Physical Health, Mental Health, and Faith
How the Christian faith benefits well-being
The challenges of the pandemic follow many years of faltering mental and physical health in the United States and many other high-income countries. For example, the Centers for Disease Control and Prevention (CDC) reported annual declines in life expectancy from 2014 to 2017 leading some to proclaim a crisis in health even before Covid-19.
Steven Woolf and Heidi Schoomaker, epidemiologists at Virginia Commonwealth University, showed declines in health have accumulated over decades. A recent editorial in the Journal of the American Medical Association said that life expectancy in the US:
“increased fastest in the 1970s, advanced more slowly in the 1980s, peaked in 2014, and declined annually from 2014–2017.”
The CDC reported that twice as many Americans in 2017 died from alcohol, drugs, or suicide than in 1999. A report for the Brookings Institution labeled these “deaths of despair.”
The benefits of religion for health
Religious people are an interesting departure from these overall negative health trends in Western societies.
Harold Koenig, Co-Director of the Center for Spirituality, Theology, and Health at Duke University, and his colleagues, have tracked this research for many years.
For example, Koenig’s systematic review in 2010 identified 1200 studies. Most of the data suggest religious people were at lower risk for depression, suicide attempts, and substance abuse. They also had lower risk of heart disease, hypertension, and cancer.
But is the data reliable?
Michael King, Professor of Primary Care Psychiatry at University College London, challenges these conclusions. He, among many others, argued in a 2015 paper this research has important limitations. He rightly observes that most studies are cross-sectional — data is only collected at a single time point.
So, it is difficult to conclude that spiritual/religious beliefs are causing improvements in health. King emphasized the need to conduct prospective studies that observe people over time. He also argued the association between spirituality/religion and health was small in most studies.
Koenig thinks more recent research has overcome these criticisms:
“There are now, however, a lot of large prospective studies that have repeatedly shown when you follow tens of thousands of people over many years religious involvement is predicting better health outcomes.”
For example, Shanshan Li and colleagues from the Harvard T. H. Chan School of Public Health followed up with 74,534 women over 16 years. They reported a 26% reduction in the risk of dying for those who attended a religious service once a week. The benefits were even higher (33% reduction) among those who attended more than once per week.
Isn’t it just the benefits of community?
Another criticism of the association between religion and health is that these benefits can be explained by the importance of community. Matt Dillahunty, host of The Atheist Experience, suggested:
“It may be the case that what people need is community, which religions have done a really good job of building, and it’s one of the things that secular organizations are working towards now — building stronger communities.”
However, this criticism is convincingly addressed by Koenig:
“Research coming out of Europe [in a study of 9,068 people] has shown regular social involvement is not associated with health as strongly as religious-related social involvement. There is research also in the US showing once you adjust for social support in the analyses religious involvement still significantly predicts mental and physical health outcomes.”
Why faith may benefit health: cultivating virtue
There is no one definitive answer to how spirituality/religion impacts mental and physical health. Koenig’s review suggests there are likely many mechanisms. One factor is that religions often promote the development of virtues. Growth in traits like humility, altruism, and forgiveness can act as a buffer against stress and help build social support.
For example, more than 100 studies have assessed the relationship between forgiveness and health. Tyler VanderWelle, Professor of Epidemiology at Harvard University, stated:
“Forgiveness is associated with lower levels of depression, anxiety, and hostility; reduced nicotine dependence and substance abuse; higher positive emotion; higher satisfaction with life; higher social support; and fewer self-reported health symptoms.”
Theology and suffering
Another factor is that spirituality/religion helps people to cope and find meaning amidst suffering. Pastor and theologian Tim Keller reviewed anthropological and sociological research on how people cope with pain and suffering. He argued these studies show:
“our own contemporary secular, Western culture is one of the weakest and worst in history at doing so.”
Keller argued secular Western culture sees the purpose of life as choosing what makes you most happy. He suggested suffering cannot have a meaningful place in such a worldview. We can only try to avoid the impact of affliction.
In contrast, most cultures in history have seen suffering as an inevitable fact of life that can have inherent meaning. According to the reformer Martin Luther, God’s character is primarily revealed in the weakness and suffering of the cross. As Keller observed:
“Why should we be surprised…that our lives are filled with darkness and pain. Even God in Christ did not avoid that.”
Lived experience of faith and suffering
Many qualitative studies have found faith can have an important impact during times of suffering. A common theme in these studies is knowing the presence and purpose of God in troubled times. For example, a breast cancer survivor reported:
“ I think my faith in God’s plan for me helped me maintain a positive attitude through the surgery and treatments. I did feel He was watching over me.”
Qualitative studies also find people often experience spiritual growth during times of adversity. For example, in a study of African American woman a participant reflected:
“[Spirituality] gives you that grace and that strength to deal with the reality of issues and to come out of them having learned some kind of lesson…. The Spirit provides that.”
It is often assumed in secular Western countries that human flourishing depends on progressing beyond Christianity. Studies conducted mainly in Christian populations have challenged this presumption. Theological and spiritual resources provided by religions profoundly impact physical and mental health.
