'Mental health and self-rated health among U.S. South Asians: the role of religious group involvement'

Age Changes in Religious Service Attendance in Mexican American Older Adults: A Growth Curve Analysis

OBJECTIVES

This study examines age patterns in religious attendance in older Mexican Americans. Previous research has focused on majority-white samples, limiting generalizability to other groups. Research in ethnic minority populations is needed.

METHODS

We descriptively analyze Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE) data and estimate a mixed effects linear growth curve model to assess the relationship between age and religious attendance. Results: Descriptive results reveal an inverse U-shaped pattern of religious attendance. Results from the growth curve model indicate rising religious attendance after age 65 and a decline after the mid-70s, an earlier decline compared to majority-white studies. Discussion: These findings have implications for individual well-being, the functioning of religious congregations, and for understanding the patterning of a salient form of social participation among older adults. Further research is needed to explore the underlying mechanisms and to examine religious attendance patterns in understudied populations.

Psychiatric Healthcare Experiences of South Asian Patients with Severe Mental Illness Diagnoses and Their Families in New York City: A Qualitative Study

South Asians (SAs) underutilize mental health services compared to many racial and ethnic groups in the United States (US), yet there is limited research on the experiences of SAs living with severe mental illness (SMI). This study examined psychiatric healthcare experiences of SA patients with SMI diagnoses (e.g., severe depression, bipolar disorder, schizophrenia) in New York City. Data collection included semi-structured interviews with 36 participants (21 patients, 11 family members, 4 clinicians). Data was managed in NVivo. Two pairs of SA researchers conducted thematic analysis. Limited mental health knowledge led to delayed care for SAs due to a low perceived need for help. Ease of access, linguistic resources, patient-provider relationships, and family involvement influenced psychiatric healthcare experiences. Prescribed medications, self-motivation, communication, and religious practices were factors aiding symptom management and recovery. Findings highlight the need for improving psychiatric healthcare access and culturally-salient mental health education for SA communities.

Profiles of cardiometabolic risk and acculturation indicators among South Asians in the US: latent class analysis of the MASALA study

Background

South Asians (SA) represent the fastest growing US immigrant group, and previous studies have indicated that they face disproportionately high burden of cardiometabolic disease. Cardiometabolic disease manifests as a syndemic or synergistic epidemic encompassing multiple disease clusters influenced by biological, social, and psychological factors stemming from the acculturative process. This process may exacerbate morbidity within immigrant subgroups. Our aim was to identify cardiometabolic risk profiles among SA using indicators of acculturation.

Methods

We conducted a latent class analysis on data from the Mediators of Atherosclerosis in South Asians Living in America study (N=771). A composite cardiometabolic disease outcome was constructed using prevalent hypertension, type 2 diabetes, and body mass index. Acculturation indicators included years living in the US, English language proficiency, dietary behaviors, preservation of cultural traditions, social and neighborhood support, maintenance of social relationships (i.e., friendships), and experiences of discrimination, along with proxies of acculturative stress (i.e., depressive symptomology, trait anxiety and anger). Social and environmental determinants of health, health behaviors, religiosity and spirituality served as covariates to further assess latent class membership.

Results

Four cardiometabolic risk profiles emerged: (1) lowest risk [73.8% of sample] characterized by high integration into both SA and US cultures; (2) the modest risk [13.4% of sample], exhibiting elevated levels of mental health distress and experiences of discrimination, and distancing themselves from both cultures; and the (3) moderate risk [8.9% of sample] and (4) highest risk [3.9% of sample], demonstrating greater assimilation into US culture. Compared to the lowest risk profile: the modest risk profile was associated with low-income and conflicting attitudes about religion/spirituality, while the moderate risk profile was characterized by lower income and educational attainment with positive behaviors and attitudes toward religion/spirituality.

Conclusion

Findings expand our understanding of immigrant cardiometabolic health as a syndemic issue wherein multiple co-occurring and interacting processes synergize to produce negative outcomes in already at-risk subpopulations. Furthermore, acculturation emerges as a crucial factor in understanding health disparities among immigrant and refugee groups in the US.

Why Is Religious Attendance Linked to More Anxiety in U.S. South Asians? The Mediating Role of Congregational Neglect

OBJECTIVES

Previous research has identified a positive association between religious attendance and anxiety in U.S. South Asians. The current study assesses the mediating role of congregational neglect as a potential mechanism explaining this association.

DESIGN

Analyses relied on data from the Study on Stress, Spirituality, and Health (SSSH) questionnaire in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 936), the largest community-based study of health among U.S. South Asians. Analyses were conducted using path analysis and adjusted for a variety of background characteristics.

