Research on Religion and Aging Among Black Americans and Mexican Americans: The Impact of the National Institute on Aging

Abstract

For 50 years, the National Institute on Aging (NIA) has supported and promoted research on religious involvement among older adult populations. NIA funding of research on religious involvement has (i) broadened our understanding of how religious involvement is conceptualized and measured; (ii) explored the important role of social networks and interactions within religious communities in relation to congregants’ health; (iii) supported research on national samples of the U.S. population that explore demographic variability in religious practices and beliefs, as well as their social correlates; and (iv) examined health-relevant frameworks and topics in relation to religion’s association with physical and mental health and well-being. This article focuses on research on African Americans and Mexican Americans as well as comparative work involving non-Latino Whites. Selected topics in religion and aging include Conceptualization and Measurement of Religious Participation; Religious Participation; Religion and Mental Health; Religion and Physical Health, Church-Based Informal Support, Church Support, and Mental and Physical Health; Religious Coping; and the Use of Clergy for serious problems. NIA’s long record of support for scholarship and research has significantly enriched our understanding of why and how religion matters for the health and social well-being of diverse populations of older adults.

The National Institute on Aging (NIA) has played an instrumental role in supporting research on religious participation among older adults from ethnic and racial minority groups. Much of this support was in the form of research grants from unsolicited investigator-initiated proposals. A review of the literature on religion among ethnic and racial minority older adults reveals that an interdisciplinary group of scholars produced the vast majority of NIA-supported research: Chatters (R01 AG018782; R29 AG007179; F32 AG005297), Taylor (R01 AG010135; R29 AG006856; F32-AG05296), Krause (R01 AG00921; RO1 AG014749; RO1 AG026259), Ellison (R01 AG018432), and Levin (R29 AG009462). NIA also funded several health interventions for older adults within African American churches (Epps, K23 AG06545; Johnson, R21 AG044677). Several NIA grants have funded research on religion, as well as research on several other issues that are important for understanding the life circumstances of older racial and ethnic minority adults, for example, Taylor’s work with the Michigan Center for Urban African American Aging Research, P30 AG015281 and Markides’ Mexican American Aging study (R01 AG04170 and R01 AG010939). In addition, pilot studies from program project grants have focused on religion (e.g., Nguyen study P30 AG043073 and Epps study P50 AG025688).

Collectively, this body of research has exponentially improved the quality and quantity of information on religion and aging among racial and ethnic minority groups. For example, prior to the development of the National Survey of Black Americans (NSBA), research on African American adults was limited to very small-scale studies based on nonprobability samples. Beginning in the mid-1980s, NIA-supported research on religion and aging among ethnic and racial minorities was for the first time based on nationally representative probability samples, employed multiple dimensions of religious participation, controlled for important confounders in multivariate analyses, and investigated both between- and within-group differences in overall profiles in religious participation and in their antecedents and consequences.

It is important to note that simply with time, there would be a corresponding progression of research on minority aging and religion. However, funding provided by the NIA accelerated growth in this area and led to a significant increase in the quality and quantity of research and in the breadth of research topics examined. For instance, NIA’s support for secondary data analyses was strategic in assuring maximum use of and benefit from publicly supported surveys while remaining consistent with NIA’s mission to promote the development and dissemination of information about aging to public, professional, and scientific communities. This approach provided investigators with enhanced opportunities to develop and test theoretical frameworks focused on questions of aging and life course development, and to bring together interdisciplinary research teams that included key roles for student involvement and mentoring in the research process (e.g., data coding and statistical consultation). Most importantly, NIA’s robust support offered investigators more time to devote to this research. These combined elements resulted in a higher level of productivity and increased quality of research efforts.

A single article cannot cover the breadth of material in this area of research. Several important reviews of the literature are relevant to this topic. Two recent systematic reviews investigated federal funding in religion/spirituality research (Park et al., 2022; Salsman et al., 2024). Levin (2017) discussed the history of research on religion and health, focusing on older adults. In addition, Nguyen (2020) conducted a review of research on religion and mental health among older African Americans and Latinos.

