- Simon G. Brauer. 2018. "The Surprisingly Predictable Decline of Religion in the United States." Journal for the Scientific Study of Religion 57 (4) 654-675.
Scholars over the past several decades have noted the resilience of religion in the United States (Chaves 2011; Gorski and Altınordu 2008; Hadden 1987:601–02; Presser and Chaves 2007), but many recognize that the youngest U.S. cohorts are significantly lower on several religious characteristics than older cohorts (Hout and Fischer 2014; Putnam and Campbell 2012; Voas and Chaves 2016). Scholars have proposed several explanations for this trend, disagreeing about whether it is the result of a particular cultural moment or an ongoing process leading to even greater religious decline. Voas (2009) proposed one such explanation. He used European data to show that the proportion of nonreligious people in each cohort only became significant when previous cohorts reached a critical mass of moderately religious people. Voas's model is novel and promising but has neither been examined statistically nor applied to U.S. data, which I take up here. I find that, surprisingly, the United States fits closely on the same trajectory of religious decline as European countries, suggesting a shared demographic process as opposed to idiosyncratic change. I conclude by discussing how these findings inform theories of self‐reinforcing religious decline and cross‐national patterns of religiosity.
- Thompson, Kathryn, Hyo Jung Tak, and Magdy El-Din. Syed Madani. Simon G. Brauer. John D. Yoon. 2018. "Physicians' Religious Characteristics and Their Perceptions of the Psychological Impact of Patient Prayer and Beliefs at the End of Life: A National Survey." Accepted to be published in American Journal of Hospice and Palliative Medicine.
Physicians who are more religious or spiritual may report more positive perceptions regarding the link between religious beliefs/practices and patients’ psychological well-being.
We conducted a secondary data analysis of a 2010 national survey of US physicians from various specialties (n = 1156). Respondents answered whether the following patient behaviors had a positive or negative effect on the psychological well-being of patients at the end of life: (1) praying frequently, (2) believing in divine judgment, and (3) expecting a miraculous healing. We also asked respondents how comfortable they are talking with patients about death.
Eighty-five percent of physicians believed that patients’ prayer has a positive psychological impact, 51% thought that patients’ belief in divine judgment has a positive psychological impact, and only 17% of physicians thought the same with patients’ expectation of a miraculous healing. Opinions varied based on physicians’ religious and spiritual characteristics. Furthermore, 52% of US physicians appear to feel very comfortable discussing death with patients, although end-of-life specialists, Hindu physicians, and spiritual physicians were more likely to report feeling very comfortable discussing death (adjusted odds ratio range: 1.82-3.00).
US physicians hold divided perceptions of the psychological impact of patients’ religious beliefs/practices at the end of life, although they more are likely to believe that frequent prayer has a positive psychological impact for patients. Formal training in spiritual care may significantly improve the number of religion/spirituality conversations with patients at the end of life and help doctors understand and engage patients’ religious practices and beliefs.
- Schleifer, Cyrus, Simon G. Brauer, and Visha Patel. 2018. "Patterns of Conservative Religious Belief and Religious Practice across College Majors." Sociology of Religion 79 (3) 299-322.
This study addresses the question: Do individuals who have completed different college majors show different patterns of conservative religious belief and religious practice? Previous research on the relationship between college education and religion focused on institutional factors and precollege characteristics. Few studies, however, accounted for the role of college majors in shaping these processes. Research that looked at college majors emphasized changes during college and tended to use nonrepresentative samples. Using the General Social Survey, we test whether there are different patterns of religious belief and practice among those with different college degrees. We find that those with degrees in the natural sciences and the mathematical areas show the lowest rates of religious belief and practice, but these results are partially moderated by age. We discuss the implications that our findings have for future research on education and religion.
- Frush, Benjamin W., Simon G. Brauer, and Farr A. Curlin. 2018. "Physician Decision-Making in the Setting of Advanced Illness: An Examination of Patient Disposition and Physician Religiousness." Journal of Pain and Symptom Management 55 (3) 906-912.
Little is known about patient and physician factors that affect decisions to pursue more or less aggressive treatment courses for patients with advanced illness.
This study sought to determine how patient age, patient disposition, and physician religiousness affect physician recommendations in the context of advanced illness.
