Religion and physical health

1
Religion and physical health
2
Religion and physical health

• A meta analysis of over 40 independent samples
  has reported that religious involvement is
  significantly and positively associated with
  longevity (McCullough et al., 2000).
• After adjusting for demographics, mortality risk
  continued to be associated with non-attendance
  (Hummer et al., 1999).

3
Historical development

• Reports of positive associations vastly outnumber
  reports of negative associations (Koenig et al.,
  2001) yet religion has been ignored as a health
  related variable.
• James (1902) wrote that religion prevents certain
  forms of disease equally as well as science.
• Freuds negative views on religion remained
  highly influential throughout much of the middle
  of the 20th century.

4
Historical development

• Single dimension measures of religion were often
  conceptualized as substitutes for health
  behaviours or social connections.
• The 1960s and 70s saw the initiation of
  scientific research on secularized or religious
  forms of meditation.
• In the 1980s and 90s researchers such as Larson
  and Levin alerted scientific readers to the
  existence of a large but neglected body of
  research on religion and physical health.

5
Historical development

• More recently, signs of growing interest
  regarding religion and health have become highly
  evident within psychology.
• International psychology journals have published
  special issues on religion that have included or
  focused upon health.

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Special Issues

• Psychological Inquiry
• British Journal of Health Psychology

7
Definitional issues

• Religion and spirituality each may be viewed as
  multidimensional and latent constructs.
• Earlier studies avoided definitional issues by
  relying on secondary data sets containing
  institutionally based measures of religiosity .
• Increasingly data collection is now designed more
  specifically for understanding the relationship
  of religion and spirituality to physical health.
• More recent definitions highlight the more
  dynamic, experiential emotion and goal-directed
  features of religion and spirituality.

8
Definitional issues

• Some individuals who regard themselves as
  religious but not spiritual engage in
  non-traditional but committed forms of spiritual
  practice that clearly possess a moral dimension
  and a binding quality (Wuthnow,1998).

9
Mediating factors

• Mechanisms by which religion might improve health
  include
• Health behaviours e.g., refrain from
  drinking/smoking
• Psychological states e.g., religious involvement
  may foster more positive psychological states
  joy, hope, compassion resulting in reduced
  burden on physical organ systems
• Coping religious involvement may foster more
  effective ways of dealing with stressful events
• Social support religious involvement may foster
  larger and stronger social networks

10
Mediating factors

• Superempirical or psi mechanisms
• Religious/spiritual practices may act through
  laws governing subtle energies (Levin, 1996) that
  are beyond current scientific understanding.
• Mechanisms not seen as acting in isolation.
• Interaction of the mechanisms may engender better
  immune competence and less cardiovascular
  reactivity.
• Confusion arises from several different
  interpretations of claims that religious
  involvement causes better health outcomes.
• E.g., if religious coping is identified as
  helping to explain health benefits, that evidence
  may be dismissed as simply due to the generic
  features of social support.

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Mediating factors

• Denominational differences appear secondary in
  their influence, although they clearly exist
  (Krause, 2004).
• E.g., Latter Day Saints, Seventh Day Adventists,
  Jews or other religious groups may benefit by
  promoting specific protective health behaviours
  such as vegetarian diet or not smoking.

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Evidence linking religious/spiritual factors
directly to the body physical health and
disease outcomes mortality

• Attendance at religious services was associated
  with lower mortality in large population samples
  (Powell et al., 2003)
• 30 reduction in mortality after adjustment for
  demographic, socioeconomic, and health-related
  confounders.
• Meta analysis found an average mortality
  reduction of about 25 associated with religious
  involvement (primarily religious attendance)
• When only private religious involvement was used
  results failed to predict changes in mortality.

13
Mortality

• Two studies found a protective effect for
  attendance on circulatory disease mortality, and
  respiratory disease mortality, but not a
  significant protective effect against cancer
  (Hummer et al., 1999 Oman et al., 2002).

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Morbidity

• While religious involvement is generally
  associated with lower morbidity, most religion-
  morbidity studies to date have been
  cross-sectional, and very few have controlled for
  possible confounding factors.
• Increased physical pain has been associated with
  more frequent praying in several cross-sectional
  studies, but a longitudinal study reported that
  more frequent prayer predicted later decreases in
  pain (McCullough Larson, 1999).