This article reviews the literature on religion and aging among older African American and Mexican American adults, and, to a lesser degree, comparisons with non-Latino White and Black Caribbeans. We begin with a discussion of the direct contributions of the NIA in establishing a standardized set of measures of religious involvement. This is followed by a discussion of research on religious participation, relationships between religion and mental/physical health, church-based social support, religious coping, and the use of clergy for serious problems. Given space limitations, we do not cover research on church-based health interventions for older adults (see Epps et al., 2020, for information about NIA-supported efforts in this area).

African American, Black Caribbean, and Mexican American Aging and Religiosity

African Americans

Historically, the Black Church and religious practices and beliefs have played a critical role in the lives of African Americans. This impact is particularly evident among older African Americans with higher religious participation levels than their younger counterparts. However, before the advent of funding by NIA, there was surprisingly little information on several basic questions, such as the frequency of religious practices including prayer, reading religious materials, and rates of church membership. The little that was known was based on small nonprobability samples of African American older adults that typically focused only on bivariate analyses. Research funded by the NIA and based on the NSBA represented the first studies that adequately investigated: (1) within-group differences in multiple dimensions of religious participation, (2) whether demographic variables assumed to be important for religious involvement based upon bivariate analysis are significant when controlling for covariates, and (3) the types and nature of religious coping practices among Black Americans. Funding by NIA also supported the development of the first survey-based studies focusing on church-based informal social support for any population and the first multisample survey studies on Black–White differences in religious participation (see Taylor et al., 2004 for a discussion of these studies).

Black Caribbeans

As noted, before the NSBA and funding by NIA, survey-based information on African American religious participation was extremely limited. However, information from probability-based surveys of the religious involvement of Black immigrants from the Caribbean region was nonexistent. Available research on Black Caribbean religious participation was limited to social historical and ethnographic research. These studies tended to be in localized urban and rural communities (e.g., Haitians in Florida) and, in many cases, concentrated on Indigenous spiritual systems in the Caribbean, including Vodou, Obeah, Santeria, and Rastafarianism. Until the advent of the National Survey of American Life (NSAL), we knew very little about the religious and spiritual lives of Black Caribbeans in relation to the broad range of religious denominations covering the entire population of Black Caribbeans in the United States. As noted by Taylor et al. (2010), the systematic and broad-scale research on religious involvement among Black Caribbeans in the United States was practically nonexistent before the advent of the NSAL and corresponding funding by NIA. This was particularly true of research on Black Caribbean older adults.

Mexican Americans

Religion has historically played an integral role in the culture and daily lives of Mexican Americans. Unlike older African Americans, denominational profiles indicate that the majority of older Mexican Americans are Roman Catholic. Further, relatively few research studies explored the protective effects of religion on health and other outcomes among this population. Given limited knowledge concerning the associations between various religious dimensions (e.g., religious attendance) and health outcomes, significant gaps in the literature remained (see Lujan & Campbell, 2006 for a review). The NIA contributed to advancing conceptual and empirical work on Mexican American older adults through its support of the early research efforts of Kyriakos Markides (Markides et al., 1987). NIA support of research by Neal Krause and colleagues (R01 AG014749; R01 AG026259) further expanded our understanding of religious involvement patterns and psychosocial correlates among Mexican American older adults. Research in this area included exploring (1) within-group differences across multiple dimensions of religiosity, (2) between-group differences across ethnicities (i.e., older Whites and older African Americans), and (3) qualitative assessments of how religiosity operates as a significant psychosocial resource. Further, Krause and colleagues conducted psychometric analyses of religious scale development and longitudinal studies of religion and health associations among Mexican American older adults.

Overall Impact of NIA for Research on African American, Black Caribbean, and Mexican American Religiosity

The impact of NIA on the quantity and quality of research on these populations has been substantial. Before the advent of NIA support, there was very little survey-based research on African American and Mexican American religiosity. Additionally, research on Black Caribbean religious participation was practically nonexistent. Researchers who NIA supported were able to substantially expand the field in numerous ways including the examination of (1) religion and mental health including psychiatric disorders, (2) religion and physical health, (3) church-based informal social support and negative interactions, (4) religious coping, and (5) the utilization of clergy for mental health problems. Research on each of these issues is discussed in more detail in the next sections.

