Religiosity and Hiv/Aids Impact on well-being among the elderly: A Scientific model of the discourse
By Paul Andrew Bourne
Religiosity
From theologians’ perspective, spirituality and religiosity are critical components in the lifespan of people. They believe that man (including woman) cannot be completely whole without religion. With this fundamental concept, theologians theorize that man cannot be happy, lowly depressed or feel comfortable without a balance of spirit and body (Whang 2006). In order to acquire a state of personal happiness, self-reported subjective well-being, some pundits forward a construct that people are fashioned in the image of God, which requires some religiosity before man, can be happy or less stressed. Religion is, therefore, association with well-being (Dierendonck and Mohan 2006; Krause 2006; Jurkovic and Walker 2006; Ardelt 2003; Graham et al. 1978; Zuchkerman et al. 1984) as well as low mortality (Schonenbach et al. 1986; House, Robbin and Metzner 1982). Religion is seen as the opiate of the people from Karl Marx perspective but Theologians, on the other hand, hypothesized that religion is a coping mechanism against unhappiness and stress. According to Kart (1990), religious guidelines aid well-being in that through restrictive behavioural habits which are health risk such smoking, drinking of alcohol, and even diet.
The discourse of religiosity and spirituality influencing well-being is well documented (Frazier et al. 2005; Edmondson et al. 2005; Thorson et al. 2001; Moberg 1984; Graham et al. 1978). Researchers have sought to concretize this issue by studying the influence of religiosity on quality and life, and they have found that a positive associate exist between those two phenomena (Maskelko and Kubzansky 2006; Franzini et al. 2004). They found that the relationship was even stronger for men than for women, and that this association was influenced by denominational affiliation. Graham et al’s (Graham, et al 1978) study found that blood pressure for highly religious male heads of households in Evan County was low. The findings of this research did not dissipate when controlled for age, obesity, cigarette smoking, and socioeconomic status. A study on the Mormon in Utah revealed that cancer rates were lower (by 80%) for those who adhere to Church doctrine (Gardner and Lyon 1982a, 1982b) than those with weaker adherence.
In a study of 147 volunteer Australian males between 18 and 83 years old, Jurkovic and Walker (2006) study found a high stress level of non-religious than compared to religious men. The researchers in constructing a contextual literature quoted many studies that have made a link between non-spirituality and "dryness", which results in suicide. Even though, Jurkovic and Walker’s research was primarily on spiritual well-being, it provides a platform that can be used in understanding linkages between psychological status of people and their general well-being. In a study which looked at young adult women, the researchers found that spirituality affects the physical well-being of its populace (Edmondson et al. 2005). Embedded within that study is the positive influence of spirituality and religion on the health status of women. Edmondson’s et al. work constituted of 42 female college students of which 78.8 percent were Caucasian, 13.5 percent African-American, 5.8 percent Asian and 92 percent were non-smokers.
Health psychologists concurred with Theologians and Christians that religion influence psychological well-being (Taylor 1999; Rice 1998; Paloutzian and Kirkpatrick 1995). Taylor argued that religious people are more likely to cope with stressors than non-religious individuals, which explains the former better health status. She forwarded the position that this may be done through avoidance or vigilant strategies. This response is an aversive coping mechanism in addressing serious monologue or confrontational and traumatic events. Coping strategies, therefore, are psychological tools used by an individual to problem-solve issues, without which are likely to construct stressors and threaten ones health status. Taylor (1999, 214) said that "some religious beliefs also lead to better health practices" which see lower cancer mortality rates from all cancers in Orthodox Christians.
Stressors may arise from within the individual or outside his/her environment. One such external stressor that may affect the individual is the death of love ones. Response to mortality of close family members may be more traumatic dependent on expectancy or non-expectancy. Bereavement influences incidence of mortality (Rice 1998). This may result in exhaustion of the individual's 'adaptive reserve'. The person body wears down and becomes highly vulnerable to morbidity and even death. Rice forwarded a study (by Levav, Friedlander, Kark, and Peritz 1995) that contradicted an association between bereavement and mortality. He wrote that "Fathers who lost sons in war had lower mortality rates than those who lost son in accidents" (Rice 1998, 76). Despite that study, Rice quoted other research (Baker 1987; Jemmott and Locke 1984; Locke 1982) that showed the impact of stress on physiology of humans. He argued that it is through suppression after and during bereavement that creates the stressors, which become potent devices for mortality and morbidity.
According to Moody (2006), "Empirical data show that religious belief is correlated with good health", and this ethos according to some writers is not limited to Christian scholars or spiritualists. According to Moody (2006), Koenig and Cohen forwarded a stance that was dialectic in nature. They believed that religiosity was both a positive as well as a negative determinant on health in particular ‘life span’ (Moody, 2006 p. 148).
Cox and Hammonds (1988) found that there is a positive relationship between religiosity and well-being of the elderly; this was also concurred by Edward and Klemmack (1973) Hummer (1999) and Spreitzer and Synder (1974) in separate studies on the same space. Cox and Hammonds in their abstract, they forwarded the perspective that all past studies that have analyses religiosity and life satisfaction came to the same conclusion that individuals who attend church experience a greater life satisfaction. They forwarded the justification for the association. The researcher cited that:
A plausible explanation for the positive value that religious participation has on the lives of the elderly is that the church becomes a focal point of social integration and activity for the elderly, providing them with a sense of community and well-being (Cox and Hammonds 1988).
