Religious or spiritual coping, religious service attendance, and type 2 diabetes: A prospective study of women in the United States

Purpose: To investigate religion and spirituality (R/S) as psychosocial factors in type 2 diabetes risk. Methods: Using the Nurses' Health Study II, we conducted a 14-year prospective analysis of 46,713 women with self-reported use of religion or spiritual beliefs to cope with stressful situations, and 42,825 women with self-reported religious service attendance, with respect to type 2 diabetes. Cox regression was used to assess the associations. Results: Compared with not using religious or spiritual coping at all, the fully-adjusted hazard ratios (HR) were minimally different across all categories: a little bit (HR=1.01; 95% CI:0.85, 1.19), a medium amount (HR= 0.96; 95% CI:0.80, 1.14), a lot (HR= 0.93; 95% CI: 0.77, 1.11) (P-trend= 0.24). Similarly, compared with participants who never or almost never attend religious meetings or services, there were minimal differences with participants attending less than once/month (HR= 1.06; 95% CI:0.92, 1.22), 1-3 times/month (HR=1.00; 95% CI:0.85, 1.17), once/week (HR=0.98; 95% CI:0.85, 1.14), more than once/week (HR=1.20; 95% CI:1.01, 1.43) (P-trend = 0.29). Perceived stress did not modify these associations. Our hypothesis of mediated effects through lifestyle factors and social integration was not supported. Conclusions: R/S was not significantly associated with type 2 diabetes, but its role in other chronic conditions may be important. (C) 2021 Elsevier Inc. All rights reserved.