Conceptualization and Measurement of Religious Participation

One of the major accomplishments of the NIA has been its ongoing support for research on the conceptualization and measurement of religion and religious participation as multidimensional constructs. In 1995, NIA and the Fetzer Institute convened a conference and workgroup to establish a standardized set of religious measures for use in health and mental health research (Fetzer, 1999). One of the problems in the field of religion and aging was the absence of standardized measures of religious participation. Further, existing measures of religious participation contained too many items for effective use in surveys that were focused on areas such as physical or mental health. For instance, some measures of religiosity contained over 50 items (see Taylor et al., 2004 for a discussion of this issue). Further, health researchers who wanted to include items of religion and spirituality in their surveys were unfamiliar with the long history of research on religion and health and had a limited understanding of the multidimensional nature of religiosity.

The NIA-Fetzer conference and resulting publication (Fetzer, 1999) directly addressed these conceptual and methodological limitations. This project identified and developed a collection of religiosity measures that were significant for physical and mental health research. These measures have been used in numerous studies and found to be highly reliable and valid (Idler et al., 2003). NIA also commissioned three review articles on research on religion and aging (e.g., Levin, 1998). The review by Levin (1998) was one of the most comprehensive and highly cited reviews of the literature at the time.

Correlates of Religion and Religious Participation

NIA-funded research led to both important descriptive analyses of the demographic correlates of religious participation, as well as the mental and physical health outcomes of religious participation. Before this research, little was known about the basic correlates of religious participation and involvement (e.g., private and public religious behaviors and attitudes), including important factors like race, gender, age, and socioeconomic status. Gender, region, and race are several of the most consistent correlates of religious participation among older adults. Among both African Americans and non-Latino Whites, women have higher levels of religious participation and spirituality than men (Taylor et al., 2007). One notable exception is that older Black men spent more hours per week at their places of worship (Taylor et al., 2009). Regional differences have not been routinely examined, but findings from nationally representative samples indicate that Southerners have higher levels of religiosity (Taylor et al., 2007). Racial differences indicate that African American (Krause, 2006; Krause & Chatters, 2005; Taylor et al., 2007), Black Caribbean (Taylor et al., 2007), and Mexican American older adults (Krause, 2012) all have higher levels of religious participation than older non-Latino Whites.

Research on older Mexican Americans indicates they are actively involved in their churches (Krause & Bastida, 2011b; Krause & Hayward, 2013) and religious participation is an important aspect of everyday life. Similar to African Americans, Mexican Americans who were older in age and women engaged in greater religious participation than their counterparts (e.g., Krause & Bastida, 2011b; Krause & Hayward, 2013). Notably, unique factors such as experiencing greater financial strain and less frequent English use were also associated with less formal religious participation (Krause & Bastida, 2011b). Studies led by Krause revealed that religious participation rates differ between older Mexican American and older African American adults. Older Mexican Americans prayed less frequently, both alone and in a group, but exhibited a wider variety of prayer contexts than older African Americans (Krause, 2012). Mexican American older adults also had significantly lower religious commitment, volunteered less at church, and received less emotional support from church members than African American older adults (Krause & Hayward, 2014a, 2014b).

In sum, research supported by the NIA has been instrumental in highlighting demographic variability in religious involvement within specific racial and ethnic groups, as well as variability in religious involvement across racial and ethnic groups. This information has been particularly useful in dispelling characterizations and stereotypes of African American and Mexican American older adults as uniformly religious. Further, the specification of demographic variability in religious involvement within and across racial and ethnic groups has facilitated a more precise understanding of for whom (e.g., women, Southerners) and under what conditions religious factors are pertinent correlates for outcomes of interest, such as mental and physical health.

Religious Participation and Mental Health

A strength of the NSAL is that it is one of the few studies that contain a battery of religious items, as well as measures of psychiatric disorders, as opposed to only assessments of symptoms of depression or anxiety. In an analysis of older African Americans, Chatters, Bullard, et al. (2008) found that religious service attendance was significantly and inversely associated with having a lifetime mood disorder. Another analysis of African Americans across the adult age range found that religious service attendance was inversely associated with both 12-month and lifetime major depressive disorder (MDD), and religious coping was inversely associated with 12-month MDD (Taylor et al., 2012). Similarly, service attendance was negatively associated with suicidal attempts and ideation (Taylor et al., 2011).

