Oman D, Reed D
Buck Center for Research in Aging, Novato, Calif. 94948, USA.
Am J Public Health. 1998 Oct;88(10):1469-75. doi: 10.2105/ajph.88.10.1469.
This study analyzed the prospective association between attending religious services and all-cause mortality to determine whether the association is explainable by 6 confounding factors: demographics, health status, physical functioning, health habits, social functioning and support, and psychological state.
The association between self-reported religious attendance and subsequent mortality over 5 years for 1931 older residents of Marin County, California, was examined by proportional hazards regression. Interaction terms of religion with social support were used to explore whether other forms of social support could substitute for religion and diminish its protective effect.
Persons who attended religious services had lower mortality than those who did not (age- and sex-adjusted relative hazard [RH] = 0.64; 95% confidence interval [CI] = 0.52, 0.78). Multivariate adjustment reduced this relationship only slightly (RH = 0.76; 95% CI = 0.62, 0.94), primarily by including physical functioning and social support. Contrary to hypothesis, religious attendance tended to be slightly more protective for those with high social support.
Lower mortality rates for those who attend religious services are only partly explained by the 6 possible confounders listed above. Psychodynamic and other explanations need further investigation.
本研究分析了参加宗教活动与全因死亡率之间的前瞻性关联，以确定这种关联是否可由6个混杂因素解释：人口统计学、健康状况、身体功能、健康习惯、社会功能与支持以及心理状态。
通过比例风险回归分析了加利福尼亚州马林县1931名老年居民自我报告的宗教活动参与情况与随后5年死亡率之间的关联。使用宗教与社会支持的交互项来探讨其他形式的社会支持是否可以替代宗教并削弱其保护作用。
参加宗教活动的人的死亡率低于未参加宗教活动的人（年龄和性别调整后的相对风险[RH]=0.64；95%置信区间[CI]=0.52，0.78）。多变量调整仅略微降低了这种关系（RH=0.76；95%CI=0.62，0.94），主要是通过纳入身体功能和社会支持。与假设相反，宗教活动参与对社会支持较高的人往往具有更强的保护作用。
参加宗教活动的人死亡率较低，这在一定程度上仅由上述6个可能的混杂因素解释。心理动力学和其他解释需要进一步研究。
