Part 1 Part 2 Part 3 Part 4 Part 5
What is the conclusion of the matter? Church is good for you. You know it’s good for your soul. But now you also know it’s good for your body. Without looking at other factors, people who don’t go to church have an 87% increased chance of dying every year compared to those who attend more than weekly. This works out to a 7 year increase in life expectancy. Even after adjusting for risk factors, a 50% reduction in risk remains. The presence of this effect has been confirmed by many studies on over a hundred thousand people.
What should you do? If you’re in church, stay there. If you’ve left church, go back! It’s good for you! If you’ve never been to church, give it a try! I’m sure your religious friends would love to take you. Christians believe that God has built us to be in spiritual community. Is it any surprise that we operate better when live as we were made to?
In 1964, a group of doctors came together to critically evaluate the risks of smoking. They published their report and it, "hit the country like a bombshell. It was front page news and a lead story on every radio and television station in the United States and many abroad." News of a common behavior, smoking, increasing mortality by 70% was the public health crisis of our grandparents’ generation. Thousands of lives were saved by this information. Now the mantle falls to us. Our generation will be the one to make public this knowledge about church, to save the lives of thousands alive today and those yet to be born. We look at old movies and snicker because everyone is smoking; our children will look at our movies and snicker at people sitting at home on Sundays.
Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts
Friday, December 3, 2010
Thursday, December 2, 2010
Living an Extra Seven Years - Medical Implications
Part 1 Part 2 Part 3 Part 4 Part 5
Church abstinence is today what smoking was in 1954. Everyone who’s looked at this knows it’s bad for you. There is debate on the mechanism of action, but not on the effect itself. What do we do? Or perhaps a better question is: did the Surgeon General do the right thing in condemning smoking before it was fully understood?
Church abstinence is today what smoking was in 1954. Everyone who’s looked at this knows it’s bad for you. There is debate on the mechanism of action, but not on the effect itself. What do we do? Or perhaps a better question is: did the Surgeon General do the right thing in condemning smoking before it was fully understood?
Because this is a behavior and not an opinion or belief, we can, in good conscience, recommend it to everyone. An atheist can go to church without changing a single belief. He can attend church potlucks and volunteer with church members without agreeing to a single point of theology. It wouldn’t be easy; an atheist might get withdrawal symptoms like a smoker, but if this can be pushed through, it’s probably a good thing in the long run. Pushing belief on an unwilling person had ethical implications, but a doctor can push a behavior like attendance with no ethical misgivings.
Even if we don’t care about atheists (or are afraid of their anger at such a reasonable suggestion), doctors should have absolutely no misgivings with asking Christians about church attendance and encouraging them to increase it. We have very solid evidence to support such a recommendation.
In the Hippocratic Oath, Doctors swear to ‘do no harm.’ If you went to your doctor, it would be unethical for the doctor to ignore your smoking habit; he has information that could prevent you harm; withholding it is wrong. How is this information about church attendance different? Can we doctors, in good conscience, withhold this information from our patients? Would this be anything other than harm?
Unfortunately doctors are terrified of religion. An enlightening essay was published in the New England Journal of Medicine on this topic (5). The author (a non-physician) told physicians that they should not talk about religion. Even though 77% of hospitalized patients want physician to consider their spiritual needs and 48% of patients want their physician to pray with them, the authors explain, “Patients often ask for things that are unrealistic or that may not be in their best interests.” After all, “physicians are not trained to engage in in-depth conversations with their patients about their spiritual concerns.” In other words, doctors are so bad at spiritual conversations, they shouldn’t even try. This idea comes straight from the Hippocratic Oath; all doctors swear to, “Never attempt a thing I’m not already good at.” Actually that’s a lie. We don’t swear silly things like that. And neither should we live by them.
It is clear to me that doctors ought to recommend church attendance to every one of his patients. It is likely that patients will ignore him as they do with smoking. But if he truly cares about their wellbeing, he must at least mention the risk his patient is taking by staying at home on Sundays.