Hodge et al. (2022) completed an extensive analysis of the associations between religious participation and lifetime and 12-month anxiety disorders. They found that religious attendance was inversely associated with 12-month and lifetime panic disorder, lifetime agoraphobia, and 12-month and lifetime post traumatic stress disorder (PTSD) (Hodge et al., 2022). Prayer was inversely associated with 12-month agoraphobia, 12-month social phobia, and lifetime PTSD. Listening to religious radio and looking to God for strength were also inversely related to, respectively, 12-month and lifetime panic disorder.

Himle et al. (2012) examined obsessive-compulsive disorder (OCD) among African Americans and Black Caribbeans. Examining the relationship between religion and OCD is important because even though OCD has low prevalence rates (roughly 3 in 100 people), it is an extremely debilitating disease. Further, OCD patients tend to have symptoms of repetitive prayer and compulsions related to religious symbols (Himle et al., 2012). Study findings indicated religious service attendance was negatively associated with OCD and that Catholics were more likely to have OCD than Baptists.

Theory based on stress and coping models (Ellison & Levin, 1998) suggests that religion is protective for mental health problems. Given this, inverse relationships between religious participation and the psychiatric disorders mentioned earlier are consistent with theory in this area. However, research in this area also indicates that some aspects of religion are positively associated with psychiatric problems. For example, reading religious materials was positively associated with 12-month and lifetime MDD (Taylor et al., 2012) and suicidal ideation (Taylor et al., 2011). Reading religious materials was also positively associated with 12-month agoraphobia, 12-month panic disorder, lifetime PTSD, and lifetime generalized anxiety disorder (GAD; Hodge et al., 2022). At first glance, it would be easy to infer that reading religious materials is a risk factor for psychiatric disorders. However, that is not the case. Positive associations between reading religious materials and psychiatric problems are consistent with the Resource Mobilization model (also known as the Stressor Response model) of religion and health (Ellison & Levin, 1998). African Americans may read religious materials to cope with psychiatric problems (see Taylor et al., 2012 for a fuller discussion). This example demonstrates the importance of examining religion as a multidimensional construct and understanding the nuanced ways that religion is associated with mental health.

Several religious dimensions have been studied in relation to mental health outcomes among Mexican American older adults. The most extensively studied measure, religious attendance, was positively associated with self-rated health (Krause & Hayward, 2014b), positively associated with happiness (Krause et al., 2018), and mixed associations were found for depressive symptoms (e.g., Krause & Hayward, 2012a). Religious doubt was positively associated with depressed affect and somatic symptoms of depression (Krause & Hayward, 2012a). Overall, these studies indicate that certain religious dimensions may have a positive and protective effect on mental health outcomes for Mexican American older adults.

In summary, research efforts funded by NIA have provided important information regarding connections between specific indicators of religious involvement (e.g., service attendance, prayer, and religious media) and mental health disorders. This work is important for indicating which dimensions of religion are consequential in protecting older adults’ mental health. Further, research examining possible causal links between religious factors and mental health disorders suggests that when faced with a stressor event, African American older adults mobilize religious resources as part of the stress and coping process (i.e., stressor response model). Finally, Krause and colleagues’ analyses of religious factors and mental disorders among Mexican American older adults indicate distinctive protective effects of religious behaviors (service attendance) on self-rated health and happiness, deleterious impacts of religious doubt for depressive factors, as well as denominational differences in depressive symptoms and life satisfaction.

Religious Participation and Physical Health

Several studies examine the relationship between religion and physical health, the most consequential of which addresses religion’s impact on mortality. In a landmark study by Ellison et al. (2000), frequent religious involvement was found to be a significant protective health factor associated with lower mortality among African Americans. Similarly, Hill et al. (2005) found that older Mexican Americans who attended church once per week had a 32% reduction in risk for mortality.

