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In this issue of JAMA Internal Medicine, Li et al1 report a clear and moderately strong association between attendance at religious services and decreased mortality during a 16-year follow-up of a subgroup from the Nurses’ Health Study. The study by Li et al1 includes baseline and follow-up data from 74 534 participants and documented 13 537 deaths. The inverse association of attendance at religious services and adverse health outcomes has been studied extensively, with most results in concert with the study by Li et al, so the results are primarily confirmatory. However, this study is a major contribution to the literature.2 A particular strength of the study, in addition to the large sample size and excellent participation over time by the enrolled women, is the ability to test the temporal association between the independent variable and the outcome variable at multiple time points as well as the use of time-varying covariates to control for confounding, especially by social support and functional status. A favorable distribution of participants across the different categories of attendance at religious services, from almost never to more than once per week, provides ample numbers for comparison. Even so, the study exhibits limitations in terms of generalizability, many of which are acknowledged by the authors yet should be highlighted. Before addressing these limitations, however, we may ask, “What is the rationale for publishing studies about religion in a medical journal focused on documenting empirical evidence related to health and health care?”
Blazer DG. Empirical Studies About Attendance at Religious Services and Health. JAMA Intern Med. 2016;176(6):785-786. doi:10.1001/jamainternmed.2016.1626