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Variables associated with religious practice in Brazilian adults and older adults aged 50 and over: ELSI-Brazil

Abstract

Objective

To identify variables associated with religious practice in Brazilian adults and older adults aged 50 and over.

Method

In this observational and cross-sectional study, the participants included 7,171 individuals aged 50 and over from a representative national sample (N=9,412), interviewed in the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), on frequency of participation in religious services, religious affiliation, self-rated health, sex, age, education, living arrangements, region of residence, and race. The Poisson regression model was used to investigate crude and adjusted associations between variables.

Results

Fifty-seven percent of the sample was female, the mean age was 62.5±9.4 years old, the majority had 5 to 8 years of education and lived with 3 or more people, 42% resided in the Southeast region, and 48% self-declared as Pardo [mixed race], 66% were Catholic, 76% attended religious services once or more times a week, and 45% rated their health as fair. The most frequent participants in religious services were Black (PR=1.06, 95%CI 1.00-1.12)and mixed race (PR=1.07, 95%CI 1.03-1.11), Evangelical (PR =1.26, 95%CI 1.22-1.30), and self-rated their health as fair (PR=1.07, 95%CI 1.02-1.11). In contrast, the least frequent were male (PR=0.87, 95%CI 0.84-0.90), with 5 to 8 years of education (PR=0.92, 95%CI 0.88-0.97), residing in the Southeast (PR=0.91, 95%CI 0.86-0.95) and South (PR=0.90, 95%CI 0.82-0.99) regions.

Conclusion

Self-declaration as Black and mixed race, Evangelical religion, and self-rated health as fair were associated with higher attendance at religious services among Brazilians aged 50 and over.

Keywords
Religion; Aging; Self-assessment; Aged

Resumo

Objetivo

Identificar variáveis associadas à prática religiosa em adultos e idosos brasileiros de 50 anos e mais.

Método

Neste estudo observacional e transversal, participaram 7.171 indivíduos de 50 anos e mais, integrantes de amostra nacional representativa (N=9.412), entrevistados na 1ª onda do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), sobre frequência de participação em serviços religiosos, afiliação religiosa, autoavaliação de saúde, sexo, idade, escolaridade, arranjo de moradia, região de residência e raça. O modelo de regressão de Poisson foi usado para investigar associações brutas e ajustadas entre as variáveis.

Resultados

Cinquenta e sete por cento da amostra eram mulheres; a média de idade foi 62,5±9,4 anos; a maior parte tinha 5 a 8 anos de escolaridade e morava com 3 ou mais pessoas; 42% residiam na região Sudeste e 48% declararam-se pardos; 66% eram católicos e 76% participavam de cerimônias religiosas uma ou mais vezes por semana; 45% avaliaram a própria saúde como regular. Os mais assíduos em serviços religiosos foram os participantes pretos (RP=1,06, IC95% 1,00-1,12), pardos (RP=1,07, IC95% 1,03-1,11), evangélicos (RP=1,26, IC95% 1,22-1,30) e com autoavaliação da saúde como regular (RP=1,07, IC95% 1,02-1,11). Os menos assíduos eram do sexo masculino (RP=0,87, IC95% 0,84-0,90), com 5 a 8 anos de escolaridade (RP=0,92, IC95% 0,88-0,97) e residiam nas regiões Sudeste (RP=0,91, IC95% 0,86-0,95) e Sul (RP=0,90, IC95% 0,82-0,99).

Conclusão

Cor de pele preta e parda, religião evangélica e autoavaliação de saúde como regular estão associadas à maior assiduidade em serviços religiosos entre brasileiros de 50 anos e mais.

Palavras-Chave:
Religião; Envelhecimento; Autoavaliação; Pessoa idosa

INTRODUCTION

Religiosity is a multidimensional phenomenon and concept that includes a person’s involvement in beliefs, behaviors, rituals, and sacred and transcendent symbols shared and practiced by religious institutions and communities11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,22 Hood RW, Hill PC, Spilka B. The psychology of religion: an empirical approach. 5a ed. New York: The Guilford Press; 2018. Capítulo 1, The psychology of nature and functions of religion; p. 1–25.. Etymologically, “religion” comes from the Latin term religare, which refers to religious practices through which human beings are bound to God and to a community that shares the same principles11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.. Religiosity offers an understanding of how the world and human existence works11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.33 Palitsky R, Sullivan D, Young IF, Schmitt HJ. Religion and the construction of identity. In: Vail III KE, Routledge C, organizadores. The Science of Religion, Spirituality, and Existentialism [Internet]. 1a ed. London: Elsevier; 2020 [acesso em 29 abr. 2022]. p. 207–22. Disponível em: https://doi.org.10.1016/B978-0-12-817204-9.00016-0
https://doi.org/10.1016/B978-0-12-817204...
, and brings together individuals with similar behaviors and beliefs about transcendence11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,22 Hood RW, Hill PC, Spilka B. The psychology of religion: an empirical approach. 5a ed. New York: The Guilford Press; 2018. Capítulo 1, The psychology of nature and functions of religion; p. 1–25.. It performs psychological functions, since it provides social support, optimism, purpose in life, a sense of belonging, and favors adaptation to stressful situations11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,33 Palitsky R, Sullivan D, Young IF, Schmitt HJ. Religion and the construction of identity. In: Vail III KE, Routledge C, organizadores. The Science of Religion, Spirituality, and Existentialism [Internet]. 1a ed. London: Elsevier; 2020 [acesso em 29 abr. 2022]. p. 207–22. Disponível em: https://doi.org.10.1016/B978-0-12-817204-9.00016-0
https://doi.org/10.1016/B978-0-12-817204...
.

