Boston—So-called deaths of despair are a troubling issue in the United States, including among healthcare professionals. Those concerns are only heightened with the strain the COVID-19 pandemic has put on care delivery across the country.

A study published in JAMA Psychiatry looked at mortality related to drugs, alcohol, and suicide among female nurses and a range of male healthcare providers, including pharmacists.

Harvard T. H. Chan School of Public Health–led researchers note that, despite the public health crisis related to those deaths, there has been little empirical investigation of their antecedents.

To remedy that, the team sought to prospectively examine the association between religious service attendance and deaths from despair, using a population-based cohort. The study extracted data from self-reported questionnaires and medical records of 66,492 female registered nurses who participated in the Nurses’ Health Study II (NHSII) from 2001 through 2017 and 43,141 male healthcare professionals, including pharmacists, dentists, optometrists, osteopaths, podiatrists, and veterinarians, who participated in the Health Professionals Follow-up Study (HPFS) from 1988 through 2014.

Researchers obtained data on causes of death from death certificates and medical records and performed data analysis from September 2, 2018, to July 14, 2019. Religious service attendance was self-reported at study baseline in response to the question, “How often do you go to religious meetings or services?”

The research focused on deaths from despair, defined specifically as deaths from suicide, unintentional poisoning by alcohol or drug overdose, and chronic liver diseases and cirrhosis.

Among the 66,492 female participants in NHSII, with a mean age of 46.33 years, 75 incident deaths from despair were identified during 1.03 million person-years of follow-up. Among the 43,141 male participants in HPFS, with a mean age of 55 years, 12,306 incident deaths from despair occurred over 973,736 person-years of follow-up, the researchers report.

Results indicate that, in the fully adjusted models, participants who attended services at least once per week had a 68% lower hazard (HR, 0.32; 95% CI, 0.16-0.62) of death from despair in NHSII and a 33% lower hazard (HR, 0.67; 95% CI, 0.48-0.94) of death from despair in HPFS compared with those who never attended religious services.

"The findings suggest that religious service attendance is associated with a lower risk of death from despair among health care professionals,” the authors conclude. “These results may be important in understanding trends in deaths from despair in the general population.”

An accompanying editorial from Marino A. Bruce, PhD, MSRC, MDiv, of the Program for Research on Faith and Health at Vanderbilt University and colleagues, raised some concerns about the study’s methodology but concludes that the results raise “both important answers and questions; thus, it would be a mistake to dismiss it. Close reading of this article provides some exciting potential avenues of inquiry at the interface of religiosity, spirituality, and health.”

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