Wellness

Does a Prayer A Day Keep Illness at Bay?

Research into the impact of religious and spiritual beliefs on our health continues.

By John Leifer

When we are sick, we rely on our physicians to heal us. And for good reason: they possess the knowledge, tools, drugs, and procedures to conquer many maladies. But not all illnesses respond to the ministrations of modern medicine, as many of us learn with the passage of time.

As we age, virtually all of us will be afflicted with one or more chronic diseases, some of which can be quite devastating. Cancer, once considered an acute disease, now often falls within this category. If good fortune prevails, medicine will control the progression of the disease. If not, we hope it will at least provide us with a modicum of comfort.

But medicine is not omnipotent, which is why, for some patients, healing is not the sole province of doctors. Those patients turn to their religious and spiritual beliefs in the hope that solace and, perhaps, healing will be found there. But do such beliefs—and the accompanying prayers, spiritual self-examination, and other practices—truly make a difference in the trajectory of our health?

If longevity and reduced mortality are the ultimate proxy for health, the jury may be out on that question. More than two dozen studies have revealed a correlation between how long we live and the degree to which we regularly attend religious services.1

According to researchers Doug Oman and Carl “One of the most thorough of these studies, an eight year follow-up of more than 20,000 adults representative of the US population, found a life expectancy gap of over seven years between persons never attending services and those attending more than once weekly.”1 The correlation between religious attendance and longevity is so strong that even the National Institutes of Health acknowledge it.2

But it is not just the length of our lives that may be affected by our spirituality or religious beliefs; it is also the quality of our lives. Researchers have found strong correlations between our beliefs and our ability to maintain hope, derive meaning and purpose, and maintain critically important relationships during times of great adversity.

It is important to note that our beliefs can also have an adverse effect on health, as was powerfully demonstrated in a study of HIV patients by Gail Ironson and colleagues. Ironson sought to determine the impact of both positive and negative views of God on the progression of this devastating disease.

Ironson’s results were tied to two clinical indicators of disease progression: CD4 cells (an important component of one’s immune system) and the viral load (the amount of active virus circulating in the patients’ bloodstreams). Ironson’s findings: “Those who viewed God as merciful/benevolent/forgiving had five times better preservation of CD4 cells than those who did not view God positively. Those who viewed God as harsh/judgmental/ punishing lost CD4 cells at more than twice the rate of those who did not view God negatively.”3

Such conclusions are powerful and provocative, yet many scientists remain skeptical about the relationship between religious beliefs/ spirituality and health. It’s not that they refute their colleagues’ findings, assuming that the research is methodologically sound; rather they raise important questions regarding the interpretation of those findings and the attribution of positive benefits to religion and spirituality.

Part of this skepticism comes from a well-founded distrust of the words religion and spirituality because there is no universally agreed upon definition of the terms. For some people these words communicate a profound and personal relationship with God, whereas for others they communicate a more agnostic outlook on life, where one’s sense of spirituality is derived from community. With such disparity it is understandably difficult to draw meaningful conclusions about the influence of religion and spirituality on health.

Beyond semantics looms another important issue: Are there discernible mechanisms at work, underlying religious and spiritual beliefs, that impact health outcomes? Oman and Thoresen offer four such mechanisms1 that may be responsible for improved health and well-being:

  • Health behaviors. Certain religious traditions foster the adoption of positive health habits while discouraging negative behaviors. When smoking, alcohol consumption, promiscuous sex, and other detrimental behaviors are shunned, adherents may benefit from such prohibitions.
  • Social support. There is vast evidence supporting the power of social connection in fostering health and well-being. Faith and religious organizations form the very heart of the social network for many people. Thus religion/spirituality brings social connectedness, which is essential to health.
  • Psychological states. Oman and Thoresen suggest that religious beliefs/spirituality may contribute to a heightened sense of emotional or psychological well-being—whether through elevated levels of positive affect, such as joy and hope, or reduced levels of negative emotional states, such as despair.
  • Psi influences. Psi in parapsychology refers to phenomena that cannot be explained using conventional rules of science. Mystical or transcendental experiences, synchronicity, and other phenomena fall into this category. Because we are unable to explain, measure, or replicate these phenomena, they remain largely outside the realm of scientific investigation.

So what should you take away from this research-oriented discussion?

Empirical research is important, but each of us will approach our health and well-being in a very personal way. Some of us will primarily turn inward, with our focus on how health issues change our sense of self and perhaps our direction in life. For others the journey will be more outwardly focused, emphasizing the importance of personal relationships in helping us cope with whatever health issues arise. Others will ultimately look upward, to God and their relationship with Him.

References

  1. Oman D, Thoresen CE. “Does religion cause health?”: Differing interpretations and diverse meanings. Journal of Health Psychology. 2002;7(4), 365-80.
  2. Hummer RA, Rogers RG, Nam CB, Ellison CG. Religious involvement and U.S. adult mortality. Demography. 1999;36(2):273-85.
  3. Ironson G, Stuetzle R, Ironson D, et al. View of God as benevolent and forgiving or punishing and judgmental predicts HIV disease progression. Journal of Behavioral Medicine. 2011;34(6):414-25. doi: 10.1007/s10865-011- 9314-z.
  4. Swinton J, Bain V, Ingram S, Heys SD. Moving inwards, moving outwards, moving upwards: The role of spirituality during the early stages of breast cancer. European Journal of Cancer Care. 2011;20(5):640-52. doi: 10.1111/j.1365-2354.2011.01260.x.