Religious practice and religious affiliation are dimensions of religiosity, together with religious commitment and coping11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.. Religious practice involves public and private religious activities, also known as organizational and non-organizational practices44 Koenig HG, Büssing A. The Duke University Religion Index (DUREL): A Five-Item Measure for Use in Epidemological Studies. Religions. 2010;1(1):78–85. Disponível em: https://doi.org/10.3390/rel1010078
https://doi.org/10.3390/rel1010078...
. Public religious practice refers to a person’s attendance and participation in religious services and ceremonies and in other community activities, such as groups for reading religious writings and prayer groups44 Koenig HG, Büssing A. The Duke University Religion Index (DUREL): A Five-Item Measure for Use in Epidemological Studies. Religions. 2010;1(1):78–85. Disponível em: https://doi.org/10.3390/rel1010078
https://doi.org/10.3390/rel1010078...
. Private religious practice comprises religious activities that the individual carries out alone, such as praying, meditating, reading religious writings and watching religious channels on television44 Koenig HG, Büssing A. The Duke University Religion Index (DUREL): A Five-Item Measure for Use in Epidemological Studies. Religions. 2010;1(1):78–85. Disponível em: https://doi.org/10.3390/rel1010078
https://doi.org/10.3390/rel1010078...
. Religious affiliation is related to the religious tradition that a person practices, publicly or privately, and with which they identify, sharing beliefs and rituals with other individuals11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p..

The frequency of religious practice changes as a person ages. According to Bengtson et al.55 Bengtson VL, Silverstein M, Putney NM, Harris SC. Does Religiousness Increase with Age? Age Changes and Generational Differences Over 35 Years. J Sci Study Relig. 2015;54(2):363–79. Disponível em: https://doi.org/10.1111/jssr.12183
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, participation in religious services is low in early adulthood, increases during middle age, reaches its peak in early old age, remains stable for a period and then declines due to losses associated with senescence, multimorbidity, and physical and cognitive disabilities. This trajectory is also affected by generational and context variables, including the secularization of societies66 Idler E. Is Secularization an Age-Related Process? Int J Aging Hum Dev. 2022;94(1):8–22. Disponível em: https://doi.org/10.1177/00914150211027547,77 Hayward RD, Krause N. Patterns of change in religious service attendance across the life course: Evidence from a 34-year longitudinal study. Soc Sci Res. 2013;42(6):1480–9. Disponível em: http://doi.org/10.1016/j.ssresearch.2013.06.010
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.

The frequency of attendance at churches and temples for religious practices varies according to sex, education, and race. Women tend to participate more assiduously in public religious activities than men because they value the social aspects of religiosity more than men88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
. In addition, public practices offer opportunities for deriving a sense of belonging, valuing oneself11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,33 Palitsky R, Sullivan D, Young IF, Schmitt HJ. Religion and the construction of identity. In: Vail III KE, Routledge C, organizadores. The Science of Religion, Spirituality, and Existentialism [Internet]. 1a ed. London: Elsevier; 2020 [acesso em 29 abr. 2022]. p. 207–22. Disponível em: https://doi.org.10.1016/B978-0-12-817204-9.00016-0
https://doi.org/10.1016/B978-0-12-817204...
, social involvement11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
, volunteer services1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
, giving and receiving support11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,22 Hood RW, Hill PC, Spilka B. The psychology of religion: an empirical approach. 5a ed. New York: The Guilford Press; 2018. Capítulo 1, The psychology of nature and functions of religion; p. 1–25. which are activities valued more by women than by men88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
,1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
. Older adults with formal education of eight or more years tend to be less assiduous practitioners of religious ceremonies than less educated older adults99 Varella AC, Benseñor IM, Fonseca MJM, Griep RH, Pereira AC, Lotufo PA. Religious Service Attendance, Educational Attainment, and Hypertension at Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Hypertens. 2020;33(5):452–7. Disponível em: https://doi.org/10.1093/ajh/hpz199
https://doi.org/10.1093/ajh/hpz199...
,1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
. In research conducted among Europeans1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
,1111 Brenner PS. Cross-National Trends in Religious Service Attendance. Public Opin Q. 2016;80(2):563–83. Disponível em: https://doi.org/10.1093/poq/nfw016
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, Asians and White North Americans1111 Brenner PS. Cross-National Trends in Religious Service Attendance. Public Opin Q. 2016;80(2):563–83. Disponível em: https://doi.org/10.1093/poq/nfw016
https://doi.org/10.1093/poq/nfw016...
, the most common finding is that these groups have a low frequency of public religious practice, a fact not observed among African Americans residing in the United States1212 Krause N. Assessing the relationships among race, religion, humility, and self-forgiveness: A longitudinal investigation. Adv Life Course Res. 2015;24:66–74. Disponível em: https://doi.org/10.1016/j.alcr.2015.02.003
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, who show a high frequency of attendance at religious services.

