Religiousness/spirituality (R/S) and physical health are clearly linked (Oman & Thoresen, 2005). Many pathways of influence have been proposed (e.g., Park, 2007), but little research has established the actual physiological pathways through which R/S influences physical health. The proposed project will examine the impact of multiple dimensions of R/S on biomarkers of cardiac functioning and mortality. We propose to collect additional data in an existing NIA-funded study of R/S and quality of life in 175 congestive heart failure patients by including a new module to access biomedical data, including inflammation markers, ejection fractions, cardiac enzymes, and mortality. By tracing the pathways through which multiple dimensions of R/S exert their impact, this project will address all three of the -big questions- stated in this RFA: (1) Does spirituality need to include a religious component for it to have a beneficial impact on health? (2) Can religious involvement affect the aging process, and if so, how? and (3) What kinds of spirituality reduce mortality? Our expected outcomes are multiple presentations and publications regarding the new knowledge we will develop on the pathways through which different aspects of R/S affect cardiac health, aging and mortality. We expect that this research endeavor will make an enduring impact on the fields of behavioral medicine and health psychology.