Religious Service Attendance Research Articles

What Aspects of Religiosity are Associated with Values?

AbstractA large body of research shows that religiosity in general is associated with values. Yet, we know little about the specific aspects of religiosity that drive this association. Using nationally representative data from a sample of young adults in the United States, we examined how various aspects of religiosity—religious tradition, service attendance, frequency of prayer, religious salience, belief in God, closeness to God, and number of religious friends—are associated with the 10 values comprising Schwartz's circle of values. Bivariate results indicate that most measures of religiosity are correlated with Schwartz's circle of values. Multivariate regression results, however, show that the relationship between religiosity and values is largely due to the positive associations between closeness to God and social focus values, the positive associations between number of religious friends and social focus values, and the negative associations between religious service attendance and personal focus values. We conclude by discussing why these aspects of religiosity appear to be most relevant to Schwartz's circle of values and by suggesting directions for future research on religiosity and values.

Working for God: Religion and Occupational Crime and Deviance

ABSTRACT Although previous research suggests that many dimensions of religion (e.g., religious service attendance, importance of religion) are significantly related to juvenile delinquency and substance use, fewer studies have examined the relationship between religiosity and adult crime, particularly white-collar crimes. Based on Wave 4 of the Baylor Religion Survey, we used Ordinary Least Squares (OLS) regression to determine if religiosity reduces occupational crime and deviance due to feelings of work as a vocational calling which we hypothesized would increase job satisfaction and affective commitment to work. We find that people who attend religious services more frequently are significantly less likely to engage In occupational crime and deviance, but importance of religion is not significantly related to occupational crime or deviance. Contrary to our expectations, vocational calling, job satisfaction, and affective commitment do not explain the relationship between religious service attendance and occupational crime and deviance. Our research suggests future research is warranted to better understand the relationship between religion and adult crime, particularly white-collar crime, and the possible mediating factors that may explain this relationship.

A Longitudinal Examination of the Relationship between Religious Service Attendance and Young Adult Substance Use

Abstract Young adulthood is a time of increased substance use. To better understand the effects of potential protective factors, this study explores the relationship between four types of religious service attendance during emerging adulthood and six measures of young adult substance use. Study data were abstracted from waves I (time 1 [T1]) and IV (time 2 [T2]) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) surveys (N = 14,800). Logistic regression was conducted to calculate the odds of using each substance with the results weighted to produce nationally representative estimates. Analysis revealed that service attendance was generally associated with a lower likelihood of lifetime and recent use across all measures examined at T2. Relative to the reference group (nonattenders at T1 and T2), the protective effects were largest for the consistent attendance group (attenders at T1 and T2), followed by the adult attendance group (nonattenders at T1, attenders at T2), and then the childhood attendance group (attenders at T1, nonattenders at T2). The results suggest that diverse attendance types may exert a protective influence on adult substance use. Practitioners might explore attendance options in clinical settings in a client-centered manner.

Exploring the feasibility of ex-post harmonisation of religiosity items from the European Social Survey and the European Values Study

This paper examines the feasibility of ex-post harmonisation strategies using European Values Study (EVS) Wave 5 (2017–2020) and European Social Survey (ESS) Round 9 (2018–2019) data across 17 countries. The study shows an empirical assessment of the comparability of four items measuring religious behaviours (belonging to a religious denomination at present/in the past, religious services attendance, and praying), captured in both surveys. The novelty of this paper lies in the analytical comparison of religiosity indicators that are rarely assessed from a comparative perspective.The harmonisation strategy was based upon several analytical techniques that seek to determine similarities and differences between the selected items in terms of (a) their validity, by examining their correlations with a set of sociodemographic and substantive correlates, (b) their distributions, supplemented by visual comparisons and relevant statistical tests, and (c) item non-substantive shares. The findings pointed to the most consistency among the partial correlations, where individual religiosity produced the most differences between the surveys. Distributions produced the most discrepancies that also corresponded to less similarity across variable categories as gauged by Duncan’s index. This paper is descriptive and exploratory in its aim. It can be taken as a jumping-off point for future research where the time series of these two surveys, and potentially others, can be examined across aggregate levels (e.g. birth cohorts, countries).

Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study.

Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50-59, 60-69, ≥70] for the frequency of arts participation outcome and [50-69 vs ≥70] all other outcomes. Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50-69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.

Religious Service Attendance, Allostatic Load, and Mortality Among Black Men

Black men experience high levels of social and psychological stress and religion has been a coping strategy. The purpose of this study was to examine the association between religious service attendance and mortality among Black men. Data were drawn from the NHANES III (1988-1994) sample linked to the 2015 public use Mortality File. The analytic sample (n=2300) was restricted to Black men. All-cause mortality was the primary outcome and religious service attendance was the primary independent variable. Findings from Cox proportional hazards models indicated participants who attended at least once per week were 18% less likely to die than their peers who did not attend a religious service at all (fully adjusted HR 0.82; CI 0.68-0.99). The robust association between religious service attendance and mortality among Black men suggest that prospective studies are needed to further examine the influence of religion on health among this population.

Social Determinants of Men’s Health Across the Life Course

There is a paucity of research focusing on the complex interaction between social, behavioral, biological, and psychosocial factors, and health outcomes among men. This symposium contains a collection of papers that discuss some key social determinants of health (SDOH) that can provide insights to advance our understanding of men’s health and aging across the life course. Dawn will discuss the Stroke Counseling for Risk Reduction (SCORRE) intervention designed to increase awareness, risk perceptions, and health behaviors to reduce stroke risk in African Americans. Findings suggest tailoring the intervention to the needs and preferences of young African American men. Archibald and colleagues seek to determine if race differences in allostatic load (AL) among adult men vary by age. Black men 45-64 had a higher AL score (PR = 1.14, 95% CI 1.02, 1.28) than White men. Skipper and colleagues used a grounded theory approach to examine the negative interactions of 35 religious middle and old age Black men. Analyses reveal that church-related negative interactions broadly fall within the following themes: (1) ageism within intergenerational churches, (2) people are messy, and (3) issues with leadership. Bruce and colleagues examine the association between religious service attendance and mortality among Black men. Participants who attended at least once per week were 18% less likely to die than their peers who did not attend a religious service at all (HR 0.82; 95% CI 0.68-0.99). These presentations collectively will bolster our knowledge on key SDOH among men across the life course.

Examining religious/spiritual change among women with metastatic breast cancer

AbstractTo what extent and how does religion/spirituality change after a terminal breast cancer diagnosis? Utilizing a nationwide survey and semistructured interviews, I examine how prayer, meditation, religious service attendance, importance of religion, and religiosity may change after a metastatic breast cancer diagnosis. Results from the survey show that most people experienced change on at least one religious/spiritual indicator. “No change” is the most common response for religiosity, importance of religion, and religious service attendance, while prayer and meditation increased. Themes from the interviews shed light on coping mechanisms, such as the increased consumption of religious texts and writings, leaning on God, (re)commitment to religious institutions, prayer, and meditation. Religion (or lack thereof) remained consistent for some of the participants. A decrease in religion was less common. The results of this study have important implications for how women with a terminal disease use religious coping to manage their illness experiences.

Religious Service Attendance and Mortality among Adults in the United States with Chronic Kidney Disease

Religion and related institutions have resources to help individuals cope with chronic conditions, such as chronic kidney disease (CKD). The purpose of this investigation is to examine the association between religious service attendance and mortality for adults with CKD. Data were drawn from NHANES III linked to the 2015 public use Mortality File to analyze a sample of adults (n = 3558) who had CKD as defined by a single value of estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and/or albumin-to-creatinine ratio ≥17 mg/g for males or ≥25 for females. All-cause mortality was the primary outcome and religious service attendance was the primary independent variable. Cox proportional hazards models were estimated to determine the association between religious service attendance and mortality. The mortality risks for participants who attended a service at least once per week were 21% lower than their peers with CKD who did not attend a religious service at all (HR 0.79; CI 0.64–0.98). The association between religious service attendance and mortality in adults with CKD suggest that prospective studies are needed to examine the influence of faith-related behaviors on clinical outcomes in patients with CKD.