The frequency of attendance at religious services may also vary according to religious affiliation. Among practitioners of Evangelical religion, frequent participation in cults is a precept that is more important to follow than among Catholics1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
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. Ninety-four percent of Brazilian adults and older adults report following at least one religion that performs public and community rituals and ceremonies, including masses, cults, and meetings1414 Instituto Brasileiro de Geografia e Estatística. Censo demográfico 2010 [Internet]. Brasília, DF; 2010; Características gerais da população, religião e pessoas com deficiência; [acesso em 17 dez. 2021]. Disponível em: https://www.ibge.gov.br/estatisticas/sociais/populacao/9662-censo-demografico-2010.html?edicao=9749&t=resultados
https://www.ibge.gov.br/estatisticas/soc...
, in which the Catholic and Evangelical religions are the affiliations with the highest number of practitioners1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,1414 Instituto Brasileiro de Geografia e Estatística. Censo demográfico 2010 [Internet]. Brasília, DF; 2010; Características gerais da população, religião e pessoas com deficiência; [acesso em 17 dez. 2021]. Disponível em: https://www.ibge.gov.br/estatisticas/sociais/populacao/9662-censo-demografico-2010.html?edicao=9749&t=resultados
https://www.ibge.gov.br/estatisticas/soc...
.

In addition to being a reliable indicator of general health status, self-rated health is a subjective variable capable of identifying signs of functional decline and mapping the risk of mortality1515 Zimmer Z, Rojo F, Ofstedal MB, Chiu CT, Saito Y, Jagger C. Religiosity and health: A global comparative study. Popul Health. 2019;7:100322. Disponível em: https://doi.org/10.1016/j.ssmph.2018.11.006
https://doi.org/10.1016/j.ssmph.2018.11....
. Older adults who show assiduous public religious practices present better self-rated health than older adults with low or no attendance at public or organizational religious activities1515 Zimmer Z, Rojo F, Ofstedal MB, Chiu CT, Saito Y, Jagger C. Religiosity and health: A global comparative study. Popul Health. 2019;7:100322. Disponível em: https://doi.org/10.1016/j.ssmph.2018.11.006
https://doi.org/10.1016/j.ssmph.2018.11....
,1616 Shen A. Religious Attendance, Healthy Lifestyles, and Perceived Health: A Comparison of Baby Boomers with the Silent Generation. J Relig Health. 2019;58(4):1235–45. Disponível em: https://doi.org/10.1007/s10943-018-0736-6
https://doi.org/10.1007/s10943-018-0736-...
, because of the adoption of healthy behaviors and the emotional and social support received in churches and within congregations1717 VanderWeele TJ, Balboni TA, Koh HK. Invited Commentary: Religious Service Attendance and Implications for Clinical Care, Community Participation, and Public Health. Am J Epidemiol. 2022;191(1):31–5. Disponível em: https://doi.org/10.1093/aje/kwab134
https://doi.org/10.1093/aje/kwab134...
,1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
.

According to the literature, public religious practice among older adults can be influenced by social and health factors, and is associated with psychological well-being. There is some controversy, but religiosity tends to be more valued by older adults than by the adult population in general, partly due to the tendency to adopt it as a coping mechanism for stressful events, the incidence of which increases in old age, in part due to generational issues.

There are few Brazilian studies with recent population-based data that investigate the characteristics of public religious practice in the older adult population. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is the first survey conducted on a representative sample of the Brazilian population aged 50 and over. The inclusion of the religiosity domain in the data collection protocol enables the investigation of public religious practice and its relation with sociodemographic and health indicators. In this study, the domain of religiosity was divided into two aspects – affiliation and religious practice. The purpose was to identify associations between public religious practice, religious affiliation, self-rated health, and sociodemographic variables (sex, age, education, living arrangement, region of residence, and race) in a national sample representative of the Brazilian population aged 50 and over, among participants of ELSI-Brazil.

METHODS

This is an observational, cross-sectional study conducted on baseline data from the Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brazil), collected in 2015 and 2016. The full sample of the ELSI-Brazil consisted of 9,412 individuals1919 Lima-Costa MF, de Andrade FB, Souza PRB de, Neri AL, Duarte YA de O, Castro-Costa E, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol. 2018;187(7):1345–53. Disponível em: https://doi.org/10.1093/aje/kwx387
https://doi.org/10.1093/aje/kwx387...
. The size and composition of the full sample were representative of the non-institutionalized Brazilian population aged 50 and over, randomly selected by inverse sampling to avoid increasing the sample size to compensate for missing data1919 Lima-Costa MF, de Andrade FB, Souza PRB de, Neri AL, Duarte YA de O, Castro-Costa E, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol. 2018;187(7):1345–53. Disponível em: https://doi.org/10.1093/aje/kwx387
https://doi.org/10.1093/aje/kwx387...
. For this study, data from 7,171 participants were used. The sample losses did not comply with any selection criteria, they included participants who declared themselves nonreligious and who therefore did not respond to the variable “public religious practice”, and those who failed to respond to items from the other instruments used. Briefly, those who did not respond to all the variables of interest were excluded. The participants lived in 7,500 households in 70 small, medium and large municipalities in the five Brazilian macro-regions, selected through stratification into four categories, according to population size1919 Lima-Costa MF, de Andrade FB, Souza PRB de, Neri AL, Duarte YA de O, Castro-Costa E, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol. 2018;187(7):1345–53. Disponível em: https://doi.org/10.1093/aje/kwx387
https://doi.org/10.1093/aje/kwx387...
,2020 ELSI-Brasil - Estudo Longitudinal da Saúde e Bem-Estar dos Idosos Brasileiros. [Internet] ELSI-Brasil. 2015 [acesso em 17 dez.2021]. Disponível em: https://elsi.cpqrr.fiocruz.br/
https://elsi.cpqrr.fiocruz.br/...
. All residents of selected households aged 50 or older, who accepted the invitation to answer an individual questionnaire1919 Lima-Costa MF, de Andrade FB, Souza PRB de, Neri AL, Duarte YA de O, Castro-Costa E, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol. 2018;187(7):1345–53. Disponível em: https://doi.org/10.1093/aje/kwx387
https://doi.org/10.1093/aje/kwx387...
,2020 ELSI-Brasil - Estudo Longitudinal da Saúde e Bem-Estar dos Idosos Brasileiros. [Internet] ELSI-Brasil. 2015 [acesso em 17 dez.2021]. Disponível em: https://elsi.cpqrr.fiocruz.br/
https://elsi.cpqrr.fiocruz.br/...
, were included in the study. If the participant presented any physical and/or mental limitation that prevented them from responding, a substitute informant was elected to answer the individual questionnaire on their behalf1919 Lima-Costa MF, de Andrade FB, Souza PRB de, Neri AL, Duarte YA de O, Castro-Costa E, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol. 2018;187(7):1345–53. Disponível em: https://doi.org/10.1093/aje/kwx387
https://doi.org/10.1093/aje/kwx387...
.

