National Opinion Research Center (NORC) General Social Survey (N = 1,481). Findings reveal that prayer is frequently practiced at all ages, but more frequently in successively older cohorts. In addition, females and, to a lesser extent, African Americans pray more frequently than males and Whites, respectively. Further, hierarchical multiple regression analyses reveal statistically significant associations across age cohorts between prayer and key measures of religious behavior, feeling, belief, and experience.
OBJECTIVES. This article summarizes the deliberations of the Quantitative Methods Working Group convened by the National Institutes of Health (NIH) in support of the NIH Office of Alternative Medicine.
METHODS. The working group was charged with identifying methods of study design and data analysis that can be applied to empirical research on complementary and alternative medicine. This charge was broad and inclusive and addressed the evaluation of alternative therapies, the investigation of the basic science of complementary medical systems, studies of health promotion and disease prevention, and health services research.
RESULTS. The working group produced a “methodological manifesto,” a summary list of seven recommended methodological guidelines for research on alternative medicine. These recommendations emphasize the robustness of existing research methods and analytic procedures despite the substantive unconventionality of alternative medicine.
CONCLUSIONS. Contrary to the assertions of many researchers and alternative practitioners, established methodologies (eg, experimental trials, observational epidemiology, social survey research) and data-analytic procedures (eg, analysis of variance, logistic regression, multivariate modeling techniques) are quite satisfactory for addressing the majority of study questions related to alternative medicine, from clinical research on therapeutic efficacy to basic science research on mechanisms of pathogenesis and recovery.
This article presents results of an NIA-funded systematic review of research on religion and aging published from 1980-1994 in mainstream gerontology and religion journals, including the Journal of Religious Gerontology. Findings are summarized from 73 empirical studies, a subset of the 115 articles included in NIA’s bibliography on this topic. In general, these studies use multi-ethnic samples, include multiple religious dimensions, and focus on age-comparative analyses and on analyses of religious effects on life satisfaction, health, and well-being. Also summarized is gerontological research on patterns, predictors, outcomes, and measures of religious involvement, and an agenda for future research is provided.
This study examined the effects of religious attendance on three dimensions of psychological well-being using panel data from a three-generations study of Mexican Americans from Texas (N = 624). Well-being dimensions included life satisfaction (the 13-item LSIA), and respective seven- and four-item depressed and positive affect subscales of the CES-D. Two-wave path analyses revealed a cross-sectional association between religious attendance and life satisfaction in the two oldest generations, and a salutary longitudinal effect of religious attendance on subsequent depressed affect in the youngest generation. Findings for life satisfaction and depressed affect withstood controlling for health and five sociodemographic correlates of religious attendance and well-being.
This paper surveys the field that has come to be known as the epidemiology of religion. Epidemiologic study of the impact of religious involvement, broadly defined, has become increasingly popular in recent years, although the existence, meaning and implications of an apparently salutary religious effect on health have hot yet been interpreted in an epidemiologic context. This paper attempts to remedy this situation by putting the “epidemiology” into the epidemiology of religion through discussion of existing empirical findings in terms of several substantive epidemiologic concepts. After first providing an overview of key research findings and prior reviews of this field, the summary finding of a protective religious effect on morbidity is examined in terms of three important epidemiologic concepts: the natural history of disease, salutogenesis and host resistance. In addition to describing a theoretical basis for interpreting a religion-health association, this paper provides an enumeration of common misinterpretations of epidemiologic findings for religious involvement, as well as an outline of hypothesized pathway, mediating factors, and salutogenic mechanisms for respective religious dimensions. It is hoped that these reflections will serve both to elevate the status of religion as a construct worthy of social-epidemiologic research and to reinvigorate the field of social epidemiology.
Jeffrey S. Levin. (1996). “How Prayer Heals: A Theoretical Model.” Alternative Therapies in Health and Medicine 2 (1):66-73.
This article presents a theoretical model that outlines various possible explanations for the healing effects of prayer. Four classes of mechanisms are defined on the basis of whether healing has naturalistic or supernatural origins and whether it operates locally or nonlocally. Through this framework, most of the currently proposed hypotheses for understanding absent healing and other related phenomena–hypotheses that invoke such concepts as subtle energy, psi, consciousness, morphic fields, and extended mind–are shown to be no less naturalistic than the Newtonian, mechanistic forces of allopathic biomedicine so often derided for their materialism. In proposing that prayer may heal through nonlocal means according to mechanisms and theories proposed by the new physics, Dossey is almost alone among medical scholars in suggesting the possible limitations and inadequacies of hypotheses based on energies, forces, and fields. Yet even such nonlocal effects can be conceived of as naturalistic; that is, they are explained by physical laws that may be unbelievable or unfamiliar to most physicians but that are nonetheless becoming recognized as operant laws of the natural universe. The concept of the supernatural, however, is something altogether different, and is, by definition, outside of or beyond nature. Herein may reside an either wholly or partly transcendent Creator-God who is believed by many to heal through means that transcend the laws of the created universe, both its local and nonlocal elements, and that are thus inherently inaccessible to and unknowable by science. Such an explanation for the effects of prayer merits consideration and, despite its unprovability by medical science, should not be dismissed out of hand.
Jeffrey S. Levin and Thomas R. Cole. (1996). “’Song of Ourselves’: A Quantitative History of American Autobiographies.” The Gerontologist 36:448-453.
This article highlights the major descriptive findings of an exploratory, quantitative study of American autobiographies published before 1945. Of particular importance for gerontology, age-cohort distributions of autobiographers are graphed, demonstrating that the genre itself has been created predominantly by men and women aged 55 and over. This study suggests that these writers offer scholars a virtually untapped resource for the historical phenomenology of aging.
