Since its emergence in Wuhan, China in late 2019 (Huang et al., 2020), the novel coronavirus disease (COVID-19) has had an unprecedented impact that ignited a global pandemic (WHO, 2020). As of August 1, 2021, there have been 197, 788, 117 confirmed cases of COVID-19, and 4,219,578 global deaths (WHO, 2021a). The virus has resulted in mass panic with reports of hoarding of antibacterial supplies, physical aggression in grocery stores, voluntary self-isolation, and racial aggression towards individuals of Asian descent (Menzies & Menzies, 2020). COVID-19 has led to intense nervousness in the public and has pushed individuals into a state of high stress and anxiety (Bao et al., 2020; Wang et al., 2020). Additionally, there has been widespread fear of the severity of the disease, its side effects, and the probability of transmission (Xiang et al., 2020). With the emergence of this new disease and its rapid spread amongst the public, governments around the world began implementing stringent public health measures to curtail the spread of the virus (Menzies & Menzies, 2020).

In the race to prevent hospitalization numbers from rising and diseases from spreading, vaccination role outs are the most effective means in controlling the spread of COVID-19, and in achieving herd immunity to halt the transmission of the virus (Wouters et al., 2021). To ensure global and equal access to the COVID-19 vaccinations, an initiative by COVAX announced plans to provide nearly two billion doses of COVID-19 vaccine to select candidates, with Palestine being among those chosen (WHO, 2021a).

As infections in the West Bank and Gaza began to increase, Palestinians began receiving vaccinations under the global COVAX program, which included the Russian-made vaccine, Sputnik V, and the Moderna vaccine. However, vaccination rates remained low since the availability of such vaccines was difficult to guarantee, as they were arriving in small amounts, and vaccine hesitancy began to rise (Maraqa et al., 2021).

This virus has aroused significant attention nationwide with health professionals seeking answers, the media continuously sharing information to alleviate any uncertainty (Zheng et al., 2020), and the public’s insurmountable psychological pressure leading to fear, anxiety, insomnia, and depression (Li et al., 2020). Psychological stress exists when there is panic in the public under the effect of the internal and external environment. There exists an imbalance between one’s ability and the objective requirements, thus leading to a state of tension that one must adapt to the environment. The psychosomatic and behavioral responses employed by individuals to stress are a psychological mechanism for self-defence (Veronese et al., 2021). These responses are natural, and also necessary when confronted with dangerous situations. From a physical and mental health perspective, an adequate response towards COVID-19 can stimulate the internal drive of humans to fight against the threat of this infection (Wang et al., 2020). If a reaction is inappropriate and exceeds the limit that the human body can endure, it can disrupt the equilibrium of psychological and physical functioning, thus impacting one’s mental and physical health and resulting in either severe physical or mental illness (Drury et al., 2019). In essence, the response formulated towards a spreading contagious disease is likely to result in anxiety and the amplification of risk perceptions (Chew & Eysenbach, 2010).

Fear amongst the public is not an unusual occurrence; fear of death is a significant part of the human experience (Becker, 1973). Death anxiety is a conscious or unconscious psychological state employed as a defense mechanism when one feels threatened by death (Kesebir, 2014). Death anxiety has been found to underpin varying conditions related to depressive symptoms (Ghaemi, 2007; Iverach et al., 2014; Simon et al., 1998). Fear of death is also prevalent in obsessive-compulsive disorders as individuals diagnosed with the contamination subtype stress find ways to avoid death from illness or diseases (Menzies & Dar-Nimrod, 2017). It is also prevalent in those who continuously act on their intrusive thoughts with aggressive obsessions (Menzies et al., 2015). Further examples of death anxiety include the ways in which individuals respond to traumatic events such as toxic contamination (Barak et al., 1998). Similarly, patients who were infected with HIV had high levels of death anxiety (Safren et al., 2003), along with those who could only watch as their loved ones struggled to recover from influenza A/H1N1 (Elizarraràs-Rivas et al., 2010).

Death is beyond an individual’s control, hence the concept itself has generated great anxiety and concern among human beings (Latha et al., 2013). Death anxiety is the greatest when death is found to be correlated with pain (Abdel-Khalek, 2002). However, the amount of death anxiety one may internalize depends on a variety of factors, such as religion, education, gender, age, culture, and psychosocial variables (Dadfar & Lester, 2017; Routledge & Juhl, 2010).

Studies conducted within the Palestinian context examined the effects of the COVID-19 pandemic on different aspects of mental health and overall well-being. For example, Veronese et al. (2021) investigated the association between stress associated with COVID-19 and mental distress manifested by anxiety, depression, and stress. Results showed that mental health problems (anxiety, depression, and stress) were positively associated with stress due to COVID-19; while mental health and the stresses of COVID-19 were negatively associated with well-being and resilience.

