Exploring the Association of Religion and Religiosity on Mammography Screening Among White and Black Women: Results from the Brazilian Longitudinal Study of Aging (Elsi-Brazil)

This study examines the relationship between religious denomination, religious attendance, and mammography screening among White and Black women in Brazil, using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2015-2016). The sample comprised 3120 women aged 50-69 who self-identified as White or Black (including Brown). Mammography use was categorized as never, within the past two years (in accordance with national guidelines), or more than two years ago. Multinomial logistic regression models assessed associations, controlled by sociodemographic, and health-related factors. Results show that Evangelical women were significantly more likely than Catholics to have never undergone a mammogram (RRR = 1.53) and to be overdue (RRR = 1.52). Higher religious attendance was associated with a lower risk of never having been screened. These findings underscore a dual role of religion: it can either facilitate preventive care through, for instance, social support and health-promoting norms, or hinder it when certain beliefs-such as "faith healing"-discourage medical engagement. Furthermore, racial disparities persist within Evangelicals. Among Black women, Evangelical affiliation was associated with a higher likelihood of never being screened, while high religious attendance substantially reduced this risk. Among White women, Evangelical affiliation did not influence initiation of screening but was linked to nearly double the risk of being overdue, with no significant effect of attendance. Ultimately, our findings underscore the complex intersection of religion, race, and health. This study makes a novel contribution by being the first in Brazil to assess how religious denomination and religiosity relate to mammography screening among racial groups. Future research on religion and health should account for racial disparities.