Public religious practice was examined based on an item from the Duke University Religion Index (DUREL)44 Koenig HG, Büssing A. The Duke University Religion Index (DUREL): A Five-Item Measure for Use in Epidemological Studies. Religions. 2010;1(1):78–85. Disponível em: https://doi.org/10.3390/rel1010078
https://doi.org/10.3390/rel1010078...
,2121 Lucchetti G, Lucchetti ALG, Peres MF, Leão FC, Moreira-Almeida A, Koenig HG. Validation of the Duke Religion Index: DUREL (Portuguese Version). J Relig Health. 2012;51(2):579–86. Disponível em: https://doi.org/10.1007/s10943-010-9429-5
https://doi.org/10.1007/s10943-010-9429-...
, which measures the frequency of participation in religious services: “In the last 12 months, how often did you participate in religious services, such as masses, services or prayer groups in temples or churches or on TV?”. This was evaluated according to the responses: 1, more than once a week; 2, once a week; 3, two or three times a month; 4, one or more times a year; 5, never; which were then grouped as “once or more than once a week”, “two or three times a month”, and “one or more times a year/never”. The first two categories represent greater regularity and religious involvement, while the last category combined the response “one or more times a year”, corresponding to low regularity for participation in religious ceremonies that represents minimal religious involvement, and the response “never”, which represents no involvement.

Religious affiliation was verified by means of nine items: 1, No religion; 2, Catholic; 3, Protestant; 4, Evangelical; 5, Spiritism/Kardecism; 6, Buddhism; 7, Islam; 8, religions of African origin; 9, other, which were then grouped as “Catholic”; “Protestant”; “Evangelical”; “Spiritism”; and “other religions”. Participants in the “Protestant” category correspond to those affiliated with the Lutheran, Baptist, Adventist, Presbyterian and Methodist Churches, among others. Participants in the “Evangelical” category correspond to those affiliated with Pentecostal and Neo-Pentecostal churches. The other religions were grouped in the category “other religions” to enable statistical calculations.

Health self-assessment was investigated through the item: “In general, how do you rate your health?”, according to the answers: 1, very good or excellent; 2, good; 3, fair; 4, poor; 5, very poor, which were reduced to three categories: “good/very good”; “fair”; and “poor/very poor”.

The sociodemographic variables measured were sex (female and male), age (50 to 59 years old, 60 to 69 years old, 70 to 79 years old, and 80 years old and over), education (none, 1 to 4 years, 5 to 8 years, and ≥9 years), living arrangements (alone, with 2 people, and with 3 or more people), region of residence (North, Northeast, Southeast, South and Midwest), and self-reported race/color (White, Black, Pardo [mixed race], Asian and Indigenous).

The sample responses recorded were submitted to descriptive analysis, with absolute and relative frequency measurements of all the variables. Subsamples of participants were compared according to the frequency of participation in public religious practices, using Pearson’s chi-square test, for a value of p<0.05. To verify associations between frequency of religious practices, religious affiliation, self-rated health, and sociodemographic variables, crude and adjusted prevalence ratios and respective confidence intervals (95%) were analyzed using the Poisson regression model. All variables were included in the final model and those that presented a value of p<0.05 remained.

The ELSI-Brazil project was approved by the research ethics committee of the René Rachou Research Center of the FIOCRUZ, under report protocol no. 2111911. For each stage of data collection, all participants signed a term of free, informed consent.

RESULTS

Table 1 presents the descriptive results of the sample of 7,171 individuals regarding sociodemographic variables, religious affiliation, public religious practice, and self-rated health.

Table 1
Sample characterization (N=7,171). Brazilian Longitudinal Study of Aging, Brazil, 2015-2016.

