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A Thesis Submitted to New College of Florida In Partial fulfillment of the requirements for the degree Bachelor of Arts Under the sponsorship of Professor Douglas Langston Sarasota, Florida May 2008
ii Acknowledgments I would like to thank Professor Douglas Langston, who has served as both my advisor and thesis sponsor, for all of his guidance and assistance in completing this project. He has been an inspirational me ntor who has enabled me to recognize my potential while providing me with the academic counsel to achieve my lifelong ambitions. I am also grateful to the professors w ho served on my thesis committee. Professor Karsten Henckell offered much inspiration re garding topics involvi ng alternative health and Professor Alfred Beulig devoted a la rge portion of time to guiding me through the more unfamiliar scientific topics. The entire religion department has also been extremely helpful and giving of their time: Dr. Susan Marks aided me in devel oping my writing skills and Dr. John Newman guided me in researching eastern systems of medicine. I am also gr ateful to Dr. Sandra Gilchrist, Dr. Paul Scudder, Dr. Katherine Walstrom, and Dr. Eirini Poimenidou for their excellent abilities to convey complex scientif ic topics in a motivational and interesting fashion. I must extend a final acknowledgment to New College of Florida for providing me with financial support to unde rtake the task of research fo r this thesis and for offering such an excellent learning environment.
iii Table of Contents Introduction 1 Mental Health 8 Social Support 24 Physical Behaviors 38 Integrating Science and Religion 54 Appendix 71
iv HOLISTIC PREVENTION THROUGH THE RELIGIOUS APPROACH Gretchen Specht New College of Florida, 2009 ABSTRACT This thesis investigates the rela tionship between religion and health by considering the effect of religion on illness prevention. By utilizing the holistic model of mind, body and spirit, this thesis explores the benefits of incorporating religious ideas into the realm of health. In seeking to unders tand this view, we consider the effect of religious thought on mental health, the importance of religiously-based social interactions, and the direct phys ical suggestions promoted by religious groups and texts. The author suggests integrating timeless reli gious traditions with modern scientific discoveries in order to reach the most e ffective foundation for health. This framework would not only benefit individuals but it would also assist p hysicians in connecting with their patients and the health care industry in reducing the number of cases related to the lack of preventive care. Ultimately, religion is demonstrated to be an important tool in establishing health and wellness. Dr. Douglas Langston General Studies
1 Introduction In a society in which the health care system operates mainly through an orthodox approach founded on scientific principles, some unknown element is clearly lacking from the effectiveness of the system. On e third of the population will die from some form of cancer and one half of the population will die due to heart fa ilure. Although the factors leading up to such premature deaths are considered to be indu ced through poor health and lack of preventive measures, society as a whole has failed to successf ully execute actions associated with health and wellness. Even with the advice a nd efforts of medical do ctors, the percentage of patients that follow through with their doctor's instruction is painfully low. Unearthing the motivation to live a high-quality life should not be as difficult as it may initially seem. Harold Koenig reports that 96% of people in the United States follow a defined religion or recognize an unnamed spiritual power driving the fo rces of life (Koenig 1997 34). Another poll discovered that 69% of the general population believe religi on influences other aspects of life, and as many as 84% of older a dults connect religion to other areas (Ibid 36). Although religion has been perceived as a declining in stitution, the statistics reveal otherwise. In fact, one survey found an 18% increase from 1985 to 1996 of individuals who believe that religion influences other aspects of lives (Ibid 37) Applying the religious influence to the area of health should then be one of the most effectiv e and powerful intrinsically motivating factors in maintaining wellness. The link between religion and health is not a new or novel idea. In correlating health practices to religious beliefs, patients feel both greater motiva tion and a better outlook on their physical condition, thereby producing the highest st ate of wellness possible for the patient. The
2 religious model can also appeal to physicians and clinicians, who attribute much frustration to the surprisingly high percentage of patients w ho fail to follow the prescribed lifestyle advice offered by their doctors. Religious beliefs may help to instill an intrinsic drive for patients to follow through with their doctors instructions. Only with doctors and patients working together with outside elements, such as the religious perspective, can patients recognize both the scientific aspects of health care promoted by their doc tor as well as the psychological elements. In applying such nontraditional approaches, more than one form of treatment may be beneficial to the patient. Orthodox medicine, also known as conventional medicine, is the dominant form of health care in most of the developed countries. Or thodox medicine focuses exclusively on the symptoms exhibited by a patien t and utilizes drugs, surgery, or radiation to remove the symptoms. Alternative medicine is a term commonly employed for medical procedures that fall outside the realm of conventional medicine (Guinness 21). Naturopathy, chiropractic, and homeopathy are forms of alterna tive medicine. Natural medicine relies on the healing powers of the human body and considers such elements effective enough to be considered a medical treatment. Diet and wate r therapies as well as herbal treatments are common forms of natural medicine. Traditional medi cine refers to a medical system that can be traced to ancient origins. This form of medi cine includes Shamanism and Chinese medicine and is characterized by its strong cultu ral ties and trained healers (Ibid) Folk medicine varies from culture to culture but always involves a belief in the power or effectiveness of a selected treatment option. Folk medicine re lies on plants, charms, and ritual s to act as medical treatment in the patient. Holistic therapy treats the patient as a whole i ndividual as opposed to treating merely the symptoms1. Self care and preventative health are emphasized, and th e integration of 1 Holistic medicine criticizes orthodox medicine for treating merely the symptoms. This system considers the failure of mainstream medicine to be a re sult of what it sees as a narrow approach.
