Religion & health: a dose of spirituality can be good for your body.

Are religious people healthier than their unbelieving neighbors? Yes, according to research by the National Institute for Health Care Research (NIHR). This nonprofit agency headed by Dr. David Larson has funded numerous studies examining the role of spirituality in health and healing. Their research confirmed that both mentally and physically, religious people enjoy better health than their nonreligious friends.

For centuries the line between faith and science has been carefully drawn. The study of natural and explicable phenomena belonged to science. The unexplained remained in the religious realm. Society maintained a mysterious taboo against bringing the two together, especially within the practice of medicine.

But many in the medical profession are now beginning to discover that health is far more than a physical matter. It involves body, mind, and more.

According to the latest NIHR survey, approximately 70 U.S. medical schools are addressing spirituality issues in their curricula. Dr. Christina M. Puchalski, assistant professor of medicine at George Washington University School of Medicine and Health Sciences, teaches a course on spirituality and medicine at both George Washington and Georgetown universities. She sees this trend in medical education as a return to wholistic medicine and insists spirituality should be considered as a broad term addressing multiple parts of a person's life and should not be confined to organized religion.

Researching the Relationship

Dr. Jeff Levin, a social epidemiologist and former medical school professor, has been researching the relationship between spirituality and health since the mid-80s. While doing graduate work in public health at the University of North Carolina in Chapel Hill, he discovered an unknown research article that showed that hundreds of adult men who frequently attended church services maintained lower blood pressure than those who didn't attend, even when controlling for age, smoking, and socioeconomic status. Intrigued, he spent nights and weekends for five years searching for more evidence of a religion-and-health effect.

In his recent book, God, Faith, and Health, Levin explains how the health benefits of religious practice can be understood from a physical perspective (i.e., healthy behaviors, such as diet; sexual discretion; and avoidance of tobacco and alcohol). Other benefits that make sense from a psychological point of view include a positive self-image, a sense of purpose in life, and participation in social support groups. Levin explores compelling evidence of the connection between health and an array of spiritual beliefs and practices including prayer, worship services, meditation, and faith in God. He cites examples from traditions as diverse as Christianity, Judaism, and yoga, and looks at the many ways religious involvement can prevent illness and promote health and well-being.

Specific Pathways

One of the first studies to examine the specific pathways by which religion affects health was done by Dr. Harold Koenig, a researcher at Duke University Medical Center. In a study of 1,718 older adults in North Carolina who attended church at least once a week, he found they were only half as likely as nonattendees to have elevated levels of interleukin-6 (IL-6), an immune system protein involved in a wide variety of age-related diseases. It was hypothesized that if religious commitment could reduce stress, it would keep down the production of substances that impair the body's ability to fight disease. One such substance was determined to be IL-6. Dr. Koenig's findings were reported in a 1997 article in the Journal of Psychiatry in Medicine.

Koenig says he has run the numbers and found that religious people spend less time in the hospital, are healthier, recover faster, have fewer heart attacks, and generally handle life's ups and downs in more positive ways. Other studies report that religious people tend to live 30 percent longer and experience better physical and mental health. They also have better marriages, use addictive substances less, and have stronger support systems. Even the skeptics, he says, should pay attention to his latest findings because of the practical results in terms of savings for insurance companies and hospitals. He advises that doctors need to factor in the patient's religious beliefs and use their faith to help them recover.

Higher Levels of Wellness

People of faith consistently exhibit higher levels of mental, physical, and relational wellness according to a study by research psychiatrist Daniel Larson, funded by the NIHR. In the area of psychiatry, 92 percent of the findings showed that religious commitment produced a beneficial effect and that religious people lived longer than non-religious. He also found that smokers who were not religious were "seven times more likely to have elevated blood pressure than those who said religion was important."

A study of elderly women hospitalized with broken hips reported in a 1990 issue of The American Journal of Psychiatry, found that those who were religiously committed were less depressed, had shorter hospital stays, and could walk farther at the time of discharge than those who were not religious.

Controversial Despite Support

The concept of a religion-health connection remains controversial despite the volume of research supporting it. Some physicians and scientists reject it outright.

One of the most frequent objections is that it promotes a sense of failure or guilt in religious people who become sick. They may equate their illness with spiritual failure. Levin is stern with critics and meets this criticism head on. He explains that spirituality does not guarantee good health or increased longevity. "Epidemiology (the study of spread and control of diseases in a population) deals with averages, and average findings tend to hide or obscure the exceptions. Epidemiology is incapable of addressing these issues."

Levin explains that the weight of published evidence overwhelmingly confirms that spiritual life influences health. He explains that the concept of a body-mind-spirit connection is already changing medical practice, medical education, and research. These changes are based on scientific epidemiology and will likely not go away.

An ardent critic of the religion-health connection is Richard P. Sloan, Ph.D., professor in the Department of Psychiatry at Columbia University. Writing in the New England Journal of Medicine, he challenges the validity of the studies that support the religion-health connection model. He also argues against courses in medical schools dedicated solely to issues of spirituality. Decisions about religion are personal and private, he says, and have no place in the physician-patient relationship.

Advocates of the spirituality-health connection agree that physicians should not abuse their position of authority by proselytizing or pushing their own agendas. Obviously, the patient's well-being should always come first.

Predictably, some zealots interpret these findings as an example of divine intervention. Levin rejects this interpretation. However, individual patients will no doubt interpret their own health outcomes as they wish in light of their religious belief or spiritual experience.

Why Religion Makes You Healthier

In his syndicated health column, Dr. Peter Gott quotes an article in the December 1998 issue of Health Education and Behavior that explores a range of explanations for the religion and health relationship.

1. Religious people usually exhibit healthful behavior and make positive lifestyle choices.

2. They benefit from active social support groups within the church.

3. Religious involvement promotes feelings of self-worth and confidence in the ability to control one's own affairs.

4. Prayer and meditation may help people deal with unpleasant situations and avoid or relieve stress and depression.

5. Religious commitment can cause positive emotions that favorably influence the immune system.

6. Faith promotes a positive outlook that enables its believers to better cope with the vicissitudes of life.

Dr. Gott concluded that "spirituality is associated with health benefits, not because of divine intervention but because the various aspects of a religious life promote behavior and attitudes that are healthful."

Nellie Jones writes on health issues from Walls, Mississippi.