A decline in religious participation among middle-aged, less educated white Americans may have played a role in the widely noted increases in "deaths of despair," a new study finds.
Researchers found that states that had the largest declines in churchgoing from 1985 to 2000 also had larger increases in death by drug overdoses, suicide and alcoholic liver disease - what have been called deaths of despair.
While the increase in deaths of despair has often been linked to the introduction of OxyContin and other new opioids in the late 1990s, this study shows the trend began years earlier when religious participation started to fall, said Tamar Oostrom, co-author of the study and assistant professor of economics at The Ohio State University.
"What we see in this study is the beginning of the story, before opioids became a major issue, and it shows rises in deaths of despair were already beginning to happen when the opioid crisis hit," Oostrom said.
Oostrom conducted the study with Tyler Giles of Wellsley College and Daniel Hungerman of the University of Notre Dame. It was published online recently in the Journal of the European Economic Association.
The researchers used data on religiosity from the General Social Surveys and mortality data from the Centers for Disease Control and Prevention.
Their analysis showed that the decline in religious participation was driven by white, middle-aged Americans without a college degree - the same group that experienced increases in mortality, Oostrom said.
The link between declining churchgoing and increased mortality was found among both men and women, in both rural and urban areas of the United States.
In order to further confirm that link, the researchers analyzed the repeal of "blue laws" that had prohibited many stores and businesses from doing business on Sunday, eliminating competition from going to church.
The largest repeal of blue laws occurred in 1985, when Minnesota, South Carolina and Texas all repealed their laws. The researchers compared those three states to others.
Findings showed that the repeal of blue laws led to a 5- to 10-percentage-point decrease in weekly attendance of religious services, and later an increase in the rate of deaths of despair in those states.
Oostrom said that deaths of despair were on a steady decline among middle-aged white Americans from the late 1970s to the early 1990s, when the decline leveled off, Oostrom said. This leveling off is consistent with the effects of the repeal of blue laws and declines in religious participation.
The mortality rates then began to skyrocket after the introduction of OxyContin in 1996.
"OxyContin and the opioid crisis made a bad situation worse, but the deaths of despair were already on the rise," Oostrom said.
How is the decline in churchgoing related to increases in deaths of despair?
Oostrom said when people stop going to church, they lose those social connections, which studies have shown are very important to health. But it appears to be more than that.
This study didn't find any decline in other forms of social activity at the same time as the decline in churchgoing.
"Religion may provide some way of making sense of the world, some sense of identity in relation to others, that can't easily be replaced by other forms of socialization," Oostrom said.
She noted that belief in God didn't decline during the time of this study.
"What changed is whether people identified as religious and whether they go to church. Those are the things that matter when it comes to deaths of despair," she said.
The results raise the question of whether a return to participation in organized religion, or maybe other secular community organizations, could reverse these mortality trends.
"To our knowledge, findings on this point have so far been pessimistic," the authors write in the paper.
Oostrom noted that there is no evidence that general declines in community participation are reversing. And the benefits of religious participation for life satisfaction are difficult to replicate with other forms of social engagement.
If anything, the 21st century rise of social media may make a reversal even less likely, she said.
"People are less religious now, and there hasn't been a substitute that provides what religion provided to many people. And our paper suggests this could have long-term impacts on health and mortality," Oostrom said.
