For much of American history, attending church was a normal part of weekly life for millions of families.
Every Sunday, people gathered not only to worship but also to spend time with friends, support neighbors, and strengthen their local communities.
Churches often became places where people celebrated important life events, received help during difficult times, and built lifelong friendships.
Many people found comfort, purpose, and a feeling of belonging through these regular gatherings.
Over the past several decades, however, church attendance in the United States has fallen steadily.
While many Americans still say they believe in God or consider themselves religious, fewer people attend religious services on a regular basis.
A new study suggests that this social change may be linked to an important public health problem: the growing number of what experts call “deaths of despair.”
Deaths of despair refer to deaths caused by suicide, drug overdoses, and liver disease related to long-term heavy alcohol use. These deaths have increased dramatically in the United States during recent decades and have become one of the country’s most serious health challenges.
Researchers have tried to understand why these deaths have risen so sharply, examining factors such as unemployment, financial stress, family changes, and the opioid epidemic. The new study suggests that the loss of community connections may also be an important part of the story.
The research was conducted by Tamar Oostrom of The Ohio State University together with Tyler Giles of Wellesley College and Daniel Hungerman of the University of Notre Dame. Their findings were published in the Journal of the European Economic Association.
To investigate the issue, the researchers combined information from several large national datasets. They examined surveys showing how often people attended religious services and compared them with government records on causes of death across different states over many years.
A clear pattern appeared. States that experienced the largest declines in church attendance between 1985 and 2000 later experienced larger increases in deaths of despair. The connection was especially strong among middle-aged White Americans without a college degree, a group that previous research has already identified as being at particularly high risk for suicide, alcohol-related disease, and fatal drug overdoses.
The pattern was found among both men and women and in both cities and rural communities. This suggests that the relationship was not limited to one type of place or one particular lifestyle.
One of the most interesting parts of the study involved so-called blue laws. These were state laws that restricted many businesses from opening on Sundays. Because fewer stores operated and fewer people worked on Sundays, many families were more likely to attend church services.
During the 1980s and 1990s, many states removed these laws. Minnesota, South Carolina, and Texas repealed their blue laws in 1985. After these changes, weekly church attendance dropped by about five to ten percentage points in those states. In later years, deaths of despair also increased.
The timing is important because it suggests that the trend began before the widespread opioid crisis of the late 1990s. Powerful prescription painkillers such as OxyContin are often blamed for rising overdose deaths, but the researchers found that changes in despair-related deaths had already started before these drugs became widely available.
According to Oostrom, deaths of despair had actually been falling from the late 1970s into the early 1990s. As church attendance declined, that improvement slowed and eventually stopped. After prescription opioids became widely available in 1996, death rates rose much more quickly.
The researchers believe that churches may protect health because they provide more than religious teaching. They also create strong social networks. People who attend regularly often have trusted friends who notice when they are struggling, offer emotional support, or help during difficult times. These relationships may reduce loneliness, improve mental well-being, and give people a stronger sense of purpose.
Interestingly, belief in God did not decrease nearly as much as church attendance. Many people continued to report religious beliefs but no longer took part in regular community activities. This suggests that simply having personal beliefs may not provide the same benefits as belonging to a supportive group that meets face to face.
The researchers also asked whether other community organizations have replaced churches. So far, there is little evidence that they have. Many traditional clubs and civic organizations have also become less common, while people increasingly spend time interacting online. Although social media can help people stay connected, it may not fully replace the deeper relationships that develop through regular in-person gatherings.
The study does not claim that attending church alone can prevent deaths of despair. Human health is shaped by many influences, including income, education, employment, family relationships, access to healthcare, and many other social and economic factors. Instead, the findings suggest that strong community ties may play a much larger role in protecting health than many people realize.
The researchers hope their work encourages policymakers, healthcare professionals, and community leaders to think more broadly about preventing deaths of despair.
Building stronger social connections, creating opportunities for meaningful relationships, and helping people develop a sense of purpose may become important parts of improving public health in the years ahead.
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