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Does religious observance promote health? mortality in secular vs religious kibbutzim in Israel.

J D Kark, G Shemi, Y Friedlander, O Martin, O Manor and S H Blondheim

Department of Social Medicine, Hadassah Medical Organization and Hebrew Unversity-Hadassah School of Public Health and Community Medicine, Ein Karem, Jerusalem, Israel.

OBJECTIVES. This study assessed the association of Jewish religious observance with mortality by comparing religious and secular kibbutzim. These collectives are highly similar in social structure and economic function and are cohesive and supportive communities. METHODS. In a 16-year (1970 through 1985) historical prospective study of mortality in 11 religious and 11 matched secular kibbutzim in Israel, 268 deaths occurred among 3900 men and women 35 years of age and older during 41347 person-years of observation. RESULTS. Mortality was considerably higher in secular kibbutzim. Cox proportional hazards analysis was used to adjust for age and the matched design; rate ratios were 1.67 (95% confidence interval [CI]=1.17, 2.39) for men, 2.67 (95% CI=1.55, 4.60) for women, and 1.93 (95% CI=1.44, 2.59) overall. Kaplan-Meier survival analysis of birth cohorts confirmed the association. The lower mortality in religious kibbutzim was consistent for all major causes of death. CONCLUSIONS. Belonging to a religious collective was associated with a strong protective effect not attributable to confounding by sociodemographic factors. Elucidation of mechanisms mediating this effect may provide etiologic insights and leads for intervention.

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