Maureen R. Benjamins

Religion and preventative health care utilization among the elderly

Evidence supporting a relationship between religion and physical health has increased substantially in the recent past. One possible explanation for this relationship that has not received much attention in the literature is that health care utilization may differ by religious involvement or religious denomination. A nationally representative sample of older adults was used to estimate the effects of religious salience and denomination on six different types of preventative health care (i.e. flu shots, cholesterol screening, breast self-exams, mammograms, pap smears, and prostate screening). Findings show that both men and women who report high levels of religiosity are more likely to use preventative services. Denominational differences show that affiliated individuals, especially those who are Jewish, are significantly more likely to use each type of preventative care than non-affiliated individuals. The results of this study open the door to further exploration of this potentially important, but relatively neglected, link between religion and health.

Religion and Functional Health Among the Elderly Is There a Relationship and Is It Constant

Objectives: Religion significantly influences a variety of health outcomes, especially among the elderly. Fewstudies have examined howthe relationship may differ by age within this age group. It is possible that increasing levels of religiosity within the elderly, or other age-related differences, may strengthen the influence of religion on functional limitations. Method: This study used the Assets and Health Dynamics Among the Oldest Old Survey, a nationally representative, longitudinal data set, to estimate the effects of religious attendance and salience on functional ability. Results: More frequent attendance is associated with fewer functional limitations, whereas higher levels of salience are associated with more limitations. No significant age interactions were found. Discussion: Attendance and salience predict the number of functional limitations in the elderly but in different directions. These effects tend to be stable within the elderly population, indicating that further age divisions may not be necessary when examining this relationship in future studies.

Religious Influences on Preventive Health Care Use in a Nationally Representative Sample of Middle-Age Women

Despite the many benefits of preventive services, they are often underutilized. Social factors, such as religion, can figure prominently in these discrepancies by either creating barriers or facilitating use. Using data from the Health and Retirement Survey (HRS, 1992–1996), the current study examines the relationship between religious attendance, religious salience, and denomination and three types of female preventive services in a sample of middle-age women (N = 4253). Findings indicate that women who attend religious services more frequently use more mammograms, Pap smears, and self-breast exams. In addition, women belonging to Mainline Protestant or Jewish denominations use certain preventive services more than Evangelical Protestants. Finally, women with higher levels of religious salience are more likely to conduct self-breast exams. These findings add important information to the public health literature concerning factors that influence preventive service use. They also add to the growing field of religion and health research where preventive health care use is emerging as a possible mechanism linking religion to a wide variety of physical health outcomes.

Race/ethnic discrimination and preventive service utilization in a sample of whites, blacks, Mexicans, and Puerto Ricans.

Background:Race/ethnic discrimination is associated with poorer mental and physical health, worse health behaviors, and increased mortality, in addition to overall race/ethnic disparities in health. More specifically, it has been suggested as a possible determinant of the significant race/ethnic differences in the quantity and quality of medical care received by individuals in the United States. Objectives:The current study examines the association between 3 measures of racial/ethnic discrimination (Experiences of Discrimination, Everyday Discrimination Scale and discrimination in health care) and 6 types of preventive services (mammogram, clinical breast examination, Pap smear, colonoscopy/sigmoidoscopy, blood pressure screening, and diabetes screening). Research Design:Frequencies and correlations are run within a population-based sample of 1699 respondents from Chicago that includes whites, African Americans, Mexicans, and Puerto Ricans. Adjusted logistic regression models are run separately by race/ethnicity. Results:Findings show that levels of perceived discrimination vary between all race/ethnic groups, with blacks consistently reporting the highest levels and whites the lowest. Discrimination is only inconsistently related to obtaining screenings for cancer, hypertension, and diabetes. The few significant relationships found differed both by measure of discrimination and the respondents’ race and ethnicity. Conclusions:Given the growing diversity in the United States and the prevalence of discrimination, more research regarding its impact on health care utilization is needed. Only when all the factors influencing patient behaviors are better understood will policies and interventions designed to improve them be successful. These are important steps that will help attain our national goals of eliminating race/ethnic disparities in health.

Specifying the effects of religion on medical helpseeking: The case of infertility

Several recent studies have examined the connection between religion and medical service utilization. This relationship is complicated because religiosity may be associated with beliefs that either promote or hinder medical helpseeking. The current study uses structural equation modeling to examine the relationship between religion and fertility-related helpseeking using a probability sample of 2183 infertile women in the United States. We found that, although religiosity is not directly associated with helpseeking for infertility, it is indirectly associated through mediating variables that operate in opposing directions. More specifically, religiosity is associated with greater belief in the importance of motherhood, which in turn is associated with increased likelihood of helpseeking. Religiosity is also associated with greater ethical concerns about infertility treatment, which are associated with decreased likelihood of helpseeking. Additionally, the relationships are not linear throughout the helpseeking process. Thus, the influence of religiosity on infertility helpseeking is indirect and complex. These findings support the growing consensus that religiously-based behaviours and beliefs are associated with levels of health service utilization.

