Prescription: God spirituality: does what you believe affect how fast you heal?

IS SPIRITUALITY GOOD FOR YOUR HEALTH?" The question hangs in the auditorium air as Stephen E. Straus, M.D., director of the National Center for Complementary and Alternative Medicine (NCCAM), looks out over the Christian clergy and local seminary students assembled at the National Institutes of Health (NIH) campus hospital in Bethesda, Maryland. "Does spirituality have a medicinal value alternative to normative procedures?" he continues. "Can we live longer and get better more quickly?"

Harvard University's Anne Harrington, Ph.D., distinguished lecturer for the NCCAM, takes her place behind the podium and begins her response to those questions by pointing to a chart indicating prayer as the number one practice among more than 31,000 adults the center surveyed. Forty-three percent of those polled said that they prayed for their own health, and 24 percent prayed for others as well.

The results of that survey led to federal funding of five NIH studies on prayer, spirituality, and healing. Researchers knew that patients prayed. They wanted to know how and why that simple practice enhanced their health.

Godless Exam Rooms

Christian spirituality--as defined by the studies--is the belief an individual has in one God. While 67 percent of doctors surveyed professed a belief in God and 95 percent felt that a patient's spiritual outlook was important to handling health difficulties, less than 20 percent of all patient visits included spiritual factors.

Practitioners felt that lack of time was an important barrier to addressing those elements in their patients' diagnoses. However, a majority stated that proper training in how to manage such issues could overcome those barriers and improve their ability to more fully respond to a patient's spiritual requirements.

To help bridge the gap between patient and health-care provider, the NCCAM defines prayer as "an active process of appealing to a higher spiritual power, specifically for health reasons," and includes individual or group prayer on behalf of one's self or others. The term spirituality is broader, defined as "an individual's sense of purpose and meaning in life beyond material values, including religion."

At Johns Hopkins University's Department of Managed Care in Baltimore, Maryland, clinicians measured the spiritual pulse of patients in order to identify perceived barriers to integrating spirituality into their care. They discovered that 90 percent of adults believe in God, 82 percent pray weekly, and a majority want their physicians to address spirituality during a health-care visit.

Dr. Harrington cites that, within the past five years, 70 medical schools have begun offering courses in spirituality and health. With proper post-doctoral medical education training, physicians are learning to gather not only a patient's medical and family health history during an examination, but their spiritual history as well.

Studies have shown that attending church is good for the immune system and allows changes in brain chemicals that "kick-start" many health practices. Increasing scientific research also suggests that not only are religion and spirituality connected directly to mental and physical health, but they also can play a powerful role in the medical treatment of patients with severe chronic illnesses.

Warming to her subject, Dr. Harrington goes on to explain that "Presently, we're dealing with spirituality on a cultural level. Medicine will be better off when we start dealing with spirituality on an ethical level." She adds that patients' immune systems are crying out for spirituality. But doctors can't hear spirituality on their stethoscopes, and therefore, many don't consider it to be medically curative. Harrington declares that an ethical and moral agenda--instead of a purely scientific agenda--should be adhered to by health-care providers.

NCCAM's future studies will also evaluate the curative effects of contemplation, meditation, and faith.

Making the Connection

When frightened or concerned about their health, most people turn to their main source of strength. They don't wait until scientific research creates a framework built on what other people believe. Harrington cites the Seventh-day Adventist Church as being known for the health benefits associated with a vegetarian diet and a strong sense of community--faith elements not always shared by other religions.

North Carolina's Duke University researchers found that when organized religious activities were included in a patient's care, his or her acute-care hospitalization stay was shorter. The robust and persistent effects of religiousness and/or spirituality in long-term health care were well documented as particularly beneficial among African-Americans and women over 50.

Children represent another area of consideration. With the rapidly increasing use of complementary therapies, North Carolina's Wake Forest University School of Medicine researchers also discovered an improved effectiveness in clinical practice and enriched, deepened pediatric patient response during clinical care. The cases, reported in a clinical pediatric journal, supported the use of spirituality-based role-playing and personal reflection in complementary medicine.

Evidence of Faith

The interest in the possibility that religious and spiritual activity may confer health benefits is increasing. A Columbia-Presbyterian Medical Center director of behavioral medicine feels it's important to conduct clinical trials in order to provide the scientific basis that will allow physicians to make recommendations such as "attend religious services" along with their regular medical treatment.

Dr. Harrington provides a poignant example correlating increased longevity with church attendance within an almost entirely Italian-American tightly knit community in Roseto, Pennsylvania. In the years following World War II, the members of this community boasted the lowest heart-disease rates in the entire United States. An earlier eight-year study found the average life span was 83.

Cardiac mortality in Roseto hovered near zero in men 55 to 64, half the national average in spite of high levels of obesity and other lifestyle risk factors. This led researchers to write about the role of faith and belief in stimulating the ability to heal. The community's spiritual integrity included faith that God could see them through any surgery. Twenty years after the initial Roseto coronary artery disease study, the same spiritual philosophy was being confirmed in other studies.

However, after 30 years had passed, Roseto residents' values and goals were becoming more in line with the more materialistic views held by the residents of nearby Bangor. The death rate from myocardial infarctions (heart attacks) increased to equal that of their less spiritually inclined neighbors. A 50-year Roseto-Bangor comparison completed by nearby Bethlehem, Pennsylvania's Lehigh University, found that the mortality rate increase experienced by the Rosetans was owing to a larger number of younger men and elderly women in the community. The "Americanization" of Roseto, with its reduced solidarity and church attendance, created the matched mortality between these two originally diverse communities.

Texas researchers, in reviewing a national health interview survey on multiple causes of death and its relationship with religious attendance, found that people who never attended church had a 1.87 times higher risk of death than those who attended more than once a week. Nonattendance increased the likelihood of: being unhealthy, having a reduced life expectancy of seven years when compared with churchgoers, and dying. Five years after their published study, additional researchers were confirming that religious involvement is linked to mortality risks. The evidence was strongest for public religious activity and the weakest for private religious activity.

Therapeutic Benefits of Prayer

A San Francisco intercessory prayer (IP) group focused on 192 hospitalized Christian coronary care individuals and compared the results with 201 individuals in a control group without IP. During the 10-month study, members of the IP group experienced a significantly lower severity during their hospitalization; while those in the control group required ventilatory assistance, antibiotics, and diuretic medication more frequently. The collected data suggests that prayer to a Christian God--one of the oldest forms of therapy--produces definite therapeutic benefits. The study also acknowledges that little attention is being devoted to these benefits in modern medical literature.

Harvard Medical School researchers, knowing that prayer is common in the U.S., conducted a national survey of 2,055 individuals in 1998 to determine prayer's prevalence and patterns. They discovered that 35 percent of those surveyed prayed for health concerns, 75 percent went to God concerning their overall wellness, and 22 percent petitioned for specific concerns. While 69 percent found prayer "very helpful," only 11 percent discussed this with their physician.

The Answer Is Yes

Dr. Harrington concludes her remarks at the NIH campus hospital auditorium by saying that multisite national researchers have found that patients experience significant improvement in disease-fighting antibodies after participating in a mindful meditation program. Spirituality and emotional well-being also allowed for alterations in brain structure and immune system functioning. NCCAM-supported researchers report that there is a small but growing body of literature linking faith in God with enhanced health and healing.

Is spirituality good for your health? In study after study, science is uncovering irrefutable evidence to support what people of faith have known for a long, long time.

Barbara Anan Kogan, O.D. (known to her friends as "Beltway Barb"), writes on health topics from her home in Washington, D.C.