More religious people are at elevated risk of spreading and dying from COVID-19. Here’s why.
If we hope to “flatten the curve” and prevent the United States from becoming the world leader in COVID-19 death rates, we must examine the psychology of risk. We already know that being older is a big risk factor for dying of COVID-19. And we already know that COVID-19 is disproportionately harming poor and densely populated communities. Consider Detroit, Michigan and New York City. Then puzzle over Albany, Georgia. This Georgia city of only 75,000 people has been hit hard by COVID-19. A main reason why seems to be a couple of well-attended funerals. I grew up in Georgia, and I know that funerals in Georgia mean lots and lots of hugging. Of course, hugging is the direct opposite of social distancing. COVID-19 doesn’t ask why you were hugging. It just uses this as a chance to spread.
I suspect that the well-intended but tragic hugging in Albany, Georgia sprang partly from religiosity. Georgia is one of the most religious states in the nation. When I lived there, for the first 22 years of my life, we proudly called our state the “buckle of the Bible belt” — even though neighboring Alabama probably had better claim to the title. But is religiosity really a risk factor for contracting and spreading COVID-19? All else being equal, are people living in more religious places at elevated risk for getting COVID-19? There are some reasons to think not. A 2009 review team led by Yoichi Chida examined 91 studies of religiosity and mortality. That’s right; they studied the most important health outcome ever studied — death rates. They found that, in healthy populations, religious people lived longer than less religious people. But in populations that were suffering from serious diseases, religiosity offered no hope of increased survival.
Religiosity is known to promote health via several routes. One is that religion provides people with social support. This refers to having someone who “has your back” when the going gets rough. This is true whether people help you financially, pragmatically, or emotionally. Religious people usually get a good deal of social support from their fellow believers. Studies show very clearly that having more social support predicts greater longevity. Religion also promotes at least some kinds of healthy behavior. Consider what most religious leaders tell us about drug and alcohol abuse, gluttony, risky sex, and suicide.
But as the story of Albany suggests, religion can also lead people to ignore health risks. In fact, some of the principles that make religious people kind to others can occasionally backfire among religious people who have fallen deeply into trouble. For example, Memoona Hasnain and her colleagues studied religiosity levels in more than 800 illegal injection drug users. More religious drug users were more likely than less religious drug users to share their drug use paraphernalia in dangerous ways, presumably because they wanted to be helpful to other users.
To see if religiosity is a risk factor for COVID-19, I consulted public records on both religiosity levels and COVID-19-related internet searches across all 50 U.S. states. States vary widely in religiosity. Recent Pew polls show that 51% of Alabamans report frequently attending religious services. Georgia is in the top ten, too, coming in at 42%. But in places like Maine and Vermont, religious attendance barely exceeds 20%. Remind me not to open a Christian bookstore in Maine. I also used the Google research tool, Google Trends, to see how often people in different states sought out useful information about COVID-19 in the month of March 2020. I looked at several searches, but the most relevant one is “social distancing.” Almost all epidemiologists agree that social distancing is the biggest key to flattening the COVID-19 curve.
There is a very strong negative correlation between religiosity levels across the 50 states and the frequency with which people in each state searched Google for “social distancing” in March of 2020. Of course, this is the window when Americans learned that COVID-19 is not going to spare the United States (despite our President’s rosy predictions). The more deeply religious a U.S. state is, the less frequently people in that state searched for information in March about how to stop the spread of COVID-19.
Of course, religiosity levels vary with other important variables that might predict who seeks out useful information about COVID-19. In light of this, I controlled for two other important variables — the percentage of people in each state who were college educated and the number of known cases of COVID-19 in each state. These competing variables, especially state education levels, also predicted how much people in different states searched for “social distancing.” But the strong association between religiosity levels and such searches remained even when accounting for both of these variables.
To look at actual health behavior rather than internet searches, I also examined state by state religiosity levels and CDC reports of the percentage of people in each state who actually got tested for COVID-19. In more religious states, fewer people got tested. This was true, again, even after considering both education levels and infection rates in each state. Finally, my surveys of my own undergraduate students show that in mid-March of 2020, students who reported being more religious reported less social distancing. They were less likely to say that in the past week they had obeyed the six-foot spacing rule with strangers.
I am further exploring this finding. What aspect of religiosity, exactly, causes people to be less vigilant about social distancing? Is it feeling that one benefits from God’s divine protection? Or is it feeling that “this life is but a vapor”? My preferred hypothesis so far is that religious people may be more likely than less religious people to believe that bad things do not happen to good people — a finding known as the “just world hypothesis.”
Regardless of which specific beliefs explain the association between religiosity and risky COVID-19 behavior, this association has major implications for public health. For example, Dan Foster argues that COVID-19 may “kill the church.” This, he argues, is the logical conclusion to be drawn from two facts. First, older Americans are more religious than younger Americans. Second, older Americans are more likely to die when they get COVID-19. The fact that religiosity seems to get in the way of social distancing adds insult to both of these injuries.
This all means that medical professionals and public health experts who are dealing with deeply religious populations may face unexpected pushback about how to prevent the spread of COVID-19. But perhaps we can flatten the coronavirus curve even in the deeply religious. To do so, we might remind those who happen to be Christians that “thou shalt not test the Lord thy God” (Mathew 4:7). As any devout Christian will tell you, this means one should not take unnecessary health risks.
For Further Reading
Chida Y., Steptoe A., & Powell, L.H. (2009). Religiosity/spirituality and mortality: A systematic quantitative review. Psychotherapy and Psychosomatics, 78, 81–90.
Hasnain, M., Sinacore, J.M., Mensah, E.K., & Levy, J.A. (2007, Jan 18). Influence of religiosity on HIV risk behaviors in active injection drug users. AIDS Care, 7, 892–901
Pelham, B. & Nyiri, Z. (2008). In more religious countries, lower suicide rates: Lower suicide rates not a matter of national income. Retrieved at https://news.gallup.com/poll/108625/more-religious-countries-lower-suicide-rates.aspx