Consider the magnitude of this public health problem. Every year in the US, 2.5 million people die; if we consider the frequency of church attendance and adjust robustly, the number of deaths that can be attributed to missing church is 568,000 (9, 11, 12, 13). Every year, half a million people die because they missed church. This is one-fifth of the total mortality rate. In 2004, a paper was published to try to calculate the actual causes of death in the US (14). They tabulated that smoking causes 435,000 deaths per year. Church attendance is more important than smoking. Inactivity and poor diet cause 400,000 deaths per year. Church attendance is more important than diet and exercise. Deaths attributable to car crashes, alcohol, illicit drugs, sexual behavior, microbes, and incidents involving firearms together add up to 324,000 deaths per year. Church attendance is more important than all of these combined. Church abstinence is the single strongest association with mortality in the United States, but it doesn’t even get mentioned in a paper on the subject.
[All references are listed under the first post]
Wednesday, December 1, 2010
Living an Extra Seven Years - Clarifications
Part 1 Part 2 Part 3 Part 4 Part 5
This effect is very interesting because it is so tightly linked to behavior, not belief. It doesn’t matter how ‘spiritual’ you feel or how religious you say you are (6). You only live longer when you actually go to church (though there is some suggestion that private religious practice counts). It’s very much like the behavior of smoking: people who do X, die. People who smoke, die. People who stay home on Sunday, die. It’s as simple as that.
Because the models have been adjusted, we can’t recommend anything other than the thing itself. For example, if it were the case that church only worked by reducing smoking, then we could say: either go to church OR quit smoking (if you can...). When they found out smoking was bad, they didn’t know entirely what parts of the cigarette caused the cancer; they could only recommend quitting altogether (today they understand the mechanisms better and sell ‘smokeless’ cigarettes). One day, that might be possible for church; but for today, we can recommend nothing but simply attending church.
It is important to note that we don’t have final ‘proof’ that church causes lower mortality. ‘Proof’ in a modern medical sense demands a particular kind of study called a Randomized Control Trial. Correlation is not causation (4). We cannot be absolutely certain that this effect is caused by church. That is to say, if a doctor recommends a non-churchgoer to go to church, we are not certain that the effect would remain.
The skeptic might say that there might be some other effect (maybe a yet-unobserved healthiness factor) which makes people go to church and also makes them live a long time. But it’s also possible that smoking doesn’t cause lung cancer, but that there is some yet-undiscovered sickness factor which makes people who smoke get lung cancer (we could certainly have argued this in 1950). To silence the skeptic, we’d have to get a big group of people and have them each flip a coin. Heads gets treatment 1 (smoking/no church); tails gets treatment 2 (no smoking/church). The problem is that we have good reason to suspect that treatment group 1 is going to die, and for better or worse, we decided killing people for science advancement was generally a bad idea. And even if we weren’t sure, nobody objecting to recommendations on church attendance would support an experiment randomly assigning people to church or no church. The experiment is ethically impossible. We package cigarettes with a warning label and doctors push patients into smoking cessation programs without ever having done a perfect study on their deadliness. How is church abstinence different?
[All references are listed under the first post]
This effect is very interesting because it is so tightly linked to behavior, not belief. It doesn’t matter how ‘spiritual’ you feel or how religious you say you are (6). You only live longer when you actually go to church (though there is some suggestion that private religious practice counts). It’s very much like the behavior of smoking: people who do X, die. People who smoke, die. People who stay home on Sunday, die. It’s as simple as that.
Because the models have been adjusted, we can’t recommend anything other than the thing itself. For example, if it were the case that church only worked by reducing smoking, then we could say: either go to church OR quit smoking (if you can...). When they found out smoking was bad, they didn’t know entirely what parts of the cigarette caused the cancer; they could only recommend quitting altogether (today they understand the mechanisms better and sell ‘smokeless’ cigarettes). One day, that might be possible for church; but for today, we can recommend nothing but simply attending church.
It is important to note that we don’t have final ‘proof’ that church causes lower mortality. ‘Proof’ in a modern medical sense demands a particular kind of study called a Randomized Control Trial. Correlation is not causation (4). We cannot be absolutely certain that this effect is caused by church. That is to say, if a doctor recommends a non-churchgoer to go to church, we are not certain that the effect would remain.
