Theologists, scientists and thought leaders have attempted for centuries to understand the impact that religion can have on human beings; both mentally and physically. And it is commonly accepted around that world that religion and spirituality are among the most important of cultural factors – giving structure and meaning to behaviors, value systems and experiences.
Thus, there is ample reason to believe that faith in a higher power is associated with health, and in a positive way. For example, researchers at the Mayo Clinic concluded, “Most studies have shown that religious involvement and spirituality are associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness) and less anxiety, depression, and suicide. Several studies have shown that addressing the spiritual needs of the patient may enhance recovery from illness.”
Which is why it is surprising in 2019 that there is still little quantitative research published in peer-reviewed journals exploring the relationship between spirituality, religiosity and health. A primary reason for the lack of institutional knowledge in this area of study is that as the centuries have progressed, scholars in fields of medicine, public health, psychology, sociology, spirituality, religion, economics and law, have all gone to distinct silos. Subsequently, there is a growing body of research, but it exists in disparate fields, with little overlap addressing the implications of health and health care. There is also much contention about working definitions of terms like “religious” and “spiritual,” making research difficult to standardize and impossible to randomize.
That said, the lack of knowledge linking religious behaviors and health is fascinating given that health care is deeply rooted in religious institutions, and vice versa. In fact, it was religious organizations that built many of the first hospitals, and clergy (supplementing low church wages) were often practicing physicians and medical providers. This was true both in the Middle East and in the American colonies, and included much focus on mental health services – with both positive and negative recorded histories.
However, as time passed, the link between religion and health care has slowly fallen to the wayside in favor of strict clinical practices and medical protocols. Despite multiple studies over the last several decades concluding that those who are religiously involved live longer, and that many patients welcome spiritual beliefs into their care, this is no longer the norm in America. But given how much we are learning about the influence social-emotional aspects of life can have on overall health, religious beliefs and activities should be an area of intense focus for the medical research community.
In an exploration to better understand the role that spirituality and religion play in health and care, a few key themes appeared across the various disciplines. Some of the most interesting include:
- 80% of research on spirituality/religiousness and health focuses on mental health. This is because most associations with faith are related to how one thinks about the world and their role in it. Words that are often associated with religious beliefs include connectedness, hope, optimism, trust and purpose. All of which have been shown to boost mental health. Compassion, forgiveness and gratefulness are also qualities that are strongly associated with individuals who are spiritual and religious. Practicing these qualities is thought to be associated with deceased stress and increased resiliency.
- Interestingly, although religion and spirituality correlate to an external locus of control (God as a higher power in control of our destiny), most research concludes that those who are religious have a strong internal sense of control. Dr. Harold Koenig of Duke University contends that as people pray, and ask God for guidance, they feel a sense of control over their own situation, helping them cope with depression and anxiety.
- Fear that one is being punished or abandoned by God in the face of medical problems exists for some. These negative thoughts associated with religion can be linked to higher rates of depression and lower quality of life. Additional stress in these cases can also be harmful to mental health.
- While mental and physical health are intricately intertwined, the physical manifestations of spirituality and religious beliefs are indirect. What this means is that our belief system drives the way we think and behave, which in turn impact our health-related actions. For example, people with greater depression and anxiety have more physical health problems. In turn, worse mental health and physical health lead to lower quality of life and a shorter life expectancy.
- Caring for one’s physical body is emphasized in many faiths, including Judeo-Christianity. This leads many individuals to actually take better care of their bodies by abstaining from drinking, prioritizing meditation or not partaking in activities that have negative consequences on the body.
- There is a chasm between doctors and patients. A 2018 survey of American physicians and patients suggests that about 64% of physicians believe in the existence of God or a higher power, and more than 90% of patients claimed the same. This is consistent with a Pew study which concluded that about 90% of Americans believe in a higher power. In contrast 25% of physicians reported uncertainty in their beliefs.
- While many in the medical community may think it inappropriate to ask patients about beliefs and faith, patients disagree. One study concluded that 77% of patients thought physicians should consider patients’ spiritual needs. More specifically, 48% welcomed or desired that their physicians pray with them, and another 37% wanted physicians to discuss religious beliefs with them. Despite these desires, the same study found that almost 70% of patients claimed their physician had never broached the topic of religion with them.
Existential questions that cannot be answered by medical professionals often accompany seeking medical care. This is particularly true for those with more traumatic or chronic conditions. Thus, when seeking answers to questions such as, “Why me?” or “What is the meaning of this?” people often look outside traditional health care settings – including religion – to find answers. So it is natural behavior for humans to turn to faith and belief systems when touching the health care system.
Now we just need the care system and the research community to integrate the growing body of knowledge into the patient experience and continuum of care.