The results of comparisons between the frequency of participation in public religious practices, religious affiliation, self-rated health and sociodemographic variables are presented in Table 2. Among the most assiduous individuals, there were more women than men, more mixed race than White individuals, more Catholics than Evangelicals, and more individuals who rated their health as fair than good/very good or poor/very poor. Among the less assiduous participants, those with 5 to 8 years of education, who lived in the Southeast region, were White, Catholic, and self-rated their health as good/very good predominated (Table 2).

Table 2
Percentage of adults and older adults according to frequency of participation in public religious practices, considering the sociodemographic variables, religious affiliation and self-rated health (N=7,171). Brazilian Longitudinal Study of Aging, Brazil, 2015-2016.

Table 3 shows the crude and adjusted prevalence ratios of all variables, according to the probability of the participant’s frequency of participation of at least once a week. In the crude analysis, higher attendance was observed among Black (PR = 1.06) and mixed race participants (PR = 1.07) than among White participants, among Evangelicals (PR = 1.28) than among Catholics, and among those who rated their health as fair (PR = 1.07) than among those who rated their health as good/very good. Lower attendance was observed among men (PR = 0.85) than among women, among those with 1 to 4 (PR = 0.83) and 5 to 8 years of education (PR = 0.92) than those with no formal education, and among those residing in the Southeast (PR = 0.88) and South (PR = 0.86) regions than in the North region. Analysis of PR adjusted for sex, age, education, living arrangement, region of residence, race/color, religious affiliation, and self-rated health indicated that Evangelicals were more assiduous than Catholics (PR = 1.26) and that being a man (PR = 0.87) and living in the Southeast (PR = 0.91) and South (PR = 0.90) regions were associated with lower attendance for public religious activities (Table 3).

Table 3
Crude and adjusted prevalence ratios (PR) of higher attendance compared to less attendance in public religious practices, according to sociodemographic variables, religious affiliation and self-rated health (N=7,171). Brazilian Longitudinal Study of Aging, Brazil, 2015-2016.

DISCUSSION

Self-declared Black and mixed race adults and older adults aged 50 and over, Evangelicals and individuals who self-rated their health as fair were the most assiduous participants in ceremonies and other public religious activities. In contrast, men, participants with 1 to 8 years of formal education, and those resident in the Southeast and South regions were the least assiduous in public religious practices.

The majority of the study participants were Catholics, most likely because the current generation of older adults and Brazilians of advanced age were socialized in this religion as children and adolescents, since Catholicism was highly widespread from the early to mid-twentieth century1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
,2323 Steil CA, Toniol R. Strong Church, Weak Catholicism: Transformations in Brazilian Catholicism. J Glob Cathol. 2021;5(2):4–29. Disponível em: http://doi.org/10.32436/2475-6423.1093
https://doi.org/10.32436/2475-6423.1093...
. Catholicism has been losing ground in Brazil in recent years1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
,2323 Steil CA, Toniol R. Strong Church, Weak Catholicism: Transformations in Brazilian Catholicism. J Glob Cathol. 2021;5(2):4–29. Disponível em: http://doi.org/10.32436/2475-6423.1093
https://doi.org/10.32436/2475-6423.1093...
due to the occurrence of social changes that determined a reduction in family influence in the transmission of Catholic precepts and traditions1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,2323 Steil CA, Toniol R. Strong Church, Weak Catholicism: Transformations in Brazilian Catholicism. J Glob Cathol. 2021;5(2):4–29. Disponível em: http://doi.org/10.32436/2475-6423.1093
https://doi.org/10.32436/2475-6423.1093...
. The prevalence of Evangelicals in this study is important, since there has been a diffusion of Evangelical churches on the outskirts of Brazilian metropolises, with more believers engaging this religion1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
. The realization of social programs by Evangelical communities and the use of different means of communication in the propagation of the Evangelical doctrine have also facilitated the affiliation of new adherents, particularly among persons of low income and with less education2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
.

