Coping strategies play a central role in how individuals manage life’s challenges, and their effectiveness has been linked to both psychological and physical health outcomes (Ano & Vasconcelles, 2005). One such strategy, religious coping, has received growing attention for its significance among individuals for whom religion is an important aspect of identity. Religious coping refers to the use of religious beliefs or practices to manage stress, and has been categorized in terms of both positive religious coping (such as seeking comfort in a benevolent higher power) and negative religious coping (such as spiritual struggle or feeling punished by God) (Pargament et al., 2001). It is important to note that positive religious coping is not an inherently adaptive coping strategy, and negative religious coping is not an inherently maladaptive coping strategy. Religious coping research, including this study, aims to explore whether positive and negative religious coping, used in response to various life challenges, contributes positively or negatively to overall health outcomes.

This question is particularly relevant in the context of Muslim Americans, a religious minority group in the US that reports frequent use of religious coping but remains underrepresented in health research. Studies have shown that Muslims are more likely than members of other religious groups to report using religious and spiritual coping strategies to manage distress (Loewenthal et al., 2001; Tepper et al., 2001; Adam & Ward, 2016), including in response to systemic discrimination, Islamophobia, and global events like the COVID-19 pandemic (Thomas & Barbato, 2020). Despite this, few studies have examined whether such coping strategies are associated with better or worse health outcomes in this population. Importantly, while the connection between religious coping and psychological well-being has received more intuitive and empirical attention, its relationship with physical health is less explored. By assessing the relationship between religious coping and overall subjective health, this study aims to offer a more comprehensive understanding of how these coping strategies impact the lived experiences of Muslim Americans.

Religious coping methods, as first defined by Pargament and colleagues (1998), are efforts an individual takes to understand and cope with life stressors in ways related to the sacred, those traditionally associated with God, as well as aspects of life that are related to the divine. To measure religious coping and the extent to which it is used to deal with serious life events, Pargament developed scales that reflect five religious functions: meaning, control, comfort, intimacy, and life transformation. Two types of religious coping have been identified in the literature: positive and negative. Whereas positive religious coping refers to strategies such as turning toward religion for meaning and support (e.g., benevolent religious appraisals and spiritual comfort), negative religious coping reflects religious doubt and struggle (e.g., reappraisals of God and spiritual discontent) (Pargament et al., 2011). However, it is important to note that this established typology of positive versus negative religious coping is contentious, as it was created considering a specific worldview and, as such, may not be cross-culturally accepted.

The development of standardized religious coping scales has driven a large scholarly body of psychological research dedicated to investigating the mediating role of religious coping in the association between stress and health outcomes. Several studies have demonstrated significant associations between both positive and negative religious coping and health status across various demographics and belief systems (Contrada et al., 2004; Ironson & Kremer, 2009; Tarakeshwar & Pargament, 2001). Among Muslims globally, research has repeatedly demonstrated an association between negative religious coping and psychiatric disorders, including depression and Post-Traumatic Stress Disorder (PTSD), as well as a corresponding inverse relationship between positive religious coping and depression (Abu-Raiya & Jamal 2021; Aflakseir & Mahdiyar, 2016; Berzengi et al., 2017; Mahamid & Bdier, 2021; Sharif et al., 2018; Thomas & Barbato, 2020). Although the bulk of the literature surrounding religious coping has identified the strongest associations between religious coping and mental health outcomes such as depression, anxiety, and PTSD, there is also accumulating evidence linking religion and spirituality to a variety of other health outcomes (Koenig et al., 2004; Matthews et al., 1998; Sherman et al., 2009).

