宗教、精神与健康:流行病学的新考量

Religion, Spirituality, and Health: New Considerations for Epidemiology.

出版信息

Am J Epidemiol. 2020 Aug 1;189(8):755-758. doi: 10.1093/aje/kwaa022.

Abstract

Religion and spirituality are important social determinants that drive public health practice. The field of epidemiology has played a vital role in answering long-standing questions about whether religion is causally associated with health and mortality. As epidemiologists spark new conversations (e.g., see Kawachi (Am J Epidemiol. (https://doi.org/10.1093/aje/kwz204)) and Chen and VanderWeele (Am J Epidemiol. 2018;187(11):2355-2364)) about methods (e.g., outcomes-wide analysis) used to establish causal inference between religion and health, epidemiologists need to engage with other aspects of the issue, such as emerging trends and historical predictors. Epidemiologists will need to address 2 key aspects. The first is changing patterns in religious and spiritual identification. Specifically, how do traditional mechanisms (e.g., social support) hold up as explanations for religion-health associations now that more people identify as spiritual but not religious and more people are not attending religious services in physical buildings? The second is incorporation of place into causal inference designs. Specifically, how do we establish causal inference for associations between area-level constructs of the religious environment (e.g., denomination-specific church membership/adherence rates) and individual- and population-level health outcomes?

摘要

宗教和精神信仰是重要的社会决定因素,推动着公共卫生实践。流行病学领域在回答宗教是否与健康和死亡率存在因果关系这一长期存在的问题方面发挥了至关重要的作用。随着流行病学家引发新的讨论(例如,参见 Kawachi(Am J Epidemiol.(https://doi.org/10.1093/aje/kwz204))和 Chen 和 VanderWeele(Am J Epidemiol. 2018;187(11):2355-2364))关于用于在宗教与健康之间建立因果关系的方法(例如,全结局分析),流行病学家需要参与该问题的其他方面,例如新兴趋势和历史预测因素。流行病学家需要解决 2 个关键方面。第一个是宗教和精神认同模式的变化。具体来说,随着越来越多的人认为自己是有精神信仰但无宗教信仰的人,以及越来越多的人不在实体建筑中参加宗教服务,传统机制(例如社会支持)如何仍然能够解释宗教与健康之间的关联?第二个是将地点纳入因果关系推断设计中。具体来说,我们如何为宗教环境的区域层面结构(例如特定教派的教会成员/信仰率)与个体和人群健康结果之间的关联建立因果关系推断?

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