15
Disability and recovery

• Powell et al. (2003) noted insufficient evidence
  to draw firm conclusions regarding protection
  against disability.
• Powell et al. (2003) noted consistent failures of
  evidence to support hypotheses that religious
  involvement slows the progression of cancer or
  improves recovery from acute illness.

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Physiological measures

• Seeman et al. (2003) reported evidence linking
  religion and spirituality with lower blood
  pressure.
• Seeman et al. (2003) reported evidence for an
  association between religion and spirituality
  with better immune function.

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Evidence on mediating factors lifestyle health
behaviours

• Full understanding of mediators between religion
  and health requires that their effects be
  investigated in spiritual as well as secular
  settings (Thoresen et al., 2005).
• More religiously involved adolescents engage in
  less risky sexual behaviour, less smoking, less
  drinking, and more frequent use of seat belts
  (Koenig et al., 2001 Oman Thoresen, 2005).
• Several studies report higher prevalence of
  excessive body weight among more religious people
  (Koenig et al., 2001).

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Lifestyle health behaviours

• Beneficial effects on health behaviours from
  religious attendance were stronger for women than
  men (Strawbridge et al., 2001).
• The mediating effect of religious/spiritual
  experience on alcohol abstinence emerged
  gradually over time and did not exercise a direct
  main effect on a health outcome (Tonigan, 2003).

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Improved coping

• Religious coping measures help predict adjustment
  to stressful life events beyond purely secular
  measures of coping (Pargament, 1997).
• Viewing religious coping as a distinctive
  religious/spiritual dimension, Powell et al.
  (2003) found evidence to date inadequate for
  predicting longevity.

20
Social support

• Several dimensions, including social networks and
  perceived social support, have been found to
  predict lower risk of morbidity and mortality,
  but the mechanisms remain unclear.
• Evidence that social support explains more than a
  small portion of any religious/spiritual health
  relationship is lacking (George et al., 2002).
• Evidence suggests that religious families offer
  more stable social support through lower divorce
  rates and improved marital functioning (Mahoney
  et al., 2001).

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Positive psychological states

• Positive emotional states could lead to improved
  physical health by reducing overall chronic
  burden on organ systems from adapting to
  environmental challenges (reduced allostatic
  load).
• Positive emotional states derived from
  religious/spiritual coping might help people
  overcome internal barriers in adopting positive
  health behaviours, and to form supportive social
  connections.
• A recent meta analysis demonstrated a negative
  correlation between religious involvement and
  measures of depression (Smith et al., 2003).

22
Health services utilization

• Studies report patterns of greater use of
  preventative care and compliance with medical
  regimens among individuals with higher levels of
  religion or spirituality (Keonig et al., 2001).

23
Meditation

• Studies have shown improved stress management
  sills as well as reduced somatic and mental
  arousal, lower blood pressure and lower
  cholesterol (e.g., Patel et al., 1985).
• Davidson et al. (2003) reported that meditation
  increased activity in the left prefrontal cortex
  area and reduced activity in the right prefrontal
  cortex area
• Left area often associated with positive emotions
  such as compassion, and the right area with
  negative emotions such as fear.

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Forgiveness

• Emerging evidence indicates that forgiveness may
  lead to better physical and mental health by
  reducing rumination and enhancing positive
  emotions.
• Studies have rarely compared the effectiveness of
  spiritually versus secularly presented
  forgiveness interventions.

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Services to others

• Protective effects of altruism may occur through
  mechanisms, such as reduction in excessive
  self-focus, reduced stress reactivity, and
  increased social support (Oman et al., 1999
  Underwood et al., 2002).
• Two studies have found that the protectiveness of
  volunteering was significantly larger in
  fostering longevity among frequent attenders at
  religious services (Harris Thoresen, in press
  Oman et al., 1999).

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Virtues

• Virtues such as self-control, hope, wisdom, and
  love, may promote health by a variety of
  mechanisms (Levin, 1996).
• Each virtue seems likely to have its own specific
  properties and correlates (Brown Ryan, 2003).

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Distant healing

• Most research on distant healing has been purely
  secular, investigating effects on humans,
  animals, or other biological systems (e.g., Kiang
  et al., 2002).
• Research on intercessory prayer can also be seen
  as distant healing.
• Reviews suggest reasonable, but not persuasive
  evidence exists for healing benefits from being
  the recipient of prayers by others (Powell et
  al., 2003).
• The challenge may be to find doctors or other
  healthcare providers who are not using some form
  of psychic healing.