The literature on religion and physical health among Mexican American older adults is somewhat limited. Krause and associates (2018) recently analyzed associations between church attendance, private prayer, and spiritual struggles and symptoms of physical illnesses (e.g., dizziness) in a national sample of older adults. For older Mexican Americans, frequent church attendance predicted fewer physical symptoms, whereas frequent prayer predicted more physical symptoms. Finally, higher levels of spiritual struggles were associated with more physical symptoms. Both older Mexican Americans and older African Americans were less vulnerable to the adverse effects of spiritual struggle on physical health than older Whites. A further investigation explored the types of spiritual struggles associated with physical symptoms. Compared to older Whites, older Mexican American adults had fewer spiritual struggles that were categorized as being divine (e.g., “I felt angry at God”), interpersonal (e.g., “I was frustrated or annoyed by the actions of religious/spiritual people”), and moral (e.g., “I worried my actions were morally or spiritually wrong”).

Church-Based Informal Social Support

One of the major innovations in research on religious participation was the renewed focus and expansion of studies on informal church support networks; more specifically, research examining how church members constitute a network of relationships that provide social support, companionship, and other instrumental assistance. The NSBA was the first major survey to include in-depth questions on church-based support networks. In questionnaire construction, the staff of the NSBA conducted focus groups. When discussing religion, focus group participants noted the importance of church members as a source of support, so these types of questions were included in the NSBA. The church support items in the NSBA and the later NSAL were based on the family solidarity theoretical model (Bengtson et al., 2002; see the Silverstein and Fingerman article in this special collection), which focuses on the themes of associational, affective, and behavioral solidarity as the basis of social support exchanges. Krause’s development of a more extensive set of church support measures similarly began with information from focus groups of older adults (Krause, 2008). Research on church support has examined various topics, including (1) correlates of receiving and giving support within church settings, (2) negative interactions with church members and clergy, and (3) mental and physical health outcomes of church support and negative interactions.

The first survey-based articles on informal church support appeared in the 1980s and were supported by the NIA through individual fellowship grants to Taylor (R29 AG006856; F32 AG05296) and Chatters (R29 AG007179; F32 AG005297). Several studies of church support using the NSAL data greatly expanded the initial work from the NSBA by using a broader range of church support variables, including negative interaction, focusing on both African American and Black Caribbean respondents, and examining relationships with unique demographic factors and life circumstances (e.g., material hardship and incarceration history).

Although much of this work is based on the entire age range, we briefly discuss research focusing on older African American and Black Caribbean adults. In a study by Taylor et al. (2022), older African American and Black Caribbean adults were similar in terms of patterns of service attendance, contact with church members, emotional support, and negative interactions with church members. One important difference, however, was that church attendance was associated with emotional support among African Americans. In contrast, attendance did not directly or indirectly affect emotional support among Black Caribbeans.

Research on church support indicates that higher levels of religious service attendance and contact with church members are positively associated with the frequency of giving and receiving overall support and emotional support from church members (Nguyen et al., 2019). These findings are generally consistent among African Americans (Nguyen et al., 2019) and Black Caribbeans (Nguyen et al., 2016). Nguyen et al. (2019) also found that African American women who were formerly incarcerated had less contact with church members than women who had never been incarcerated; however, this was not the case for men. Moreover, this study identified age differences in church relationships. Although older African Americans had more frequent contact with church members than their younger counterparts, they were less likely to receive overall support and emotional support from church members than their younger counterparts.

In an analysis of instrumental support among church members, Taylor et al. (2017) found that African Americans were more likely to report giving/receiving help during an illness, followed by transportation, financial assistance, and help with chores. Further analysis specifically focused on providing support to others found that 43.3% of respondents helped church members who were ill often, followed by providing transportation (29.5%), financial assistance (23.3%), and help with chores (20.5%). Regarding instrumental assistance (Taylor et al., 2017) and overall assistance (Nguyen et al., 2019), African American respondents report that they provide more assistance than they receive. Further, African Americans with fewer years of formal education were more actively engaged in supplying and receiving instrumental support than those with higher levels of education (Taylor et al., 2017).

Studies of the complementary roles of church, family, and friends as sources of informal support (Taylor et al., 2016) indicate that characteristics of these networks (i.e., contact and subjective closeness) are consistently associated with reciprocal support exchanges involving extended family, friends, and church members. Seven out of 10 (69.86%) respondents reported being involved with reciprocal support exchanges with church members as opposed to 82.61% with friends and 87.42% with family members. In addition, a latent class analysis study of social network typologies of church and family members among African Americans found that the optimal network type included respondents who were socially integrated in both church and family networks and who experienced minimal negative interaction with these groups (Nguyen et al., 2016).