Does Religion Buffer Against the Detrimental Effect of Cyberbullying Victimization on Adults' Health and Well-Being? Evidence from the 2014 Canadian General Social Survey.

While prior research has well-documented the detrimental effect of cyberbullying victimization on health and well-being among children and adolescents, less is known about whether the same adverse pattern can be observed among adults. Moreover, it is unclear about what psychosocial resources might moderate this association. The present study uses a nationally representative cross-sectional survey—2014 Canadian General Social Survey (N = 17,548)—to examine three research questions. First, is cyberbullying victimization associated with adults’ self-rated health, mental health, and life satisfaction? Second, how does religiosity—religious service attendance and religious beliefs—moderate this association? Third, do any observed patterns further differ for men and women? Through a series of logistic and ordinary least squares regression models, the results show that adults who experienced cyberbullying victimization in the past 5 years are more likely to report poor self-rated health and mental health compared to those who did not experience cyberbullying victimization in the past 5 years. Likewise, cyberbullying victimization is also associated with lower levels of life satisfaction. In addition, the adverse associations of cyberbullying victimization in the past 5 years with self-rated health and life satisfaction are weaker among those who attended religious service at least once a week in the past twelve months. A similar pattern is observed for the buffering effect of viewing religious beliefs as very important in the adverse association of cyberbullying victimization in the past 5 years with self-rated life satisfaction. There is also evidence suggesting the gendered buffering effect of the importance of religious beliefs in the association between cyberbullying victimization and self-rated health. This study makes important empirical and theoretical contributions to the growing field of research on the association between cyberbullying victimization and health and well-being and to our understanding of how religion matters to individuals dealing with stressful experiences.

Modeling recent gun purchases: A social epidemiology of the pandemic arms race

In this paper, we document the social patterning of recent gun purchases to advance a contemporary social epidemiology of the pandemic arms race. We employ cross-sectional survey data from the 2020 Health, Ethnicity and Pandemic Study, which included a national sample of 2,709 community-dwelling adults living in the United States. We use binary logistic regression to model recent pandemic gun purchases as a function of age, sex, race/ethnicity, nativity status, region of residence, marital status, number of children, education, household income, pandemic job change, religious service attendance, pandemic religion change, and political party. Overall, 6% of the sample reported purchasing a new gun during the pandemic. Multivariate regression results suggest that pandemic gun purchasers tend to be male, younger, US-born, less educated, recently unemployed, experiencing changes in their religious beliefs, Republicans, and residents of southern states. To our knowledge, we are among the first to formally document a new population of pandemic gun owners that is characterized by youth, US-nativity, and religious volatility. Our analyses underscore the need for public health initiatives designed to enhance gun-related safety during pandemics, including, for example, addressing underlying motivations for recent gun purchases and improving access to training programs.

School types in adolescence and subsequent health and well-being in young adulthood: An outcome-wide analysis.

While past empirical studies have explored associations between types of primary and secondary schools and student academic achievement, outcomes beyond academic performance remain less well-understood. Using longitudinal data from a cohort of children (N = 12,288, mean age = 14.56 years) of nurses, this study examined associations between the types of schools participants attended in adolescence and a wide range of subsequent psychological well-being, social engagement, character strengths, mental health, health behavior and physical health outcomes. Results in this sample suggested little difference between attending private independent schools and public schools across outcomes in young adulthood. There were, however, notable differences in subsequent outcomes comparing homeschooling and public schools, and possibly some evidence comparing religious schools and public schools. Specifically, there was some evidence that attending religious schools versus public schools was associated with a higher likelihood of frequent religious service attendance and becoming registered voters, a lower risk of overweight/obese, fewer lifetime sexual partners, and a higher risk of subsequently being binge drinkers; however, these associations were not robust to correction for multiple testing. Homeschooling compared with public schooling was associated with subsequently more frequent volunteering (ß = 0.33, 95% CI = 0.15, 0.52), greater forgiveness (ß = 0.31, 95% CI = 0.16, 0.46), and more frequent religious service attendance (Risk Ratio [RR] = 1.51, 95% CI: 1.27, 1.80), and possibly also with greater purpose in life, less marijuana use, and fewer lifetime sexual partners, but negatively associated with college degree attainment (RR = 0.77, 95% CI: 0.67, 0.88) and possibly with greater risk of posttraumatic stress disorder. These results may encourage education stakeholders to consider a wider range of outcomes beyond academic performance in decision-making.

