Anybody spending time thinking has to acknowledge our existential moment of crisis: within the academy, the communities of Spirit, within the polis and within fields of practice, especially the sciences formed around healing. Anyone who cares for children and grandchildren feels the crisis. And we must groan with of all creation for polar bears standing on melting ice and to butterflies afraid to fly north. Those of us thinkers privileged by position, profession and confession awake every day wondering if our work is relevant to the crisis of our time.
TC and I have long done “thinking work” with intellects and academics trying to accelerate and deepen the teaching and research at the intersection of faith and health. This goes back decades to work at The Carter Center, lives at the heart of both Hold.Health and the Leading Causes of Life Initiative as well as more recently, with Interfaith America project on faith and health.
Notice the energy of those attacking universities and trying to outlaw academic thinking. They obviously consider open intellectual discourse a problem for their Radical Undoing project. We should take intellectual work at least as seriously as they do.
Good intellectual work begins by not spending time and resources redoing what is already done, what is “settled.” This is directly relevant to the “Radical Undoing” being attempted. That project will likely fail precisely because it is trying to undo things that are quite settled, even in what for many seems to be new field, that built where faith and health—faithhealth—have emerged.
What do we know; what is settled?
Starting Point:
Early faithhealth research (pre- 1980’s to late 1990’s-2000) was often accused of being flawed methodologically and many felt it was biased, although there have been many seminal studies, articles, books and chapters of greater rigor since then. Religion, spirituality and faith generally have positive impact on health (of all kinds) outcomes, with a few exceptions (e.g., early 2000’s religious rigidity studies). Early work focused mostly on individual patient-provider dyads, as is nearly always the case in medically oriented studies.
A major landmark was the 2022 gold standard study in Journal of the American Medical Association by Balboni, et all. This used meta analyses and a 38 expert Delphi panel to zero in on the mere 215 of 6485 studies that were beyond any possible academic question. It found the following eight findings for health outcomes were settled (although it did not use that phrase).
- Frequent service attendance was associated with lower risk of mortality, with a
- Dose-response association between attendance and lower risk of mortality.
In addition, frequent attendance was associated with:
- less smoking and less alcohol, marijuana, and illicit drug use compared with adults with less frequent or no attendance;
- better measures of quality of life (e.g., life satisfaction);
- better mental health;
- fewer depressive symptoms; and
- fewer suicidal behaviors.
- Among adolescents, frequent attendance was associated with less risky sexual behaviors, less smoking, and reduced use of alcohol, marijuana, and illicit drugs.
This group published a follow-up piece in Health Affairs (Long et al., 2024) to recognize some community based and real life work/studies and grey literature that didn’t make the meta analysis cut. TC and I were honored to be authors on this one. The piece also suggested policy recommendations. Here’s a breakdown of the contents:
- Part I: Existing Evidence
- Recognizing Spirituality as a Social Factor in Health
- Person-centered, Evidence-based Approaches
- Spiritual Care Education for Health Professionals
- Spiritual Care and Support within Health Systems
- Part II: Recommendations
- Fostering spiritual/religious literacy as an extension of cultural humility
- Strengthen communication, relationships, and trust-building between sectors
- Focus on payment and reimbursement issues
- Improve coordination and measurement of faith-based efforts
I recommend a honeybee standard. The honeybees rarely get live-and-death decisions wrong, such as leaving an old hive and starting a new one. They do not wait for their decision to be 100% agreed. The process is dependable because every bee gets the same vote including the queen: honeybee democracy. Once they have settled the matter, they get on with the work of the new hive so to not waste the season. Good model.
What else do we know that is settled?
Religion is a driver or “determinant,” but really a variable of health at individual and social scales. The phrase “social determinants” annoys libertarians a great deal. But it is settled that the lifespan health of every human reflects the widely accepted four-fold model the World Council of Churches embraced in Vellore India in 2007. Every human without exception is a bio-psycho-social-spirit phenomenon. This pertains to all humans of every faith, race, ethnicity, politics, language and every other distinction without exception.
Congregations—of all faiths—have strengths perfectly aligned with this settled science. We saw this at The Carter Center, settled again at the National Academies of Science Roundtable on Population Health.
Faithhealth is best understood in light of complexity theory, NOT the old-fashioned creedal-oriented distinctions between traditions.
Faithhealth does not fit the sharp divide between clinical venues and varieties of public health. It is inherently integrative.
Faithhealth relates not just to the upstream-downstream continuum of interventions to the whole health shed of factors driving health outcomes and possibilities.
Faithhealth is mostly about life and living, not death and dying; the Leading Causes of Life are more helpful than the Leading Causes of Death.
So, what should academics do in this moment?
Teach the settled science as the foundation on which ongoing discovery can build.
Use the this settled science in service of implementation and process improvement in places where it might be valuable between the campuses and their social contexts.
Then turn our attention to what is not yet settled as the most interesting things of both faith and health sciences are not yet known. This next phase of intellectual work is likely to be organized differently than the old. It should build on seven foci for “organized pursuit.” I’ll avoid the word “research” as that triggers premature clarity about the tools and ways of organizing the pursuit of the seven questions:
Learn and act on what matters
- How can diverse faith-leaning organizations partner with health sciences to clarify credible scientific findings and translate them across diverse social settings? I am thinking of how faith and health both accept that new things continue to emerge and need to be tested openly.
Abandon simplistic linear metaphors in favor of complex watersheds
- How can we contribute to more useful ways of understanding the “healthshed” of populations (chapter 28 of our Handbook of Religion and Health, Cochrane, Gunderson, Cutts, 2024). What kinds of participatory research can be blended with more objective findings in what manner?
- How can we help each other listen and relate to human communities—across differences of discipline and worldview—to find coherence and credibility?
Shift focus from death to life.
- How can we foster learning around the leading causes of life, vital capacities, and other positive phenomenology at individual, family, social and geographic scales?
- How can we help each other develop leaders and those in roles of influence to function appropriately in complex human ecologies?
- How can we inform practices and protocols that help generative practitioners find joy and muscle for the lifetime of work that calls us to give our very best?
God so loved…the whole planetary phenomenon.
- How can we help each other live appropriately into the local and planetary natural and human ecosystems—the ultimate and most urgent issue of our time?
To be clear; in the current crisis the first job of every thinking citizen is to say no to the Radical Undoing.
And then give our very best to the organized thinking we will all need for the next yes.