Religion: A Sociocultural Predictor of Health Behaviors in Mexico

OBJECTIVE Tobacco, alcohol, and physical inactivity are now among the top 10 risk factors for mortality in the Americas region. Subsequently, a more complete understanding of the various cultural factors that influence health behaviors such as these is needed. METHOD This study investigates how religion influences the use of alcohol and cigarettes within a large, nationally representative sample of older adults in Mexico (Mexican Health and Aging Study, N = 10,399). RESULTS Religious salience and participation in religious activities are both significantly associated with smoking status, but not alcohol use. DISCUSSION This is one of the first studies to examine these associations in a developing country. Despite cultural differences, the negative relationship between religion and smoking in Mexico corresponds to associations seen in the United States and other Western countries. This type of information may be useful to health researchers, providers, and policy makers attempting to reduce deaths due to preventable causes.

Exploring differences in self-rated health among Blacks, Whites, Mexicans, and Puerto Ricans

Objectives. Self-rated health (SRH) is a robust predictor of subsequent health and mortality. Although age, gender, and race differences in SRH have been explored, less work has examined ethnic differences, particularly in the US. Design. The current study uses representative data from six Chicago communities to compare levels and determinants of fair–poor health for Blacks, Whites, Mexicans, and Puerto Ricans (n=1311). Results. Mexicans and Puerto Ricans were at least three times more likely to report fair or poor health than Whites, while African-Americans were over twice as likely. In adjusted logistic regression models, only Mexicans remain significantly more likely to report fair–poor health than Whites (OR = 4.3, CI = 1.8–9.8). However, this effect disappears when controlling for acculturation. No variable predicted poor subjective health for all groups, though depression was associated with poor health for most. Conclusion. Together, these analyses suggest that the single item measure of SRH might not be appropriate for comparing health status across members of different race/ethnic groups. More research is needed to understand what factors influence how an individual perceives his or her health.

Using Religious Services to Improve Health Findings From a Sample of Middle-Aged and Older Adults With Multiple Sclerosis

Purpose: The purpose of this study is to examine the use of religious services to improve health among middle-aged and older adults with multiple sclerosis (MS). Method: Data from the study “Aging With MS: Unmet Needs in the Great Lakes Region” were used to investigate religious service use among 1,275 adults with MS. Results: The findings indicate that nearly two thirds of the sample currently use religious services to improve their health or well-being. Individuals whose MS is stable and those who have had the disease longer are significantly more likely to use religious services to improve their health. Conclusions: Religious organizations should continue providing out-reach and increasing accessibility for individuals with disabling conditions. In addition, health care professionals should be aware of the importance of religious services to individuals with MS and do their part to facilitate participation for those who desire it.

A Culturally Appropriate School Wellness Initiative: Results of a 2-Year Pilot Intervention in 2 Jewish Schools

BACKGROUND Despite the growing number of school-based interventions designed to reduce childhood obesity or otherwise promote health, no models or materials were found for Jewish schools. The current study describes an effort within a Jewish school system in Chicago to create, implement, and evaluate a school-based intervention tailored to the unique characteristics of Jewish religion, culture, and school structures. METHODS Two schools (with approximately 600 students) were selected for the 2-year pilot study. The schools were required to form a wellness council, write a wellness policy, and implement policy changes or activities in 5 target areas (health education, physical education, school environment, family involvement, and staff wellness). Objectives were measured using pre- and postintervention surveys for students, as well as the School Health Index and other tools. RESULTS Findings showed several significant increases in student knowledge, as well as an increase in the percentage of older students regularly meeting physical activity guidelines. Few changes in attitudes, other behaviors, or environmental factors were seen. CONCLUSIONS Due to a strong partnership between researchers, schools, and community organizations, meaningful changes were made within the pilot schools. These changes were reflected in a limited number of improvements in student knowledge and activity levels. Future work is needed to determine how to bring about behavioral changes, how to increase the sustainability of all of the changes, and how to disseminate the model and products of this intervention to other day schools.

A local community health survey: findings from a population-based survey of the largest Jewish community in Chicago

Accurate estimates of health risk factors and outcomes are difficult to obtain for certain ethnic populations. The health of Jewish individuals is particularly hard to determine because of the small group size and because health data rarely include information on religious affiliation. Furthermore, local level health information (for any population subgroup) is limited. To assess health risk factors and outcomes, as well as issues related to access to care, within a Jewish community in Chicago, a group of community agencies and researchers initiated a unique, population-based health survey. Specifically, a three-stage sampling design was used to select a representative sample of 201 adults and 58 children in the most concentrated Jewish neighborhood in the city. Nearly 500 questions were asked, covering a wide variety of demographic, socioeconomic, and health-related topics. The findings revealed that these Jewish individuals were generally as healthy (or healthier) than the average residents of Chicago and the U.S.; however, many serious health concerns still existed. In particular, health problems such as obesity, depression, disability, and domestic violence were common and, in some cases, more prevalent than in the general population. This local level information provides the first accurate estimates of key health variables for the estimated 23,000 Jewish individuals living in this community. This type of data is essential because it enables the efforts and priorities of health and social service providers to be focused on the most pressing health problems. Moreover, this project provides an example for other population subgroups (based on residence, ethnicity, religious affiliation, country of origin, or other characteristics) who would benefit from local level health information.