Influences of religiousness/spirituality on mental and physical health in OEF/OIF/OND military veterans varies by sex and race/ethnicity

Abstract: Background: Religiousness/spirituality (R/S) has been associated with greater mental wellbeing in US military veterans, but this work has been conducted primarily with older veterans, cross-sectionally, using a constrained set of R/S and mental health constructs, and lacking consideration of the influence of sex and race/ethnicity. Further, few studies have focused on associations of R/S with veterans’ physical health. Method: We investigated the relationship of R/S to mental and physical health in a sample of 410 Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn veterans within five years of military separation and one year later. Results: In the full sample, R/S coping, R/S organized practices and private prayer minimally related to mental or physical wellbeing, yet R/S struggle related inversely to concurrent and subsequent mental and physical health. For women only, higher baseline organized R/S was associated with lower subsequent stress, anxiety, and insomnia. For men only, baseline R/S coping predicted subsequent poorer physical quality of life and baseline R/S struggle predicted subsequent increased pain. For minority race but not white veterans, higher baseline private prayer predicted increased current pain level at 12 months; for Latinx ethnicity only, higher baseline R/S coping predicted increased quality of life a year later and higher baseline R/S struggle predicted higher subsequent levels of anxiety. Conclusions: R/S, broadly conceptualized, may relate to wellbeing in military veterans in different ways depending on sex and race/ethnicity, with implications for the role of R/S and R/S struggle in personalizing mental and physical health services.