Investment in local health-shaping institutions: Reconsidering the role of the religious environment.

A body of research dating back to Durkheim has linked religious environments to population health and mortality rates. Scholars have argued that local religious subcultures influence population health through important pathways, including a community's propensity to invest in health-shaping institutions - such as public hospitals. A noticeable shortcoming of this literature, however, is a lack of evidence that these mechanisms exist as proposed. This study uses county-level data from the 2010 Religious Congregations and Membership Study and the 2012 U.S. Census of Governments to examine contextual religion's relationship with public investment in health-shaping institutions. Findings suggest that associations between religious traditions and institutional investment explain a significant and notable portion of the total effect of these traditions on mortality rates. This manuscript applies a more refined approach to studying health-shaping investment, and the results suggest interesting new directions in the study of cultural determinants of population health.