The skeptic might say that there might be some other effect (maybe a yet-unobserved healthiness factor) which makes people go to church and also makes them live a long time. But it’s also possible that smoking doesn’t cause lung cancer, but that there is some yet-undiscovered sickness factor which makes people who smoke get lung cancer (we could certainly have argued this in 1950). To silence the skeptic, we’d have to get a big group of people and have them each flip a coin. Heads gets treatment 1 (smoking/no church); tails gets treatment 2 (no smoking/church). The problem is that we have good reason to suspect that treatment group 1 is going to die, and for better or worse, we decided killing people for science advancement was generally a bad idea. And even if we weren’t sure, nobody objecting to recommendations on church attendance would support an experiment randomly assigning people to church or no church. The experiment is ethically impossible. We package cigarettes with a warning label and doctors push patients into smoking cessation programs without ever having done a perfect study on their deadliness. How is church abstinence different?
[All references are listed under the first post]
Tuesday, November 30, 2010
Living an Extra Seven Years - Adjustment
Part 1 Part 2 Part 3 Part 4 Part 5
My grandfather came to California from Oklahoma at 18 with a nickel in his pocket. He got a blue collar job working at Ralphs. It was good work that paid well enough, but the hours were long. The managers, wanting to be kind to their employees, gave them a smoke break. My grandfather, a nonsmoker, tried to take a break with his coworkers, only to be told that it was a smoke break, not a do-whatever-you-like break. So he took up smoking.
My grandfather came to California from Oklahoma at 18 with a nickel in his pocket. He got a blue collar job working at Ralphs. It was good work that paid well enough, but the hours were long. The managers, wanting to be kind to their employees, gave them a smoke break. My grandfather, a nonsmoker, tried to take a break with his coworkers, only to be told that it was a smoke break, not a do-whatever-you-like break. So he took up smoking.
Imagine a researcher asked, “Does working at Ralphs cause lung cancer?” There are two ways to answer the question. You could say yes: working at Ralphs causes smoking, and smoking causes cancer. Statistically, this is called “un-adjusted risk.” Un-adjusted risks tend to be a less specific and so less convincing answer. The 87% increase in risk of dying from never going to church is unadjusted.
But maybe it wasn’t Ralphs’ smoke-break policies, but some other factor which causes lung cancer (maybe they used dangerous chemicals in the canning process). How could you tell the difference? You’d look at the non-smokers. Were non-smokers getting lung cancer, too? If so, you’d suspect that there was some other factor at the cannery. Using the data from the nonsmokers, you can “subtract” the effect of smoking from the smokers and find out for someone like my grandpa, if there was any “adjusted” risk of working at Ralphs. That is, you can find out if there is any effect outside of the known effect of smoking.
So can we tell if the 87% increase in life expectancy is just from Christians reducing known risk factors? The researchers in the papers subtracted the effects of age, gender, race, socioeconomic status, social support (e.g. marital status, number of friends, relatives), health risks (e.g. smoking, alcohol consumption). If church improved health by working through these things, after we’d subtracted the effects of bad behavior, there would be no difference between the churchgoers and the abstainers. We would conclude that the church is a really good way of changing unhealthy behaviors. But even after these risk factors were taken out, the effect remains. Church does indeed lead to healthier lifestyles (less smoking, drinking, etc.). After subtracting all these from the 87%, someone who never goes to church still has a 50% higher chance of dropping dead compared to a frequent churchgoer (6, 15). Church attendees live longer and we don’t know why.
There is speculation, but no solid data to support them. It might be volunteerism. Maybe it’s a more positive outlook on life. Perhaps there is some unidentified good of being in community (“psychosocial effect”). Or maybe there is actually something supernatural going on in church (7). For all we know, it could be the potlucks. But does it matter how it works? Or more accurately, for whom does it matter? Certainly researchers ought to pursue the Truth wherever it goes. But for the average American, mechanism is much less important. And for the average physician, an understood mechanism rarely comes before a treatment.