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Strength of the evidence

• Persuasive evidence now demonstrates the
  existence of positive associations between health
  and practices such as attendance at worship
  services and meditation.
• A fully persuasive picture will require much more
  attention to contextual factors, treated not as
  static constructs, but as variables that in
  themselves often change with time.

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Research needs

• More qualitative studies, longitudinal studies,
  and multiwave panel studies can help reveal which
  findings are robustly supported across diverse
  designs.
• The contexts in which religious/spiritual
  practices typically occur are not homogeneous
  entities, but are dynamic, multicultural, and
  heterogeneous (Chatters, 2000).
• The importance of cultural variability is
  demonstrated by Krause et al. (1999) who offer
  evidence and theoretical arguments that service
  attendance may be less relevant to health in
  Japanese culture than in U.S. culture.

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Higher consciousness and primal energies

• Evidence suggests that correlates of advanced
  states of consciousness may include atypical,
  high-theta brain wave patterns (Hood et al.,
  1996), as well as changes in prefrontal cortex
  areas of the brain (Davidson et al., 2003).
• Little research has addressed the experience of
  flow when attention is trained on e.g.,
  spiritual experience.
• Prayer may be more understandable in terms of
  flow theory (Nakamura Csikszentmihalyi, 2002).

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Higher consciousness and primal energies

• A deeper understanding of homeostatic processes
  underlying higher states of spiritual
  consciousness might help clarify the complex
  relationship between adult sexual energies, risky
  sexual behaviour, and physical and mental health.
• Sexual restraint could reduce disease risk (e.g.,
  Green, 2003).
• All major religious faiths have affirmed,
  especially in their mystical tradition, that a
  higher being can function as an absorbing and
  fulfilling focus of a human beings true love.

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Higher consciousness and primal energies

• Long-term faith/health dialogue and collaboration
  to address the AIDS pandemic might benefit from
  improved scientific understanding of persons who
  function as stable exemplars of the rewards and
  processes underlying the intense spiritual
  transformation of primal human energies (Oman
  Thoresen, 2003).

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Spiritual self regulation

• The regulation of ones conduct in order to
  attain spiritual goals remains unstudied.
• Social-cognitive theory recognizes that the
  self-evaluative processes underlying
  self-regulation are shaped in part by standards
  acquired from models (Bandura, 2003).
• The concept of spiritual self-regulation could be
  useful for developing new spiritual interventions.

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Attachment styles

• Perceived relationships with God meet all of the
  defining criteria of attachment relationships and
  function psychologically as true attachments
  (Kirkpatrick, 1999).
• Considerable evidence, often indirect, supports
  the plausibility that secure attachment
  relationships promote physical health (Maunder
  Hunter, 2001).
• Relationships between secure spiritual
  attachments and physical health remain unstudied.

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Negative effects from religion

• Religious struggle has been associated with
  elevated mortality (Exline Rose, 2005).
• Some religious groups discourage certain forms of
  medical care, such as vaccination or blood
  transfusion (Koenig et al., 2001).
• Institutionalized religion will undoubtedly
  contribute at times to certain negative health
  effects for some people
• E.g., physical and sexual abuse by members of
  religious orders

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Spirituality and religious interventions

• If religious/spiritual factors do indeed foster
  improved mental and physical health, then
  respectful, ethically grounded interventions to
  alter these practices may be warranted (Post et
  al., 2000).
• Some studies of meditation interventions have
  examined self-reported measures of spiritual
  experiences or self-rated spirituality (Astin,
  1997 Oman et al., 2005).
• Few studies have examined longer term outcomes on
  a broader range of spiritual or religious
  dimensions.

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Spirituality and religious interventions

• Some medical patients or counselling clients may
  benefit from interventions aimed at reducing
  maladaptive rumination by teaching repetition of
  a holy name or mantra (Oman Driskill, 2003).
• Meditating on sacred scripture or spiritual
  figures produced substantial reductions in
  several health related factors, such as perceived
  stress and burnout.

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Spirituality health

• The construct of spiritual health holds promise
  as a pivot around which modern healthcare systems
  might reintegrate spiritual sensitivity into
  their daily operations .
• Although most systems of alternative medicine
  address spirituality, it is unclear to what
  extent these meanings agree with each other, with
  spirituality defined as a search for the sacred
  (Zinnbauer Pargament, 2005).

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• Emma Gough, Martyr or Victim?
• (http//www.youtube.com/watch?vlmzZs_TnlZ0)