December 15, 2008

Does Keeping The Faith Improve Health Outcomes?

By  Michael D. Shaw

Sociologist Émile Durkheim’s Suicide, published in 1897, is said to be one of the first examinations of the effect of religion on health outcomes. Moving closer to our own time, The Handbook of Religion and Health, published in 2001, identified more than 1,600 studies and reviews that examine the religion-health relationship. As it happens, Harold G. Koenig, MD—one of the authors of the Handbook—recently revised that figure to “…as many as 3,000 studies…the majority reporting positive findings.”

That quote from Koenig comes from a review paper he recently presented at the “Religious Practice and Health: What the Research Says” conference sponsored by the Heritage Foundation.

Here are some interesting findings from that paper—all supported by numerous literature references:

• Religious involvement may help to reduce stress, minimize depression, and enhance quality of life
• Religious involvement is related to healthier lifestyles and fewer risky behaviors that could adversely affect health
• Religion is related to better physical health and faster recovery

As to the third point, Koenig gets more specific. He cites studies that suggest less cardiovascular disease on the part of religious people and better outcomes for those individuals after cardiac surgery. Studies also indicate lower blood pressure, enhanced immune and endocrine functioning, and less cancer risk. Additionally, HIV/AIDS patients with religion show better outcomes.

What about longevity and mortality? An oft-cited meta-study from 2000, that looked at 42 independent clinical and population-based samples—taking in 125,826 subjects—reported that respondents with low levels of religious involvement had odds of mortality that were 1.29 times higher than for those with high levels of religious involvement. In this case “religious involvement” included attendance at religious services, membership in religious groups, finding strength and comfort from one’s religious beliefs, and religious orthodoxy.

The same meta-study does note that “Studies using public measures of religious involvement yielded larger effect sizes than did those using other types of measures of religious involvement.” Subsequent research has confirmed the link between attending religious services and improved health outcomes.

The most prominent critic of the religion/health connection is Columbia University behavioral psychologist Richard Sloan, who argues that while faith or prayer may bring comfort to many people, there are no scientific methods to accurately measure the value of faith or prayer. In a narrow technical sense this is true, but the statement betrays a foolish scientism. Many aspects of the human experience—such as love and happiness—cannot be measured, but no one would argue that they have no effect, or that they are not observable.

Indeed, medicine is as much an art as it is a science. Many treatment modalities are not completely understood, but are used millions of times per year based on empirical evidence. Even then, some patients will respond differently to therapies and so-called scientific clinical trials may be of little value when dealing with an individual.

Sloan attacked the 2000 meta-study, noting that many covariates (gender, race, income, education, and functional status) could have affected the results, and that church attendance—even if frequent—could be more of a social than sincere religious experience. His analysis concluded that the relationship between religious involvement and mortality is weak or nonexistent.

The authors of the meta-study replied that the covariates invoked by Sloan were meaningless. Their study focused on the positive outcomes of religiosity on mortality, which survive all attempts to debunk with covariates. Moreover, determining a person’s sincerity on any matter, let alone religion, is by no means straightforward. Rather, it could be extremely confrontational and may skew a study on its own.

Likewise, should we attempt to get inside Sloan’s head as he takes a completely different tack in assailing the religion/health connection with his “Trivializing the Transcendent” article in Christianity Today? After submitting numerous scientific papers attacking the purported connection, he wonders whether people should even examine the connection at all.

How sincere is he when he concludes that “To do so runs the risk of trivializing religious experience, stripping it of the transcendence that distinguishes religion from other aspects of our lives”? It seems to me that his journal articles try to do exactly that.

Catholic theology speaks of the “gift of faith.” For those who have it, much research indicates better health outcomes. For those who don’t, there may be other pathways. Seek and ye shall find.