Religion and “Deaths of Despair”

Religion and “Deaths of Despair” May 14, 2020


Widener from Harvard Yard
Harvard’s Widener Library, in 2007 (Wikimedia Commons public domain image)


A reader of, and commenter on, this blog who goes by the moniker LB has kindly called this fascinating article — which appeared on 6 May 2020 in JAMA [Journal of the American Medical Association] Psychiatry — to my attention:


“Religious Service Attendance and Deaths Related to Drugs, Alcohol, and Suicide Among US Health Care Professionals”


Four of the the article’s five authors — Ying Chen, ScD; Howard K. Koh, MD, MPH; Ichiro Kawachi, MD, PhDMichael Botticelli, MEd; and Tyler J. VanderWeele, PhD — are associated with Harvard University.  The fifth is affiliated with the Grayken Center for Addiction at Boston Medical Center.


I hope that the authors and JAMA Psychiatry won’t mind my reproducing some of the first paragraphs of the article.  I do so in order to pique interest in it, in the hope that some in my audience will read it:


Key Points

Question  Is frequent religious service attendance associated with a lower risk of deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) among US health care professionals?

Findings  In this cohort study of 66 492 female registered nurses and 43 141 male health care professionals in the US, attendance at religious services at least once per week was associated with a 68% lower hazard of death from despair among women and a 33% lower hazard among men compared with never attendance.

Meaning  The findings suggest that frequent attendance at religious services is associated with lower subsequent risk of deaths from despair.


Importance  The increase in deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) has been identified as a public health crisis. The antecedents associated with these deaths have, however, seldom been investigated empirically.

Objective  To prospectively examine the association between religious service attendance and deaths from despair. . . .

Main Outcomes and Measures  Deaths from despair, defined specifically as deaths from suicide, unintentional poisoning by alcohol or drug overdose, and chronic liver diseases and cirrhosis. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) of deaths from despair by religious service attendance at study baseline, with adjustment for baseline sociodemographic characteristics, lifestyle factors, psychological distress, medical history, and other aspects of social integration. . . .

Conclusions and Relevance  The findings suggest that religious service attendance is associated with a lower risk of death from despair among health care professionals. These results may be important in understanding trends in deaths from despair in the general population.


Life expectancy in the US has decreased for 3 consecutive years since 2015. In particular, the mortality rates among middle-aged non-Hispanic white men and women aged 25 to 64 years increased by 5.2% between 1999 and 2016, with the differences particularly pronounced among individuals without a college degree. This increase in midlife mortality was largely associated with the increasing deaths from suicide, unintentional drug (eg, opioids) and alcohol poisoning, and alcohol-associated chronic liver disease and cirrhosis. These 3 causes of death have increased in parallel since 1999. Economists Case and Deaton introduced the term deaths of despair because these deaths may share a context of hopelessness and indifference toward living. As Deaton testified before the US Senate, suicide, drug misuse, and heavy drinking are all “plausible outcomes of processes that have cumulatively undermined meaning of life.”


It’s interesting to contemplate a study such as this one in connection with the rise — much celebrated in some circles — of the rise of the religious “nones.”


In any event, those still actively working on their Christopher Hitchens Memorial “How Religion Poisons Everything” Files may want to consider adding this item to their collection.  Why?  “‘If they would rather die,’ said Scrooge, ‘they had better do it, and decrease the surplus population.'”  But it appears that religious involvement, by decreasing the desire to die, could significantly interfere with the goal of surplus-population reduction.


Incidentally, I treated related matters — even citing Tyler J. VanderWeele, one of the authors of this latest study — in my remarks at the 2017 FairMormon conference:


“What Difference Does It Make?”



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