Research in some religious countries shows that religiosity and spirituality positively affect adolescent health. We studied whether religiosity and spirituality also have positive associations with adolescent health in a secular country. We tested the associations between religious attendance and spirituality and self-reported health and health complaints using a representative sample of Czech adolescents (n = 4182, 14.4 ± 1.1 years, 48.6% boys) from the 2014 health behavior in school-aged children (HBSC) study. We used religious attendance, the adjusted shortened version of the spiritual well-being scale (SWBS), and its two components-religious well-being (RWB) and existential well-being (EWB)-as independent variables and the eight item "HBSC symptom checklist" and self-reported overall health as dependent variables. A higher level of spirituality was associated with lower chances of health complaints and self-reported health, ranging from a 9% to 30% decrease in odd ratios (OR). Religious attendance was not associated with any of the observed variables. The EWB showed a negative association with all of the observed variables, with associations ranging from a 19% to 47% decrease. The RWB was associated with a higher risk of nervousness (OR = 1.12), while other associations were not significant. Non-spiritual but attending respondents were more likely to report a higher occurrence of stomachache (OR = 2.20) and had significantly worse overall health (OR = 2.38). In a largely secular country, we found that spirituality and the EWB (unlike religious attendance and the RWB) could have a significant influence on adolescent health.

Department of Community and Occupational Medicine University Medical Center Groningen University of Groningen 9713 AV Groningen The Netherlands

Department of Recreation and Leisure Studies Faculty of Physical Culture Palacky University in Olomouc 771 11 Olomouc Czech

Graduate School Kosice Institute for Society and Health P J Safarik University in Kosice 040 11 Kosice Slovak

Institute of Psychology Czech Academy of Science 11000 Prague Czech

Olomouc University Social Health Institute Palacky University Olomouc 771 11 Olomouc Czech

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