The Association of Religion and Spirituality with Obesity and Weight Change in the USA: A Large-Scale Cohort Study.

The association between religion, spirituality, and body weight is controversial, given the methodological limitations of existing studies. Using the Nurses' Health Study II cohort, follow-up occurred from 2001 to 2015, with up to 35,547 participants assessed for the religious or spiritual coping and religious service attendance analyses. Cox regression and generalized estimating equations evaluated associations with obesity and weight change, respectively. Religious or spiritual coping and religious service attendance had little evidence of an association with obesity. Compared with not using religious or spiritual coping at all, the fully adjusted hazard ratios (HRs) were minimally different across categories: a little bit (HR = 1.05, 95% CI: 0.92-1.18), a medium amount (HR = 1.09, 95% CI: 0.96-1.24), and a lot (HR = 1.10; 95% CI: 0.96-1.25) (Ptrend = 0.17). Compared with participants who never or almost never attend religious meetings or services, there was little evidence of an association between those attending less than once/month (HR = 1.08, 95% CI: 0.97-1.10), 1-3 times/month (HR = 1.01, 95% CI: 0.90-1.13), once/week (HR = 0.92, 95% CI: 0.83-1.02), and more than once/week (HR = 0.94, 95% CI: 0.82-1.07) (Ptrend = 0.06). Findings were similar for weight change. There was no significant association between religious or spiritual coping, religious service attendance, obesity, and weight change. While religion and spirituality are prominent in American society, they are not important psychosocial factors influencing body weight in this sample.

Childhood Abuse–Related Weight Gain: An Investigation of Potential Resilience Factors

Childhood physical, sexual, and emotional abuse are linked to adult obesity, and little is known about what protective factors might mitigate this association. Data from female (n=4,247) and male (n=1,982) participants in the longitudinal Growing Up Today cohort study from 1996 to 2013 were used to examine whether factors found to promote mental health resilience after abuse also operate as buffers (modifiers) of the abuse-weight status association. At ages 20-25 years, participants were asked about their history of child abuse before age 18 years. Potential resilience factors (modifiers) included childhood family SES, neighborhood safety, supportive relationships with adult nonfamily members, quality of maternal relationship, family structure, religious service attendance, and prayer/meditation. Associations between child abuse and BMI at ages 25-32 years were modeled using linear regression, adjusted for sociodemographic variables and baseline BMI. Potential modifiers were tested with interaction terms. Analyses were run in 2019-2020. Severe abuse was associated with 0.9 kg/m2 (95% CI=0.5, 1.2) higher adult BMI than no abuse, corresponding to a 46% increased risk of obesity (95% CI=1.28, 1.67). Less severe abuse was not significantly associated with BMI (β=0.1, 95% CI= -0.2, 0.4). There were no significant interactions between modifiers and abuse. Factors previously found to promote resilience to mental health sequelae after abuse did not modify the association of severe child abuse with higher weight status.