3 mind and body is key. A final category concerns complementary medicine, which is the use of any of the above alternative forms of treatme nt combined with or thodox medicine. A thorough examination of the interacti on of religion and health suppor ts the use of complementary medicine above all other forms of therapy. The complementary approach connects the scientific documentation found in orthodox medicine to the multiple benefits offered by the alternative approach, producing an end result of an indivi dualized combination unique to each patients needs. In producing this personalized treatment plan, doctors and cl inicians should take certain steps to ensure the patient is receiving the best care and advice availa ble. All health care personnel, from physician to psychologist, should examine their patients with regard to the patient's personal religious and/ or spiritual beliefs. The duty of the health care industry should then include incorporating th ese beliefs into a multifaceted model. For this reason, it is absolutely vital for all persons involved with he alth care to understand the varying aspects of wellness as seen through the different world religions. To best create a strong relationship between religion and health, the factors connecting the two ideas must be more closely examined. Such an investigation reveal s three distinct ways in which religion fosters health. First, religious and spiritual id eas often promote the cessation of harmful practices. For example, both the avoidan ce of smoking and the act of abstinence from alcohol have documented health benefits. Secondl y, religious and spiritual ideas promote actions that may be associated with an improvement in health. The implicit social factors of religion and its rituals, including pr ayer and meditation, may lead to habitual activities that have been demonstrated to provide psychol ogical benefits. Finally, the dire ct connections indicated through religious practices benefit h ealth through physical means. A dherence to specific practices,
4 including dietary laws and nontradi tional therapies such as Ayurveda, have been shown to cause an improvement in overall physical well-being. Th is model displays the connections, allowing the health care industry to best determine which treatment plan should be used for each patient. Unfortunately, religion has been losing cred ibility as the philos ophical belief system presented by religion has been called into questio n. Nonetheless, this thesis proposes that, in terms of issues of health, the question of truth is less important than the perceived benefits the religious model offers. Within the holistic model, mind, body, and spirit are used to both prevent illness and maintain health. The belief system of religion maximizes the benefits of the holistic model by providing a framework upon which to build the health system. This framework can be conceptualized through three aspects: mental hea lth, social support, and p hysical behaviors. All three areas have been studied and found to represen t areas in which religion plays a strong role in the prevention of illness. Through these studies, the benefits of connecting religion to health become apparent in creating the best health available and preventing the occurrence of illness.2 Such an idea suggests that al l persons involved in the health care industry should consider a spiritual history and utilize the proper treatm ent when evaluating a patient. Furthermore, individuals should recognize their own beliefs and apply the preventative concepts offered by their religion in their journey to optimal health. Defining Terms Religion is an intangible concept that is c onsequently difficult to define simply. Religion is also unique in that it is not limited to one dimension of behavioral as pects. Instead, religious ideas are applicable to many facets of daily exis tence ranging from material and earthly matters to existential questions (Schumaker 5). Th e psychologist Eric Erikson recognized the 2 See appendix, Figure 1
5 problematic nature of existence itself as a mo tivating factor that drives mankind to seek supernatural answers. To Erikson, religion can be defined as a sense of order in a world of, exceeding darkness which surrounds mans existen ce, and the light which pervades it beyond all discrete comprehension (Ibid 6). Allport considers religion far too broad to define; however, some attempt to quantify religion is necessary to reach an understanding of the purpose of this overall study (Ibid 7). Still, the problematic nature of religion makes it diffi cult to create a single definition that can be agreed upon by persons of the many diverse religious backgrounds It seems that the general consensus within the western world is that re ligion is an institution concerned with the interaction of man with a Suprem e Being or force. Another attempt to define religion considers faith in the institution itself to be the factor co mmon within all religions. Still another effort to find a common ground links the religions through the quest of man to understand either the creation or creator. All of thes e conceptualizations fall shor t of complete accuracy. While religions such as Islam and Christianity adhere to one higher authority, ot her religions such as Buddhism do not ascribe to the notion of a suprem e deity. Additionally, the concepts of faith and creation are not univers al to all religions. In recognition of this dilemma, the very definition of religion has been a controversial topic with many different points of view. Geertz s definition of religion has been held with esteem and quoted by many of his contemporaries. He states, religion is a system of symbols which acts to establish powerful, pervasive, a nd long-lasting moods and motivations in men by formulating conceptions of a gene ral order of existence and clothi ng these conceptions with such an aura of factuality that th e moods and motivations seem uni quely realistic (Geertz 4). The psychologist and philosopher Erich Fromm contribut es an important element to the idea of
6 religion by indicating that it is, a system of id eas, norms, and rites that satisfy a need that is rooted in human existence, the need for a syst em of orientation and an object of devotion (Schumaker 5). For the application of religion to health, a combination of these multiple definitions seems best suited. This is because he alth is an immaterial need (Fromm) which can use the order offered by religion (Geertz) to better the existen ce of man (Erikson). In order to make the transition to religion within the field of health, the application of religion to earthly matters must be more deeply analyzed. Within the material realm, perhaps the most valuable issue is the pursu it of health and wellness. Heal th, described by the World Health Organization as a state of complete physical, mental and soci al well-being and not merely the absence of disease or infirmity, can then be included in religion as an extrinsic goal.3 The primary medical system concerned with health is the field of prevention, a practice commonly employed by complementary medicine. Although prevention of illness4 sounds like an ideal aspiration, the factors involved are often difficult to isolate. Marie Boyles Personal Nutrition emphasizes the need to examine our current ideas about preventing illness by citing that 71% of deaths are based on lifestyle fact ors (Boyle 6). Religious beliefs and practices certainly have an important effect on lifestyle, whic h reveals the connection between religion and health. Many religions provide nutritional and dietary guidelin es; if adhered to, religious suggestions could aid in preven ting the 64% of deaths attribut ed to poor nutritional choices (Ibid). Thus, while the documented studies help to reveal the psychological attributes of religion to health, the preventative aspects of religion are also found implicitly within the religious beliefs themselves and manifest in the form of physical assets. 3 Fromm's aforementioned emphasis on need plays a critical role in the application of religion to health because wellness is a part of basic human needs.
