Religious Attendance and Life Satisfaction in the

Journal of Psychology and Theology

Copyright 2001 by Rosemead School of Psychology

2001, Vol. 29, No. 2, 158-164

Biola University, 0091-6471/410-730

RELIGIOUS ATTENDANCE AND LIFE SATISFACTION IN THE FINNISH GENERAL POPULATION JUKKA HINTIKKA, TARJA KOSKELA, OSMO KONTULA, KAJ KOSKELA, HELI-TUULIE KOIVUMAA-HONKANEN, and HEIMO VIINAMÄKI Kuopio, Finland

lates with mental health (Green et al., 1992; Koivumaa-Honkanen et al., 1996). A positive association between religious activity and life satisfaction among elderly people has been found in several studies from different populations (Ayela, Mulligan, Gheorghiu, & Reyes-Ortiz, 1999; Bienenfeld, Koenig, Larson, & Sherrill, 1997; Coke, 1992; Ho et al., 1995; Hunsberger, 1985; Markides, 1983). A positive relationship between religious activity and life satisfaction has also been found among college students (Hamilton, Lynch, Naginey, Peters, & Piske, 1989), young adults (Hong & Giannakopoulos 1994), adults with physical disabilities (Kinney & Coyle 1992), spinal cord-injured persons (Decker & Schulz, 1985) and, for example, among physicians (Ayela et al., 1999). A study using data from a nationally representative sample of black Americans suggested that the association between religiosity and well-being is consistent throughout the life course (Levin, Chatters, & Taylor, 1995). Nevertheless, as far as we know there have been no previous studies on associations between religious activity and life satisfaction in unselected nationwide samples of a general population. Religious beliefs are generally shared and practiced by social groups that can offer important sources of social support and also strengthen family ties (Shams, & Jackson, 1993). In psychiatric literature, increased opportunities to receive social support has been one of the most often mentioned aspects of religious attendance (Larson et al., 1992). Nevertheless, a recent study suggested that religious attendance might be unrelated to social support (Koenig et al., 1997). In this study we examined whether there were associations between religious attendance and life

In this study we investigated whether there were associations between religious attendance and life satisfaction in the Finnish general population. Furthermore, we examined whether social support could explain these associations. The nationwide sample included 869 women and 773 men. The respondents were asked during telephone interviews about sociodemographic variables, their household category, social and family support, and the frequencies of religious attendance and other social contacts. Life satisfaction was assessed by means of a scale developed by the Survey Research Center of the University of Michigan. Women were religious attenders more often than men (62% versus 50%). There was no gender difference in life satisfaction. Positive associations were found between life satisfaction and both social support and religious attendance. In multivariate logistic regression analysis an independent positive association was found between religious attendance and the absence of severe life dissatisfaction. Hierarchical loglinear modeling suggested that social support did not mediate the association between religious attendance and life satisfaction.

ife satisfaction refers to a personal assessment of one’s condition (McDowell, & Newell, 1987). It has been conceptualized as an assessment of life as a whole based on the match between personal goals and achievements (Andrews, & Withey, 1976; Campbell, Converse, & Rodgers, 1976). Life satisfaction is one dimension of subjective well-being (Horley, 1984) and corre-

L

Correspondence concerning this article may be addressed to Dr. Jukka Hintikka, Kuopio University Hospital, P.O. Box 1777, FIN-70211 KUOPIO, FINLAND. Electronic mail may be addressed to [email protected]. 158

HINTIKKA, KOSKELA, KONTULA, KOSKELA, KOIVUMAA-HONKANEN, and VIINAMÄKI

satisfaction in the Finnish general population. Moreover, our aim was to study whether these associations could be explained by social support. SUBJECTS AND METHODS A random sample (n=1985) was selected by Statistics Finland-from the Central Population Register to represent individuals 18 to 74 years of age living permanently in Finland in May, 1997. The study was conducted mainly on the basis of telephone interviews. The study subjects whose telephone number could not be found (7%) were interviewed face-to-face. The response rate was 83% (n=1656). Fourteen of the respondents were excluded because of missing data concerning religious attendance. The final sample (n=1642) included 869 women and 773 men. The loss was only moderate, and is not considered to have distorted the final sample or results. In addition to providing information about basic sociodemographic variables including household category and employment status, the interviewees were asked to estimate their frequency of religious attendance. Responses were classified as never, less than once a month (occasional), 1 – 3 times a month (regular), and once a week or more frequently (regular). Inquiry was also made into the frequency of social contacts (e.g, meeting relatives, entertaining guests, visiting friends) and replies were classified in the same way as religious attendance. Social and family support was assessed via five questions. Respondents were first asked to answer, on a six-point scale, the question “Do you receive adequate understanding and support from those close to you?” Understanding and support were classified as adequate (1 to 3) or inadequate (4 to 6). Other questions were, “Do you receive adequate support from your family/relatives/friends in the work place/other friends?” (yes/no). During preliminary phases of the study we tested these questions and found strong positive associations between the responses to them and social activities. These associations support the validity of the measures. Life satisfaction was assessed by means of a scale including four items which were originally developed in the Survey Research Center of the University of Michigan for measuring quality of life (Andrews & Withey 1976; Campbell et al., 1976), and were modified by Allardt (1973) to suit Scandinavian circumstances. The respondents were asked to assess on a four-point scale how interesting their life is,

