During America’s first six months of the pandemic, with New York City comprising the nation’s initial COVID-19 epicenter, despite restricted access to in-person religious activities, religiosity among Black and Hispanic New Yorkers in this sample was associated with lower prevalence of alcohol, cannabis, or other drug use. There was no significant association observed between religiosity and depression or anxiety. These findings suggest that religiosity may not have been associated with a reduction in depressive and anxious symptoms in the initial shock of facing a global pandemic, but it may have been protective against substance use. The findings also suggest that disparities in substance use in socially marginalized groups, at least during the first six months of the pandemic, may have been aided by religious support among those who consider themselves to be religious.

The findings complement findings of other studies. For example, according to a recent systematic review on spirituality and health, religious service attendance was shown to be associated with less smoking, as well as lower levels of alcohol use and drug use [15]. It was also associated with better mental health and better quality of life, including fewer depressive symptoms and lower levels of suicidal ideations and behaviors. However, religious service attendance in the first six months of the COVID-19 pandemic in New York City was restricted and it is unclear how this might have impacted the mental health and substance use of otherwise religious people. Despite limited access to in-person religious services, some studies from the time of the COVID-19 pandemic reported that religiosity/spirituality was, nonetheless, a commonly used coping strategy. For example, in New York City, specifically, 46% of healthcare workers reported using religion/spirituality and meditation to cope with stresses associated with the COVID-19 outbreak [16].

In general, findings on the association between religiosity and mental health outcomes during the COVID-19 pandemic have been mixed. Many have reported religiosity/spirituality to be associated with decreased symptoms of mental disorders and increased well-being. For example, higher levels of religious coping in Muslims, compared to their Christian counterparts, revealed an inverse relationship between religious coping and current symptom levels of depression in the Muslim cohort [17]. Religious coping was further shown to moderate the relationship between hope and well-being in people observing stringent lockdown regulations [18]. Similar findings were also observed beyond New York and the USA. For example, in a sample of Palestinian adults, an inverse correlation was observed between positive religious coping and perceived stress, as well as a negative correlation between positive religious coping and depressive symptoms [19].

On the other hand, and consistent with our findings, several studies failed to find an association between religiosity and mental health outcomes. For example, no association was observed in the relationship between mental health and various religious beliefs as measured by the Duke University Religious Index (DUREL) [20]. Lack of an association was also observed in another study that investigated the relationship between religiosity and COVID-related anxiety in a sample of health care workers in Portugal [21].

The fact that there was limited access to houses of worship and in-person religious services at the height of the COVID-19 outbreak in New York City, and at the time of this study, may account for the lack of an association between reported religiosity and symptoms of anxiety and depression. It is possible that restricting in-person religious service attendance decreased the likelihood that religiosity would be associated with lower rates of anxiety and depression. Moreover, limiting access to in-person religious services may have reduced people’s tendency to adopt a religious identity and to seek solace in religious beliefs and practices.

It should also be noted that symptoms of anxiety and depression tend to focus on affective states, rather than behaviors. Religiosity may not have shielded individuals from the negative affect (i.e., symptoms of depression and anxiety) spurred by the COVID-19 pandemic, but it may have, nonetheless, been associated with protective effects on behavioral outcomes, as observed in alcohol and drug consumption. Rather than using substances to cope with the pandemic’s stressors, religious individuals may have turned to faith to help regulate potentially destructive coping strategies, despite limited access to in-person congregational supports and services.

The paucity and, hence, diversity of studies on religion and health during the COVID-19 pandemic may also account for the mixed associations reported in the literature as several variables remain inconsistent across studies and complicate comparability across studies, including geographic locations, religious groups sampled, religious/spiritual measures, mental health and substance use outcomes, and the timeframe of the study within the (to date, 3-year) COVID-19 pandemic. Despite these limitations, the present study contributes to the complex literature uniquely by adding a voice for historically minoritized groups—Black and Hispanic Americans.

There are several implications of the study’s findings—not only in North America, but globally, as well. The findings suggest that guided public health outreach by churches and religious groups may be beneficial to those who are religious; these may include social outreach to isolated members, access to resources for addiction and substance use, and information sharing about vaccinations and other supportive services. The findings also support the potential value of chaplaincy outreach as the role of chaplaincy is to support religiosity through spiritual awareness, solace, and a connection to the sacred at times when access to in-person services may not be possible—amid a pandemic or otherwise.

The study’s findings, although limited by their cross-sectional design and single item measure of self-reported religiosity, contribute to research that investigates religiosity as a potentially protective and supportive mechanism in times of crisis. They hint at the possibility that religiosity might help reduce substance use and suggest that religiosity itself may be helpful from a public health perspective, independent of serving as a conduit for other social services. They also support the possibility that in-person religious services are important for mental health and limiting access to these services (including, in some cases, sacraments) may have repercussions of which we are little aware. It is a limitation that we did not assess the specific religious practices in which respondents engaged. Also, the study was cross-sectional in design, so no causal claims can be made. Further study is needed to assess how specific religious/spiritual factors relate to mental health and substance use in times of collective crisis. As such, in-depth, longitudinal examination of religiosity (e.g., prayer, access to online religious services) is warranted.