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To the Editor:
Do healthy people go to church, or does church make you healthy? If the answer is that church makes you healthy, what is the mechanism? Leaving out divine intervention, what happens in church that produces health?
Economists and other social scientists have examined the relationship between health and social capital, which includes church, social clubs and having a support network of friends. Social capital provides information on health habits, better doctors or hospitals, and reduces stress, which can lead to heart disease and mental problems.
But we must confront the problem of causation. Those who attend church are on average healthier than those who do not: the selection effect. To deal with this, we would need to study the health of those who are randomly assigned to attend church and who do not attend.
Without this evidence, we can only hope that going to church makes us healthier, though it might be a good thing anyway.
Madrid, April 22, 2013
The writer is a professor of health economics and public policy at the University of California, Berkeley.