Excerpt
A large body of research has now emerged suggesting that religious participation is strongly associated with numerous health and well-being outcomes [
1‐
3]. Longitudinal studies with good confounding control indicate that religious service attendance is associated with greater longevity [
4‐
9], less depression [
10‐
13], less suicide [
14,
15], better cancer and cardiovascular survival [
4,
16], less divorce [
3,
11,
17], greater likelihood of making new friends and social support [
4,
5,
11,
18], greater life satisfaction [
18], greater meaning and purpose in life [
19], more charitable giving [
20], and greater civic involvement [
20]. While many of the earlier studies were methodologically weak, there are now, for the outcomes and references listed above, rigorous studies with longitudinal designs, large sample sizes, and extensive confounding control, including control for baseline outcomes [
21], suggesting associations of fairly substantial magnitude. For several of these outcomes including mortality, depression, and suicide, sensitivity analysis [
22], moreover, suggests that the associations are robust to a fairly substantial degree of potential unmeasured confounding [
4,
10,
14]. By our ordinary criteria for assessing evidence for causality, the evidence is quite strong [
21]. Schwartz [
23] raises the interesting question of the extent to which such associations can be interpreted causally within a counterfactual framework, that is to say, as indicating what would have happened if those who did not attend services in fact had, or as indicating what might have happened if those who did attend services in fact had not. These important questions relate centrally to the causal interpretation, if any, of the research, and, as discussed below, also to the public health relevance of the results. …