We have a very strong case for church attendance. Our case for church attendance today is stronger than our case against smoking was in 1950. Our statistical sophistication and our data collection have improved a lot since the 1950’s. But for the family practice physician, does it matter? To the policy makers, does it matter? We started lecturing patients and slapping warning labels on cigarettes before we knew how they were bad.
[All references are listed under the first post]
Monday, November 29, 2010
Living an Extra Seven Years - Introduction
Part 1 Part 2 Part 3 Part 4 Part 5
In 1912, Dr. Isaac Alder suggested that there was a link between smoking and lung cancer. Immediately everyone stopped smoking. Actually, that’s not true at all. He was promptly and almost universally ignored. It took another four decades before anyone really listened. By 1957, the evidence had accumulated and the Surgeon General declared that smoking caused cancer. One year after this announcement, 44% of Americans believed smoking caused lung cancer. In 1964, “Smoking and Health” was published, and laws started getting passed restricting smoking, from advertisements to taxes (8). In 1968, 78% of Americans believed smoking caused lung cancer. Unfortunately, knowing something is good for you is not the same thing as doing what’s good for you.
For decades we didn’t know for sure if smoking was bad for you. Movie stars and cool kids pushed the habit, and when we found out it was bad, it was too late. People were already addicted. For those who did quit, severe damage was already done. The slowness of the research, the industry lobbying, and the lack of will on the part of the government and public cost countless lives.
Smoking remains to be one of the most important risk factors for heart disease and cancer. It’s not just hypothetical risk. Life insurance, an industry which bets on your life and death, is keenly aware of this risk and charges smokers much more because of this high risk. A smoker has a 70% higher annual risk of death than a nonsmoker (8). Smoking is the single best observable factor in determining your risk of dying. Or at least it was. What if I told you that there’s another behavior that is even better at tracking with lifespan than smoking is?
People who don’t demonstrate this behavior have an 87% higher annual risk of than those who do (9). A 20 year old who did engage in this behavior throughout his life would live 7 years longer than one who didn’t (for blacks, it’s even better: 14 years longer). You might be thinking you know what it is: exercise! Nope. Exercise is good, but not that good. Those who do what the American Medical Association tells them to do (1400 calories per week of exercise; 30 minutes daily) (2) have a 29% lower annual risk of death(1). What about losing weight? Those who are normal weight (BMI <24) have a 25% lower annual risk of death compared to those who are overweight (BMI >26) (1). What could this behavior be? What could be more important than what our doctors talk about when we visit? What’s more important than smoking? What’s more important than exercise? What’s more important than weight loss?
In 1912, Dr. Isaac Alder suggested that there was a link between smoking and lung cancer. Immediately everyone stopped smoking. Actually, that’s not true at all. He was promptly and almost universally ignored. It took another four decades before anyone really listened. By 1957, the evidence had accumulated and the Surgeon General declared that smoking caused cancer. One year after this announcement, 44% of Americans believed smoking caused lung cancer. In 1964, “Smoking and Health” was published, and laws started getting passed restricting smoking, from advertisements to taxes (8). In 1968, 78% of Americans believed smoking caused lung cancer. Unfortunately, knowing something is good for you is not the same thing as doing what’s good for you.
For decades we didn’t know for sure if smoking was bad for you. Movie stars and cool kids pushed the habit, and when we found out it was bad, it was too late. People were already addicted. For those who did quit, severe damage was already done. The slowness of the research, the industry lobbying, and the lack of will on the part of the government and public cost countless lives.
Smoking remains to be one of the most important risk factors for heart disease and cancer. It’s not just hypothetical risk. Life insurance, an industry which bets on your life and death, is keenly aware of this risk and charges smokers much more because of this high risk. A smoker has a 70% higher annual risk of death than a nonsmoker (8). Smoking is the single best observable factor in determining your risk of dying. Or at least it was. What if I told you that there’s another behavior that is even better at tracking with lifespan than smoking is?