Muslim Americans make up approximately 1.1% of the US population, representing around 3.5 million people, and the percentage is rapidly growing, with Muslims projected to become the second largest religious group in the US after Christians by 2040 (Pew Research Center, 2017). However, while almost two-thirds of Muslim Americans (65%) say religion is a crucial aspect of their lives, research exploring the role of religious coping on various health outcomes among Muslim Americans has been sparse (Pew Research Center, 2017). Moreover, the limited research available demonstrates mixed findings. For example, while some studies have reported that positive and negative religious coping are predictive of depressive symptoms (Abu-Raiya et al., 2011; Ahmad et al., 2023; Areba et al., 2018), others have not. In a study among Muslim Pakistani college students, negative religious coping predicted depressive symptoms while positive religious coping did not provide a buffering effect (Khan & Watson, 2006). Other studies conducted by AIP (a co-author on this paper) and colleagues exploring the relationship between negative religious coping and delayed healthcare seeking among Muslim women found no association at all (Vu et al., 2016), while another found that negative religious coping was associated with a lower probability of obtaining a pap smear (Padela et al., 2014). The scarcity and variability within the existing literature underlie the importance of further exploring the relationship between religious coping and health outcomes among Muslim Americans. Building on the established significance of religious coping in health outcomes, this study seeks to further explore this relationship by specifically focusing on the subjective health of Muslim Americans.

This study aims to examine the relationship between religious coping and subjective health among Muslims living in the US. For this study, any usage of the term “Muslim Americans” will refer specifically to Muslims living in the US. The study hypothesizes that Muslim Americans who engage in positive religious coping strategies will exhibit a positive correlation with subjective health outcomes. Conversely, the study hypothesizes that Muslim Americans who engage in negative religious coping strategies will exhibit a negative correlation with subjective health outcomes. In addition, given the diverse nature of the Muslim American population, the study hypothesizes that the relationship between religious coping and subjective health will be impacted by demographic characteristics such as gender, age, race or ethnicity, and immigration status.

Exploratory research has provided strong evidence to establish that religious coping directly and indirectly plays a role in health outcomes of Muslims around the world (Abu-Raiya et al., 2020; Abu-Raiya & Jamal, 2021; Mahamid & Bdier, 2021; Thomas & Barbato, 2020). The current study sought to explore such relationships among Muslim Americans. First and foremost, the findings show that Muslim Americans use positive religious coping in their daily lives and report using it to a greater extent compared to negative religious coping (Abu-Raiya et al., 2008).

The results from this study also suggest that positive and negative religious coping are both independent predictors of overall subjective health. Specifically, positive religious coping was positively correlated with overall subjective health, and negative religious coping was negatively correlated with overall subjective health. This suggests that increased utilization of positive religious coping skills, as represented by a higher positive religious coping score, is correlated with improved overall health (and vice-versa regarding negative religious coping). Although these correlations reduce the complex relationship between religious coping and health to a simple binary, the findings remain important, as they underscore the role of religious coping in health outcomes. Notably, given the cross-sectional nature of the study, causality cannot be inferred. It is possible that individuals with better subjective health are more likely to engage in positive religious coping, rather than religious coping directly influencing health outcomes.

This finding also echoes prior research conducted among American and non-American Muslim populations globally. Whereas other studies compared religious coping with specific health concerns such as depression (Thomas & Barbato, 2020), life satisfaction and affect (Abu-Raiya & Jamal, 2021), perceived stress (Mahamid & Bdier, 2021), and anxiety (Ahmad et al., 2023), this study is the first to explore the association between religious coping and overall self-rated health status in this population. Although a subjective measure, self-rated health status is an independent predictor of mortality and may represent a combination of physical and mental health status.

While one may speculate that both ethnicity and immigration status would impact any associations between religious coping and subjective health, the findings presented a different narrative. This study revealed a consistent association between religious coping and overall subjective health across diverse ethnicities and immigration statuses within the Muslim American community. These findings differ from prior research, which had indicated differences in the strength of correlation between religious coping and life satisfaction across various ethnicities within a multinational Muslim sample (Abu-Raiya et al., 2019). Moreover, this study did not find significant differences in reported health outcomes based on ethnicity.

