This study aimed to assess self-rated health (SRH) and self-rated mental health status (SRMH) among community dwellers in relation to individual religiosity and neighborhood religious characteristics and to consider factors associated with SRH and SRMH in Sotome District, Nagasaki, Japan. A comparison was made between the Kurosaki area, which has a high proportion of Christian residents, and the Konoura area, which has a proportion of Christian residents consistent with the Japanese average. An anonymous self-administered survey that collected data on sociodemographic information, religion, current medical history, self-rated economic satisfaction, SRH and SRMH was conducted in 2013. Comments about community activities, including religious activities, were obtained from leaders of residents' associations. A total of 424 (19.4%) eligible residents living in the study area responded to the survey. After exclusion of responses with missing values, 287 (mean age 66.0 (standard deviation (SD) 14.0) years, range 30-91 years) responses were analyzed. The bivariate analysis showed that Christians from the Christian area were more likely than non-Christians to feel anxiety about the future (chi-square test, P=0.001). In the multivariate logistic regression analysis, the main factor associated with SRMH, which included anxiety (adjusted odds ratio (AOR): 3.74, 95% confidence interval (CI): 2.01-6.94), helplessness (AOR: 3.97, 95% CI: 2.20-7.17) and depression (AOR: 2.67, 95% CI: 1.50-4.76), was poor self-rated economic status, regardless of individual religious faith or neighborhood religious characteristics. The main factor associated with mental health status in Sotome District was poor self-reported economic satisfaction. Interviews with the leaders of residents' associations revealed that Christian residents were more likely than non-Christian residents to be involved in religious and non-religious community activities. The mental health of residents in two regions with different neighborhood religious characteristics seems to be associated with self-rated economic satisfaction rather than religious factors.
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