African American church participation and health care practices.
BACKGROUND
While religious involvement is associated with improvements in health, little is known about the relationship between church participation and health care practices.


OBJECTIVE
To determine 1) the prevalence of church participation; 2) whether church participation influences positive health care practices; and 3) whether gender, age, insurance status, and levels of comorbidity modified these relationships.


METHODS
A cross-sectional analysis using survey data from 2196 residents of a low-income, African-American neighborhood.


METHODS
Our independent variable measured the frequency of church attendance. Dependent variables were: 1) Pap smear; 2) mammogram; and 3) dental visit-all taking place within 2 years; 4) blood pressure measurement within 1 year, 5) having a regular source of care, and 6) no perceived delays in care in the previous year. We controlled for socioeconomic factors and the number of comorbid conditions and also tested for interactions.


RESULTS
Thirty-seven percent of community members went to church at least monthly. Church attendance was associated with increased likelihood of positive health care practices by 20% to 80%. In multivariate analyses, church attendance was related to dental visits (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3 to 1.9) and blood pressure measurements (OR, 1.6; 95% CI, 1.2 to 2.1). Insurance status and number of comorbid conditions modified the relationship between church attendance and Pap smear, with increased practices noted for the uninsured (OR, 2.3; 95% CI, 1.2 to 4.1) and for women with 2 or more comorbid conditions (OR, 1.9; 95% CI, 1.1 to 3.5).


CONCLUSIONS
Church attendance is an important correlate of positive health care practices, especially for the most vulnerable subgroups, the uninsured and chronically ill. Community- and faith-based organizations present additional opportunities to improve the health of low-income and minority populations.
Felix Aaron
Kaytura
K
Center of Primary Care Research, Agency of Healthcare Research and Quality, Rockville, MD 20850, USA. kfaaron@ahrq.gov
Levine
David
D
Burstin
Helen R
HR
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data; D012067:Religion; D012068:Religion and Medicine; D012944:Social Support; D014505:Urban Population / Q000706:statistics & numerical data