Association between Religiosity and Mental Health Symptoms Among Puerto Ricans Who Migrated to the United States after Hurricane Maria

Background and purpose: For several months after Hurricane Maria made landfall in Puerto Rico, many Puerto Ricans continued facing serious challenges, including lack of access to food and clean water, limited communication, among others. In the face of such dire conditions, several hundred thousand Puerto Ricans left the island and tens of thousands remain permanently on the United States (US) mainland. Emerging research suggests that the mental health sequelae of Hurricane Maria survivors is of particular concern. Religiosity and its social aspects are potential factors that can relate positively to mental health and help mitigate negative mental health outcomes. Previous studies demonstrate that among the overall Latinx population, increased religious attendance is associated with lower rates of depression and anxiety. However, to our knowledge there are no studies examining the role of religiosity, and its intersections with mental health, among Hurricane Maria survivors. To address these gaps, the purpose of the present study was to examine the intersections between religiosity and mental health in a sample of Hurricane Maria survivor adults in the US.

Methods: Between August 2020 and October 2021, a total of 319 Hurricane Maria survivor adults over the age of 18 were recruited to participate into the Adelante Boricua study. Most participants had relocated to the U.S. between 2017 and 2018. We measured religiosity, depressive symptoms, anxiety, negative context of reception, and discrimination using scales that have been previously validated with Puerto Rican populations. We controlled for the following variables: age, gender, income, and spoken English level. We conducted multivariate logistic regression analysis using Stata 17 and mediation analysis using MPLUS 8.7.

Results: The results indicated that overall levels of religiosity pre-migration were not associated with depressive or anxiety symptoms. It was also found that overall levels of religiosity post-migration were significantly associated with decreased symptoms of depression and anxiety, after controlling for demographics. When further investigating the types of religious activities that might be driving this difference, it was found that looking to one’s faith as a source of inspiration, being active in one’s faith or church, and attending religious service were all significantly associated with decreased symptoms of depression and anxiety. The mediation analysis revealed that cultural stress mediated the relationship between religiosity change score from pre to post-migration and anxiety and depressive symptoms, accounting for the correlation between these.

Conclusions and implications: Our findings demonstrate that religiosity serves as a protective factor against depression and anxiety, particularly after migrating to the US, where people do not have readily available support systems as they do back in Puerto Rico. Future studies should continue investigating the role of religiosity among recently arrived migrants and immigrants, since these seem to serve as social oasis that help rebuild the social capital that people lose after migrating to the US. Social workers and other providers working with Puerto Rican migrants are well positioned to help migrants navigate their new environment and find a place where they can find meaning and rebuild social support networks.