Taken together, these findings suggest that the Muslim American experience may transcend sociocultural differences and even differences in religiosity. Despite the undeniable diversity of the Muslim American population, the findings suggest that the role of religious coping on health outcomes may be heavily influenced by the unique social, cultural, economic, and political landscape that characterizes Muslim communities in the US. It also underscores the necessity for further exploration into the role of religious coping among Muslim Americans in particular.

The findings are also consistent with previous literature that has demonstrated that positive religious coping is positively correlated with life satisfaction within the Muslim population (Abu-Raiya et al., 2020; Abu-Raiya & Jamal, 2021). However, unlike studies assessing overall life satisfaction, studies exploring the relationship between positive religious coping and mental health outcomes such as depression and PTSD have yielded mixed results (Abu-Raiya et al., 2020; Areba et al., 2018; Berzengi et al., 2017; Thomas & Barbato, 2020). The relationship between positive religious coping and various health outcomes is multifaceted and often linked to various elements intrinsic to religious beliefs and practices.

Notably, religious convictions imbue life with a sense of purpose and meaning, fostering fulfillment and life satisfaction (French & Joseph, 1999; Pargament et al., 2000). Similarly, religious practices, such as prayer, are associated with stress reduction and increased mindfulness, contributing to a calmer demeanor (Ano & Vasconcelles, 2005). Moreover, the communal aspect of religion cultivates a sense of belonging, reducing feelings of isolation and enhancing social connections within communities (Koenig et al., 1998). Additionally, religious beliefs and practices often nurture hope, gratitude, and forgiveness, thereby bolstering emotional well-being and resilience (Pargament et al., 1998).

In summary, positive religious coping may enhance overall health outcomes by influencing an individual’s purpose, social integration, mindfulness, and emotional resilience—all elements fostered through religious beliefs and practices. This suggests that the positive impact of religious coping on subjective health could be mediated by these factors. However, it is crucial to consider that positive religious coping might predominantly influence subjective well-being rather than objectively defined mental health conditions such as depression, as observed in prior research. In line with this idea, prior research has suggested that the most significant impacts of positive religious coping tend to emerge when utilizing assessments focusing on positively framed items, such as post-traumatic growth or spiritual advancement, as they tend to intercorrelate more strongly (Berzengi et al., 2017; Gall & Guirguis-Younger, 2013). Thus, while positive religious coping likely plays a vital role in nurturing subjective well-being, its impact might be primarily associated with the subjective sense of well-being rather than clinical mental health conditions.

In contrast to the positive correlation established between positive religious coping and enhanced subjective health, the findings consistently align with existing literature regarding the inverse relationship observed with negative religious coping. Most available data on negative religious coping revolves around mental health outcomes, particularly depressive symptoms, demonstrating associations between negative religious coping and decreased life satisfaction, increased depressive symptoms, and negative affect (Abu-Raiya et al., 2020; Abu-Raiya & Jamal, 2021; Areba et al., 2018). One possible explanation is that negative religious coping often magnifies distressing elements within religious contexts, potentially leading to a diminished sense of purpose and meaning in life, increased stress, decreased mindfulness, a sense of isolation, and a lack of emotional resilience. Consequently, the findings suggest that negative religious coping is associated with poorer overall subjective health, echoing the adverse effects witnessed in mental health outcomes and other subjective measures of well-being.

This study also revealed a nuanced relationship between gender, religious coping, and subjective health. Although women reported higher positive religious coping and lower negative religious coping than men, men rated their subjective health more favorably and had 1.56 times higher odds of reporting higher subjective health. This paradox is not entirely unexpected. For instance, a study from Pakistan during the COVID-19 pandemic found that women reported significantly higher religious coping than men. The authors attributed this to gendered social norms and caregiving responsibilities that may heighten stress and reliance on faith-based coping strategies (Ahmad & Jafree, 2023). This finding suggests that women are more likely to turn to religion as a coping mechanism, yet this may coexist with greater emotional or caregiving burdens that negatively influence self-rated health.

