Higher religious participation linked to fewer deaths of despair; research suggests it's the social ties that matter

National Bureau of Economic Research working-paper graph
shows underlying cultural trends that preceded the opioid edpidemic

In 2000, the label "death of despair" did not exist. The phrase is now common and often attached to the opioid epidemic, but a deeper understanding of its root causes is still being explored. "A new paper by Tyler Giles of Wellesley, Daniel Hungerman of Notre Dame and Tamar Oostrom of Ohio State bolsters the case that deaths of despair stem in part from weakening social ties. It shows that mortality from these causes among middle-aged whites stopped falling around 1990—well before the rise in opioid use," The Economist reports. "What changed at that time? The authors studied attendance at religious services. They found that states with more participation had fewer deaths of despair and that the faster religious attendance fell in a state, the more such deaths rose. A paper in the Journal of American Medical Association in 2020 also showed that of 110,000 health workers, those who went to services were less likely to die from these causes."

To study the relationship between deaths of despair and religious participation, "The authors tried to isolate the impact of religion by studying blue laws, which banned commerce on Sundays to encourage churchgoing," The Economist reports. "Whenever a state repealed a blue law, religious attendance tended to plummet, creating a natural experiment. And sure enough, deaths of despair rose unusually quickly in the few years following these repeals. Although legalizing alcohol sales on Sundays may account for some of this trend, the biggest increase in mortality came from suicides."

A Google search of "Why go to church if I can pray at home?" yields pages of responses. And yet, this study "strikingly found that private prayer was not linked to lower deaths of despair," The Economist notes. "This suggests that the risk reduction stems not from belief, but rather from the interpersonal connections that organized religion provides. Although secular groups like charities or labor unions also produce such 'social capital,' the JAMA authors say that faith-based networks provide unusually potent protection."

The phrase "death of despair" comes from a 2015 milestone paper published by Anne Case and Angus Deaton that analyzed death rates in America and found deaths of despair to be disproportionately rural. "The economists found that mortality had been rising among middle-aged whites, thanks to a surge in drug overdoses, alcohol-related illness, and suicides—causes they deemed 'deaths of despair,'" reports The Economist. Since 2015, academics have sought tease out the root cause of these deaths -- are they caused by mental anguish or opioid abuse -- the answer is yet to come.