 

Taking Responsibility for Our Health

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Many of you have written to me stressing the importance of maximizing one’s health by engaging in appropriate lifestyle behaviors. I agree that this is a vitally important theme, and thus offer the following excerpt from The Myths of Modern Medicine for your consideration:

“I’m Just the Patient; I’m Not Part of the Problem”

Sarah Matthews had always struggled with her weight. Her life was a series of disappointing attempts to control her insatiable appetite. It came at a hefty price—to her self-esteem, her relationships, and ultimately to her health.

Though her physician had long counseled her to lose weight and begin to exercise, Sarah continued her habit of consuming more than four thousand calories a day. Her weight at age forty-two had swelled to more than 280 pounds, and her joints were showing the wear of carrying such a big burden.

But it was more than Sarah’s joints that were beginning to fail. Her annual physical revealed that she was perilously close to becoming a full-blown diabetic. Her blood pressure hovered at 160/100, which is very high, and the slightest exertion made her short of breath. At this pace, Sarah’s life would be dramatically shortened. As a diabetic, she would run the risk of blindness, loss of limbs, and eventually death. If her blood pressure remained high, coronary-artery disease would naturally follow—potentially precipitating a stroke or heart attack. Furthermore, recently published research suggested that the earlier one becomes obese, the greater the probability of developing atherosclerosis.

This time, her physician was unflinching in his strongly worded advice: “Lose the weight now. There are no more tomorrows.” Sarah broke down in tears. It was not a lack of desire to lose weight; she simply didn’t know how to win the battle against her lifelong demon. Fortunately, her physician had a dedicated nurse educator, who not only started Sarah on the path to recovery but enlisted the help of a counselor, a nutritionist, and an exercise coach.

Frightened by the prospect of a grim future, Sarah became compliant. Though it took more than a year, she successfully shed just shy of one hundred pounds through daily diet and exercise. Her lab values responded in tandem with her changes in lifestyle. After eighteen long, difficult months, Sarah was able to stop taking her medications. What appeared to be the beginning of a lifelong path of advancing chronic illness had been stopped in its tracks.

Taking Personal Responsibility for Our Behavior

The message emblazoned in every chapter of this book has been that our health-care system has gross deficiencies that can seriously affect your care. Numerous strategies have been outlined about how to increase the probability of receiving the “right” care for you and your family. Yet the best strategy of all is to simply not need care in the first place.

That means taking exquisitely good care of ourselves—a lesson that Sarah is learning late in life. Sarah was not merely the patient. She was also the problem. It was her eating behavior—not some random disease or virus—that was causing her to develop debilitating, chronic conditions. Had she maintained her current trajectory, these conditions could have robbed her of joy, health, and ultimately her life. In the process, Sarah would have required an increasing onslaught of medications and other interventions, all of which would have brought their own associated risks and contributed to feeding the national health-care bill.

Granted, not all of us seem to suffer the ill effects of an unhealthy lifestyle. Some people get away with murder when it comes to their bodies. My mother was such a person. Finding the best restaurants and bakeries was a lifelong passion for her, though she somehow stayed slim. Her idea of strenuous exercise was a full day of shopping. Her habits finally caught up with her at the age of sixty-five, though, when her severely blocked arteries necessitated quadruple-bypass surgery. Having her chest brutally cracked open slowed her down for a short time, but before long she was back to her diet of candy, cookies, fried chicken, and steaks.

My mother’s diet contributed to her development of cardiovascular disease (including a heart attack), transient-ischemic events (TIAs—or “mini-strokes”), and insulin-dependent diabetes. Despite her multiple comorbidities, she lived another twenty-two years and seemed to enjoy almost every minute.

There are always exceptions, but poor lifestyle choices eventually catch up with most of us, taking a major toll on our health and well-being. Whether it is smoking, overindulging in food or alcohol, or foolishly taking chances with drugs, promiscuous sexual behavior, or the need for speed when behind the wheel of an automobile, our choices often determine our fates.

Proof can be found in the data collected by the Centers for Disease Control, who keep close tabs on our nation’s health. The CDC’s website contains some startling illustrations of the impact of lifestyle choices on the health of the population:

  • Seven out of ten deaths among Americans each year are from chronic diseases. Heart disease, cancer, and stroke account for more than 50 percent of all deaths each year.
  • In 2005, 133 million Americans—almost one out of every two adults—had at least one chronic illness.
  • Obesity has become a major health concern. One in every three adults is obese, and almost one in five youths between the ages of six and nineteen is obese.
  • Diabetes continues to be the leading cause of kidney failure, nontraumatic lower-extremity amputations, and blindness among adults age twenty to seventy-four.
  • Excessive alcohol consumption is the third leading preventable cause of death in the United States behind diet, physical activity, and tobacco.[i]

The bottom line is that we are a chronically ill nation and our illnesses are not merely debilitating but also costly—resulting in hundreds of billions of dollars spent unnecessarily on health-care expenditures every year. And the situation is deteriorating!