One possible mechanism is that women may feel more secure to express distress in religious or spiritual terms, using their faith as an emotional outlet. Based on prior literature, women often see religion as a “relationship with God,” whereas men may perceive religion more as a belief system or rules, which may shape how coping is internalized and expressed (Rassoulian et al., 2021).

Additionally, in a study on gender and self-rated health, women were somewhat less likely to rate their health as “excellent or very good” than men, even after accounting for objective health differences, suggesting that women may incorporate broader psychosocial and emotional factors into their health self-assessment (Zajacova et al., 2017). Overall, although women engage in more positive religious coping, higher exposure to stressors, along with a broader interpretive lens for health, may blunt the observable benefit of coping on their subjective health.

This study presents several strengths, notably being the first to establish a relationship between positive and negative religious coping and subjective health among Muslim Americans. The use of a validated religious coping scale tailored to the Muslim population adds credibility. Additionally, the study sample’s immigration status distribution and mean age were comparable to those of the broader US Muslim population (Pew Research Center, 2017), contributing to its representativeness.

While this study provides valuable insights, it has its limitations as a survey-based cross-sectional study. Participant recruitment was limited by the COVID-19 pandemic, and the English-only survey targeted English-literate Muslims in large communities, potentially underrepresenting those with lower English literacy or those living in smaller or rural areas. The sample demographics also show discrepancies compared to the broader US Muslim population, with an overrepresentation of Asians (38.2%) and females (68%), and an underrepresentation of Black Muslims (8.6%), which impacts generalizability (Pew Research Center, 2017).

The survey-based data introduces response biases, such as recency bias in self-reported health and the potential for bias in labeling coping strategies as positive or negative. Additionally, while the coping scale is tailored to Muslims, it may not encompass all coping strategies, limiting measurement accuracy.

Although exploratory in nature, the study is the first to examine the relationship between positive and negative religious coping and overall subjective health status in a national sample of Muslim Americans, utilizing a validated and peer-reviewed religious coping scale tailored to the Muslim population. Additionally, the results indicate a prevalence of positive religious coping among Muslim Americans, which is significantly associated with enhanced subjective health across diverse ethnic groups (Brewer et al., 2015; Falb & Pargament, 2013; Holt et al., 2014; Thomas & Barbato, 2020). Contrastingly, the results also demonstrate the inverse relationship between negative religious coping and subjective health perception in the sample. While the present study is the first to corroborate these associations among Muslim Americans, further research is needed to understand the mechanisms through which both positive and negative religious coping operate to influence overall health indirectly and directly. A more focused exploration can shed light on the interplay of these mechanisms in affecting various facets of health, encompassing psychological, social, and cultural dimensions, to offer a more comprehensive understanding of their effects.

Given that our study shows a significant association between both positive and negative religious coping and subjective health, and prior studies have found that Muslims are more likely to engage with religion as a coping mechanism for stress relative to other religious groups (Adam & Ward, 2016), there are substantial implications for healthcare practitioners and healthcare systems providing care to Muslim Americans. Conducting spiritual assessments and inquiring about religious practices, beliefs, and coping mechanisms for Muslim patients can serve as a starting point to understanding how religion might influence a patient’s overall well-being. Additionally, the present study may have implications for considering religious coping practices when designing interventions to support Muslim American patients. For example, healthcare systems can strive to foster environments that respect and facilitate religious practices, such as providing patients with private spaces for religious observations. Further research that dives deep into the mechanisms through which religious coping influences subjective health can provide a foundation for targeted treatment and intervention toward various physical and mental health challenges.

Despite its limitations, this study presents foundational insights into the relationship between religious coping and subjective health among Muslim Americans. Limitations related to sample demographics emphasize the need for caution when generalizing these findings to the broader US Muslim population. However, future research with more demographically representative samples would likely address these limitations and help expand upon this study’s preliminary findings. Additionally, utilizing measures such as objective health indicators would enhance the comprehensiveness and validity of future studies. However, the evidence proposed in our study will open the door for further research addressing the direct impacts of the lived Muslim American experience on their overall health and well-being.