People who don’t demonstrate this behavior have an 87% higher annual risk of than those who do (9). A 20 year old who did engage in this behavior throughout his life would live 7 years longer than one who didn’t (for blacks, it’s even better: 14 years longer). You might be thinking you know what it is: exercise! Nope. Exercise is good, but not that good. Those who do what the American Medical Association tells them to do (1400 calories per week of exercise; 30 minutes daily) (2) have a 29% lower annual risk of death(1). What about losing weight? Those who are normal weight (BMI <24) have a 25% lower annual risk of death compared to those who are overweight (BMI >26) (1). What could this behavior be? What could be more important than what our doctors talk about when we visit? What’s more important than smoking? What’s more important than exercise? What’s more important than weight loss?
Church attendance. People who never go to church(3) have an 87% increased chance of dropping dead compared to those that attend more than weekly. Statistically speaking, never going to church is worse for your health than smoking a pack a day for the rest of your life (9). I’m not joking. This is an effect that has been seen in dozens of studies over the last thirty or so years. Scientists really don’t like it, but it’s there, and it’s real.
We have lots of evidence that church attendees have a lower risk of dying. We have so much data in these studies, we can even ‘pool’ it, adding up the results of many studies into one “meta” analytic study. The best meta study that did this found, after looking at a total of over 125,000 people in 42 separate investigations, the odds of a churchgoer surviving were better than a non-churchgoer (10).
But how can this be? Perhaps churchgoers are just goody-two-shoes who never smoke or drink or cuss. To evaluate that theory, I need to tell a story.
[Note: this is the first of a 5-part post. The references for all 5 will be posted here in the first post]
References
(1) Paffenbarger, RS; Hyde, RT; Wing, AL; Lee, IM; Jung, DL; Kampert, JB. The Association Of Changes In Physical-Activity Level And Other Life-Style Characteristics With Mortality Among Men. NEJM, 328 (8): 538-545 Feb 25 1993.
(2) Pate RR; Pratt M; Blair SN; Wilmore JH; et. al. Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-407.
(3) Most of the studies are representative US populations and so are literally measuring church attendance. Others look at ‘religious service attendance’ and find the same thing. I will use ‘church attendance’ in this article as these results do not have enough data to religious services of other faiths (though it is my belief that this would be true).
(4) Correlation doesn't imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing 'look over there' – xkcd.com/552/ . Also, I am among those who are not happy about the monopoly that the Randomized Control Trial has on science. It’s a good technique, but not the only good technique.
(5) Sloan, RP. Should physicians prescribe religious activities? NEJM 342(25): 1913-1916 JUN 22 2000
(6) Powell, LH; Shahabi, L; Thoresen, CE. Religion and spirituality - Linkages to physical health. AMERICAN PSYCHOLOGIST, 58 (1): 36-52 JAN 2003
(7) I say supernatural not to give up the search, but to focus it. The effect might be mediated through an undiscovered non-classical mechanism; perhaps it is a hyper-dimensional effect, perhaps it is quantum mechanical. With regard to unsolved mysteries, we must always be ready for a paradigm shift to be hiding underneath it.
(8) “The Reports of the Surgeon General” <http://profiles.nlm.nih.gov/NN/Views/Exhibit/narrative/smoking.html>
(9) Hummer RA; Rogers RG; Nam CB; Ellison CG. Religious Involvement and U.S. Adult Mortality. Demography 36(2): 273-285 May 1999
(10) McCullough ME, Hoyt WT, Larson DB, Koenig HG, Thoresen C. Religious involvement and mortality: a meta-analytic review. Health Psychol.19(3):211-22 2000 May
(11) FASTSTATS. Accessed on 10/23/2010. Centers for Disease Control. <http://www.cdc.gov/nchs/fastats/deaths.htm>
(12) American FactFinder. Accessed on 10/23/2010. US Census Bureau. <http://factfinder.census.gov/home/saff/main.html?_lang=en>
(13) US Population: 310,546,653. US Mortality rate: 803.6 per 100,000.