7 Because of the nature of religion, one of th e primary concerns is the tendency towards a biased promotion of one specific re ligion's beliefs at the cost of devaluing other beliefs. For this reason, it is important for the health care i ndustry to refrain from prescribing religion to nonreligious patients or to ar gue or coerce patients into ad apting a religious viewpoint. Ultimately, the idea is to treat the patient in a manner most effective to the patients individual beliefs rather than to attempt to convert the pati ents faith. While the issue of religion and health can be viewed from a theological or evangelical point of view, Harold Koenig wisely points out that such an association does not need to limit the research on this topic (Koenig 1999 23). It is entirely possible to conduct an objective study on this topic and ask what the implications of religion as a whole can be on the health and well-being of the human population. 4 The term illness is used in place of disease. These te rms differ in the role of ex perience: disease refers to the physical or psychiatric symptoms as seen by the physic ian, while illness refers to th e patient's subjective view of the same sickness (Siegel 55).
8 Chapter One: Mental Health In order to most effectively prevent illness, an individual must address more than merely his or her physical condition. Historically, phys icians and healers would aim to establish a balance of both physical well-be ing and a healthy state of mind (Guinness 39). While it logically makes sense that mental health is of critical importance, modern orthodox methods examine only the physical symptoms and tend to overlook other as pects of a patient's treatment. In fact, unless the patient seeks counseling from a mental health specialist, he or she is unlikely to receive any advice concerning mental health. Recent studies have revealed that th e population recognizes this flaw and reportedly desires to be treated as a whole patient rather than as a part (Koenig 1997 26). In light of the populati on's concern, it would seem sens ible to incorporate both physical care and psychological advice in modern medical treatments. This method of care is supported by the holistic model, which states that a patient's physical health can only be in the best possible state when the patients mental health is also taken into consideration. Previously, the effect of religion on mental well-being wa s anecdotal and only strongly held by some members of the clergy as well as religious professionals. In recent years, the scientific method has led to new discoveries in this area. For in stance, Duke University Medical Center has devoted much time and research to we ll-defined studies that examine the relationship between mental health and religion (Koenig 2000 97). Much of the evidence has found positive correlations with one's reliance on religion and a better state of mental health. As scientific research supporting the holistic model has emer ged, advocates of the complementary approach have made stronger claims regarding the benefits of the religious experience. Deepak Chopra, a medical doctor who incorporates holistic practices into his treatments, understands that only a
9 person who has balanced mental health can have proper physical health (Chopra 1990 94). Chopra cites several studies reveal ing that people with the poore st mental health have higher rates of lifestyle disease, such as coronary illn ess (Ibid 31). He uses his knowledge to focus on creating a healthy state of mind in patients, ultimately leading to better physical health. Within the realm of prevention, sc ientific evidence confirms that re ligious ideas are advantageous in preventing illness through the reduction of mood and anxiety disorders. Additionally, religion encourages the avoidance of risky behaviors such as alcohol and drug abuse by appealing to the promotion of a healthy state of mind for religious believers. Together, these mechanisms help to instill preventative action with respect to physical illness through the religious actions of faith, meaning, prayer, and meditation. Faith Faith is often considered to be the driv ing force behind the actions associated with religion.5 Most religions depend on faith of some form to provide a framework for the belief system. Koenig relates faith in a higher power to a feeling of hope and a sense of control over destiny (Koenig 2000 90). The believer finds co mfort in the thought that God, or a superior being, cares for the faithful follower in a persona l way. This element of care becomes extremely important in times of crisis. A poll conducted after the September 11 th attack revealed that 90% of people turned to faith as a means of coping (Koenig 2005 45). Similar results have been found after the Oklahoma bombing, the Gulf War, th e Midwest floods of 1993, and the 1989 Hurricane Hugo (Ibid). One study further investigates the role of reli gious faith in coping with physical illness. The study asked participants, What enables you to cope with the diffi cult or stressful events in 5 Some define religion around this idea. See introduction.
