Religious Involvement, Social Support, and Health Among African-American Women on the East Side of Detroit

A growing body of evidence suggests that religious involvement is protective to both mental and physical health1–15 This finding has been consistent across studies despite differences of samples, designs, methodologies, measures of religious involvement, health outcomes and population characteristics. Despite widespread recognition of the complexity of religious involvement, much of this research has assessed religious involvement by a single measure, most often religious affiliation or frequency of church attendance.3,6,16–19 Prior research that has included multiple indicators of religious involvement has begun to: clarify what dimensions (and indicators) are most salient to health outcomes; suggest mechanisms that may account for associations between religious involvement20; and assist in understanding how dimensions of religious involvement are differentially related to health concerns.1 For example, subjective religious involvement (e.g., faith or religious belief) may influence physical health through encouraging behaviors that reduce health risks, such as avoidance of smoking, alcohol consumption, drug use.20 On the other hand, nonorganizational religious involvement (e.g., prayer or bible reading) may positively influence mental health through encouraging emotions such as hope and forgiveness and physical health through potential effects on physiologic processes. Greater specificity in the independent and dependent variables in research on religion and health will help clarify how religious involvement influences health. There are a variety of mechanisms through which religion may exert a positive influence on health. For example, many scholars agree that membership in religious communities may enhance social resources in ways that are beneficial for health.20–25 Considerable evidence shows that social support is associated with better mental and physical health,26–31 yet researchers have only recently begun to document the role of social support in religion and health.32 Recent research has found that those who attend church more frequently have a greater number of social ties and interactions, rate their social ties more positively, and benefit from more frequent exchanges of goods, services, and information, than do those who attend church less frequently.20–25,32–34 The conceptual framework that guides this study is adapted from a multidimensional model of religious involvement described in the literature3,6,7,16,35 and from a stress process model that reflects longstanding evidence of a strong, negative association between stressors and health.36 The context-specific stress process model used in these analyses was developed using a community-based participatory process that engaged community residents in discussions about stressors, as well as “things that make it not so bad” in their own lives and the lives of other east side Detroit residents.37 Community residents' identification of different forms of religious involvement as important buffers against the adverse effects of stress on health reinforced the importance of using a multidimensional model of religious involvement.35,36 This article explores the relationship between religious involvement and health among African-American women on the East Side of Detroit. This study was conducted using a community-based participatory research (CBPR) approach. To our knowledge, there have been no CBPR studies to date that have explored the role of religion in health. We describe the use of a CBPR approach to enhance the relevance of study findings for the community.15 We extend previous research on religion and health by using multiple indicators of religious involvement and health to examine the direct effects of religion on health and the mediating role of social support in the relationship between religion and health, while controlling for a number of correlates of religious involvement.