Krause has conducted several studies of race and ethnic differences in the provision and receipt of church support. Krause and Bastida (2011a) compared African American, Mexican American, and non-Latino White older adults across measures of emotional support, instrumental support, anticipated support, spiritual support, and negative interaction with controls for age, sex, education, marital status, church attendance, and Catholic affiliation. Mexican American older adults were less likely than African American older adults to report receiving tangible, emotional, spiritual, and anticipated support. In addition, they were less likely to report providing tangible or emotional support and had fewer negative interactions with church members. Krause and Bastida (2011a) concluded that older African Americans have more well-developed relationships with church members than older White and older Mexican American adults. Collectively, research by Chatters, Krause, Nguyen, and Taylor on the structure and functions of church support networks indicates that for many African Americans and, to a lesser degree, for Mexican American older adults, church members are a significant source of assistance and essential complement to family and friend social support networks.

Involvement in church support networks has both positive and negative aspects. Church members provide companionship, emotional support, and various types of instrumental support. There are also negative interactions with church members in the form of criticisms, arguments, and gossip. Studying negative interactions is essential because they are highly associated with mental health problems. One of the most consistent findings in the literature is that higher levels of church involvement are associated with more frequent receipt of church support (Nguyen et al., 2019; Taylor et al., 2022). However, reflecting the dual nature of social relationships, high levels of involvement in church networks are also associated with more frequent negative interactions, in part due to the increased opportunities for conflict. Taylor et al. (2022) found that both African American and Black Caribbean older adults who reported more frequent contact with church members also reported more frequent negative interactions with them. Similarly, research indicates that Mexican American older adults who received less social support from church members had fewer negative interactions as compared to African Americans who interacted more frequently and had more negative interactions (Krause and Bastida, 2011a).

Krause and Hayward’s (2012a) exploration of the linkages between church-based negative interaction, religious doubt, and depressive symptoms among older Mexican Americans found that those who had negative interactions with church members were more likely to express doubts concerning their faith. Higher levels of religious doubt were associated with an expectation that wrongdoers should make amends (i.e., apology, promise not to transgress, and provide recompense). Finally, older adults who felt that offenders should perform more acts of contrition had higher depressive symptoms.

Prior to the NIA’s role in supporting survey research exploring the church support networks of older adults, these historically and culturally important institutions were largely ignored in the scientific literature. Several smaller-scale and local studies of the characteristics and social supports provided by religious congregations were available. However, the absence of attention to nationally representative information about church support networks prevented the development of a body of findings that profiled the extent, types (emotional and tangible), and impacts of social supports and negative interactions on the health and well-being of African American older adults. Overall, this collection of findings underscores the complexity of church social support mechanisms among older African Americans and older Mexican Americans, where the interplay of positive church-based social support and occasional negative interactions shapes their religious experiences.

Church Support and Mental and Physical Health

As noted in the previous section, prior to NIA funding there was an absence of survey research on church support networks in general, and certainly no studies examining the impact of church support on mental and physical health. Chatters and colleagues’ work has investigated the impact of church support networks on mental health status. Chatters et al. (2015) examined associations between church support and family support on depressive symptoms and serious psychological distress (SPD) among older African Americans. They found that emotional support from church members was inversely associated with both depressive symptoms and psychological distress while experiencing negative interactions with church members was positively associated with depressive symptoms and SPD. Overall, the findings indicate that social support from church networks was protective against depressive symptoms and psychological distress. This finding remained significant when controlling for indicators of family social support. This is important because it was believed that the mental health effects of church support were simply a proxy for family support, and these effects would disappear if family support was controlled (also see Chatters et al., 2018).

In the first paper on church support and suicidal behaviors, Chatters, Taylor, et al. (2011) found that subjective closeness to church members was negatively associated with suicidal ideation, but not suicidal attempts among African Americans and Black Caribbeans (Chatters et al., 2011). Frequency of interaction with church members was positively associated with suicide attempts, a finding explained by the aforementioned Stressor Response Model. That is, those who have attempted suicide previously may be more likely to interact with church members to garner support as a preventive strategy.