A large part of the sample consisted of assiduous practitioners. According to Idler et al.66 Idler E. Is Secularization an Age-Related Process? Int J Aging Hum Dev. 2022;94(1):8–22. Disponível em: https://doi.org/10.1177/00914150211027547 and Hayward and Krause77 Hayward RD, Krause N. Patterns of change in religious service attendance across the life course: Evidence from a 34-year longitudinal study. Soc Sci Res. 2013;42(6):1480–9. Disponível em: http://doi.org/10.1016/j.ssresearch.2013.06.010
https://doi.org/10.1016/j.ssresearch.201...
, participation in public religious practices is higher among older adults than among younger adults. Older adults value religious issues more and, following retirement and the decrease in family obligations, they tend to have more time to devote to religious activities66 Idler E. Is Secularization an Age-Related Process? Int J Aging Hum Dev. 2022;94(1):8–22. Disponível em: https://doi.org/10.1177/00914150211027547,77 Hayward RD, Krause N. Patterns of change in religious service attendance across the life course: Evidence from a 34-year longitudinal study. Soc Sci Res. 2013;42(6):1480–9. Disponível em: http://doi.org/10.1016/j.ssresearch.2013.06.010
https://doi.org/10.1016/j.ssresearch.201...
. The generational difference in public practices is also a result of the secularization process, which involves a decrease in religious practices and beliefs in societies as a whole66 Idler E. Is Secularization an Age-Related Process? Int J Aging Hum Dev. 2022;94(1):8–22. Disponível em: https://doi.org/10.1177/00914150211027547,77 Hayward RD, Krause N. Patterns of change in religious service attendance across the life course: Evidence from a 34-year longitudinal study. Soc Sci Res. 2013;42(6):1480–9. Disponível em: http://doi.org/10.1016/j.ssresearch.2013.06.010
https://doi.org/10.1016/j.ssresearch.201...
. Higher frequency of public religious practices is associated with positive mental health outcomes, such as increased psychological well-being1717 VanderWeele TJ, Balboni TA, Koh HK. Invited Commentary: Religious Service Attendance and Implications for Clinical Care, Community Participation, and Public Health. Am J Epidemiol. 2022;191(1):31–5. Disponível em: https://doi.org/10.1093/aje/kwab134
https://doi.org/10.1093/aje/kwab134...
,1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
due to the social and emotional support that religious communities promote among their members1717 VanderWeele TJ, Balboni TA, Koh HK. Invited Commentary: Religious Service Attendance and Implications for Clinical Care, Community Participation, and Public Health. Am J Epidemiol. 2022;191(1):31–5. Disponível em: https://doi.org/10.1093/aje/kwab134
https://doi.org/10.1093/aje/kwab134...
,1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
,2424 Vicente ART, Castro-Costa É, Firmo J de OA, Lima-Costa MF, Loyola Filho AI de. Religiousness, social support and the use of antidepressants among the elderly: a population-based study. Cienc Saúde Coletiva. 2018;23(3):963–71. Disponível em: https://doi.org/10.1590/1413-81232018233.05922016
https://doi.org/10.1590/1413-81232018233...
and the acceptance of health problems as part of life2424 Vicente ART, Castro-Costa É, Firmo J de OA, Lima-Costa MF, Loyola Filho AI de. Religiousness, social support and the use of antidepressants among the elderly: a population-based study. Cienc Saúde Coletiva. 2018;23(3):963–71. Disponível em: https://doi.org/10.1590/1413-81232018233.05922016
https://doi.org/10.1590/1413-81232018233...
, lower use of antidepressants2424 Vicente ART, Castro-Costa É, Firmo J de OA, Lima-Costa MF, Loyola Filho AI de. Religiousness, social support and the use of antidepressants among the elderly: a population-based study. Cienc Saúde Coletiva. 2018;23(3):963–71. Disponível em: https://doi.org/10.1590/1413-81232018233.05922016
https://doi.org/10.1590/1413-81232018233...
, lower rates of substance use99 Varella AC, Benseñor IM, Fonseca MJM, Griep RH, Pereira AC, Lotufo PA. Religious Service Attendance, Educational Attainment, and Hypertension at Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Hypertens. 2020;33(5):452–7. Disponível em: https://doi.org/10.1093/ajh/hpz199
https://doi.org/10.1093/ajh/hpz199...
,1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
, anxiety and depression1717 VanderWeele TJ, Balboni TA, Koh HK. Invited Commentary: Religious Service Attendance and Implications for Clinical Care, Community Participation, and Public Health. Am J Epidemiol. 2022;191(1):31–5. Disponível em: https://doi.org/10.1093/aje/kwab134
https://doi.org/10.1093/aje/kwab134...
,1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
, and it may reduce the risk of mortality1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
. Brenner1111 Brenner PS. Cross-National Trends in Religious Service Attendance. Public Opin Q. 2016;80(2):563–83. Disponível em: https://doi.org/10.1093/poq/nfw016
https://doi.org/10.1093/poq/nfw016...
states that participation in religious ceremonies is an important part of socialization in South American countries.

Almost half of the participants rated their health as fair. This finding differs from the more recent descriptive results of studies that use methodologies similar to the ELSI-Brazil, such as the English Longitudinal Study of Aging (ELSA)2525 Gessa GD, Lassale C, Oliveira C. Health domain tables. In: Banks J, Nazroo J, Steptoe A, Zaninotto P, organizadores. The dynamics of ageing: evidence from the English Longitudinal Study of Ageing 2002-19 (Wave 9). 1a ed. London: The Institute for Fiscal Studies; 2020. p. 217–68., in which 74% of the sample rated their own health as good, very good or excellent2525 Gessa GD, Lassale C, Oliveira C. Health domain tables. In: Banks J, Nazroo J, Steptoe A, Zaninotto P, organizadores. The dynamics of ageing: evidence from the English Longitudinal Study of Ageing 2002-19 (Wave 9). 1a ed. London: The Institute for Fiscal Studies; 2020. p. 217–68.. Compared with English older adults, Brazilian middle-aged and older adults are considered to present less favorable health conditions, with the presence of multimorbidities, which explains the predominant self-rating of health as fair.

Black and mixed race participants were more assiduous than White participants. Krause1212 Krause N. Assessing the relationships among race, religion, humility, and self-forgiveness: A longitudinal investigation. Adv Life Course Res. 2015;24:66–74. Disponível em: https://doi.org/10.1016/j.alcr.2015.02.003
https://doi.org/10.1016/j.alcr.2015.02.0...
observed that older adult Black Americans attended more religious services than their White peers due to the fact that the social and emotional support offered by people from their religious community was greater than that offered among White people. According to Dos Santos2626 dos Santos LF. Por Uma Teologia Negra No Brasil. Cross Curr. 2017;67(1):213–32. Disponível em: http://doi.wiley.com/10.1111/cros.12243, Black and mixed race people in Brazil experience social and economic difficulties caused by the particularities of racial discrimination in the Brazilian context, such as low or no formal education, unemployment, and lack of income. However, through their involvement with a community that assiduously attends religious ceremonies of any religious affiliation, they probably find a source of support that can help them face such adversities2626 dos Santos LF. Por Uma Teologia Negra No Brasil. Cross Curr. 2017;67(1):213–32. Disponível em: http://doi.wiley.com/10.1111/cros.12243.