Mahamid and Bdier (2021) investigated the relationship between mental health outcomes and the fear of COVID-19, and the mediating role of well-being in response to the emergence of COVID-19 among Palestinian psychosocial service providers. The fear of COVID-19 was positively correlated with mental health indicators (stress, anxiety, and depression) with well-being serving as a protective factor from fear of COVID-19.

Recent literature supports the relationship between mental health and religion amongst the public, especially regarding how to adapt to psychological stressors (Koenig, 2018). Furthermore, studies have highlighted a correlation between people’s general health and religiosity (Abu-Raiya & Pargament, 2011; Moreira-Almeida et al., 2006). Positive religious coping has been found to mitigate the prevalence of depressive symptoms during the COVID-19 pandemic (Mahamid & Bdier, 2021; Mahamid et al., 2021).

Ghandour et al. (2020) assessed the prevalence and predictors of distress and insecurity among Palestinian university students during the COVID-19 pandemic and lockdown. Results suggested the prevalence of moderate/high distress and insecurity were 40% and 48% respectively. The following study examines this premise by examining the relationship between religiosity and death anxiety following the spreading of coronavirus (COVID-19) throughout Palestine.

Results of table 2 showed that participants scored moderate levels on death anxiety and had high scores on religiosity.

As shown in Table 3, religiosity was negatively correlated with death anxiety (r = −.31, p < 0.01).

Results of Table 4 indicated that regression analysis explained statistically and significantly variance in death anxiety (B = −.191, SE = .040, β = −.20).

The current study examined the correlation between religiosity and death anxiety concerning COVID-19 for Palestinians. The study found that Palestinians received significant scores on religiosity and death anxiety. Religiosity was found to be negatively correlated with death anxiety with religion also being able to predict death anxiety amongst the participants.

Consistent with prior research, the individuals in the study scored moderately on death anxiety. COVID-19 has marked a time in which death has becomfe salient in our society, updates on death tolls have become a frequent occurrence from the news, social distancing and public health campaigns are prevalent, hoarding of anti-bacterial sprays and wipes, and ubiquitous visible death cues are evident in face masks (Menzies & Menzies, 2020). A study conducted by Newton-John et al. (2020) found that participants had strong death anxiety along with anxious behaviours and beliefs regarding COVID-19. COVID-19 can be conceptualized as a mortality salience prime, and society has been confronted with an unprecedented crisis that has increased mental health symptoms and psychological distress. Additionally, participants in our study had high scores on religiosity. Turning to religion and spirituality in times of anguish is a common coping strategy through attendance of religious services, engaging in prayers, and reading scriptures (Tepper et al., 2001).

The effects of COVID-19 on vulnerable populations can further complicate the issue of death anxiety. Individuals living in the occupied territories of Palestine may be considered as vulnerable populations as they live under unique circumstances (such as militarization, poverty, lack of employment opportunities, cultural pressures, etc.). Therefore, the connection between heightened levels of death anxiety and COVID-19 is especially true for Palestinian populations. Palestinians face possible death and traumatic stressors daily due to occupation. In this scenario, neither individuals nor the state itself has the power to control or secure their borders; nor do they have the ability to create a country-wide strategy for COVID-19 prevention (Mahamid & Berte, 2021).

The relation between death anxiety and religion is frequently studied in the literature, however, the findings have revealed ambiguity. Some argue that religion correlates negatively with anxiety towards death (Lundh & Radon, 1998), while others state that religion is related to greater death anxiety (Ellis et al., 2013). Researchers have even formulated a curvilinear relationship; those who are somewhat religious claim death anxiety than very religious individuals, while people who are religious and non-religious have scored lower on death anxiety (Wink & Scott, 2005). Relating to the Terror Management Theory (TMT), religion ameliorates the anxiety an individual may experience regarding the inevitability of personal mortality. According to TMT, cultural belief systems are designed to manage debilitating anxiety over death as one conceptualizes a just and safe world by abiding by culturally prescribed standards of living (Bassett & Bussard, 2021). For one to be protected against death anxiety, individuals must assume they are living up to the standards of ethical behavior based on their own internalized cultural worldviews (Bassett & Bussard, 2021).

Various studies (Bassett & Bussard, 2021; Feifel, 1974; Shadinger et al., 1999), have found no measurable differences in death anxiety when viewed as a categorical measure of belief in God, religious affiliation, or self-reported identity. These studies recommend researching more nuanced measures of religious beliefs to explore any possible relationships. Furthermore, Kastenbaum (2000) has noted the importance of researchers to transcend beyond typical measures of religious identity and affiliation due to its complexity and contingency on individual beliefs. However, although religious participation may not be the panacea to death anxiety, religious conviction and a belief in the afterlife have been found to assist in reducing this anxiety (Alvarado et al., 1995).