A collection of studies by Krause and associates demonstrates positive indirect associations between church support and mental health among older Mexican Americans. Krause and Bastida (2011c) tested a theoretical model of church-based emotional support and self-rated health and did not find a statistically significant direct effect of church-based emotional support. Instead, an indirect effect through feelings of belonging suggested that older Mexican Americans who felt more socially integrated with their churches were more likely to have better self-rated health than those who felt more socially detached. Collectively, the studies on church support and health outcomes suggest that the multifaceted nature of church support requires a nuanced understanding of the influences of cultural and religious contexts on the health of older Mexican Americans (Krause, 2019).

Religious Coping

Prayer and other religious practices are frequently used to cope with personal problems. Religious coping methods are even used among those who are not affiliated with a religious community and do not attend services. For instance, among those who do not have a denomination and who have never attended religious services, 29% report that prayer during stressful periods is very important, and 26% state that they look to God for strength (Brown et al., 2013). Data from the NSAL indicate that 90.4% of African Americans, 86.1% of Black Caribbeans, and 66.7% of non-Latino Whites indicated that prayer is very important when coping with stress (Chatters, Taylor, et al., 2008) and both African Americans and Black Caribbeans reported higher levels of religious coping than non-Latino Whites. Among African Americans and Black Caribbeans, women reported higher levels of religious coping than men and having fewer years of formal education was associated with higher endorsement of the importance of prayer during stressful periods.

Two studies examine the specific use of prayer or other spiritual practices in relation to 12-month DSM-IV psychiatric disorders. Woodward et al. (2009) found that prayer or other spiritual practices was the most common type of complementary and alternative medicine used for a mental or substance use disorder. African Americans and Black Caribbeans were more likely to use prayer than non-Latino Whites (Woodward et al., 2009). In addition, Taylor et al. (2021) found that African Americans and Black Caribbeans with GAD were more likely than those with other disorders to report that prayer during stressful experiences was important.

Religious coping is a multidimensional construct that is composed of two higher-order coping patterns: positive religious coping and negative religious coping. Positive religious coping may involve accepting the sacred as a partner (i.e., collaborative religious coping), using a positive appraisal of stressful occurrences, or seeking spiritual support from God. In contrast, negative religious coping can entail not relying on the sacred (i.e., self-directed religious coping), negative stress appraisal as a punishment, or expressing anger towards God. Krause and Hayward (2012b) found that frequent church attendance and spiritual support predicted a greater likelihood of engaging in positive religious coping among older Mexican Americans. A qualitative study revealed that Mexican Americans also used prayers as a crucial means to maintain contact with the dead, which is an important sociocultural tradition, and acknowledged them as close intermediaries to God or saints (Krause & Bastida, 2010).

The importance of religion as a source of coping among African American and Mexican American older adults had not been thoroughly examined until the publication of studies supported by NIA. Prior work acknowledged the concept of religious coping and recognized its importance. However, the studies reviewed in this section demonstrated that many African Americans who indicated that they never attended church service still engaged in religious coping strategies. Further, NIA supported research provided the first major studies of positive and negative religious coping among older Mexican Americans.

Use of Clergy

One major aspect of religious participation, particularly regarding mental health is seeking help from clergy for problems. Clergy are sought for a variety of reasons including marital problems, problems with adolescent and adult children, substance abuse, and mental health concerns (e.g., depression and anxiety disorders). Nguyen et al.’s (2020) study of older adults’ use of clergy and other professional service providers for serious problems found that one-third of older adults did not seek any help for their serious emotional problems. When asked why they did not seek assistance, older African Americans indicated that they “thought that the problem would get better by itself” (33.9%), as compared to non-Latino White (20.5%) and Black Caribbean (16.9%) older adults. The most utilized professionals were family doctors (34%) and clergy (31%), who were contacted twice as often as psychiatrists (13%). Finally, religious service attendance was positively associated with the use of clergy.