Jeffrey S. Levin, Linda M. Chatters, and Robert Joseph Taylor. (1995). “Religious Effects on Health Status and Life Satisfaction Among Black Americans.” Journal of Gerontology: Social Sciences 50:S154-S163.
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.
This article describes the confirmation and validation of a multidimensional measure of religious involvement using data from the National Survey of Black Americans (N = 2,107). This model was developed through a multistep strategy of confirmatory factor analysis and structural-equation modeling. First, a three-dimensional factor structure comprising organizational, nonorganizational, and subjective religiosity was confirmed for twelve religious indicators. This measurement model was found to exhibit excellent overall fit; it compared favorably to alternative models; and all hypothesized factor loadings were strong and statistically significant. Second, several constructs identified by prior research as correlates of religious involvement (gender, age, education, region, and urbanicity) were found to exhibit significant associations with one or more dimensions of the model. All analyses were conducted in LISREL 8.03, using maximum-likelihood estimation and a strategy of split-sample replication.
Jeffrey S. Levin. (1994). “Religion and Health: Is There an Association, is it Valid, and is it Causal?” Social Science and Medicine 38:1475-1482.
This paper reviews evidence for a relationship between religion and health. Hundreds of epidemiologic studies have reported statistically significant, salutary effects of religious indicators on morbidity and mortality. However, this does not necessarily imply that religion influences health; three questions must first be answered: “Is there an association?”, “Is it valid?”, and, “Is it causal?” Evidence presented in this paper suggests that the answers to these respective questions are “yes,” “probably,” and “maybe.” In answering these questions, several issues are addressed. First, key reviews and studies are discussed. Second, the problems of chance, bias, and confounding are examined. Third, alternative explanations for observed associations between religion and health are described. Fourth, these issues are carefully explored in the context of Hill’s well-known features of a causal relationship. Despite the inconclusiveness of empirical evidence and the controversial and epistemologically complex nature of religion as an epidemiologic construct, this area is worthy of additional investigation. Further research can help to clarify these provocative findings.
This article examines dimensions and correlates of psychological well -being among older adults aged 55 and above using the General Well-Being (GWB) Scale with data (N = 2,931) collected in Kentucky in 1982. A shortened, 11-item version of the GWB is confirmed for use among older respondents and is found to comprise three correlated dimensions termed positive affect, enervation, and negative affect. Development of this scale involved exploratory and confirmatory factor analysis, comparison of alternative model specifications , and regression of its component dimensions onto known correlates of psychological well-being in older adults, including age, education, marriage, gender, race, and subjective health.
Levin, Jeffrey S., Robert Joseph Taylor, and Linda M. Chatters. (1994). “Race and Gender Differences in Religiosity Among Older Adults: Findings from Four National Surveys.” Journal of Gerontology: Social Sciences 49:S137-S145.
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.
Jeffrey S. Levin. (1993). “Age Differences in Mystical Experience.” The Gerontologist 33:507-513.
Age differences are examined in reports of deja vu, ESP, clairvoyance, spiritualism, and numinous experience. According to the 1988 General Social Survey (N = 1481), these mystical experiences are somewhat more common now than in 1973, and deja vu, clairvoyance, and a composite mysticism score have increased with successively younger age cohorts. Further, private and subjective religiosity are positively related to overall mystical experience, while organizational religiosity is inversely related.
Jeffrey S. Levin, John S. Lyons, and David B. Larson. (1993). “Prayer and Health During Pregnancy: Findings from the Galveston Low Birthweight Survey.” Southern Medical Journal 86:1022-1027.
In this study we examined the relationship between praying for one’s baby during pregnancy and self-ratings of health. Data were collected from a biethnic (black and Hispanic) sample of postpartum mothers in Galveston, Tex, from 1986 to 1987. This sample is representative of the annual biethnic population of live births in Galveston. Subjective health was assessed for the periods both before and during pregnancy with self-ratings of global or overall health, worry over health, and functional health or lack of disability. Analyses controlled for the effects of the mother’s age, marital status, gravidity, education, and self-rated religiosity. Findings revealed that all three prepregnancy health measures were associated with prayer. Subjectively unhealthier mothers prayed more for their baby during pregnancy regardless of their perceived health during pregnancy, and subjectively healthier mothers prayed less for their baby regardless of their self-reported religiosity. Additional analyses revealed that the effect of poor health on the frequency of prayer was not simply an outcome of the mother’s worry over her own health.
Jeffrey S. Levin and Robert Joseph Taylor. (1993). “Gender and Age Differences in Religiosity Among Black Americans.” The Gerontologist 33:16-23.
Gender and age differences were examined in over a dozen religious indicators using cross-sectional data from the National Survey of Black Americans (N = 2,107). Although both genders manifested moderate to high levels of organizational, nonorganizational, and subjective religiosity, black women significantly exceeded black men in levels of religiosity at all ages, even when controlling for the effects of education, marital and employment status, region, urbanicity, and health satisfaction.
Many scientists often assume that religious preference and involvement have little effect on physical health, or that, if such effects exist, few studies have addressed the issue. In actuality, there is a long tradition of empirical research on the interconnections of religion and physical health. Theoretical speculation as to the reasons for such a salutary effect of religious belief or involvement has been prominent in the writings of distinguished scholars and physicians past and present. Furthermore, the existence of such religion-health connections is a nearly universal feature within the cosmologies of religious traditions and is supported by empirical evidence from various scientific disciplines. This essay surveys religious factors in physical health, discussing why religious indicators should be significantly related to health status, critically reviewing key empirical evidence, offering explanations for such findings, and noting their implications for the prevention of illness.