CBHD: Spirituality, Moral Choices, and Health by David P. Gushee

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	David P. Gushee, PhD is the Graves Professor of Moral Philosophy and Senior Fellow of the Carl F. H. Henry Center for Christian Leadership at Union University.
	Post Date: September 1, 2004

Introduction

A growing body of research documents the connections between spirituality, moral choices, and human health. While much of this literature is not written from a Christian worldview, in general its conclusions provide striking confirmation of Christian beliefs and values. This issue overview will discuss briefly some of this research and point to ways in which it connects to biblical thought.

A. The Relationship Between Bad Choices and Health

A number of studies in both technical and popular journals note the many connections between unwise or dangerous human choices and negative health consequences. This research usually laments these bad choices and discusses the difficulty in getting people to develop new patterns while proposing various strategies for affecting behavior.

For example, in a 2003 US News & World Report article about risk factors for heart disease, Avery Comarow reviews the four most widely recognized factors: cholesterol, high blood pressure, smoking, and diabetes. While the author acknowledges that some at-risk patients never get heart disease, and some low-risk patients do, the evidence remains strong that these recognized risks are real and must be addressed. But how to change the behavior that leads to them, in the face of entrenched bad habits? One doctor says: “What doctors in primary care are looking for is a wedge, a lever. You sometimes feel so desperate—Twinkies taste good; it’s hard to stop smoking. We have to get people’s attention.”¹ The article goes on to advise the general reader to do what general readers are always advised to do: shed a few pounds, exercise, alter dietary choices. It doesn’t say, but only implies, that such actions are precisely the opposite of the trend in American life at this time.

B. The Relationship Between Mind/Spirit and Body

In a 2001 article in Nutrition in Clinical Care, Susan Slager Johnson and Robert F. Kushner argue from a variety of technical studies that: “Mind and emotions directly affect health and disease. A thought or emotion can manifest itself bodily; conversely, a bodily process can translate itself into a thought or an emotion.”² They support this claim with research studies from the field of psychoneuroimmunology, tracing their work back to a landmark research study by Robert Ader in 1975. They claim that reciprocal relationships have been identified between “neuroendocrinological and immune function and psychosocial behavior and immune function.” They confirm that stress affects immune system functioning negatively, while relaxation affects it positively. Thus, they review a variety of treatment options designed to address the psychological/emotional factors affecting health.

C. The Relationship Between Church Attendance, Faith Practices, and Good Health

In a much-publicized 2001 book, Harold Koenig of Duke University argues that church attendance, various religious practices, and good health are correlated. He reports on a six-year Duke study of 4,000 people over age 64 that found that frequent attendance in religious services was correlated with a lower risk of dying, lower blood pressure, and healthier immune systems. He also claims that prayer “boosts morale, lowers agitation, loneliness, and life dissatisfaction and enhances the ability to cope.”³

Dozens of other studies report similar results. A Dartmouth Medical Center study found that one of the best survival predictors among 232 heart surgery patients was “the degree to which they drew comfort and strength from religious faith and prayer.” A study of AIDS patients at the University of Miami linked long-term survival to prayer and volunteering. Andy Newberg, a physician at the University of Pennsylvania, has documented changes in blood flow in the brain during prayer and meditation.⁴ A study of over 4,500 young adults in four cities found that young adults who attend religious services have lower rates of current and subsequent cigarette smoking.⁵ Two-dozen studies have found an association between attendance at religious services and lower all-cause mortality.⁶ Other studies have shown a variety of positive connections between spirituality and the prevention of illness, recovery from illness, and coping during illness.⁷ Likewise, at least two studies have found the inverse; limited social support or religious involvement surface as risk factors for colon cancer and death after cardiac surgery, respectively.⁸

In perhaps the most striking and significant finding of all, “an eight-year follow up of more than 20,000 adults representative of the U.S. population…found a life expectancy gap of over seven years between persons never attending [religious] services and those attending more than once weekly.”⁹

A humanist skeptic named Timothy Lutero, responding to this flurry of claims, argued in a March 2003 article that the real link is between meaningful participation in community rather than in religious community per se. Citing an unpublished study conducted by John Drury at the University of Sussex, Lutero argued that while religion may or may not be good for you, community certainly is. Thus, the key is to get involved in “almost any group of people with a common interest that is acting to improve a community.”¹⁰ On either view, the role of community is stressed.

D. The Relationship Between Spirituality (as Transcendence, Values, and Community) and Health

Wrestling with the vagueness she finds in the increasingly vast spirituality and health literature, Joanne Coyle, a European researcher, has argued effectively for a conceptual framework that can help clarify the various murky meanings of “spirituality” in the spirituality/health literature—as well as the particular health benefits such spirituality provides.