According to Cox and Hammonds (1988), Guy in a study on the discourse of religiosity and life satisfaction, found that the group with the highest score on the measure of life satisfaction was that which reported the most frequent church attendance. Other research on the same space agreed with Guy, and Cox and Hammonds that religiosity was a determinant of life satisfaction experienced by the elderly (Markides1983; Ortega 1983). Cox and Hammonds stated that this space in the discipline of gerontology has a high degree of scientific bias, as scientists are less likely to reflect the secular attitudes of the public. In addition to the few longitudinal studies on matter, Cox and Hammonds argued that all the interpretation of the results and conclusion must be used cautiously (1988, 47).
According to Hummer et al. (1999), several studies have concluded that religion influences health, mortality and that the relationship varies across socio-demographic factors. They referred to studies carried out by Levin et al. (1994), Bryant and Ralowski (1992) and House et al. (1982); as those works have added to the space.
In a study conducted by Frazier et al. (2005) exclusively on African American older people, they found that several multidimensional measures of religiosity were associated with psychological well-being. Kail and Cavanaugh (2004, 584) captured the experiences of seniors and how religion enhances their survivability, when they said that "...older adults who are more involved and committed to their faith have better physical and mental health ..." When asked 'how you deal with the living', respondents listed among coping strategies spirituality (Kail and Cavanaugh 2004). From studies analyzed earlier, spiritual support is a mechanism used in coping with life's challenges as the church offers a social support system and this is a mantle of hope. Religiosity is a determinant of the health status of people more so for seniors as they continue to grapple with lose of spouse, work and other psychosocial and biological conditions.
From the Census of 2001, approximately 21 percent of Jamaican reported that they had ‘no religion’ and 2.78 percent did not report, then the discourse on influence of religiosity on the quality of life of the aged should provide an indepth understanding of this phenomenon as a predictor.
HIV/AIDS and the Elderly
The issue of HIV/AIDS is not singly limited to the infected individuals who are substantial between 15 and 24 years (UNAIDS 2004), but the elderly who will be increasingly ask to support their infected-children and other members of the family. Instead of being the socio-financially support for their children and other household members, the aged populace will be needed to absorb the stress of love ones in addition to their psychosocial and demographic challenges. According to Knodel et al’s (Knodel et al. 2001, 1320) study carried out in Thailand, "59 percent of those who died of an AIDS-related disease co-resided with a parent at the terminal stage." This implies that the aged are expected to perform caretaking duties. With this social reality, the aged person’s well-being will be affected in a two-fold manner. Firstly, the aged parents are expected to care for a dying love one. And, secondly, they are forced to absorb the stress of this arrangement with the biological and psychosocial conditions of their ageing organism. In order to understand the stresses of this situation on the aged, we need to analyze this within the context of the cost of care, length of care for the elderly and the AIDS patient. This can be supported by a study that revealed that longstanding ailments do reduce quality of life (Neteveli et al. 2006).
Globally, regionally and nationally, the core for the HIV/AIDS infected candidates is between 15 and 55 years, who are likely to be the children of many aged people. Therefore, the social support system that the elderly expects is highly likely to be reverted to the children. Day and Livingstone (2003) found that social support is an effective coping mechanism to deal with stress. From this established theory, the potential stressors that will be leveled against the elderly will automatically expand.
A longitudinal research that was conducted between 1991 and 1994 on households drawn from Northwestern Tanzania compared and contrasted the body weights of some elderly prior to and post the deaths of a "prime-age adult" in the household. According to Dayton and Ainsworth (2004), the findings indicated that the seniors with the lowest physical well-being (measured using body mass index, BMI) were those in poor families that had not experienced a household adult death in the survey period. The BMI for the elderly was lesser after the death of a love one than before the death of the household member. Another revelation from the study was the increased time spent by the elderly in household chores proceeding the adult death and reduction in waged employment.
In the event HIV/AIDS virus does not inflect the children of the elderly, or other household members, UNADS (2004) reported that less than five percent of them are infected by the epidemic. This social reality within the financial constraint of the family typology will become a psychosocial stress for the elderly. The issue of stress is determinant of well-being as HIV/AIDS virus. Lazarus and Folkman (1984) conceptualized stress as a "relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being" (p.19).
With the prevalence and incidence rates of HIV/AIDS, there is a demand on the aged populace to cope with such social setting. Coping embedded in an individual's cognitive, affective, and behavioral efforts to manage specific external and/or internal demands (Crocker, Kowalski, & Graham 1998; Lazarus 1999). Studies have shown the positive association between coping and well-being. Epping-Jordan, et al. (1994) did study on coping and health. They studied coping and health in a sample of 66 cancer patients diagnosed with a variety of different types of cancer including breast cancer, gynecologic cancers, hematological malignancies, brain tumors, and malignant melanoma. The findings revealed that the relationship between coping and disease progression demonstrates how the relationship between coping and health is ultimately quite complicated.
The elderly need to cope with the discrimination, the social exclusion, and the psychosocial and financial responsibility of the infected close family member in addition to a situation of personal infection within an aged body with its demands.
Rogers (1995) in a study titled "Sociodemographic Characteristics of Long-lived and Healthy Individuals" cited that many factors account for the long lives. Rogers’ study was based on secondary data collected by the US Department of Health and Human Services 1988 called 1984 National Health Interview Survey. The sample size was 15,938 individuals aged 5 and older. The findings revealed that of females who walk, they are expected to live 7.5 years more than males while among females who are physically incapacitated, they are expected to live 5.5 years more when compared to males. There was association between age, sex, income, education, physical health, social network participation and emotional well-being and perceived health (Rogers 1995, 41). He wrote ". . . death is more likely to occur among those who are older, male, less educated, and with disabilities, chronic conditions, and perceived poor health" (Rogers 1995, 46).
Paul Andrew Bourne
Graduate and Research Assistant
Department of Sociology
The University of the West Indies
Mona
Kingston 7
Kingston, Jamaica