10 life? (Koenig 1997 50). Of the 298 participants, 40 percent chose to use re ligious phrasing to express how they would cope with life-threat ening physical illness (Ibid). Through asking an open-ended question, this study demons trates that religious faith is a highly influential factor in dealing with physical illness. Faith also promotes readi ng of religious scriptures, th rough which role models and guidance for decision-making provide inspirational tools. Such religious instruction combined with faith has been found to result in strong and stable mental health. Within Christianity, a biblical point of view states that, faith is being sure of what we hope for and certain of what we do not see (H ebrews 11.1, New International Version). Another verse suggests that faith can overcome the world (1 John 5.4). Such passages are frequently quoted by advocates of health within religion as revealing the power of God over illness. Catholicism understands faith to be a motivating factor in the care of others. One organization, Catholic Charities of Alexandria, Virginia serves ten million people per year. This organization operates through the promotion of fa ith in services such as their division of behavioral health (Koenig 2005 194). Lutheran Services in America offers a similar program, which offers support for the mental health of as many as three million people per year (Ibid 195). Judaism recognizes figures within the Torah as representations of ro le models signifying a faithful individual). It is the duty of religious individuals to strive for faith modeled after Biblical figures such as Abraham and Mose s (Genesis, Tanakh). Through faith, YHWH's supremacy and inability to be affected by physical occurrences is passed on to his followers. Believers demonstrate faith in the hope of receiving YHWH's power in overcoming a variety of trials, difficulties, and illness. Islam considers faith to be an implicit instinct of the human soul. While all faithful
11 Muslims recognize Allah as the supreme creator, the more faithful are considered to be closest to Allah (El-Najjar 3). Muslims also categorize faith into three different levels of ascending faith: Islam, Iman, and Ihsan. The highest level of faith, Ihsan, is most honorable for the Muslim to attain (Ibid 2). The Qur'an considers the wil lingness to practice Allah's commandments as a necessary component of faith. As such, righteous ness will follow the faithful individual. Muslim faith is demonstrated through this righteousness; fo r example, the refusal of alcohol and drugs is a symbolic action displayed by the faithful man (Ibid 5). Within Buddhism, the Buddha himself considered faith to be of utmost importance in the teachings of the Dharma (Embree 179). This saddha, the Sanskrit word for faith, focuses on the authority of the Buddha. Through this faith, the Buddhist practitione r is encouraged to achieve the ultimate goal of Nirv ana. Only through Nirvana do worldly issues, including bodily illness, become overpowered by the willingness of the mind (Ibid 95). These diverse religions combine to promot e a reduction of mood and anxiety disorders through the mechanism of faith. Depression, one of the most growing threats throughout the western world, has been studied extensively within research i nvolving religion. In fact, Miller notes that research on the mental health benefits of religion ha s centered more on depression than any other clinical disorder (M iller 468). She cites a study con ducted by Smith and colleagues in 2003 that found statistical signifi cance between religious affiliati on and reduced depression in a meta-analysis of 99,000 subjects. Faith was held to be the variable responsible for the reduction in depression. In examining the implicatio ns of the study, Miller states, It seems that...religiosity is generally protective against psychopathology (Ibid 469). Depression is a debilitating disorder with serious effects. Indi viduals suffering from depression are unable to care for themselves pr operly (Butcher 220). Their sleeping patterns are
12 affected, and they may experience either insomnia or hypersomnia6. Appetite is also affected: some individuals experience a decreased appetite and rapid weight loss wh ile others experience the opposite (Ibid). Some depresse d individuals even report a d ecreased ability to focus or concentrate. Obviously, such beha viors reduce one's capability to take preventive steps. A proper balance of nutrients and sleep is critical to allow for prope r immune functioning. Anxiety is associated with similar detrimental behaviors (Ibid 197). Through faith-rel ated actions, rates of depression and anxiety are sign ificantly reduced, allowing for proper attention to center around preventive actions. Finally, faith in doctrinal authority leads to abstinence from dangerous behaviors, such as promiscuous sex and cigarette smoking, as well as refusal of drugs and alcohol (Koenig 1997 13). In a study published in the Journal of the Americ an Geriatrics Society several thousand people of all ages were asked to participate in a survey examining the relationship between alcoholism and religious activities. Subjects w ho considered themselves born again had significantly lower rates of alcoholism (Koenig 1997 45). Religi ous texts also discourage actions which promote stress, such as stealing and holding grudges (Koenig 2005 136). Because stress provokes symptoms of anxiety and depression, reduc ing stress through faith-related means helps to instill a healthy mental state of mind. Taken together, the above mechanisms of fa ith provide evidence that the act of faith promotes mental health there by creating a framework for the pr evention of physical illness. While actions such as reduced cigarette smoking and abstinen ce from alcohol and drugs are obvious preventive measures in themselves, the dire ct effects on mental wellbeing also assist in the preventive model. Only when a person is able to think clearly and without distracting thoughts of anxiety and depression can that individual's state of being promote a healthy physical
13 body as well as an awareness of actions that may be taken to prev ent physical illness. Meaning Another dimension of religion linked to pos itive mental health concerns the given meaning religion instills in the life of the believer. Several re searchers have proposed similar models that suggest religion not only provides a sense of m eaning, direction, and personal identity, but that it also helps to explain and resolve unforesee n circumstances (Chamberlain 139). Through this sense of purpose, religious individuals are able to explain physical ailments as well as to find motivation to recover. Additi onally, because religious individuals understand earthly circumstances to be part of a greater meaning, believers experience less anxiety and stress than persons attempting to isolate the meaning of individual ci rcumstances (Ibid 140). Frankl considers the search for meaning to be foundational, and when lacking, he considers frustration to be a direct consequence (Ibid 139). Through religious ideas, this foundational idea is given a solid framework. Reker and Wong build upon Frankl's theory, adding that religion provides a sense of satisfaction and fulfillment rather than a dullness of daily living (Ibid 140). Combining these elements again reveals a positive effect of religion on mental health that transposes benefits to physical health. Chamberlain recognizes this effect and argues that one may infer that rather than directly cont ributing to wellness, religious meaning influences well-being in a less direct fashion (Ibid 140). While a less direct mechanism is often more difficult to recognize, it is impor tant not to overlook the powerfu l possibilities of incorporating religion into a model for improved mental health. Different religions provide religious meaning in various ways, but they all share a common factor: they provide a sense of greater pu rpose. Through this greater purpose, believers 6 Insomnia is not enough sleep while hypersomnia is excess sleep.