Not Just Service Attendance: Associations of Religious Community Social Connections with Alcohol Use among Black Adults Header: Religious Community Social Connections and Alcohol Use among Black Adults

ABSTRACT Background: Religious involvement is a well-documented protective factor against alcohol use among Black adults, but the extent to which social connections to the religious community can explain those effects remains largely unknown. The current study was designed to capture contributions of religious community support and demands – independent of religious service attendance – to alcohol use among three age cohorts of Black adults. Methods: Data were drawn from 18- to 65-year-old Black participants in the National Survey of American Life (n = 4,462; 29.4% Afro Caribbean, 70.6% African American; 63.20% female). Ordinal logistic regression analyses, conducted separately for each age cohort (18-29, 30-44, and 45-65), were used to model frequency of alcohol use as a function of religious community support and demands in two stages: (1) prior to and (2) after accounting for religious service attendance. Results: Religious community support accounted for differences in alcohol use frequency over and above religious service attendance (in Stage 2 models) for adults aged 30-44 (OR = 0.85, CI: 0.74-0.96) and 45-65 (OR = 0.77, CI: 0.64-0.93) but not 18-29 (OR = 0.85, CI: 0.71-1.03). The association of religious community demands with alcohol use frequency was specific to the age 30-44 cohort in both stage models (Stage 2: OR = 1.33, CI: 1.06-1.68). Conclusions: Study findings suggest that in addition to attending religious services regularly, developing supportive social connections to the religious community may reduce risk for frequent drinking among Black adults, particularly during middle adulthood, when demands from the religious community may increase risk.

58. IDENTIFYING POTENTIAL ENVIRONMENTAL INFLUENCES ON CLINICAL COMORBIDITIES OF SCHIZOPHRENIA THROUGH INTEGRATION OF ELECTRONIC HEALTH DATA AND GENETICS

While there is increasing recognition of disparities in healthcare for Black Americans, there have been no comparisons in a nationally representative U.S. sample of Black and White adults with clinical diagnoses of schizophrenia.Using nationally representative survey data from the National Epidemiologic Survey on Alcohol and Related Conditions-III, we compared Black (n = 240, 36.2%) and White (n = 423, 63.8%) adults who report having been told by a physician that they have schizophrenia. Due to the large sample size, effect sizes (risk ratios and Cohen's d), rather than p-values, were used to identify the magnitude of differences in sociodemographic and clinical characteristics, including experiences of discrimination and service use. Multivariate analyses were used to identify independent factors.Black individuals with diagnoses of schizophrenia reported multiple sociodemographic disadvantages, including lower rates of employment, educational attainment, income, marriage, and social support, with little difference in incarceration, violent behavior, and quality of life. They reported much higher scores on a general lifetime discrimination scale (Cohen's d = 0.75) and subscales representing job discrimination (d = 0.85), health system discrimination (d = 0.70), and public race-based abuse (d = 0.55) along with higher rates of past year alcohol and drug use disorders, but lower rates of co-morbid psychiatric disorders. Multivariable-adjusted regression analyses highlighted the independent association of Black race with measures of discrimination and religious service attendance; less likelihood of receiving psychiatric treatment (p = 0.02) but no difference in substance use treatment.Black adults with schizophrenia report numerous social disadvantages, especially discrimination, but religious service attendance may be an important social asset.

Substance use disorders among adults who are deaf or hard of hearing in the United States

BackgroundThere has been limited research on substance use disorders (SUDs) among individuals who are deaf or hard of hearing (DHH). This study explored associations among activities of daily living, instrumental activities of daily living, major depressive episode, risk perceptions for substance use, religiosity, and past-year SUDs within the DHH population. MethodsData was drawn from the 2015–2019 National Survey on Drug Use and Health (N = 214,505) to compare rates of past-year SUDs between DHH (weighted % = 5.4) and non-DHH populations. SUD measures included were past-year alcohol, marijuana, pain reliever, and illicit drug use disorders. ResultsSUDs are more prevalent among the DHH population than the non-DHH population. When adjusted for sociodemographic variables, DHH adults were more likely to report experiencing all four types of measured SUDs. Significant associations were also found between all four measured SUDs and disability status, major depressive episodes, and perception of risk. An association between regular religious service attendance and alcohol, marijuana, or illicit drug use disorders was also identified, as well as an association between peer religiosity and marijuana use disorders. ConclusionGiven the high prevalence of SUDs and limited understanding of the mechanisms associated with the SUDs within the DHH population, more research is needed to address these issues.

