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Religious Service Attendance and Allostatic Load Among High-Functioning Elderly

From the Department of Public Health (J.M.), Temple University, Philadelphia, Pennsylvania; Department of Society, Human Development and Health (L.K., I.K., L.B.), Harvard School of Public Health, Cambridge, Massachusetts; and Department of Epidemiology (T.S.), University of California, Los Angeles, Los Angeles, California.

Address correspondence and reprint requests to Joanna Maselko, Department of Public Health, Temple University, 1700 N Broad St., Suite 300B, Philadelphia, Pennsylvania. E-mail: maselko{at}temple.edu

Objective: To examine the association between frequency of religious service attendance and an index of cumulative physiological dysregulation as measured by allostatic load (AL) (systolic and diastolic blood pressure, waist/hip ratio, high-density lipoprotein and total cholesterol, glycosylated hemoglobin, cortisol, serum dihydroepiandrosterone sulfate, norepinephrine, and epinephrine).There is growing empirical evidence of a positive relationship between religious engagement and better clinical health outcomes. However, studies exploring the subclinical levels of physiological dysregulation are rare; hence, the physiological processes underpinning the religion-health relationship are not well understood.

Methods: In 1988, 853 participants from the MacArthur Successful Aging Study provided information on the frequency of religious service attendance as well as blood and urine samples needed to obtain measures for a ten-item cumulative AL index. Gender-stratified multivariate linear regression models were used to estimate the direction and magnitude of the association between weekly religious service attendance and AL.

Results: At least weekly religious service attendance was associated with lower AL levels among women (b = –0.47; p < .01), but not among men (b = 0.02; p = .88) in models that statistically controlled for age, income, education, marital status, and level of physical functioning. This relationship could not be attributed to the association between religious attendance and any one or two of the components of the AL index. It also was not explained by either higher physical functioning or social integration.

Conclusion: Cumulative physiological dysregulation may be one mechanism through which religious engagement may influence a diverse range of clinically relevant health outcomes.

Key Words: religious activity • allostatic load • physiological dysregulation • aging • gender • social networks

Abbreviations: IL-6 = interleukin-6; HPA = hypothalamic-pituitary-adrenal; EPESE = epidemiologic studies of the elderly; HDL = high-density lipoprotein; DHEA-S = dihydroepiandrosterone sulfate; OR = odds ratio; CI = confidence interval; CHD = coronary heart disease; AL = allostatic load; SES = socioeconomic status.