14 understand the meaning of life and existence. Although the world's religions are extremely diverse, for the sake of simplic ity, the religious traditions' view of the meaning of life can be roughly divided between the easte rn and western hemispheres. Among western religions, the emphasis lies on worship of a monistic God and the practice of inspired texts. Christianity explains that earthly existe nce is merely an opportunity to know the creator. As a believer, one's purpose is to share the gospel with all of the world (Mark 16.15). Jewish scriptures reveal the purpose of man is to keep the laws of the Torah and worship YHWH. Ecclesiastes 12.13 states, Fear God and k eep his commandments, for this is the whole duty of man (New International Version). Isla m also attests that mankind exists solely to worship Allah: "I only created jinn and man to worship Me" (Qur'an, 51.56). Because this life is a test for mankind implemented by Allah, Muslims follow the religious laws and duties in hopes of achieving the goal of entering Jann ah, the Islamic heaven, after death. Eastern religions tend to be lieve that the individual ex ists in a form through many different earthly lives, and the purpose of each life is to provide an opportunity to break free from the cycle. Hinduism explains existence as a continuing cycle of death and rebirth known as Samsara (Fenton 105). The duty of the individual is to act in a way that benefits all of existence thereby promoting the individual's Karma. Through religious actions, known as Dharma, the believer ensures not only that he or she will achieve the best Karma, but also provides a path to Moksha7(Ibid 54). Buddhism shares a similar system in which Nirvana, the awakening, is the ultimate end to the cycle of death and rebirth (Embree 95). To Buddhists, this awakening is achieved through meditation on the scriptures and realization that all of life is suffering (Ibid 96). Daoism focuses more intent ly on establishing harmony with nature (Ibid 172). Daoism understands the meaning of existence to implicitly be understood within each
15 individual, and through contemplation, one can h ope to achieve a full acknowledgment of this awareness (Ibid 173). Because the world religions all have an established system of meaning, a surprising finding lies in the results of religion's impact on self awaren ess. Opponents to the benefits of religion on health have argued that religion creates a weak mindset in which the believer feels that individual efforts are of little use in a wo rld driven by a higher authority (Chamberlain 138). Instead, the opposite seems to occur in that religious individuals report a higher sense of self (Ibid 139). This finding is of gr eat use to proponents of the preven tive model of religion in that religious individuals may take great er steps to ensure that their physical health is in the most optimal state directly because they ar e driven by a greate r purpose (Ibid). The link between the search for meaning and mental health is not merely evidenced by reasoning, but it is also supported through empirical studies. Such studies display that a lack of meaning is associated with pathological outcomes (Ibid). Other variables are factored in as well, such as religious meaning as it correlates with reduced substance abuse (Mercola 1). Furthermore, both private and public religious rituals have been f ound to increase perceptions of life satisfaction (Chamberlain 139). Understanding a higher meaning of life is a st rong theme in religion. This idea also has repeatedly been proven to correlate with both be tter mental health and better physical health. Koenig even places the value of meaning in a dimension beyond mental health, stating, People who face life with an optimistic sense of purpose within God's plan pay more attention to good nutrition and moderate exercise (1 999 41). While this idea is yet to be studied in depth, a sense of meaning could logically lead to more effo rts beyond merely preventive health through the mental aspect. Still, it is safe to conclusively recognize that the drive to manage preventive 7 Moksha is the ultimate goal of Hinduism, and is liberation from the cycle of Samsara.