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how happy they are and how easy their life is, and on a three-point scale whether they are lonely at the present moment. The range of total scores is 4 - 20. As the score increases, life satisfaction decreases. As suggested by studies on a large Finnish Twin Register (Koivumaa-Honkanen, 1998; Koskenvuo, Langinvainio, Kaprio, Rantasalo, & Sarna, 1979), the life satisfaction score was trichotomized in this study: 4 6 = satisfied, 7 - 11 slightly dissatisfied and 12 - 20 very dissatisfied. In statistical analyses, the significance of differences was assessed using the Pearson χ2 test for categorical variables and Mantel-Haenszel χ2 test for linear-by-linear association. A binary logistic regression analysis tool of the SPSS statistical package, version 9.0, was used to calculate an age- and gender-adjusted odds ratio (OR) for the association between religious attendance and life satisfaction. The odds ratio tells how much more likely religious attenders were to be satisfied with their life than non-attenders. The procedure included the following variables: religious attendance (no/yes), employment status (at work, unemployed, retired, other), household category (living alone, with family, other), adequate social support (no, yes) and life satisfaction (satisfied/dissatisfied). Finally, the Model Selection Loglinear Analysis tool of the SPSS statistical package was used to determine which categorical variables were associated with each other in our sample. These hierarchical loglinear models included the same variables as were used in the logistic regression analysis. Nevertheless, both life satisfaction (satisfied, slightly dissatisfied, very satisfied) and religious attendance (never, occasional, regular) were included as trichotomous variables in these calculations. RESULTS More women than men attended religious events at least occasionally (62 versus 50 %, p < 0.001), and a correspondingly similar difference between sexes was recorded in the percentage of regular religious attenders (17 versus 10 %, p < 0.001) and weekly religious attenders (8 versus 3 %, p < 0.001). Regular religious attendance was most common among the oldest age-group, among those who lived alone and among the retired subjects (Table 1). There was no difference between men and women in life satisfaction. The middle-aged and unemployed respondents were most often dissatisfied with their life and those who lived with family were most satisfied, respective-

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RELIGIOUS ATTENDANCE AND LIFE SATISFACTION IN FINNISH POPULATION

Table 1 Religious Attendance According to Sociodemographic Characteristics Religious attendance Never

Less than once a month

1 - 3 times a month

Once a week or more

N (%)

N (%)

N (%)

N (%)

Gender *** Male Female

389 (50) 330 (38)

310 (40) 394 (45)

51 (7) 78 (9)

23 (3) 67 (8)

Age *** ≤ 44 yr 45-64 yr ≥ 65 yr

411 (49) 252 (41) 55 (30)

360 (42) 272 (44) 72 (40)

38 (4) 53 (9) 38 (21)

39 (5) 34 (6) 17 (9)

Housing category ** living alone with family other

198 (48) 486 (41) 43 (64)

151 (36) 535 (46) 15 (28)

35 (8) 92 (8) 2 (4)

31 (8) 57 (5) 2 (4)

Employment status *** at work unemployed retired other

428 (46) 93 (57) 114 (34) 84 (41)

426 (45) 54 (33) 131 (40) 93 (45)

52 (5) 7 (4) 55 (17) 15 (7)

35 (4) 9 (6) 31 (9) 15 (7)

Differences between proportions, Pearson χ2 test. ** p < 0.01. *** p < 0.001.

ly (Table 2). A significant linear-by-linear association was found between life satisfaction and religious attendance (Table 3). In general, there were positive associations between perceived social and family support, and religious attendance and life satisfaction (Table 4). Nevertheless, support from friends in the work place did not associate with religious attendance. In multivariate logistic regression analysis it was found that religious attenders had a 70% higher probability of being not very dissatisfied with their life than those who never attended religious events (adjusted OR 1.7, 95% CI 1.2 - 2.4). The final hierarchical loglinear modeling, which included the whole sample, showed the following categorical associations in a nearly complete model: “employment status * household category * social support * life satisfaction,” “religious attendance * employment status,” “religious attendance * household category * life satisfaction,” and “religious attendance * social support” (Pearson χ2 p = 0.99),

which suggests that social support did not mediate the association between religious attendance and life satisfaction. Categorical associations between religious attendance, social support and life satisfaction were not found even in modeling by gender. DISCUSSION In univariate analyses a positive association between religious attendance and life satisfaction was found in the Finnish general population, which is consistent with several previous studies (Ayela et al., 1999; Bienenfeld et al., 1997; Coke, 1992; Hamilton et al., 1989; Hong & Giannakopoulos, 1994; Hunsberger, 1985). Nevertheless, as far as we know this is the first study showing such a relationship in an unselected nationwide sample of the general population. According to multivariate analyses, the association between religious attendance and life satisfaction was an independent one, and social support was not a mediator. Opposite to the study