RESULTS

Results confirmed that higher levels of religious service attendance were associated with higher levels of anxiety. Congregational neglect was a significant mediator in this relationship, explaining 27% of the association between religious attendance and anxiety. Congregational neglect also had the second largest standardized coefficient in the model.

CONCLUSIONS

This study provides evidence that congregational neglect plays an important intervening role in the connection between religious service attendance and anxiety among U.S. South Asians. The findings move beyond description, flagging a relevant social process which underlies the relationship. By recognizing the potential adverse effects of religious attendance on anxiety in this population, it may be possible to develop interventions aimed at enhancing social inclusion in South Asian religious communities. In addition to practical implications, this study highlights the need for further research on how communal religious participation shapes mental health in ethnic and racial minority populations in the United States.

"Does Religious Service Attendance Modify the Relationship between Everyday Discrimination and Risk of Obesity? Results from the Study on Stress, Spirituality and Health"

This study examined the association of everyday discrimination with risk of obesity and the potential modifying effect of religious service attendance. Participants included Black, South Asian, and white women in three cohort studies that belong to the Study on Stress, Spirituality and Health. Logistic regression models estimated odds of obesity classification (BMI ≥ 30) relative to experiences of everyday discrimination. In initial pooled analyses, high levels of discrimination were related to increased odds of obesity. Race-specific analyses revealed marginal associations for white and South Asian women. Among Black women, high levels of discrimination and religious service attendance were both associated with higher odds of obesity. However, among women who attended religious services frequently, higher levels of everyday discrimination were associated with slightly lower odds of obesity. These findings underline the complex association between obesity and religion/spirituality, suggesting that higher levels of discrimination may uniquely activate religious resources or coping strategies. Findings highlight the need for additional studies to examine the impact of everyday discrimination on risk of obesity across racial/ethnic communities and how religious practices or coping strategies might affect these dynamics.

Do Religion and Spirituality Buffer the Effect of Childhood Trauma on Depressive Symptoms? Examination of a South Asian Cohort from the USA

Asian Americans have been identified as a racial group that is disproportionately affected by childhood trauma. The goal of this study was  to assess if religion/spirituality moderate the effects of childhood trauma on adult depressive symptoms among a sample of South Asians in the USA. Our analysis drew from the study on stress, spirituality, and health (SSSH) questionnaire fielded in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 990) during 2016-2018. A series of regression models with multiplicative interaction terms were conducted. Emotional neglect, emotional abuse, and physical neglect were associated with higher depressive symptoms. Higher religious attendance and negative religious coping techniques were found to exacerbate this relationship. There were two findings conditional on gender. Among men, gratitude and positive religious coping also exacerbated the relationship between childhood trauma and depressive symptoms. Negative religious coping also exacerbated the association between childhood trauma and depressive symptoms for women. This is the first community-based study of US South Asians to consider the association between various forms of childhood trauma and depressive symptom outcomes. South Asians remain an understudied group in the religion and health literature, and this study sheds light on the important differences in the function and effectiveness of religion/spirituality for those faced with early life trauma.

Religiosity, Aging in the Homeland, and Growing Old in the Diaspora: A Longitudinal Study of Two Cohorts of Indian Older Adults

This article reports a longitudinal study comparing religiosity among two cohorts of Indian older adults-those who age in the homeland of India (AIH cohort) and immigrants (to the USA) or diaspora older adults (DOA). Results indicated that AIH and DOA cohorts' religiosity outcomes were comparable at baseline but there was a statistically significant increase in all outcomes of the DOA cohort at subsequent time points. Women and single older adults in both the cohorts had higher religiosity scores at baseline. Religiosity scores were higher among those in the DOA cohort who migrated following marital disruption (widowhood, divorce) or grandchild birth and lived with adult immigrant children and their families. The immigration process can have an impact on religious orientation of older adults and place is a significant variable impacting religiosity possibly for augmenting the sense of self, acquire social capital and preserve cultural identity in the foreign land.

Health and Social Care Outcomes in the Community: Review of Religious Considerations in Interventions with Muslim-Minorities in Australia, Canada, UK, and the USA

The aims of this integrative review included examining the intervention characteristics, religious tailoring, and behavioural outcomes of health and social care interventions with Muslim-minorities in Australia, Canada, UK, and the USA. Nineteen articles were included, and each showed some level of improved health and social care outcomes associated with interventions that were religiously tailored to Islamic teachings, and when notions of health were extended to physical, psychological, spiritual and social domains. Future studies should measure levels of religiosity to understand whether religiously tailored interventions produce a significant intervention effect when compared to non-religiously tailored interventions with Muslims.

