Religious Fellowship and Spiritual Support

Religious Fellowship and Spiritual Support

Donna was fourteen years old and lived with her grandmother in a small town in Mississippi. For several years, Donna had been getting into more and more trouble, breaking the law and smoking marijuana, and skipping out on school. Then she became pregnant. Her grandmother was a prayerful woman, but realized that with a baby coming, Donna would soon be more than she could handle. Donna was sent to live with her aunt and uncle and cousins in Jackson.

Donna's relatives were members of the African Methodist Episcopal Church. Her uncle was a building contractor, her aunt was a nurse who helped run a church program that screened at-risk members for high blood pressure and diabetes once a month, and her three cousins were active in youth groups. One of them sang in the choir. From the day Donna moved in, it was made quite clear that she would attend church and take part in church activities. She was annoyed at first, but her aunt and uncle never left any room for doubt that they loved her unconditionally, and never once spoke a word in judgment of her pregnancy or other troubles.

A funny thing happened. Donna spent so much time in church—twice a week, typically—and felt so much pressure to do her homework and complete her chores, that she stopped getting into trouble. She did not have the time. Plus, with her baby due after the end of the school year, she had to start taking better care of herself. Her aunt made sure of that.

Right before her baby was born, Donna began to notice a change in her heart as well. She realized that she soon would have responsibility for another life, and this encouraged her to take more responsibility for herself and to think about her future. She also started enjoying church, and often went of her own accord to take part in after-school church activities. One Sunday morning during services, she accepted Jesus as her Lord and Savior.

By the time she got her diploma three years later, Donna had matured into a responsible young mother. She planned to go to the local community college and study to become a nurse, just like her aunt. Donna would tell anyone who asked that she owed everything to the love she had received from her family and from Christ and her church.

Going to church had benefited Donna's life in tangible ways as well. She had made many wonderful friends through her congregation, and the fellowship she shared with them made her feel accepted. Every other week, she and some of her friends would get together for Bible study with the assistant minister. If she needed to take her baby to the doctor and her aunt was at work, one of them or one of the church ladies would drive her. She also took part in a well-baby program at church, both as a client and a volunteer, and gave her time to another church program by talking to other teenagers about drugs and alcohol.

Donna especially loved the pastor's weekly sermons. She would always leave church inspired. The pastor was a wonderful man who had been over for dinner at her aunt and uncle's house many times. He always had the same message for Donna. He taught her that God cared about what happened to her and her baby and had a plan for their lives. He never ceased to remind her that there was something uniquely special for the Kingdom of God that only Donna and her baby could contribute. Every time he told her that, Donna would become so overcome by emotion that she could barely get out a "thank you."

Today Donna is in her late twenties. She is married and has two more children. She and her husband moved to Georgia, where she works part-time as a nurse. Donna volunteers for a church-based screening program that she co-founded, much like the one her aunt worked at in Mississippi. Neither she nor her husband uses cigarettes or alcohol, and their children are being raised in the church. She laughs sometimes when she thinks that she has become just as clean-living and wholesome as the nice church ladies she remembers as a teenager. She imagines that if her fourteen-year-old self could meet her current self, she would think she had gone crazy. That image always makes her smile.

Most Americans affiliate themselves with a religion or religious denomination and many agree, at least in principle, with the beliefs espoused by their particular faith tradition. As we saw in the last chapter, religious affiliation has a definite impact on health. When we identify with a particular faith or become a member of a religious institution, we are exposed to positive health-related messages and to a community of believers who may encourage us in our efforts to live by the tenets of our faith. In this way, religious affiliation can influence us to engage in healthy behaviors and lifestyle practices that reduce our risk of illness and promote greater health and well-being.

But just saying we belong to a religious group is not the same as actually being involved in religion. While most Americans report a religious affiliation, fewer actually participate in organized religious activities such as regularly attending worship services at church or synagogue. National surveys consistently report that just over forty percent of adults attend religious services at least weekly. These numbers have not changed much for decades, and may be declining somewhat. Recent evidence suggests that this level of attendance may even be exaggerated to no small extent. One authoritative study compared people's reports of religious attendance in national surveys with actual counts of people attending a representative sample of Protestant and Catholic churches. The researchers concluded that real levels of weekly attendance are approximately one-half of those reported in surveys.

Whether forty percent or twenty percent or some proportion in between, far fewer adult Americans are frequent participants in organized religious activities than are affiliated with a religion. Does regular involvement with church or synagogue, or other organized spiritual pursuits, have additional health implications above and beyond the beneficial effects of religious affiliation? The answer is a resounding yes.

Dozens of published studies have revealed numerous positive effects that frequent attendance at religious services consistently has on health. The salutary effect of regular religious attendance is even more striking than the link between religious affiliation and lower rates of illness. Like the data on affiliation reviewed in the previous chapter, studies of regular participation represent a largely unpublicized treasure trove of information, unfamiliar to most physicians and medical scientists. Until recently, these findings were not taught to medical students or residents, and have not been the stuff of continuing medical education or medical board exams. But the effect is as consistent and persuasive as for any important epidemiologic variable.

Is Frequent Religious Attendance Conducive to Better Health?

Back in my days as a graduate student at the University of Texas Medical Branch in the mid-1980s, my research on religious factors in health began to attract the attention of the hospital chaplains. A blurb in the campus newspaper about one of my studies caught the eye of the person in charge of the chaplains' biweekly noon seminar series. I was invited to address an audience of mostly ministers, priests, and nuns. The talk went well, but more significantly, I had the good fortune to meet someone with whom I would collaborate frequently over the next several years. Dr. Harold Y. Vanderpool, Harvard-trained bioethicist, medical historian, religious scholar, and professor of medical humanities, having no other lunch plans that day, decided to walk over to hear my presentation, which he saw advertised in a medical school flyer.

After my talk, Dr. Vanderpool introduced himself, and we hit it off immediately. I made an appointment to visit him in his office, and so began a relationship that was responsible, among other things, for the theoretical model of how religion relates to health that is the basis for this book. He informed me that while religion may be an obscure topic of research within the field of medicine, within the field of religious studies there has been a long-standing tradition of scholarly writing on health and medicine. Dr. Vanderpool, it turned out, was one of the premier authorities in the world.

I told Dr. Vanderpool of my efforts at the time to track down all of the published studies of religious differences in rates of morbidity and mortality. He was especially interested when I mentioned that along the way, I had also found more than two dozen studies that had examined how the frequency of attendance at religious services affected health. He believed that this material merited its own summary, and we quickly decided to write a detailed review article on the topic. It is one thing, he noted, to report that rates of health and illness vary across religious denominations. It would be quite another to provide evidence that regular attendance at services-a marker of actually practicing and not just professing religion-is beneficial for health.

By the time we completed our review, we had found a total of twenty-seven studies that examined the health effects of the frequency of attendance at religious services. Of these studies, twenty-two reported a statistically significant, positive association between religious attendance and health. That is, the more frequently one attended religious services, the lower the rate of whatever disease was being studied, or the higher the self-rating of health. These results were electrifying; we had no idea they would be so consistent.

The positive link between religious attendance and health persisted regardless of the particular illness or health condition examined in different studies. This mirrored the pattern that we found when examining the health effects of religious affiliation. We identified studies reporting beneficial effects of frequent attendance on all sorts of health and illness measures: atherosclerotic and degenerative heart disease deaths, cervical cancer incidence, cardiovascular pattern, depression, hypertension, neonatal mortality, Pap smear results, self-rated health, suicide symptoms, total mortality, trichomoniasis prevalence, and tuberculosis case rate.