Her first category sees spirituality as the experience of transcendence, both in terms of a transpersonal connectedness to God or a higher power, and an intrapersonal development of the self. The second approach, “value-guidance,” defines spirituality as connectedness to values, principles, and beliefs that enable people to find meaning and purpose in life and in the face of illness, regardless of whether these are explicitly religious in orientation. The third approach, the “structural-behaviourist,” understands spirituality to mean the practices associated with an organized community of faith, such as social support, prayer, church attendance, and so on.¹¹ A rather similar typology offered by Doug Oman and Carl Thoresen includes health behaviors, social supports, and psychological states, and a fourth factor, intercessory prayer. Empirical evidence for this last factor is less compelling at this time and will not be considered here.¹²

We can adapt Coyle’s second category just a bit and elaborate the three approaches in this way. Spirituality as transcendence aids health by connecting persons to the divine and/or to their own highest potential. This provides psychological/emotional/cognitive states rich with meaning, purpose, certainty, trust, motivation, serenity, and hope, all of which enhance health. Spirituality as value guidance aids health by establishing and motivating rules, principles, and goals for people that effect their behavior in health-enhancing ways. Finally, spirituality at the structural-behaviourist level aids health by connecting people to religious communities whose practices provide structure to life and offer meaningful personal support, including the support offered and received in the form of prayer. Coyle emphasizes that in each case spirituality provides not just a way of looking at illness but also motivation for particular behaviors that are proving to be health-enhancing, such as prayer, wise lifestyle choices, and serving others.¹³

E. Connections to Scripture and Christian Tradition

A Christian newcomer to this literature has little difficulty in finding confirmation of essential convictions of the historic Christian tradition, to wit:

*The relationship between moral choices and health. The Bible teaches that sin has negative consequences for the entire human person (and human family), that disordered loves and destructive habits can develop in people’s lives that reflect a kind of enslavement to patterns of sin, and that the damaged and broken relationships so characteristic of human life create deep suffering that can manifest itself physically in people’s lives.

*The relationship between and among all aspects of the human self. The very notion that the human body might somehow be cut off from the human mind or spirit in such a way that intellectual, emotional, and spiritual factors might somehow not affect physical health is deeply alien. From a Christian perspective the human person is a psychosomatic unity with intertwined body and spirit—or intertwined body, soul, and spirit, or an ineradicable monistic unity, depending on one’s theological anthropology. No matter how the interrelationship of the components of the human self is now described, no responsible Christian theologian today would posit a view that asserts a sharp distinction between mind/soul/spirit and body. Thus, the findings of medical researchers on “psychoneuroimmunology” or “reciprocal relationships” between emotions and health are not at all surprising.

*The relationship between religious faith, moral values, meaningful community, and health. Both Scripture and Christian tradition have long claimed that there can be no full human wholeness apart from meaningful connection with the God who made us; that clear moral and spiritual guidance for the conduct of life is likewise essential for moral wholeness and health; and that human beings need community, in particular faith community, as a context in which to be drawn/led toward God, others, and service to the wider world.

Conclusion

After a long season in the post-Enlightenment scientific-biomedical-rationalist universe, there seems to be a rediscovery of a deeper and richer wisdom about the human being and human health. It may be that Barnard, Dayringer, and Cassell are correct in their claim that modern western medicine, “shorn of every vestige of mystery, faith, or moral portent, is actually an aberration in the world scene.”¹⁴ To those who are just now finding that there is a relationship between spirituality, moral choices, and health, biblical theology can well and truly say “welcome back,” because (with all due humility) we have been here all along. CBHD

¹ Avery Comarow, “When Hearts Break,” US News & World Report, September 29, 2003, vol. 135, no. 10, p. 40.

² Susan Slager Johnson, RN and Robert F. Kushner, MD, “Mind/Body Medicine: An Introduction for the Generalist Physician and Nutritionist,” Nutrition in Clinical Care, vol. 4, no. 5 (2001), p. 257.

⁵ Mary A. Whooley, et al., “Religious involvement and cigarette smoking in young adults: the CARDIA study,” Archives of Internal Medicine, 162, no. 14, July 22, 2002, pp. 1604-1611.

⁶ Doug Oman and Carl E. Thoresen, “Does Religion Cause Health?”: Differing Interpretations and Diverse Meanings,” Journal of Health Psychology, 7 (4), p. 366.

⁷ Joanne Coyle, “Spirituality and health: towards a framework,” Journal of Advanced Nursing, 37 (6), p. 594.

⁸ AY Kinney, et al, “Limited social support or religious involvement as risk factors for colon cancer,” AEP vol. 12, no. 7 (October 2002), pp. 488-534; T.E. Oxman et al, “Lack of social participation or religious strength and comfort as risk factors for death after cardiac surgery in the elderly,” Psychosomatic Medicine, 57 (1), pp. 5-15.

¹⁰ Lutero, “Raising Hell May Be Good for Your Health,” The Humanist, March/April 2003, p. 6.

14 D Barnard, R Dayringer, and CK Cassel, “Toward a person-centered medicine: Religious studies in the medical curriculum,” Academic Medicine, 70 (9), p. 807.

An Overview to Health and Spirituality: Spirituality, Moral Choices, and Health

by David P. Gushee