(14) Mokdad AH; Marks JS; Stroup DF; Gerberding JL . Actual Causes of Death in the United States, 2000 JAMA. 2004;291:1238-1245
(15) This trend is supported by the meta-study (reference 10) but with a smaller magnitude. It reports that the increased chance of survival for those who attend is 25% after adjustment. The difference is probably because of a dose-effect in the Hummer paper (reference 9); they didn’t just measure attender/non-attender, but the frequency of attendance. Running 50 minutes every day is better for you than running 5 minutes, and so it seems that going to church more than weekly is better for you than going only on Christmas and Easter. The data in the Hummer paper does appear to agree with the more modest 25% if you ignore the dose-effect and pool all church attenders together.
Monday, January 26, 2009
Spiritual Health
What is spiritual health? I have long thought about this question, especially since my profession’s concern is with ‘health’. Spiritual health is certainly important for physical health. Many scientific articles have shown that things like church attendance and belief have measurable positive effects on physical health (one study showed that church attendance lowered mortality so significantly that a lifelong churchgoer would live seven additional years compared to the non-attendee). My first thought was, “Great! Everybody should go to church!” but this suggestion was vehemently opposed by those who are deathly allergic to religion (most of my classmates and professors). Even I, upon reflection, concluded that an Atheist who took my advice and went to church hating every last Sunday morning would likely not live seven years longer.
What then can I do? My job is to share whatever of God’s love and healing as I can with my patients, even those who are unwilling to go to church. Are there benefits of spiritual practice which are sharable with non-Christians? Or is it Divine intervention that gives churchgoers their extended lives? Though I can’t completely rule out God’s favor (I am, after all, a rational person who does not come to conclusions without evidence), it seems likely to me that if there were such an effect, it would at least be coupled with a natural one. That is, there is probably some positive psycho-socio-physical effect that could indeed be transferred to the heathen (גוי – literally “non-Jews”; figuratively “not God’s people”... no offense to the heathen).
And so I must return to my original question: what is spiritual health? For a long time, my thoughts on this question were informed (and limited) by the traditional Christian answer: fellowship, prayer, service/evangelism and Bible study. These have certainly laid the foundations for my own spiritual health. But can these be generalized? Is there some part of the benefit of prayer which a Hindu could get by meditation (or conversely, what of spiritual health are Christians missing by ignoring God’s command to “be still and know that I am God”)?
In considering my own spiritual life, I identified seven areas which I believe are important for spiritual health (and I didn’t make it be seven on purpose… that’s something I’m liable to do but I didn’t). They are 1. Relationship with family 2. Relationship with friends 3. Sleep and rest 4. Spiritual exercise 5. Private spiritual expression 6. Confidential spiritual expression 7. Public spiritual expression. I’ll describe how I have seen the church engage these seven points, and then how it may be generalized.
1. Relationship with Family
A Christian is encouraged to have a good relationship with her literal family. Many places command respect for parents, love of wife/husband, and care for kids. My church in Temecula places a strong emphasis on this point.
Family and family responsibility is a large part of being human. From a crude biological sense, reproduction and child-rearing is our only important role. And the sensibilities of most people today and those throughout history have placed a special significance on having a good relationship with our families. Indeed marriage has been shown to extend lifespan (and my guess is that a good marriage does so more than a bad one).
2. Relationship with Friends
A Christian is encouraged to have friends to whom she can go. These are developed in ‘Small Groups’ or via Discipling (mentoring) relationships. There are many emphatic commands to love one another, and many incredible examples of such relationships in the New Testament.
Friendship and community is one of the most universally accepted human goods. It is certainly not the exclusive domain of the church (though the Church has often been the friend to the friendless historically). Psychological studies have started mapping this as a variable that is linked to mental health.
3. Sleep and Rest
God is quite concerned about rest. He talks about the Sabbath a whole lot more than Christians are comfortable with and themes of Rest are throughout the Bible. Christian generally rest at least 1½ hours on Sunday morning.
Rest is really important. We all know this. And even the idea of intentionally not working is important. I’ve heard an apocryphal story of the USSR switching to a 6 day work week because of productivity declines after they tried a 7 day work week. We need rest and we need sleep, be we Christian or Atheist.
