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BACKGROUND: Interest has arisen in recent years in the relationship between religious involvement and health outcomes. Although most of the early literature consists of studies with methodological flaws, some recent well-conducted reports show that religious attendance is associated with reduced mortality in selected subgroups and populations. METHODS: In this study, we investigated the relationship between religious attendance and mortality using the 14,456 participants in the National Institute of Aging-funded 'Established Populations for Epidemiologic Studies of the Elderly'. RESULTS: Our analyses show that after controlling for important prognostic factors, frequent religious attendance was associated with increased survival in the entire cohort [risk ratio (RR) = 0.78, 95% Confidence interval (CI) 0.70-0.88]. However, stratified analyses show that this association exists for only two of the four sites. CONCLUSIONS: We conclude that the association between religious attendance and survival is not robust and may depend upon unknown confounders and covariates.
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