16 actions stems from contemplating one's place in the world as part of a greater meaning. Prayer The proposed connection between prayer a nd good health has led to numerous studies examining the link from a scientif ic point of view. Harold Koen ig, the director and founder of the Center for the Study of Re ligion/Spirituality at Duke University, has conducted a tremendous amount of research on this particular topic a nd steadfastly maintains that the connection is valuable and worth noting. Before the year 2000, studies mainly examined the hope and optimism offered by religious institutions without considering prayer as a variable. New studies reveal significant reductions in depression, anxiety, fear, marita l dissatisfaction, and substance abuse in religious persons who rely on prayer for communion with a higher being. The amount of research within the past fi fteen years has exponen tially increased on the subject of prayer. Koenig cites that the r easons why religion can influence coping are both logical and rational. An individual who feels he or she communicates with a higher being is likely to feel that life has more purpose and thereby to have enhanced motivation, personal empowerment, and a sense of control (Koenig 2005 69). One controversial study involving prayer was conducted by Randolph Byrd in 1998. As a cardiologist, he noted that many of his patients seemed to benefit from the use of prayer, whether the prayer was conducted by the patient on his or her own or from another individual (Byrd 826). He separated his patients into a group not ut ilizing prayer and a se cond group with anywhere from three to seven born-again Christians pr aying for the unknowing patients. Byrd observed that the patients receiving pray er required a reduced amount of antibiotics, experienced less congestive heart failure, and were less likely to develop pneumonia (Ibid 827).8 While studies of 8 See appendix, Table 2
17 this format have seldom been conducted, Byrd's research has led the way for more future studies involving intercessory prayer.9 Christian Science offers some of the most powerful suggestions pertaining to prayer. In Science and Health with Key to the Scriptures, Mary Baker Eddy suggests that prayer and faith together can produce miraculous healing and supe rior health (Eddy 12). Because prayer brings the believer closer to God, the power of God is thought to extend to those in communion with God, resulting in higher states of physical health. Interestingly, to Eddy, this divine presence is always available: the beneficial effect of such prayer fo r the sick is on the human mind, making it act more powerfully on the body through a blind faith in God (Ibid). In essence, to Eddy, the capacity of prayer's effects exists more so in the mind of the believer than in the actual religious power. She further adds that self-examination is critical before pray er, thereby forcing the individual to examine his or her mental state (Ibid 8). Islamic rituals associated with prayer al so correspond to preventive health practices. Before a Muslim conducts prayer, it is necessa ry to undergo a ritual cleansing known as ablation. Mukhtar Salem describes the preventive health aspects of ablation in his book Prayers: a Sport for the Body and Soul. He describes that the areas that must be washed are those most exposed to pollution, including the hands, feet, and face (S alem 52). Washing of the mouth is also encouraged and is likewise found to promote better dental health. Because the prayer ritual must be performed five times a day, the frequent washing has been recognizably associated with reduced health ailments (Ibid). Buddhism also uses prayer, known as pujas (Embree 6). Pujas differ from prayer in the western world because they offer spiritual co mmunion with the underlying meta-reality rather than a supreme being. These prayers, usually in the form of chants or mantras, are used as
18 inspiration as well as sources of knowledge and wisdom. Shinto prayers are thought to have evolved from both Buddhi st and Daoist notions (Ibid 199). A Shinto prayer consists of a wish or favor directed to a personified deity known as a Kami (Ibid 200). It is therefore the be lief in the Kami that seems to have a psychological influence on the health of the practitioner. In spite of these studies, prayer is potentially the most difficult concept within religion to directly connect to advantageous health actions Because prayer cannot be tested and measured in the same way as a treatment with the opportun ity for a placebo to be used, the intention of prayer itself must be analyzed. For a theist, pr ayer is an opportunity to commune with a higher power or Supreme Being. While a person engaged in prayer most frequently presents a needy disposition, the goal is not so much attainment of a request as it is to connect directly with this being. Quite simply, prayer does not claim to fulf ill requests so much as it claims to recognize dependence on a higher power. While this being ma y or may not answer the request, the goal of prayer is achieved in the very action of communication itself. Ultimately, it is the act of communication conveyed by prayer that may be related to the health benefits prayer has repeatedly demonstrat ed. Because prayer provides the mental necessity of communication, an optimal ment al state is often described by individuals who engage in habitual prayers.10 Through such communion, persons are driven to maintain their health and to practice behaviors posed by th e preventive health model. Meditation The concept of meditation has been employe d by a wide variety of religious systems. Defined as a mental exercise that, keeps the attention pleasantly anchored in the present 9 Much research is needed in this area before any assumptions may be made.
19 moment, meditation has been used as one of the most fundamental practices within both eastern and western religions (Guinness 100) The goal in meditation is to train the mind to attain a peaceful state in which subtle sources of in formation can be perceived. This practice has consistently revealed correlati ons with elevated quality of living. Habitual meditation has been associated with lowered blood pressure, and has led some physicians to recommend meditation in conjunction with other lif estyle changes to prevent hypertension (Guinness 102). Buddhism is one of the primary religious syst ems concerned with meditation. In fact, the very image of the Buddha carved into monasterie s across the world depicts the Buddha in a state of meditation (Fenton 15). Like wise, the history of the Buddha describes a person of great mental health whose message encourages individua ls to seek a state of inner peace and harmony. As Buddhism spread through Asia, variati ons of the meditation practices developed within each region. Tibetan Buddhi sts implemented a magical form of meditation which is today known as transcendental meditation (Ibid 86). The Japanese B uddhists developed Zen meditation, which reportedly resemble s psychotherapy (Guinness 101). Gary Groth-Marnat extensively investigated the role of meditati on within the Buddhist religion and its effects on ment al health. He notes that Buddhi sts make no clear distinction between spiritual and mental health, and he also compared Buddhist monks to psychotherapists using meditation as a form of therapy (Gro th-Marnat 270). To Groth-Marnat, Buddhism is extraordinarily beneficial to the mind in its quest to overcome ignorance (Ibid 271). Because Buddhism links ignorance to materialism and consumption by daily actions, the goal of meditation is to recognize the truth of existen ce and to discern which matters are truly worth concern. Groth-Marnat is quick to point out that Buddhism teaches Nirvana, the highest state, is not mere emptiness. Instead, this state signif ies a state of compassion and connection with 10 The crossover with social factors in prayer is very strong, see chapter 2.
