According to new research published today in Journal of the American Heart Associationan open-access, peer-reviewed journal of the American Heart Association.
This study is the first to investigate among African Americans the association of a comprehensive set of cardiovascular health behaviors — the American Heart Association’s 7 simple lifestyle metrics (diet, physical activity, and nicotine exposure) and physiological factors (weight, cholesterol, blood pressure and blood sugar levels) with religious beliefs and spirituality. Life’s Simple 7 metrics, created in 2010, were expanded and renamed Life’s Essential 8 in June 2022, with sleep added as the eighth component of optimal heart health.
African Americans have poorer overall cardiovascular health than non-Hispanic whites, and death from cardiovascular disease is higher in African American adults than white adults, according to the American Heart Association’s 2017 scientific statement “Cardiovascular Health in African Americans – the Americans”.
“Health professionals and researchers need to recognize the importance of religious and spiritual influences in the lives of African Americans — who tend to be very religious,” said lead study author LaPrincess C. Brewer, MD, MPH, a preventive cardiologist. and assistant professor. medicine at the Mayo Clinic in Rochester, Minnesota. “By incorporating religious and spiritual beliefs into our approaches, we can make great strides in fostering relationships between patients and physicians and between community members and scientists to build trust and sociocultural understanding of this population.”
Researchers analyzed responses assessing religiosity (strong religious feeling or belief in any religion), spirituality, and Life’s Simple 7 indicators of cardiovascular health from surveys and health screenings of 2,967 African-American participants in the Jackson Heart Study. The Jackson Heart Study is the largest single-country, community-based study of cardiovascular disease among African-American adults in the U.S. On average, participants were 54 years old at study enrollment, and 66% were women. The ongoing study, begun in 1998, includes more than 5,000 adults ages 21-84 who identify as African-American and live in the tri-county area of Jackson, Mississippi.
Researchers grouped participants according to religious behaviors (their self-reported levels of participation in church service/Bible study groups, private prayer, and use of religious beliefs or practices in coping with difficult life situations and stressful events — called coping religious under study); and spirituality (belief in the existence of a supreme being, deity or God).
The religious behavior questions were adapted from the instruments Fetzer Multidimensional Measure of Religion/Spirituality (religious attendance, private prayer) and religious coping scale (religious coping). Measures of spirituality were adapted from the Daily Spiritual Experience Scale, which assesses common daily experiences according to theistic spirituality (belief in the existence of a supreme being, deity, or God and feeling God’s presence, desire for closer union with God, sense of God’s love) and non-theistic spirituality (feel strength in my religion, feel deep inner peace and harmony, or feel spiritually touched by creation).
Participants were then grouped by religion and spirituality scores by health factors: physical activity, diet, smoking, weight, blood pressure, blood sugar and cholesterol levels, plus a composite score of the seven components of Life’s Simple 7 to assess cardiovascular health. Researchers estimated the odds of achieving intermediate and ideal levels of heart disease prevention goals based on religion/spirituality scores.
Participants who reported more religious activity or had deeper levels of spiritual beliefs were more likely to meet key measures of cardiovascular health:
- Greater frequency of attending religious services or activities was associated with a 16% increase in the odds of meeting “intermediate” or “ideal” metrics for physical activity, 10% for diet, 50% for smoking, 12 % for blood pressure and 15% for the cardiovascular health composite score.
- Greater reported frequency of private prayer was associated with a 12% increase in the odds of achieving the intermediate or ideal diet metric and a 24% increase in the odds of achieving the smoking-related metric.
- Religious coping was associated with an 18% increased odds of achieving intermediate and ideal levels of physical activity, a 10% increased odds of a healthy diet, a 32% increased odds of smoking, and a 14% increased odds of a composite health score. cardiovascular.
- Total spirituality was associated with an 11% increase in the odds of achieving intermediate and ideal levels for physical activity and 36% for smoking.
“I was somewhat surprised by the findings that multiple dimensions of religion and spirituality were associated with improved cardiovascular health across multiple health behaviors that are extremely challenging to change, such as diet, physical activity, and smoking,” Brewer said. .
“Our findings highlight the essential role that culturally tailored health promotion initiatives and lifestyle change recommendations can play in advancing health equity,” she added. “The cultural relevance of interventions may increase their likelihood of impacting cardiovascular health and also the sustainability and maintenance of healthy lifestyle changes.”
Brewer added, “This is especially important for socioeconomically disenfranchised communities facing multiple challenges and stressors. Religion and spirituality can serve as a buffer against stress and have therapeutic purposes or support self-empowerment. to practice healthy behaviors and seek preventive health services.”
The religion/spirituality survey was administered at one point during the Jackson Heart Study, so participants’ cardiovascular health was not analyzed over time. In addition, people with known heart disease were not included in this analysis.
Co-authors are Janice Bowie, Ph.D., MPH; Joshua P. Slusser; Christopher G. Scott, MS; Lisa A. Cooper, MD, MPH; Sharonne N. Hayes, MD; Christi A. Patten, Ph.D.; and Mario Sims, Ph.D., MS Authors’ disclosures are listed in the manuscript.
The study was funded by the National Center for Advancing Translational Sciences, the American Heart Association-Amos Medical School Development Program, the National Institutes of Health/National Institute on Minority Health and Health Disparities/National Heart, Lung, and Blood Institute, and the US . Centers for Disease Control and Prevention.