It doesn’t have to be this way. We have the power to change our nation’s prognosis. Many of the chronic diseases we experience are either preventable or can be delayed until the latter stages of our life. This simple yet profound message was preached for more than thirty years by Dr. James Fries. The question is, Do we have the will to change?

Compression of Morbidity: A Fancy Term for a Simple Goal

The July 17, 1980, issue of the New England Journal of Medicine featured a landmark article by Jim Fries, MD, professor of medicine at Stanford University. The article became one of the most frequently cited scientific references in the emerging field of wellness. Fries focused on the impact of chronic disease, which he described as “responsible for more than 80 percent of all deaths and for an even higher fraction of cases of total disability. Arteriosclerosis (including coronary-artery disease and stroke), arthritis, adult-onset diabetes, chronic obstructive-pulmonary disease (including emphysema), cancer, and cirrhosis represent the overwhelming majority of our health problems. They are widespread conditions that originate in early life and develop insidiously; the probability of their occurrence increases with age.”[ii]

Fries’s contribution did not lie in describing the inescapable spiral of chronic disease into disability and death. Rather, it was his challenging theory of the “compression of morbidity” that suggested the progression of disease and infirmity could be forestalled. “Disability and lowered quality of life due to the most prevalent chronic diseases are thus inescapably linked with eventual mortality,” he wrote. “These chronic diseases are approached most effectively with a strategy of ‘postponement’ rather than cure. If the rate of progression is decreased, then the date of passage through the clinical threshold is postponed; if sufficiently postponed, the symptomatic threshold may not be crossed during a lifetime, and the disease is ‘prevented.’”[iii]

Fries is stating that, while we cannot escape the human condition, by taking care of ourselves we can stay vital, active, and healthy until the very twilight of our lives. In Fries’s mind, that would be living the good life. He even went so far as to point to behavior changes that would compress morbidity, saying that “some chronic illnesses definitely can be postponed; elimination of cigarette smoking greatly delays the date of onset of symptoms of emphysema and reduces the probability of lung cancer. Treatment of hypertension retards development of certain complications in the arteries. In other illnesses, circumstantial evidence of similar effects of postponement is strong, but proof is difficult: that arteriosclerosis is retarded by weight reduction or exercise is suggested by associative data but has not yet been proven.”[iv]

I was fortunate enough to meet Jim Fries when he was part of a panel assembled by my mentor, Martin Seligman, at the University of Pennsylvania. Seligman, who was working under a Robert Wood Johnson Foundation grant, had assembled some of the brightest minds in preventative medicine to define the emerging field of positive health, including Dr. Fries. Fries obviously lives by the tenets he preaches, for he appeared to be in great physical condition.

In the intervening three-plus decades since Fries published this article, our knowledge on wellness and prevention has expanded greatly. Thousands of researchers have built on Fries’s foundational research, and the accumulated knowledge provides us with powerful but disheartening information on the degree to which our population is managing their lifestyle behaviors to affect wellness:

  • More than one-third of all adults do not meet recommendations for aerobic physical activity based on the 2008 Physical Activity Guidelines for Americans, and 23 percent report no leisure-time physical activity at all in the preceding month.
  • More than forty-three million American adults smoke. Lung cancer is the leading cause of cancer death, and cigarette smoking causes almost all cases.
  • Excessive alcohol consumption contributes to over fifty-four different diseases and injuries.[v]

If you are wondering how that compares to other people in other nations, “in terms of individual behaviors, Americans are less likely to smoke and may drink less heavily than their counterparts in peer countries, but they consume the most calories per capita, abuse more prescription and illicit drugs, are less likely to fasten seatbelts, have more traffic accidents involving alcohol, and own more firearms than their peers in other countries.”[vi] As we saw in the opening chapter of this book, our nation pays dearly for its behavior as evidenced by our poor population health status relative to every other industrialized nations.

Regardless of one’s nationality, the trick is not in knowing merely what to modify but how to modify our behaviors so that we live longer, happier, healthier lives.

 

If you would like to learn more, please consider reading: The Myths of Modern Medicine: The Alarming Truth About American Health Care, John Leifer, 2014 (Rowman & Littlefield).

 

 

[i] Centers for Disease Control and Prevention, “Chronic Diseases and Health Promotion,” last modified August 13, 2012,http://www.cdc.gov/chronicdisease/overview/index.htm.

 

[ii] James F. Fries, “Aging, Natural Death, and the Compression of Morbidity,” New England Journal of Medicine 303 (July 7,1980):doi:10.1056/NEJM198007173030304.

 

[iii] Ibid., 248.

 

[iv] Ibid.

 

[v] Centers for Disease Control and Prevention, “Chronic Diseases and Health Promotion.”

 

[vi] Institute of Medicine of the National Academies, U.S. Health in International Perspective: Shorter Lives, Poorer Health (Washington, D.C.: National Academies Press, 2012),