Table 3. Baseline Religious Service Attendance and Hazard Ratio of Deaths From Despair^a.

Study, analysis	Religious service attendance
	Never or almost never	HR (95% CI)		P value for trend
		<1 Time/wk	≥1 Time/wk
NHSII, 2001-2007 (n = 66 492)
Age-adjusted	1[Reference]	0.55 (0.32-0.92)	0.26 (0.14-0.47)	<.001
Multivariable-adjustedb	1 [Reference]	0.65 (0.38-1.12)	0.32 (0.17-0.59)	<.001
Fully adjustedc	1 [Reference]	0.66 (0.38-1.14)	0.32 (0.16-0.62)	<.001
HPFS, 1998-2014 (n = 43 141)
Age-adjusted	1 [Reference]	0.74 (0.51-1.08)	0.51 (0.37-0.70)	<.001
Multivariable-adjustedb	1 [Reference]	0.88 (0.60-1.30)	0.63 (0.45-0.88)	.01
Fully adjustedc	1 [Reference]	0.92 (0.63-1.35)	0.67 (0.48-0.94)	.02

Abbreviations: HPFS, Health Professionals Follow-up Study; HR, hazard ratio; NHSII, Nurses’ Health Study II.

^aDeaths related to drugs, alcohol, and suicide are referred to as deaths from despair. Multiple imputation was performed to impute missing data on religious service attendance and the covariates.

^bIn both studies, the multivariable-adjusted model controlled for age (years), race/ethnicity (non-Hispanic white, other), geographic region (Northeast, Midwest, South, or West), living arrangement (live alone, other), past 2-year preventive health care use (yes or no), alcohol intake (0 g/d, 0.1-9.9 g/d, 10.0-29.9g/d, or ≥30.0 g/d), smoking status (never, former, current 1-14 cigarettes per day, current 15-24 cigarettes per day, or ≥25 cigarettes per day), caffeine intake (quintiles), body mass index (calculated as weight in kilograms divided by height in meters squared) (<20.0, 20.0-24.9, 25.0-29.9, 30.0-34.9, or ≥35.0), physical activity (<3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, or ≥27.0 metabolic equivalents), history of hypertension (yes or no), hypercholesterolemia (yes or no), and diabetes (yes or no). In NHSII, the model also adjusted for past 2-year night-shift work schedule (none, 1-9 months, 10-19 months, or ≥20 months), employment status (currently employed, not employed), household income (<$50 000, $50 000-$74 999, $75 000-$99 999, or≥$100 000), childhood abuse score (assessing physical, emotional, and sexual abuse during childhood and adolescence, ranging from 0 to 5, with a higher score indicating more severe abuse²⁸), menopausal status (premenopausal or uncertain, postmenopausal), menopausal hormone use (yes or no), and depression (yes or no). In HPFS, the model also adjusted for occupation (dentist, pharmacist, optometrist, osteopath, podiatrist, or veterinarian), employment status (full-time, part-time, retired, or disabled), high phobic anxiety symptoms (yes or no), and history of kidney failure (yes or no).

^cIn both NHSII and HPFS, the fully adjusted model further adjusted for other aspects of social integration (quartiles, assessed with a social integration score derived without religious service attendance).