Rates of breast reconstruction uptake and attitudes toward breast cancer and survivorship among south asians: A literature review

Our aim in this review was to ascertain rates of breast reconstruction among South Asian patients and identify attitudes towards breast cancer, survivorship, and breast reconstruction. Mastectomy rates for South Asian patients ranged from 52% to 77% and reconstruction following mastectomy varied from 0% to 14%. A negative perception of cancer, fears of social isolation, and taboos around breasts can prevent South Asian women from receiving surgical care after a breast cancer diagnosis.

The role of family support in the self-rated health of older adults in eastern Nepal: findings from a cross-sectional study

BACKGROUND

Nepal's low fertility rate and increasing life expectancy have resulted in a burgeoning older population. For millennia, filial piety shaped family cohesion and helped Nepali older adults achieve positive outcomes, but recently, it has been eroding. Furthermore, there are not enough institutional support options or alternatives to family-based care to deal with the biosocial needs of older adults. This study explored the association between family support and self-rated health among Nepali older adults.

METHODS

A community-based cross-sectional survey in eastern Nepal's two districts, Sunsari and Morang, interviewed 847 older adults (≥ 60 years). The final analytical sample was 844. Participants were asked whether they received assistance with various aspects of daily life and activities of daily living from their families. Multivariable logistic regression examined the association between family support and self-rated health.

RESULTS

Participants who received support with various aspects of daily life had 43% higher odds of good health, but after adjusting for control variables, the result only approached statistical significance (p = 0.087). Those who received family assistance with activities of daily living had nearly four times higher odds (OR: 3.93; 95% CI: 2.58 - 5.98) of reporting good health than participants who lacked this support.

CONCLUSIONS

Given the important role of family support in Nepali older adults' health, government programs and policies should create a conducive environment to foster family-based care until more comprehensive policies for older adults' care can be put into effect. The results of this study can also help shape the global aging environment by highlighting the need for family support in older care, particularly in low-income nations with declining traditional care systems and weak social security policies.

The effect of the holy Quran recitation and listening on anxiety, stress, and depression: A scoping review on outcomes

Background and Aim

Anxiety, stress, and depressive disorders as common mental health problems have adverse effects in different populations. Holy Quran recitation and listening can help reduce these disorders. Therefore, the aim of this study was to investigate the effect of the Holy Quran on anxiety, stress, and depression.

Materials and Methods

To retrieve eligible studies, we searched PubMed, Web of Science, and Scopus databases. The articles were screened and chosen by three researchers. The selection of studies and the data extraction from the studies were done by three researchers using the data collection form based on the inclusion and exclusion criteria. Disagreements were resolved by consulting the third and fourth researchers. To report scoping review, we used the PRISMA cheklist.

Results

A total of 174 articles were retrieved from three databases and after removing irrelevant and repetitive articles, 15 articles were included in the current review. All studies were performed in Asia countries. Most studies have examined the effect of Holy Quran recitation and listening on anxiety (45%), stress (30%), and then depression (25%), respectively. The Beck Depression Inventory was the most widely used tool to evaluate the effect of Holy Quran recitation and listening on reducing anxiety, depression and stress. "Reducing the level of anxiety, stress, and depression" and "Simple, affordable, practical and cost-effective treatment to reduce depression and anxiety" were the most important outcomes of holy Quran recitation.

Conclusions

Based on the results of this study, Quran recitation and listening can be applied as a useful nonpharmacological treatment to reduce anxiety, stress, and depression.

A multilevel framework to investigate cardiovascular health disparities among South Asian immigrants in the United States

PURPOSE

Prior studies of cardiovascular health (CVH) disparities among immigrants of South Asian origin in the United States have examined South Asians as one homogenous group, focused primarily on Indian-origin immigrants, and examined risk at the individual level.

METHODS

We present current knowledge and evidence gaps about CVH in the three largest South Asian-origin populations in the United States-Bangladeshi, Indian, and Pakistani-and draw on socioecological and lifecourse frameworks to propose a conceptual framework for investigating multilevel risk and protective factors of CVH across these groups.

RESULTS

The central hypothesis is that CVH disparities among South Asian populations exist due to differences in structural and social determinants, including lived experiences like discrimination, and that acculturation strategies and resilience resources (e.g., neighborhood environment, education, religiosity, social support) ameliorate stressors to act as health protective factors.

RESULTS

Conclusions: Our framework advances conceptualization of the heterogeneity and drivers of cardiovascular disparities in diverse South Asian-origin populations. We present specific recommendations to inform the design of future epidemiologic studies on South Asian immigrant health and the development of multilevel interventions to reduce CVH disparities and promote well-being.