Religious or spiritual coping, religious service attendance, and type 2 diabetes: A prospective study of women in the United States

To investigate religion and spirituality (R/S) as psychosocial factors in type 2 diabetes risk. Using the Nurses' Health Study II, we conducted a 14-year prospective analysis of 46,713 women with self-reported use of religion or spiritual beliefs to cope with stressful situations, and 42,825 women with self-reported religious service attendance, with respect to type 2 diabetes. Cox regression was used to assess the associations. Compared with not using religious or spiritual coping at all, the fully-adjusted hazard ratios (HR) were minimally different across all categories: a little bit (HR=1.01; 95% CI:0.85, 1.19), a medium amount (HR=0.96; 95% CI:0.80, 1.14), a lot (HR=0.93; 95% CI: 0.77, 1.11) (Ptrend=0.24). Similarly, compared with participants who never or almost never attend religious meetings or services, there were minimal differences with participants attending less than once/month (HR=1.06; 95% CI:0.92, 1.22), 1-3 times/month (HR=1.00; 95% CI:0.85, 1.17), once/week (HR=0.98; 95% CI:0.85, 1.14), more than once/week (HR=1.20; 95% CI:1.01, 1.43) (Ptrend=0.29). Perceived stress did not modify these associations. Our hypothesis of mediated effects through lifestyle factors and social integration was not supported. R/S was not significantly associated with type 2 diabetes, but its role in other chronic conditions may be important.

Cohort effects on gender differences in alcohol use in the United States: How much is explained by changing attitudes towards women and gendered roles?

Gender differences in binge drinking have converged in recent cohorts, due in part to faster decreases in consumption among boys in adolescence, and faster increases in consumption among women in young to middle adulthood. Changes in education and occupation explain a portion, but not all, of these differences; the present study examines how attitudes about gender, religion and family additionally explain cohort effects in binge drinking by sex. Data were drawn from the Monitoring the Future panel studies, including >54,000 participants who were high school seniors from 1976 through 2006, followed to age 29/30 from 1988 through 2016. The main effect relationship between cohort and binge drinking was assessed, and 28 items on gender, religion and family were evaluated to determine if mediation criteria were met; mediation models assessed direct and indirect effects. Results indicated that gender, religion and family attitudes and beliefs among US adults across the 20 th and 21 st centuries have shifted dramatically but not monotonically. US adolescents and adults have largely become less religious; some attitudes on women and family have become less conservative and some more. Among men, views on marriage showed the largest mediation effects; agreeing with the statement ‘one partner is too restrictive’ mediated 3.35% of the cohort effect (95% C.I. 2.42, 4.31) and ‘couples should live together before they are married’ mediated 1.6% of the cohort effect (95% C.I. −2.37, −0.8). Among women, declines in religious service attendance mediated 2.0% of cohort effects in binge drinking (95% C.I. −3.03, −1.09), as well as similar family attitudes as men. In conclusion, changes in social roles, as well as some gender, and religious views, partially mediate cohort effects on binge drinking for men and women. The dynamic changes in how adolescents and adults view family and gender are important components of alcohol epidemiology.

Explaining US Adolescent Depressive Symptom Trends Through Declines in Religious Beliefs and Service Attendance.

Over the past decade, US adolescents' depressive symptoms have increased, and changing religious beliefs and service attendance maybecontributing factors. We examined the contribution of religious factors to depressive symptoms among 417,540 US adolescents (grades: 8, 10, 12), years:1991-2019, in survey-weighted logistic regressions. Among adolescents who felt religion was personally important, those who never attended services had 2.23 times higher odds of reporting depressive symptoms compared to peers attending weekly. Among adolescents who did not feel that religion was important, the pattern was reversed. Among adolescents, concordance between importance of religion and religious service attendance may lower risk of depressive symptoms. Overall, we estimate that depressive symptom trends would be 28.2% lower if religious factors had remained at 1991 levels.