Table 2 Life Satisfaction According to Sociodemographic Characteristics Life Satisfaction Satisfied

Slightly dissatisfied

Very dissatisfied

N (%)

N (%)

N (%)

Gender Male Female

260 (34) 311 (36)

445 (57) 481 (55)

68 (9) 77 (9)

Age ** ≤ 44 yr 45-64 yr ≥ 65 yr

328 (39) 183 (30) 60 (*33)

454 (53) 362 (59) 109 (60)

66 (8) 66 (11) 13 (7)

Housing category ** living alone with family other

128 (31) 429 (37) 13 (25)

233 (56) 664 (56) 26 (49

54 (13) 77 (6) 14 (26)

Employment status *** at work unemployed retired other

336 (36) 39 (24) 101 (31) 95 (46)

536 (57 96 (59) 198 (60) 96 (46)

69 (7) 28 (17) 32 (10) 16 (8)

Differences between proportions, Pearson χ2 test. ** p < 0.01. *** p < 0.001.

Table 3 Religious Attendance and Life Satisfaction Religious attendance Never

Less than once a month

1 - 3 times a month

Once a week or more

N (%)

N (%)

N (%)

N (%)

Satisfied

238 (33)

250 (36)

47 (36)

36 (40)


400 (56)

402 (57)

77 (60)

47 (52)

81 (11)

52 (7)

5 (4)

7 (8)

719 (100)

704 (100)

129 (100)

90 (100)

Life satisfaction *

Very dissatisfied Total

Mantel-Haenszel χ2 test for linear-by-linear association. * p < 0.05.

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Table 4 Social and family support perceived as sufficient in relation to religious attendance and life satisfaction Religious attendance Never

Occasional

Regular

N (%)

N (%)

N (%)

Support in general *

608 (85)

630 (90)

194 (89)

Family a *

418 (86)

488 (91)

138 (93)

Relatives **

425 (59)

471 (67)

149 (68)

Friends in the work place b

250 (58)

265 (62)

52 (60)

Other friends *

509 (71)

538 (76)

168 (77)

Source of support

Life satisfaction Very dissatisfied


Satisfied

N (%)

N (%)

N (%)

Support in general ***

91 (63)

816 (88)

525 (92)

Family a ***

55 (71)

590 (89)

399 (93)

Relatives ***

68 (47)

592 (64)

385 (67)

Friends in the work place b

27 (39)

309 (58)

231 (60)

***

93 (64)

670 (72)

452 (79)

Other friends *** Differences between proportions, Pearson χ2 test. * p < 0.05. **p < 0.01. *** p < 0.001. a Among those who were living with family. b Among those who were at work.

of Koenig et al. (1997), however, there seem to be also a relationship between religious attendance and perceived social support. One of the strengths of this study is that our sample was representative of the entire general population of Finland. The Finns remain racially and religiously homogenous. About 90% of the nation belong to the Finnish Evangelical-Lutheran church and 2% to other Christian churches (Statistics Finland, 1996). About 8% do not subscribe to any denomination, but many of them are members of unregistered Christian churches. Neither religious nor racial heterogeneity are therefore confounding factors in relation to our results as has been the case

in studies on associations between religiosity and subjective well-being in multiracial or multireligious countries (Ellison, 1991; Thomas, & Holmes, 1992). Several multiple comparisons were performed in this study. In such cases, a common requirement is that a more stringent criterion be used for statistical significance than the conventional p < 0.05 because of the risk of false positive results (Type I errors) (Perneger, 1998). Recently, Bonferroni adjustments have found their way into introductory texts on statistics (see for example WassertheilSmoller, 1995) which has increased their use in reducing the risk of type I errors. Nevertheless, Bonferroni adjustments were not used in this


