Having a monk in the family and all-cause mortality: a seven-year prospective cohort study.

Religious celibate monks at the household level possibly reduce all-cause mortality risk among non-monk older Tibetans. This study aims to investigate the association between having a celibate monk in a family and the all-cause mortality of non-monk household members in a Tibetan population. Baseline interviews were conducted for 713 agropastoral Amdo Tibetans aged ≥50 years residing in the eastern Tibetan Plateau from 2016 to 2017. The Cox mixed-effects regression model was used to estimate the association between having a celibate monk in a household and the mortality risk of other non-monk household members. Potential confounders included age, sex, household size, educational attainment, household wealth (measured as the number of yaks), marital status, and annual expenditure. During a median follow-up of 7 years, 54 deaths were identified. The results showed that people living in households with celibate monks had a lower risk of all-cause mortality (hazard ratio: 0.31, 95% confidence interval: 0.14, 0.67) as compared with those living in households without celibate monks. The results remained robust after controlling for confounders, suggesting that religious celibate monks at the household level were associated with lower all-cause mortality among non-monk older household members.