Despite this inconsistency in research, it has been found that individuals often turn to religion as a coping mechanism against difficult situations. Positive religious coping serves as an adaptive function to help mitigate any possible negative impacts associated with stressful and depressive symptoms. It exists as a significant coping mechanism to improve one’s mental health through the attendance of religious services and engaging in prayers, and it facilitates stress management for traumatic experiences such as in a global pandemic (Chow et al., 2021).

In our study, the results demonstrate that religiosity was found to be negatively correlated with death anxiety. The use of religion as a coping mechanism against adversity is not an unfamiliar concept. Individuals who have experienced adverse life events such as a death in the family or cancer are more likely to be religious than others (Ano & Vasconcelles, 2005; Pargament, 1997). Religious coping can be deemed as a buffer against death anxiety by interrupting negative consequences associated with death anxiety, thereby enhancing optimism and hope, and inhibiting death anxiety from progressing (Vishkin & Tamir, 2020). Religion appeases death anxiety by presenting an idea of symbolic immortality, and individuals can reflect on meaningful aspects of their lives and conceptualize death as an alteration in identity, consciousness, and relationships (Pyszczynski et al., 2015).

According to the results of our study, no significant differences were found in religiosity and death anxiety due to study demographic variables: gender and age. One possible explanation of this result is that Palestinians from different populations used positive religious copying to deal with distress during the pandemics, but it is also clear that the COVID-19 pandemic negatively affected Palestinians from different ages and groups.

The findings supported our second hypothesis that religiosity would predict death anxiety among Palestinians. This is in accordance with studies that have demonstrated that Islam provides its followers with concrete methods to ameliorate profound problems of living (Abu-Raiya & Pargament, 2015). Abu-Raiya, Ayten, Tekke et al. (2019) found that Muslims from various national backgrounds utilize religious beliefs, teachings, and practices to cope with the hardships of life. It was conclusively agreed upon that religion was their major coping resource. Islam is deeply embedded in the lives of Muslims resulting in the default usage of religion as a coping mechanism. The Islamic religion encourages its believers to accept painful events and crises as a part of God’s plan and as a test to strengthen one’s beliefs (Abu-Raiya & Jamal, 2019). The Islamic faith refers to multiple spiritual beliefs in dealing with crises and difficult situations. For example, Muslim believers are encouraged to accept traumatic and painful events as part of God’s universal plan and view the crisis as a test from God to deepen one’s faith. On the other hand, Islam discourages people from “giving up on the mercy of God” when considering self-harm (Mahamid & Bdier, 2021).

One may expand on their self-awareness through religion, emotional pain, existential crises of life and death, and in contemplating the mystery of their existence. To overcome any defensive reactions to death anxiety, individuals should experience events that lead to happiness and calms the pains of existence, as well as confronts death with equanimity, and live in the moment. (Chow et al., 2021). In the end, spiritual belief, religious faith, and satisfaction with life together work to decrease death anxiety and provide a solid measure against existential despair (Lewis, 2014; Mohammadzadeh & Najafi, 2020).

This study presented some limitations which may offer more opportunities for future studies. The study focused on the connection between religiosity and death anxiety among adult Palestinians during the COVID-19 pandemic. As such, to generalize findings, comparative studies within differing contexts should be conducted. Quantitative data was gathered through the completion of online self-reporting instruments, which may lend itself to issues such as self-report bias. The sample of our study included only Palestinian Muslims living in the West Bank of Palestine. Additionally, the methods of the study are correlational to further test the causal connection between the variables, and longitudinal and experimental studies are recommended.

The findings in this current study support previous findings demonstrating that religiosity has a positive effect on death anxiety, which means that religiosity is negatively associated with death anxiety. Also, participants scored moderately on death anxiety and had high scores on religiosity. This present work may provide further insights into practical implications, and therefore contributes to the greater theoretical understanding of how the study variables relate or affect each other. One such implication may be the development of intervention programs that may decrease death anxiety during pandemics or crises and enhance protective factors of individuals. It would possibly be of greater value to apply more international concepts in the methodology of acknowledging and managing death anxiety in Palestine. A multidisciplinary approach where professionals create a forum for shared learning may be most instrumental in gathering information on the current intersections of professional knowledge and faith-based traditions. The results of the current study reflect the need to enhance mental health services and educate the Palestinian population about positive coping skills to better manage public health efforts during national and global health incidents. Recommendations include increasing general mental health resources (both access to clinics and public health messages), as well as those related specifically to spirituality and faith-based structures. Faith-based strategies are known to be effective, more accessible than mental health professional services, and carry less stigma in the target community. Increasing the knowledge of faith leaders about mental health and adding methods related to spirituality to general clinical services will increase both accessibility and effectiveness across the territories. Mosque leadership would be helpful in increasing religious coping among congregants and thereby reducing the stress and negative mental health consequences of death anxiety. Also, religious leaders could help in defeating fatalistic and irrational religious views impeding vaccine acceptance.