study, a choice which is supported by Perneger (1998) who suggested that, even in cases of multiple comparisons, simply describing what was done and why, and discussing the possible interpretations of each result does enable the reader to reach a reasonable conclusion about the significance of the study without the help of the Bonferroni procedure. Two main weaknesses of Bonferroni adjustments are that the interpretation of the results depends on the number of other tests performed and the increased risk of false negative results (type II errors; Perneger, 1998). Dissatisfaction with life has been found to predict future depression in a three-year follow-up study of subjects without a previous psychiatric history (Green et al., 1992). Low life satisfaction, as assessed with the same scale that was used in this study, is also a strong predictor of overall mortality among the general population (Koivumaa-Honkanen et al., 2000). Among psychiatric patients (KoivumaaHonkanen et al., 1996), dissatisfaction with life is much more common than in the general population (Koskenvuo et al., 1979). Together with these other studies our work suggests that religious activity, which enchances life satisfaction, might have a beneficial role in maintaining mental and general wellbeing and in facilitating recovery. Nevertheless, studies on religious aspects of mental well-being promoting interventions are still mostly case reports or uncontrolled trials (Butler, Gardner, & Bird, 1998; Gangdev 1998; Razali, Hasanah, Aminah, & Subramaniam, 1998). There is a clear need for controlled long-term studies. It appears that religious activity is least frequent among those who have major stress factors in theirs lives, such as unemployed. Religious activity might buffer the deleterious effects of unemployment and other sources of psychosocial stress (Ellison, 1991; Shams and Jackson, 1993). In Finland, however, the opportunity to obtain relief in this way is not generally sought by those who live under stress, and especially by young adults. The church has much work to do to reverse this situation. In conclusion, this study confirms previous observations that religious activity is associated with mental well-being. Moreover, it confirms some previous suggestions that this beneficial association cannot be explained by social support. Further studies should focus in more detail on different aspects of personal religiosity.

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AUTHORS

Koskenvuo, M., Langinvainio, H., Kaprio, J., Rantasalo, I., Sarna, S. (1979). The Finnish Twin Registry: Baseline characteristics. Section III. Occupational and psychosocial factors. Public Health Publications M49. Helsinki.

HINTIKKA, JUKKA. Address: Dept. of Psychiatry, Kuopio University Hospital, P.O.Box 1777, FIN-70211 Kuopio, Finland. Title: Senior lecturer; Senior physician, Kuopio University Hospital. Degree: MD, University of Kuopio, Finland. Specializations: Mental health research, suicidology.

Larson, D.B., Sherill, K.A., Lyons, J.S., Craigie, F.C., Thielman, S.B., Greenwold, M.A., & Larson SS (1992). Association between dimension of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry, 1978-1989. American Journal of Psychiatry 149, 557-559.

KOSKELA, TARJA. Address: Sibeliuksenkatu 11 A 1, FIN-00250 Helsinki, Finland. Title: Consultant, Lung and Health Association. Degree: MSc, University of Turku, Finland. Specializations: Management.

Levin, J.S. (1994). Religion and health: Is there an association, is it valid, and is it causal? Social Sciences & Medicine 38, 1475-1482. Levin, J.S., Chatters, L.M., & Taylor, R.J. (1995). Religious effects on health status and life satisfaction among black Americans. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 50, 154-163. Markides, K.S. (1983). Aging, religiosity, and adjustment: a longitudinal analysis. Journal of Gerontology 38, 621-625. Matthews, D.A., McCullough, M.E., Larson, D.B., Koenig, H.G., Swyers, J.B., & Milano, M.G. (1998). Religious commitment and health status: A review of the research and implications for family medicine. Archives of Family Medicine 7, 118-124. McDowell, I., & Newell, C. (1987). Measuring Health. A Guide to rating Scales and Questionnaires. University of Ottawa. Oxford University Press. Perneger, T.V. (1998). What´s wrong with Bonferroni adjustments. British Medical Journal 316, 1236-1238.

KONTULA, OSMO. Address: The Population Research Institute, P.O.Box 849, FIN-00101 Helsinki, Finland. Title: Senior researcher; Population Research Institute. Degree: PhD, University of Helsinki, Finland. Specializations: Sexology, population research. KOSKELA, KAJ. Address: Sibeliuksenkatu 11 A 1, FIN-00250 Helsinki, Finland. Title: Medical director, Lung and Health Association. Degree: MD, University of Kuopio, Finland; MSc, University of Turku, Finland. Specializations: Health education. KOIVUMAA-HONKANEN, HELI-TUULIE. Address: Dept. of Psychiatry, Kuopio University Hospital, P.O.Box 1777, FIN-70211 Kuopio, Finland. Title: Senior resercher, University of Kuopio. Degree: MD, University of Kuopio, Finland. Specializations: Mental health research, life satisfaction. VIINAMÄKI, HEIMO. Address: Dept. of Psychiatry, Kuopio University Hospital, P.O.Box 1777, FIN-70211 Kuopio, Finland. Title: Professor in Psychiatry, University of Kuopio; Managing director, Kuopio University Hospital. Degree: MD, University of Kuopio, Finland. Specializations: Mental health research, administration.