Evangelicals showed greater participation in religious practices than Catholics. Religious ceremonies are occasions when practitioners praise, give thanks, ask for divine help and guidance, and receive teachings from religious leaders. These elements are more valued by Evangelical practitioners than by Catholics1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
. Coutinho and Golgher2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
state that the Evangelical religion bases its precepts on the theology of prosperity, according to which the believer prospers by individually striving to overcome difficulties and maintain the behaviors instituted by Evangelical leaders. Thus, high attendance at services is an expected behavior of the Evangelical believer. Evangelical churches usually provide more precise solutions for overcoming the problems that their practitioners may experience, such as low income and other socioeconomic adversities, chemical dependency, family problems, and urban violence2727 Spyer J. Povo de Deus: Quem são os evangélicos e por que eles importam. 1a ed. São Paulo: Geração Editorial; 2020. Parte 2, Cristianismo e preconceito de classe; p. 66–88., all of which are harmful to mental health. Presence at the services offers social and emotional support to cope with these problems and can strengthen the religious commitment of the practitioner regarding the Evangelical doctrine2727 Spyer J. Povo de Deus: Quem são os evangélicos e por que eles importam. 1a ed. São Paulo: Geração Editorial; 2020. Parte 2, Cristianismo e preconceito de classe; p. 66–88..

Individuals who self-rated their health as fair showed higher attendance than those who rated it as good or very good. Health self-assessment accurately represents the individual’s state of health1515 Zimmer Z, Rojo F, Ofstedal MB, Chiu CT, Saito Y, Jagger C. Religiosity and health: A global comparative study. Popul Health. 2019;7:100322. Disponível em: https://doi.org/10.1016/j.ssmph.2018.11.006
https://doi.org/10.1016/j.ssmph.2018.11....
and can be influenced by both sociocultural context and individual habits, such as the adoption of healthy behaviors and the use of coping strategies that reduce stress1515 Zimmer Z, Rojo F, Ofstedal MB, Chiu CT, Saito Y, Jagger C. Religiosity and health: A global comparative study. Popul Health. 2019;7:100322. Disponível em: https://doi.org/10.1016/j.ssmph.2018.11.006
https://doi.org/10.1016/j.ssmph.2018.11....
1818 Chen Y, Kim ES, VanderWeele TJ. Religious-service attendance and subsequent health and well-being throughout adulthood: evidence from three prospective cohorts. Int J Epidemiol. 2020;49(6):2030–40. Disponível em: https://doi.org/10.1093/ije/dyaa120
https://doi.org/10.1093/ije/dyaa120...
. It is possible that the individuals in this sample rated their health as fair because they have less healthy habits and experience health problems that lead to functional limitations. Thus, attending religious services regularly can act as a social and emotional resource to deal with the difficulties caused by such functional restrictions11 Koenig HG, King DE, Carson VB. Handbook of religion and health. 2a ed. New York: Oxford University Press; 2012. 1169 p.,22 Hood RW, Hill PC, Spilka B. The psychology of religion: an empirical approach. 5a ed. New York: The Guilford Press; 2018. Capítulo 1, The psychology of nature and functions of religion; p. 1–25..

Men showed less assiduous attendance than women. Schnabel2828 Schnabel L. More religious, less dogmatic: Toward a general framework for gender differences in religion. Soc Sci Res. 2018;75:58–72. Disponível em: https://doi.org/10.1016/j.ssresearch.2018.06.010
https://doi.org/10.1016/j.ssresearch.201...
observed that men tend to be more dogmatic and hold more leadership positions than women and attributed these differences to gender stereotypes, which, according to the author, contribute to women being encouraged to participate in community religious activities, while men are encouraged to assume roles of leadership and authority88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
,2828 Schnabel L. More religious, less dogmatic: Toward a general framework for gender differences in religion. Soc Sci Res. 2018;75:58–72. Disponível em: https://doi.org/10.1016/j.ssresearch.2018.06.010
https://doi.org/10.1016/j.ssresearch.201...
. According to Silva et al.88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
and Sowa et al.1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
, women are socialized to express their feelings and seek support in religious communities to a greater degree than men. Men may encounter social support and ways to deal with their personal difficulties in sources other than participation in community religious services88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
,1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
or even in leadership positions in a church or congregation88 Silva AT de M e, Tavares DM dos S, Molina NPFM, Assunção LM de, Rodrigues LR. Religiosity and spirituality related to the socio-demographic, economic and health variables in the older people. REME. 2019;23:e-1221. Disponível em: https://doi.org/10.5935/1415-2762.20190069
https://doi.org/10.5935/1415-2762.201900...
,2828 Schnabel L. More religious, less dogmatic: Toward a general framework for gender differences in religion. Soc Sci Res. 2018;75:58–72. Disponível em: https://doi.org/10.1016/j.ssresearch.2018.06.010
https://doi.org/10.1016/j.ssresearch.201...
.

