Religion and the survival of 1010 hospitalized veterans

Objective: To examine the effects of religious affiliation and religious coping on survival of acutely-hospitalized medically-ill male veterans following discharge. Sample and Methods: Between 1987 and 1989, comprehensive psychosocial and physical-health evaluations were performed on a consecutive sample of 1010 patients ages 20-39 and 65-102 years admitted to the general medicine and neurology services of the Veterans Administration (VA) Medical Center in Durham, North Carolina. Religious affiliation and religious coping (the degree to which a patient relied on his religious faith for comfort and strength) were among the variables assessed. Subjects or surviving family members were contacted by telephone in 1996-97 to determine vital status; dates of death were confirmed by the Veterans Administration's Beneficiary Identification and Records Locator Subsystem (BIRLS), death certificate, or the National Death Index. Cox proportional-hazards regression was used to model the effects of religious variables on time to death, controlling for demographic, social, psychiatric, and physical-health covariates. Results: Follow-up was obtained on all 1010 patients. During the observation period, 673 patients died. While a higher proportion of conservative Protestants than members of other religious groups died during this time (70.5% vs. 64.3%, p = .04), the association disappeared once covariates were controlled. Religious coping was unrelated to survival in both bivariate and multivariate analyses (hazard ratio 1.00, 95% CI 0.99-1.01). Conclusions: Neither religious affiliation nor dependence on religion as a coping behavior predicted survival in this sample of medically-ill male veterans. Several reasons for the absence of an effect are explored, notably the fact that the mortality force exerted by age, medical diagnosis, and severity of physical-health problems overwhelmed the weaker effects of psychosocial variables.