Religious Attendance and the Mobility Trajectories of Older Mexican Americans

Disability, dependency, and related comorbidity are major public health concerns with extensive social, psychological, and economic consequences. Although most studies have emphasized the factors that elevate the risk of disability, far fewer studies have focused on the identification of potential protective factors. Numerous studies have shown that religious attendance is associated with lower rates of morbidity and mortality in the general population. To this point, however, it is unclear whether religious attendance is in some way protective against disability. While some studies have shown that religious attendance is associated with favorable disability outcomes, other studies have reported null associations between religious attendance and disability.

Previous research is also limited by (1) an over-emphasis on non-Hispanic white and black populations, (2) self-reported disability data, (3) health selection into religious activities, (4) confounding with social ties and social support, and (5) a lack of precision concerning underlying disability trajectories. Building on previous research, we examine the association between religious attendance and disability among older Mexican Americans--the largest segment of the growing Hispanic population. We employ performance-based assessments of mobility. We include comprehensive adjustments for health selection, social ties, and social support. Employing seven waves of data collected from the original cohort of the Hispanic EPSES (H-EPESE), we used growth mixture modeling (GMM) to estimate latent classes of mobility trajectories. We then estimated a series of multinomial logistic regression models to predict the odds of membership in the mobility trajectory classes. Our GMM results suggest that multiple disability trajectories characterize the older Mexican American population: (1) High initial functioning followed by decline, (2) Moderate initial functioning followed by decline, and (3) Low initial functioning followed by no change or slight improvement. Respondents who attend religious services exhibit a greater odds of being classified in the high mobility class than the low mobility class. Level of religious attendance did not distinguish moderate versus low mobility classes. Our regression results confirm that religious attendance is associated with favorable mobility trajectories among older Mexican Americans, and persist with comprehensive adjustments for health selection, social ties, and social support.