20 others.11 With suffering and attachment with unimportant matters removed from the practitioner's concern, meditation teaches that happi ness exists within the very core of the self. Through these mechanisms, Buddhist medita tion removes anxiety through teaching that there is nothing to dread in this present worl d (Groth-Marnat 273). Consequently, the high-stress state associated with illness is reduced in B uddhists who meditate regularly. Studies on Zen monks, the Japanese form of Buddhi st practitioners, report reduced stress and tension as a result of lowered oxygen consumption and heart rate. A related form of meditation is known as qigong, a system of healing and energy medicine that originated in China (Cohen 3). Kenneth Cohen explains, qigong means working with the life energy, learni ng how to control the flow and distribution of qi to improve the health and harmony of mind and body (Ibid). Thr ough specific breathing techniques, gentle movement, and mind control, an individual's h ealth and vitality are reportedly improved. Qigong is subdivided into four types. Medical Qigong (Y i Gong), the preventive or self-healing aspect, teaches practitioners to have a positive compos ure in order to prevent high blood pressure, frustration, and anxiety. External Qi Healing (Wai Qi Zhi Liao) is used with acupuncture or osteotherapy as a form of psychotherapy. S ports Qigong (Wu Gong) is used to increase flexibility and stamina, and is particularly bene ficial to persons looking to improve stamina and performance in any demanding sport. Spiritual Qigong (Tao Gong) is the discipline concerned with tranquility and harmony with nature (Ibid 5). Today, Qigong has gained notice among the elderly and persons requiring physical therapy through the form of Taiji Quan, also known as T'ai Chi (Guinness 220). This form of exerci se combines meditation with gentle, soothing motions designed to return the body and mind to an uncorrupted state. While the term yoga is often thought of as referring to a form of bodily exercise, yoga
21 also spends much emphasis on meditation practices (Embree 298). The practice known as Raja Yoga or Ashtanga Yoga is one of the six schools of Hindu philosophy and the form of yoga that is primarily concerned with the mind (Iyenga r 23) Through this form of yoga, practitioners intently focus on the eight limbs thought to di rect the life force and balance the mind and emotions. Each limb is associated with med itation through specific t houghts. Yama is the practice of meditating on self-restraint to rem ove the innate brutality of the individual and replace it with a strong will. The limb of Niyama is concerned with meditation on religious texts (Ibid 3). Asana combines specific poses with the act of meditation in order to integrate the mind and body (Ibid 40). Pranayama connects breathing exer cises to meditation in order to keep the outgoing thoughts of the mind in check. Pratyahara is the removal of the senses from perception in order to minimize mental di straction. Dharana focuses on the concentration that leads to meditation. The limb known as Dhyana is the pr imary limb concerned with meditation and is used to focus the mind to gain self-knowledge. Through steadying of the mind, the practice of Dhyana helps the practitioner to reduce desires and cravings that are considered obstacles to a healthy mindset, leading to the eighth and final limb, Samadhi. Samadhi is the highest state of superconsciousness and blissful awareness (Ibid 3). Other forms of Hinduism also use the pract ice of meditation. The cult of Krishna, an offshoot of Hinduism, firmly uses meditation to establish mental stability and an understanding of purpose (Embree 276). Sikhs believes that through meditation, all mankind is able to understand the universal God (Ibid 373). Sikhs interpret meditation to be a tool in order to contemplate methods to aid others in leading healthy and fulfilling lives. Christianity also maintains a dimension of meditation. Mary Baker Eddy insists that through reading and meditating upon Ch ristian texts, believers can achieve true understanding of 11 The highest state in Buddhism is thus highly social as well, see chapter 2.
22 God (Eddy 505). Eddy firmly believes that medita tion can overcome any physical illness through a strong mind (Ibid 369). Other forms of Christia nity also ascribe to meditation usually as combined with prayer. Koenigs meta-analysis of longitudinal studie s also provides insight into the effects of religious meditation on the preven tion of mental disorders. Of the five longitudinal studies examining the relationship between religion and a nxiety, four found that religious people were less likely to experience fear or anxiety when surveyed m onths or years later (Koenig 2005 144). The ability of meditation to prevent anxiety held across several religions, including Christianity, Islam, Hindu, and Buddhism. Meditation demonstrates strong positive eff ects on the mental state of practitioners. Again, this healthy mental state relates to a healthy physical state. Such practices thereby pave the way for the preventive model to be employed both methodically and coincidentally with the practices associated with meditation. Summary Various religions offer support for mental health through the m echanisms of faith, meaning, prayer, and meditation. Each of these religious actions displays an element through which a positive mental state is established. As physicians better understand the link between mental health and physical health, more emphasis is being centered around the need for mental stability in order to prevent illness and create better health. The religious model offers a strong framework for preventive medicine to build upon in that each of the aspects presented contribute to optimal mental well-being. Perhaps the strongest link between religious meditation and mental h ealth is that which appears in Witter, Stock, Okun, and Haring's 1985 meta-analysis of 28 studies. These authors
23 found that, religion is positively associated with perceptions of well-being (quoted in Chamberlain 138). Deepak Chopra takes this clai m to the next level, stating that the mind ultimately controls the body, and therefore only a person who believes to be well can actually demonstrate physical health (Chopra 1990 65). Thr ough an examination of the many studies as well as an understanding of the ideas promoted through religion, it is of little surp rise that the positive effect on mental health also feeds into the preventive physical health model.