Participants with 1 to 8 years of education were less assiduous in their attendance at religious services than those with no formal education. Several studies66 Idler E. Is Secularization an Age-Related Process? Int J Aging Hum Dev. 2022;94(1):8–22. Disponível em: https://doi.org/10.1177/00914150211027547,77 Hayward RD, Krause N. Patterns of change in religious service attendance across the life course: Evidence from a 34-year longitudinal study. Soc Sci Res. 2013;42(6):1480–9. Disponível em: http://doi.org/10.1016/j.ssresearch.2013.06.010
https://doi.org/10.1016/j.ssresearch.201...
,99 Varella AC, Benseñor IM, Fonseca MJM, Griep RH, Pereira AC, Lotufo PA. Religious Service Attendance, Educational Attainment, and Hypertension at Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Hypertens. 2020;33(5):452–7. Disponível em: https://doi.org/10.1093/ajh/hpz199
https://doi.org/10.1093/ajh/hpz199...
,1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
,2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
have observed that less participation in religious ceremonies is associated with an increase in the level of formal education and attribute this phenomenon to the secularization process. The importance given to attendance at religious services may be lower among more educated individuals66 Idler E. Is Secularization an Age-Related Process? Int J Aging Hum Dev. 2022;94(1):8–22. Disponível em: https://doi.org/10.1177/00914150211027547, who dedicate themselves to other activities, such as those related to work1010 Sowa A, Golinowska S, Deeg D, Principi A, Casanova G, Schulmann K, et al. Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing. 2016;13(2):145–57. Disponível em: https://doi.org/10.1007/s10433-016-0367-2
https://doi.org/10.1007/s10433-016-0367-...
.

Participants residing in the Southeast and South regions showed a lower frequency of religious practices than those in the North region. Compared with other macro-regions, the Southeast and South regions are more economically developed, their populations have higher levels of education and a higher proportion of Catholic practitioners1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
, factors that are associated with less assiduous attendance at religious services. Considering the expansion of Evangelical religion in the North region and among the poorest Brazilians1313 Alves JED, Cavenaghi SM, Barros LFW, Carvalho AA de. Distribuição espacial da transição religiosa no Brasil. Tempo Soc. 2017;29(2):215–42. Disponível em: https://doi.org/10.11606/0103-2070.ts.2017.112180
https://doi.org/10.11606/0103-2070.ts.20...
,2222 Coutinho RZ, Golgher AB. The changing landscape of religious affiliation in Brazil between 1980 and 2010: age, period, and cohort perspectives. Rev Bras Estud Popul. 2014;31(1):73–98. Disponível em: https://doi.org/10.1590/S0102-30982014000100005
https://doi.org/10.1590/S0102-3098201400...
,2727 Spyer J. Povo de Deus: Quem são os evangélicos e por que eles importam. 1a ed. São Paulo: Geração Editorial; 2020. Parte 2, Cristianismo e preconceito de classe; p. 66–88., and that the social support offered by religious communities helps the poorest in coping with difficulties, it seems reasonable to affirm that residents in the South and Southeast find other sources of social support and other ways of exercising religiosity, in addition to participating in public religious ceremonies.

This study presents limitations in that it did not consider the presence of comorbidities, functional disability and the participants’ levels of autonomy and independence, variables that can influence participation in public religious practices. The cross-sectional design of this study means that investigating the causal relationships between the variables was not possible. However, there are advantages that should be mentioned: the use of population-based data from a longitudinal study, which has a methodology similar to other longitudinal studies on human aging, including the English Longitudinal Study of Aging (ELSA), the Health and Retirement Study (HRS), the Survey of Health, Aging and Retirement in Europe (SHARE), the Mexican Health and Aging Study (MHAS), enabling the generalization of the results obtained and transnational comparisons and meta-analysis studies; and the involvement of a panel of national experts and the use of standardized instruments that demonstrate methodological rigor. Furthermore, the support offered by government agencies and national research foundations for this study suggests the possibility of continued Brazilian research on the theme of religiosity and its associations with social and health indicators among older adults.

CONCLUSION

This study aimed to identify associations between religious practice, religious affiliation, self-rated health and sociodemographic variables in a representative sample of Brazilian older adults and adults aged 50 and over, population segments marked by strong social inequality, which is based on important social, economic and health needs. We observed that Black and mixed race participants, Evangelicals, and those who rated their health as fair were more assiduous in public religious practices than White participants, Catholics and those who rated their health as good or very good. The main explanatory hypotheses for these results are of a socioeconomic and behavioral nature, that is, religious practices can act as a community source of social and emotional support when coping with social, economic and health difficulties.

Considering that the Brazilian older adult population is highly religious and that religious practices influence the physical and mental health of older adult practitioners, we argue that it is important to research the phenomenon of public religious practice in a population-based study, since it allows us to understand the characteristics of the Brazilian older adult population that assiduously attends religious ceremonies, taking into account their different cultural and social segments, particularly during a phase of demographic changes and religious transition, with profound sociological repercussions such as those faced today.

ACKNOWLEDGEMENTS

The authors would like to thank Prof. Dr. Maria Fernanda Lima-Costa, coordinator of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), for her collaboration in and encouragement of this research.

  • The authors declare there are no conflicts in the conception of this work.

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Edited by

Edited by: Maria Helena Rodrigues Galvão

Publication Dates

  • Publication in this collection
    08 Aug 2022
  • Date of issue
    2021

History

  • Received
    07 Feb 2022
  • Accepted
    30 May 2022
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