Religious Service Attendance and Deaths Related to Drugs, Alcohol, and Suicide Among US Health Care Professionals
Religious Service Attendance and Deaths Related to Drugs, Alcohol, and Suicide Among US Health Care Professionals
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DOI：
10.1001/jamapsychiatry.2020.0175
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发表时间：
2020-07-01
期刊：
影响因子：
25.8
通讯作者：
VanderWeele, Tyler J.
中科院分区：
文献类型：
--
作者：
Chen, Ying;Koh, Howard K.;VanderWeele, Tyler J.
问题是，在美国卫生保健专业人员中，频繁参加宗教仪式是否与与药物、酒精和自杀(称为绝望死亡)有关的死亡风险较低有关？这项对美国66492名注册女护士和43141名男性医疗保健专业人员进行的队列研究发现，每周至少参加一次宗教仪式的女性死于绝望的风险比从不参加的女性低68%，男性比从不参加的风险低33%。这意味着研究结果表明，频繁参加宗教仪式与随后死于绝望的风险较低相关。重要的是，与药物、酒精和自杀有关的死亡增加(称为绝望死亡)已被确定为公共健康危机。然而，与这些死亡相关的前因很少得到实证研究。目的前瞻性研究参加宗教活动与绝望者死亡的关系。设计、设置和参与者这项基于人群的队列研究使用了从2001年到2017年参与护士健康研究II(NHSII)的66492名注册女护士和从1988年到2014年参与健康专业人员后续研究(HPFS)的43141名男性医疗保健专业人员(例如牙医、药剂师、验光师、骨科医生、足科医生和兽医)的自我报告问卷和医疗记录中提取的数据。死亡原因的数据是从死亡证明和医疗记录中获得的。数据分析时间为2018年9月2日至2019年7月14日。参加宗教仪式的人数是在研究基线时自我报告的，以回答“你多久参加一次宗教集会或仪式？”主要结果和衡量绝望死亡的指标，具体定义为自杀、酒精或药物过量意外中毒以及慢性肝病和肝硬变死亡。COX比例风险回归模型被用来估计研究基线时参加宗教服务的绝望死亡的风险比(HR)，并调整了基线社会人口学特征、生活方式因素、心理困扰、病史和其他社会融合方面的因素。结果在66492名女性参与者中(平均年龄46.33[4.66]岁)，在1039465人年的随访中，发现75例因绝望而死亡的事件。在HPFS的43141名男性参与者中(平均年龄55.12[9.53]岁)，有306人死于绝望(在973736人年的跟踪调查中)。在完全调整的模型中，与从未参加过宗教活动的参与者相比，每周至少参加一次宗教活动的参与者在NHSII中因绝望死亡的风险降低68%(HR，0.32；95%CI，0.16~0.62)，在HPFS中因绝望死亡的风险降低33%(HR，0.67；95%CI，0.48~0.94)。结论和相关性研究结果表明，在卫生保健专业人员中，参加宗教服务与因绝望而死亡的风险较低有关。这些结果可能对了解普通人群中绝望死亡的趋势很重要。这项队列研究评估了频繁参加宗教仪式与美国卫生保健专业人员中与药物、酒精和自杀相关的死亡(称为绝望死亡)之间的联系。
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 66492 female registered nurses and 43141 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. Design, Setting, and Participants This population-based cohort study used data extracted from self-reported questionnaires and medical records of 66492 female registered nurses who participated in the Nurses' Health Study II (NHSII) from 2001 through 2017 and 43141 male health care professionals (eg, dentist, pharmacist, optometrist, osteopath, podiatrist, and veterinarian) who participated in the Health Professionals Follow-up Study (HPFS) from 1988 through 2014. Data on causes of death were obtained from death certificates and medical records. Data analysis was conducted from September 2, 2018, to July 14, 2019. Exposure Religious service attendance was self-reported at study baseline in response to the question, "How often do you go to religious meetings or services?" 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. Results Among the 66492 female participants in NHSII (mean [SD] age, 46.33 [4.66] years), 75 incident deaths from despair were identified (during 1039465 person-years of follow-up). Among the 43141 male participants in HPFS (mean [SD] age, 55.12 [9.53] years), there were 306 incident deaths from despair (during 973736 person-years of follow-up). In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week had a 68% lower hazard (HR, 0.32; 95% CI, 0.16-0.62) of death from despair in NHSII and a 33% lower hazard (HR, 0.67; 95% CI, 0.48-0.94) of death from despair in HPFS. 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.This cohort study assesses the association of frequent religious service attendance with deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) among US health care professionals.