Role of Mosque Communities in Supporting Muslims with Mental Illness: Results of CBPR-oriented Focus Groups in the Bay Area, California

Objective The purpose of this study was to explore perspectives of Muslims residing in the Bay Area, California on the role of the mosque community in supporting community members' mental health needs and barriers to mental health care for members who experience mental health challenges. Methods This study employed a CBPR-focused qualitative approach in the form of content analysis of three focus group discussions organized and conducted with the help of a Community Advisory Board made up of members of the Muslim Community Association. Results Two major themes were identified upon examination of the data: services needed in the mosque community and barriers to addressing mental health issues in the mosque community. Specifically, participants reported wanting support groups within the mosque space, mosque-based activities, virtual support, community social workers, and family-oriented services. Barriers reported included community stigma, lack of cultural awareness of race-ethnic minorities within the community, attribution of mental illness to lack of faith or supernatural causes, and specific barriers unique to vulnerable/special subgroups within the community. Conclusion These findings highlight the need for developing mental health-related services and social support initiatives within the mosque space, specifically for those Muslim Americans living in the Bay Area in California. Furthermore, special attention needs to be placed on the barriers to accessing these services as identified by the community members.

Associations of Changes in Religiosity With Flourishing During the COVID-19 Pandemic: A Study of Faith Communities in the United States

This study explored the extent to which perceived changes in religiosity from before to during the COVID-19 pandemic are associated with flourishing. Participants from a diverse set of faith communities in two United States metropolitan regions (N = 1,480) completed an online survey between October and December 2020. The survey included items capturing perceived changes in four dimensions of religiosity (i.e., importance of religion, frequency of prayer, frequency of religious service attendance, and sense of connectedness to one's faith community) and a multidimensional measure of flourishing. Based on multilevel regressions, results indicated that self-reported decreases in each dimension of religiosity were associated with lower overall flourishing. This pattern of findings was largely similar for the domains of flourishing, with some variation in the strength of associations that emerged. An increase in frequency of religious service attendance was associated with lower overall flourishing and lower scores on selected domains of flourishing (e.g., mental and physical health), indicating possible evidence of religious coping. Faith communities might have to find ways of supporting members during the challenging COVID-19 period to prevent long-term declines in flourishing.

Spirituality during COVID-19 in Northern Italy: The experience of participating in an online prayer group

Spirituality has ascendant value during times of adversity. Religious activities have beenfound to increase spirituality, and therefore might be considered a coping resource for the individual. The present research aims to explore participants' experience in an online Catholic prayer group in northern Italy that was held throughout the period of COVID-19 social restrictions. The group comprised 16 Catholic individuals aged 34 to 85, who were interviewed in writing following a protocol of four open-ended questions. The results reported four main thematic areas: (1) the benefits of the spiritual journey while coping with the pandemic; (2) the potential of the online setting; (3) the challenges of the online setting; and (4) the bond with God and how it evolved during the pandemic. The findings confirm the valuable contribution of the on-line group religious activity to the participants'    wellbeing, particularly during the time of social distancing.

Private religion/spirituality, self-rated health, and mental health among US South Asians

PURPOSE

Connections between private religion/spirituality and health have not been assessed among US South Asians. The aim of this study was to examine the relationship between private religion/spirituality and self-rated and mental health in a community-based sample of US South Asians.

METHODS

Data from the Mediators of atherosclerosis in South Asians living in America (MASALA) study (collected 2010-2013 and 2015-2018) and the attendant study on stress, spirituality, and health (n = 881) were analyzed using OLS regression. Self-rated health measured overall self-assessed health. Emotional functioning was measured using the mental health inventory-3 index (MHI-3) and Spielberger scales assessed trait anxiety and trait anger. Private religion/spirituality variables included prayer, yoga, belief in God, gratitude, theistic and non-theistic spiritual experiences, closeness to God, positive and negative religious coping, divine hope, and religious/spiritual struggles.

RESULTS

Yoga, gratitude, non-theistic spiritual experiences, closeness to God, and positive coping were positively associated with self-rated health. Gratitude, non-theistic and theistic spiritual experiences, closeness to God, and positive coping were associated with better emotional functioning; negative coping was associated with poor emotional functioning. Gratitude and non-theistic spiritual experiences were associated with less anxiety; negative coping and religious/spiritual struggles were associated with greater anxiety. Non-theistic spiritual experiences and gratitude were associated with less anger; negative coping and religious/spiritual struggles were associated with greater anger.

CONCLUSION

Private religion/spirituality is associated with self-rated and mental health. Opportunities may exist for public health and religious care professionals to leverage existing religion/spirituality for well-being among US South Asians.