Credit: Andrei Tchernov
Imagine you're in an examination room for your annual physical. While taking your medical history, your physician notes that heart disease runs in your family, and then asks if you're religious.
"I was raised Catholic but haven't gone to church in years," you say. Surprisingly, your doctor suggests that you start attending Mass again, as studies have shown religion protects against cardiovascular disease.
An unlikely scenario, yes, but the notion that the wall separating medicine and religion ought to be torn down has gained popularity over the last two decades.
Hundreds of studies examining the link between religion or spirituality and health have concluded that religious activity promotes wellbeing, from protection against cancer to schizophrenia and hypertension. Some members of the medical community are taking the association seriously, probing into a patient's spiritual history to prescribe treatment or advocating prayer with patients. In fact, more than half of the medical schools in the US now offer courses on religion, spirituality and health.
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Overall, data tends to support a positive relationship between religion and health, say the authors of the Handbook of Religion and Health—a review of 1,200 studies. Such evidence, reported in scientific journals and the media, is getting both doctors' and patients' attention and should be applied in medicine, according to Harold G. Koenig, one of the book's authors and co-director of the Center for Spirituality, Theology and Health at the Duke University Medical Center.
"If you ask people what enables them to cope, what helps them get through difficult times, many tell you it's their religious beliefs," he said. "When you measure religious beliefs, you find that they're related to better mental health, better coping and greater life satisfaction."
However, some researchers remain unconvinced, questioning whether religion should enter into the doctor-patient interaction at all, despite the abundance of studies. These critics insist there is a paucity of evidence proving the association.
"The methodology in most of these studies is very weak," said Richard P. Sloan, professor of behavioral medicine at Columbia University. He, along with his colleagues, began publishing reviews of such studies in 1999, highlighting methodological flaws, conflicting findings and ambiguous data.
"The strongest evidence is in the studies that show association between attendance at religious services and mortality," he said.
People attend church for reasons that have little to do with faith such as tradition, to meet people socially or to make business contacts, said Sloan, who is also the author of the forthcoming Blind Faith: the Unholy Alliance of Religion and Health. Furthermore, he added, studies indicate that people often inflate their church attendance when surveyed.
"Attendance at religious services is an exceptionally crude index," Sloan said. "We don't have any idea what the true degree of religious service attendance is, and we have no idea how that self-presentation bias is altering the findings."
Lynda H. Powell, a cardiovascular epidemiologist and professor of preventative medicine, agrees with Sloan that religious attendance is the flaw in the argument for a causal link. Powell was lead author of a 2003 National Institutes of Health review on religion/spirituality and mortality, morbidity, disability or recovery from illness.
The authors found that data failed to support both the hypothesis that deeply religious people are physically healthier and that spiritual activity slows the progression of cancer and improves recovery from acute illness. They also observed a 25% reduction in risk of mortality in healthy religious service attendees after controlling for confounders.
"We understand that there's an effect but we don't understand why the effect exists," said Powell, who was surprised by the robustness of this discovery, and called the results an "epidemiological puzzle."