An analysis explicitly on the use of clergy among African Americans (Chatters, Bullard et al., 2011) found that clergy are seen for a variety of problems, including bereavement, emotional issues (e.g., depression, unhappiness, and self-doubt), interpersonal problems (e.g., marital problems, problems with family and friends), physical health concerns (e.g., poor health), and economic problems (e.g., poor or declining financial status). Contrary to popular belief, African Americans with higher education and income were more likely to utilize clergy. Further, even after controlling for religious service attendance, women were more likely to utilize clergy than men, and Pentecostals had higher levels of utilizing clergy than persons with other denominational affiliations. Clergy were most often seen for help with counseling following the death of a loved one, a role that is particularly suited for clergy given their responsibilities in providing bereavement support and performing religious services and observances that are associated with death.

One of the more puzzling issues in this field was Black–White differences in the use of clergy. Research indicates that African Americans have higher levels of service attendance (Krause, 2006; Taylor et al., 2007), involvement in their church (Krause, 2006; Krause & Chatters, 2005; Taylor et al., 2007) and interactions with their clergy (Krause & Bastida, 2011a). However, research on the use of clergy for psychiatric problems (Wang et al., 2003) and serious personal problems (Chatters et al., 2017) indicates that non-Latino Whites utilize clergy more often than African Americans. Chatters et al. (2017) conducted an analysis to explain this inconsistency. They found that African Americans sought assistance from clergy in churches, whereas non-Latino Whites sought assistance in other settings such as hospitals. For Whites, their use of clergy in hospitals may reflect short-term counseling from a hospital chaplain, whereas for African Americans, contact with clergy within the context of church may be reflective of a long-standing relationship (Chatters et al., 2017).

Krause and Bastida’s work (2011b) indicates that while Mexican American older adults received significantly less emotional support and anticipated less support than older African American and non-Latino White older adults, they received more instrumental support from pastors than non-Latino White older adults. Among older Mexican American women, more negative interactions with clergy were significantly associated with poorer self-rated health and more chronic conditions (Krause & Hayward, 2013). These findings suggested that although among older Mexican Americans, gender is unrelated to the frequency of negative interactions with clergy, older women’s health appears to be more vulnerable to the adverse health impacts of negative clergy interactions in comparison to older men.

Before the advent of NIA-funded research, there were a handful of high-quality research studies that focused on how clergy functioned in providing resources and other support to adults across the life course. Work funded by NIA provided a thorough and nuanced understanding of Black–White differences in the use of clergy, as well as the first studies on the use of clergy among older Mexican Americans.

Conclusion

The NIA has played a prominent leadership role in supporting and championing research on religious involvement among older adult populations. NIA funding has broadened the scope and depth of scholarship and research efforts in four primary areas. First, attention to conceptualization and measurement has resulted in a more accurate understanding of the multiple dimensions of religious involvement. These efforts have helped the field advance from a sole reliance on behavioral indicators of religious involvement (e.g., attendance and denomination) to a more expansive focus on public religious practices as well as private devotional practices, attitudes, and beliefs. Second, research in this area has examined the social networks and interactions within religious communities that allow exploration of questions of social support provision and exchanges, negative interactions, and the social norms and expectations that shape both collective and individual behavior. Third, NIA’s support of research based on national samples of the U.S. population has provided opportunities to examine demographic variability in religious practices and beliefs and their social correlates. This work has been particularly important in highlighting demographic, ethnic, and religious diversity that exists within minoritized populations but is not often explored. Fourth, consistent with NIA’s mission, their support of research on religion among older adults focuses on the physical and mental health of older adults and allows the exploration of a range of topics and frameworks such as stress and coping, depression, anxiety, and suicidal behavior. When fully considered, the scholarship and research supported by the NIA have been fundamental in deepening our understanding of how and why religion matters for older adults.

Funding

The preparation of this manuscript was supported by grants from the National Institute on Aging to R. J. Taylor [P30 AG015281], A. W. Nguyen [P30 AG072959 and U24 AG058556], National Institute of General Medical Sciences [T32 GM139807] to E. Kim, and the National Institute of Diabetes and Digestive and Kidney Diseases to L. M. Chatters [P30 DK092926].

Conflict of Interest

None.

Data Availability

This article does not report data and therefore the pre-registration and data availability requirements are not applicable.