4. Spiritual Exercise
There are lots of exercises we’re supposed to do: bible reading, fasting and service are a few, and the Bible is full of expositions on these. Widows and orphans, justice, and evangelism are things that God would like for us to care about (and the Church generally does care).
Many of these expressions are directly translatable (service), some of them are not (Evangelism), and I think the traditional Christian picture omits some important things. My most recent thinking on the spiritual aspect of a thing is: “that part of an experience which remains after subtracting its rational and emotional aspects.” Serving others, going to church, getting married, going to a funeral all have large spiritual components. But so do hiking and stargazing, art museums and drama performances. These experiences have something about them which is sublime. And I’m inclined to call it spiritual. Even if an Atheist doesn’t go to church, I bet he’d be a spiritually healthier person by stargazing. I don’t know of any studies that link these practices to health, but I think that’s because nobody’s ever looked. This category deserves more thinking, but for the moment is broad enough to be accommodating to everyone.
5-7. Private, confidential and public spiritual expression
A Christian ought to expresses her love for Christ, her hopes and fears, her praise and thankfulness, her sorrow and joy, she confesses her guilt and asks for forgiveness. And she has opportunity to do it through prayer (privately), in small group or accountability (confidential), and at the church building (publicly).
These expression of the human heart, mind and soul cannot only be the turf of the Church. I think the Church has worked out a very convenient way to regularly express them, but the need (and opportunity) is universal. A person may quietly reflect on his guilt without asking forgiveness from God; part of the benefit of prayerful confession will be maintained. Mentees can express their hope for the future just as well as disciple-ees. Joy can be expressed at a Dave Matthews Band concert as well as at one by Switchfoot.
What is spiritual health? I’m not sure entirely. But I think the traditional Christian framework, refined by two thousand years of spiritually health people and generalized, is an excellent way to think about spiritual health. I am very interested in further refinements and improvement, but I think even in its early stage, if a person made efforts to improve in these seven areas, he’d be better off. And that goes for Christians and non-Christians alike.
In a first step to help people improve their spiritual health, I have designed a Spiritual Health Self Assessment. It takes about 20-30 minutes and encourages participants to reflect on their spiritual health and includes a section for planning for self-improvement. The next step is to recruit and train Spiritual Healthcare Providers (SPHs). But more about that later.
I would love for you, my reader, to participate and improve your own spiritual health (and give me feedback, so I can better heal the spirit):
http://spreadsheets.google.com/viewform?key=pf7AfX9bzlgKiSUawghjrKA&hl=en
Take it once a week for better health, (future) Doctor’s orders.
What then can I do? My job is to share whatever of God’s love and healing as I can with my patients, even those who are unwilling to go to church. Are there benefits of spiritual practice which are sharable with non-Christians? Or is it Divine intervention that gives churchgoers their extended lives? Though I can’t completely rule out God’s favor (I am, after all, a rational person who does not come to conclusions without evidence), it seems likely to me that if there were such an effect, it would at least be coupled with a natural one. That is, there is probably some positive psycho-socio-physical effect that could indeed be transferred to the heathen (גוי – literally “non-Jews”; figuratively “not God’s people”... no offense to the heathen).
And so I must return to my original question: what is spiritual health? For a long time, my thoughts on this question were informed (and limited) by the traditional Christian answer: fellowship, prayer, service/evangelism and Bible study. These have certainly laid the foundations for my own spiritual health. But can these be generalized? Is there some part of the benefit of prayer which a Hindu could get by meditation (or conversely, what of spiritual health are Christians missing by ignoring God’s command to “be still and know that I am God”)?
In considering my own spiritual life, I identified seven areas which I believe are important for spiritual health (and I didn’t make it be seven on purpose… that’s something I’m liable to do but I didn’t). They are 1. Relationship with family 2. Relationship with friends 3. Sleep and rest 4. Spiritual exercise 5. Private spiritual expression 6. Confidential spiritual expression 7. Public spiritual expression. I’ll describe how I have seen the church engage these seven points, and then how it may be generalized.