A survey was mailed to a stratified random sample of U.S. physicians, which included three vignettes depicting advanced illness scenarios: 1) cancer, 2) heart failure, and 3) dementia with acute infection. One vignette included experimental variables to test how patient age and patient disposition affected physician recommendations. After each vignette, physicians indicated their likelihood to recommend disease-directed medical care vs. hospice care.
Among eligible physicians (n = 1878), 62% (n = 1156) responded. Patient age and stated patient disposition toward treatment did not significantly affect physician recommendations. Compared with religious physicians, physicians who reported that religious importance was “not applicable” were less likely to recommend chemotherapy (adjusted odds ratio [OR] 0.39, 95% CI 0.23–0.66) and more likely to recommend hospice (OR 1.90, 95% CI 1.15–3.16) for a patient with cancer. Compared with physicians who ever attended religious services, physicians who never attended were less likely to recommend left ventricular assist device placement for a patient with congestive heart failure (OR 0.57, 95% CI 0.35–0.92). In addition, Asian ethnicity was independently associated with recommending chemotherapy (OR 1.72, 95% CI 1.13–2.61) and being less likely to recommend hospice (OR 0.59, 95% CI 0.40–0.91) for the patient with cancer; and it was associated with recommending antibiotics for the patient with dementia and pneumonia (OR 1.64, 95% CI 1.08–2.50).
This study provides preliminary evidence that patient disposition toward more and less aggressive treatment in advanced illness does not substantially factor into physician recommendations. Non-religious physicians appear less likely to recommend disease-directed medical treatment in the setting of advanced illness, although this finding was not uniform and deserves further research."
- Brauer, Simon G. 2017. "How Many Congregations Are There? Updating a Survey-Based Estimate." Journal for the Scientific Study of Religion. 56 (2) 438-448.
Researchers have attempted to estimate the number of congregations in the US using counts provided by denominations, existing media (newspapers, phone books, websites, etc.), and calculations using congregational surveys. Hadaway and Marler (2005) took the third approach, basing their estimate on the 1998 National Congregations Study (NCS), a representative sample of US congregations, and select official denominational statistics. Since publishing their estimate of 331,000 congregations in 1998, two subsequent waves of the NCS have been conducted. Using the same approach, I estimate the number of congregations in 1998, 2006, and 2012. I conclude that congregations probably became more numerous, likely as a result of growth among non-denominational Protestants and the extraordinarily low death rate of congregations. But I also consider alternative interpretations of the data.
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- Brauer, Simon G., John D. Yoon, and Farr A. Curlin. 2017. "Physician Satisfaction Treating Medically Unexplained Symptoms." Southern Medical Journal 110 (5) 386-391.
To determine whether treating conditions with medically unexplained symptoms is associated with lower physician satisfaction and higher ascribed patient responsibility, and to determine whether higher ascribed patient responsibility is associated with lower satisfaction in treating a given condition.
We surveyed a nationally representative sample of 1504 US primary care physicians. Respondents were asked how responsible patients are for two conditions with more developed medical explanations (depression and anxiety) and two conditions with less developed medical explanations (chronic back pain, fibromyalgia), and how much satisfaction they experienced treating each condition. We used Wald tests to compare mean satisfaction and ascribed patient responsibility between medically explained and medically unexplained conditions. We conducted single and multilevel ordinal logistic models to test the relationship between ascribed patient responsibility and physician satisfaction.
Treating medically unexplained conditions elicited less satisfaction than treating medically explained conditions (Wald p’s 〈0.001). Physicians attribute significantly more patient responsibility to the former (Wald p’s 〈.0.005), though the magnitude of the difference is small. Across all four conditions, physicians reported experiencing less satisfaction treating symptoms that result from choices for which patients are responsible (multilevel OR = 0.57; p=0.000).
Physicians experience less satisfaction treating conditions characterized by medically unexplained symptoms, and they experience less satisfaction treating conditions for which they believe the patient is responsible.
- Brauer, Simon G., John D. Yoon, and Farr A. Curlin. 2016. "US Primary Care Physicians' Opinions about Conscientious Refusal: A National Vignette Experiment." Journal of Medical Ethics 42: 80-84.
Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object, and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterize physicians’ beliefs about what responses are appropriate.
We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient’s physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent’s judgments.
Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one’s objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient’s request (38% vs. 22%, OR = 1.75; 95% CI, 1.06-2.86).
This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one’s personal or professional standards. Referring seems to be physicians’ preferred way of responding to requests for interventions to which physicians object.
Published or accepted papers
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