Abstract

Introduction: Religion is an important aspect of personal identity, which is linked to education and wealth. Religion is changing in prevalence, notoriously difficult to obtain from surveys, and seldom accounted for in clinical research. We characterized religious affiliation among patients with common diagnoses treated by vascular surgeons and explored associations with patient-level factors and health risk behaviors. Hypothesis: We hypothesize health risk behaviors will be more common among vascular patients that are unaffiliated with a particular religion. Methods: Patients treated from 2019-2021 at a single center with vascular disease (abdominal aortic aneurysm; carotid, renal, or mesenteric stenosis; or peripheral artery disease) were identified. Self-reported religious affiliation was obtained from the medical record. Patients self-reporting any religion (regardless of religion name or denomination) were categorized as religion-affiliated (RA); self-reporting as atheist, agnostic, or no religion were categorized as unaffiliated (UA). Health risk behaviors were evaluated as individual outcomes and in aggregate based on heavy drinking (per CDC recommendations), tobacco, or illegal drug use. Statistical comparisons used chi-square and Wilcoxon scores. Results: Among 3,568 patients identified, 3,247 (91%) had self-reported religion and form the basis of analysis. 2198 (67.7%) reported RA, and over 40 denominations were identified. RA was more common among women [70.3% (1041 of 1480) vs. 65.5% (1157 of 1767); P=0.003] and married patients [71.1% (1162 of 1635) vs. 65.5% (598 of 913): P=0.003]. RA by race was most common among African American patients [70.9% (158 of 223)] and least common among Asians [48.2% (26 of 54)] (P=0.002). Self-reported health risk behaviors were more common among UA patients [33.2% (348 of 1049) versus 27.2% (598 of 2198); P<0.001], who also had a higher median weekly alcohol consumption (1.2 [IQR 3.6] vs. 0.6 [IQR 2.4] ounces; P=0.024). Conclusions: Self-reported RA is associated with demographics and health risk behaviors among vascular patients. Interventions leveraging religious organizations and leaders may not reach nearly one third of patients who are UA. Future work will explore associations with socioeconomic factors and surgical outcomes.

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