1. Relationship with Family
A Christian is encouraged to have a good relationship with her literal family. Many places command respect for parents, love of wife/husband, and care for kids. My church in Temecula places a strong emphasis on this point.
Family and family responsibility is a large part of being human. From a crude biological sense, reproduction and child-rearing is our only important role. And the sensibilities of most people today and those throughout history have placed a special significance on having a good relationship with our families. Indeed marriage has been shown to extend lifespan (and my guess is that a good marriage does so more than a bad one).
2. Relationship with Friends
A Christian is encouraged to have friends to whom she can go. These are developed in ‘Small Groups’ or via Discipling (mentoring) relationships. There are many emphatic commands to love one another, and many incredible examples of such relationships in the New Testament.
Friendship and community is one of the most universally accepted human goods. It is certainly not the exclusive domain of the church (though the Church has often been the friend to the friendless historically). Psychological studies have started mapping this as a variable that is linked to mental health.
3. Sleep and Rest
God is quite concerned about rest. He talks about the Sabbath a whole lot more than Christians are comfortable with and themes of Rest are throughout the Bible. Christian generally rest at least 1½ hours on Sunday morning.
Rest is really important. We all know this. And even the idea of intentionally not working is important. I’ve heard an apocryphal story of the USSR switching to a 6 day work week because of productivity declines after they tried a 7 day work week. We need rest and we need sleep, be we Christian or Atheist.
4. Spiritual Exercise
There are lots of exercises we’re supposed to do: bible reading, fasting and service are a few, and the Bible is full of expositions on these. Widows and orphans, justice, and evangelism are things that God would like for us to care about (and the Church generally does care).
Many of these expressions are directly translatable (service), some of them are not (Evangelism), and I think the traditional Christian picture omits some important things. My most recent thinking on the spiritual aspect of a thing is: “that part of an experience which remains after subtracting its rational and emotional aspects.” Serving others, going to church, getting married, going to a funeral all have large spiritual components. But so do hiking and stargazing, art museums and drama performances. These experiences have something about them which is sublime. And I’m inclined to call it spiritual. Even if an Atheist doesn’t go to church, I bet he’d be a spiritually healthier person by stargazing. I don’t know of any studies that link these practices to health, but I think that’s because nobody’s ever looked. This category deserves more thinking, but for the moment is broad enough to be accommodating to everyone.
5-7. Private, confidential and public spiritual expression
A Christian ought to expresses her love for Christ, her hopes and fears, her praise and thankfulness, her sorrow and joy, she confesses her guilt and asks for forgiveness. And she has opportunity to do it through prayer (privately), in small group or accountability (confidential), and at the church building (publicly).
These expression of the human heart, mind and soul cannot only be the turf of the Church. I think the Church has worked out a very convenient way to regularly express them, but the need (and opportunity) is universal. A person may quietly reflect on his guilt without asking forgiveness from God; part of the benefit of prayerful confession will be maintained. Mentees can express their hope for the future just as well as disciple-ees. Joy can be expressed at a Dave Matthews Band concert as well as at one by Switchfoot.
What is spiritual health? I’m not sure entirely. But I think the traditional Christian framework, refined by two thousand years of spiritually health people and generalized, is an excellent way to think about spiritual health. I am very interested in further refinements and improvement, but I think even in its early stage, if a person made efforts to improve in these seven areas, he’d be better off. And that goes for Christians and non-Christians alike.
In a first step to help people improve their spiritual health, I have designed a Spiritual Health Self Assessment. It takes about 20-30 minutes and encourages participants to reflect on their spiritual health and includes a section for planning for self-improvement. The next step is to recruit and train Spiritual Healthcare Providers (SPHs). But more about that later.
I would love for you, my reader, to participate and improve your own spiritual health (and give me feedback, so I can better heal the spirit):
http://spreadsheets.google.com/viewform?key=pf7AfX9bzlgKiSUawghjrKA&hl=en
Take it once a week for better health, (future) Doctor’s orders.
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