Religious Attendance: More Cost-Effective Than Lipitor?

To the Editor: The title of this piece is unnecessarily provocative and inappropriate for a scientific medical journal. The study is not, as the author actually acknowledges, a proper econometric analysis. The title is not only deceptive in this regard, but it also suggests—which the author himself disavows—that religious attendance could potentially substitute for cholesterol-lowering drugs or other medical interventions.

The study mentions, but does not address as directly and prominently as it should, the importance of confounding: the idea that people who attend religious services regularly may also be more likely to do other things that benefit their health, such as get regular exercise, eat well, enjoy social support, see doctors, and adhere to medications. Alternatively, healthier people may be more likely than those who are less healthy to attend religious services on a regular basis. Nothing more than a quick nod to these possibilities—which, prima facie, have a more directly causal relationship to health—encourages the interpretation, especially by unsophisticated readers, that religious belief or attendance at religious services is itself responsible for health benefits.

A study such as this should, but does not, present a plausible scientific (read: mechanistic) hypothesis as to why religious attendance, per se, has positive health effects. If confounding variables are more important, then these should be the focus of further research. Simply reporting an association (the veracity of which I do not doubt) and then calling for “further research” is trivial and unworthy of publication in this journal.

Ultimately, I am concerned that this kind of “research” is part of a larger, troubling trend in American society to bring religion closer to politics and to enhance the “scientific credibility” of concepts such as Intelligent Design and the healing power of prayer at a distance (recently discredited in a large clinical trial, by the way). Certainly, religious beliefs are valuable to those who hold them, but scientific studies of the potential health benefits of religion need to go beyond the mere reporting of associations.

I believe your decision to publish this article, and to publish it under the title you did, was regrettable.