Saturday, July 25, 1998

The connection between faith and health

By Eric Adler

Knight Ridder Newspapers

It is one of the most famous medical stories in the Bible:

Sick with leprosy, 10 men approach Jesus on the road to Jerusalem and, begging for pity, are cleansed of their illness. Grateful, cured, praising God, one leper falls to the feet of Jesus, who replies:

"Rise and go; your faith has made you well."

Well, these days many in the medical community - a group hardly known for its unquestioning nature - are starting to think the story may be more than just a parable. It may be a prescription.

In hospitals across the country, researchers are taking a fresh look at the effects faith, prayer and religion have on patients' health. Although many physicians remain dubious, many others are starting to view a growing body of data - gleaned from more than 10 years of studies at university hospitals such as Duke, Georgetown, Yale and Dartmouth - as just short of miraculous.

The data suggests this: Whatever one's religion - Christian, Jewish, Hindu, Buddhist - persons of deep, abiding religious faith whose spirituality is an essential part of their lives get ill less often and get better faster.

Studies show that with faith as their comfort, they exhibit lower blood pressure, lower anxiety and lower rates of many related illnesses including heart disease and stroke, cancer, depression, suicide and alcohol and drug abuse.

"I think there is now convincing data," said cardiologist James Vacek of Kansas City's St. Luke's Hospital. "People who have strong spiritual beliefs do better, even with serious illness."

For their part, critics point out rightly that the world is crowded with countless healthy and long-lived individuals who are agnostic, atheistic or ascribe to mixed or less dogmatic beliefs.

Moreover, scientifically, there is no proof that faith alone can heal, which leads many researchers to speculate that positive effects of deep faith may be as earthly as the peace of mind, social support and temperate avoid-smoking-drinking-gluttony lifestyles that many religions foster. It escapes few physicians' notice that Catholic nuns, Buddhist monks and other ascetic clerics enjoy particularly long and healthy lives.

But whatever the case, interest in the subject has so expanded that late last year, scores of medical, psychological and psychiatric researchers from across the country gathered in Boston for a three-day conference on the subject. Two new books, "Is Religion Good for Your Health?" and "The Faith Factor, Proof of the Healing Power of Prayer" - both written by physicians - have just been released.

In the past five years, nearly one-third of all medical schools, and the majority of nursing schools, have begun addressing, even offering classes, on health and spirituality. Researchers on the topic are now popular lecturers on the hospital circuit.

"I have personally spoken at more than 30 medical schools," said Georgetown University physician Dale Matthews, author of 'The Faith Factor" (Viking Books).

This spring Duke University psychiatrist Harold G. Koenig, author of "Is Religion Good for Your Health?" (Haworth Press) and a leading researcher in the area, was invited to Kansas City twice in two weeks, by St. Luke's Hospital and Research Medical Center.

"There was no interest at all in this subject until two or three years ago," Koenig said. "Since then it has virtually exploded."

Research is growing, too. Beginning in August, for example, Koenig and his colleagues at Duke - and armed with a four-year $550,000 grant, and having already looked at the positive effects of devout religious faith on health - will begin a study with 600 people to see if similar effects are found in individuals who are spiritual, although not necessarily religious.

At St. Luke's in Kansas City, two studies are now ongoing. The first, by Vacek and colleague William Harris, is looking at the effect outside prayer, or so-called intercessory prayer, has on 900 heart patients at the Mid-American Heart Institute.

he results of that study, the largest one of its kind, are now being analyzed. But a similar study conducted a decade ago at San Francisco General Hospital, although never replicated, did indeed show that patients who are prayed for seem to need fewer antibiotics, less ventilation and other medications.

The second St. Luke's study, conducted by nurse Joan Walton, is a qualitative study that attempts simply to assess exactly how patients define faith and spirituality in their lives so that caregivers can find ways to address it.

"I think we're just coming to an age," Walton said, "where patients are saying to us, 'We are not just physical beings, we're spiritual beings. And we want you to acknowledge that.' "

To be sure, such acknowledgment has been long in coming.

Although thousands of America's hospitals bearing ecclesiastic names such as St. Mary's, St. Joseph's, Baptist, Trinity and Menorah were born of religious institutions, the exercises of medicine and ministry traditionally have remained as separate as body and soul. As the century progressed, that separation increased.

Evoking science over faith, many physicians, particularly psychiatrists, have been openly contemptuous of religion for being seen as doing more harm than good - keeping patients from seeking care and promoting guilt, blame and the belief, in some patients, that their illnesses are punishments for past sins.

Sigmund Freud, in fact, spent the last years of his life decrying religion, which he wrote was the "universal obsessional neurosis of humanity" - a view still held by many physicians.

But increasingly physicians and others are coming to understand the importance of faith in their patients' lives.

Americans clearly are a faithful bunch. Some 40 percent of the population attends a church or synagogue each week, a number virtually unchanged for 50 years. Gallup and other polls show that 96 percent of Americans believe in God, 90 percent pray, 80 percent read the Bible.

Rather than being a bane, religion, faith and spirituality, for many patients, often offers the deepest comfort.

"For many patients it's their faith that is the bedrock of who they are," said Georgetown's Matthews.

In one of Koenig's studies at Duke, 40 percent of patients, when asked to rank the most important factors that help them cope with their health problems, said "faith," "the Lord" or "God" was No. 1. That was ahead of money, work, friends and all else.

"Four of 10. That, in itself, makes it relevant to medicine," Koenig said.

Koenig, of course, knows that many physicians are likely to find the work dubious, believing that delving into a patient's faith is neither their role nor business, even if they had time to do so.

But his hope, he said, is simply for nurses and doctors to become more aware of the importance of faith in their patients' lives, to understand the positive impact it can have on their health, and to at least be mindful of it when planning their care.

"I think that times are really changing. Patients are demanding us to look at them as a whole person," said Walton, who says she, like Vacek, has even engaged in prayers with patients.

But it's important to note, said Walton and others, that addressing faith in medicine does not mean proselytizing. It doesn't mean debating or invading patients' religious privacy or, if it's uncomfortable, joining in their prayers.

More simply, it means asking about and being open to things that help patients cope. And if one answer is faith, religion or spirituality, it means recognizing and supporting that part of their care.

"Saying, 'You know, I know religion is an important part of your life. And the fact that you are using this to help you get through your illness, is wonderful and can have a powerful effect,' " Koenig said. "That's called support."