24 Chapter Two: Social Support Religious institutions are often characterized by their strong social networking systems. Not only is social support an important foundation of the religious model, but it also can provide a method to quantify religion for the purpose of comparing it to health, such as through the frequency of congregational attendan ce or degree of participation in religious activities. Multiple studies have been conducted that link positive asso ciations to health through such statistics and indicate that persons who are invo lved in religious soci al activities have be tter health and longer lifespans. The correlative results reveal a conn ection between religious gatherings and health benefits through this social aspe ct. In fact, the consistency with which such results are obtained has led researchers to recognize that psychosocial benefits ar e one of the most documented aspects through which religion is th ought to contribute to health. The most recent breakthroughs have shown th at religious social aspects may be even more powerful than previously be lieved. While past studies indica te correlations between better health and religious activities, the most recent studies support cau sality in explaining the effects of religion on health. In one such study, religi ous interventions, whethe r Christian, Buddhist, or Islam, caused the symptoms of depression, bere avement, and pain in individuals to lessen significantly (Koenig 2005 92). Such results have led researchers to further investigate the link between religion and preventive health, as eviden ced through attendance at religious institutions, social support, and values.
25 Attendance at Religious Institutions Religious institutions12 provide an excellent social s upport system for members of the congregation. One quantifiable way in which re ligion may be empirically demonstrated to influence physical health is through the support o ffered through attendance at such institutions. The Handbook of Religion and Health contains one of the most thorough collections of studies revealing the role of at tendance at religious institutions in influencing health (Koenig 2001 382). The book demonstrates that religion influences ph ysical health through an interaction of the social networking support of the religious instit utions with additional guidelines for better physical health. Indeed, much evidence supports the benefits of this inte raction on health specifically studies examining the elderly (Krause 405). Doug Om an, a lecturer at UC Berkeleys school of public health, believes that the social support o ffered through church attendance increases the perceived power of religion itself, there by allowing for better coping (Oman 2002 365). The social environment of a religious gathering appeal s to the human need for interaction with others. This action stabilizes one's mental health, allo wing for an optimum sense of inner peace in the individual, which in turn provides for a bett er immune system and motivation for preventive health as well as the pot ential for healing (Ibid). The Handbook of Religion and Health also quotes Omans study, in which a connection between the social aspects of religious involveme nt and immune and endocrine function helps to explain the influence of religion on physical h ealth (Koenig 2001 384). Participants in the study demonstrated significantly lower blood pressure, a reduced mortality from cancer, and a longer lifespan not just among clergy, as previous studie s had revealed, but amo ng practitioners within
26 the community as well. The link between self-reported attendance at religious services and reduced mortality is undoubtedly one of the strongest connections for individuals as well as clinicians. A 2002 study conducted at UC Berkeley revealed that weekly church attendance is a ssociated with a longer lifespan even when other lifes tyle variables are controlle d, including smoking and exercise (Oman 2002 366). Longevity has been found to correla te with church attendance in more than one study; in fact, the authors of the Handbook for Religion and Health found 21 studies examining the connection between religious attendance and longevity (Koenig 2001 385). Koenig writes, Frequency of church attendance (an indicator of level of involvement in the religious community) seems to be the strongest pred ictor of survival (Ibid) In fact, nearly 3 out of 4 of the studies which were examined found longer lifespans among those with more frequent church attendance (Ibid 386). Other variables have also b een studied in conjunction with church attendance. One study conducted by Colantonio in 1992 examined the rela tionship between religious attendance and the rate of stroke. The occurrence of stroke among subjects who attended religious services weekly was significantly lower than among those who attended less frequently (Koenig 2001 384). Studies in immune system functi oning, measured by interleukin-6 and CD4+ counts, have also demonstrated that better immune system functioning is associated with higher rates of church attendance (Ibid 384). While studies involving heart disease are less conclusive, most studies have found lower rates of hypertension among su bjects who report more frequent religious attendance (Ibid 383). In another interesti ng study, Koenig found that high chur ch attendance along with prayer 12 Religious institutions include churches, temples, mosque s, chapels, or other places intended for meeting to worship as well as to promote religious ideas and beliefs.
27 is associated with the lowest diastolic blood pressure levels while those with low church attendance and prayer had the highe st diastolic blood pressure. Perh aps most interesting is that high church attendance and low pr ayer has been found to be asso ciated with lower diastolic blood pressure than low church attendance and hi gh prayer (Ibid). From examining this study, it appears that church attendance is a more influential variable than prayer. Again this result is explained through the benefits of the social interaction provide d within church attendance, leading to the conclusion that social support is one of the reli gious model's strongest preventive health factors. Koenig recognizes this powerful social interaction and states, This social bond can become an informal hea lth-promotion network (1999 73). A different approach on the connection betw een attendance at religious institutions and preventive health concerns the use of health screening for secondary preventive purposes. A study conducted in Utah found that persons within religious communities were more likely to use preventive measures such as cancer screening (Merrill 38). This study asked both members of the Church of Jesus Christ of Latter Day Sain ts as well as non-religious individuals their likelihood for screening for cervical cancer. The results found that, of subjects who identified themselves as religious, 79% of unmarried wo men had undergone a screening for cervical cancer within the past two years (Ibid 43). A similar study examined African American women with regard to breast cancer screen ing (Paskett 40). This study also found higher rates of screening within church members than non-members. The au thor used these findings to conclude that religious institutions may help to instill practitio ners to take preventive measures by providing an avenue for awareness as well as the social enc ouragement to insure optimal health (Ibid). These findings are of great value to advocates of preventive medicine because of their consistency across religions and around the world. While this is a less studied avenue, it is
28 remarkable to note that the studies always reve al more than just a steady parallel between religion and awareness of health, but also a desire to detect illness in order to preserve life and meaning in this existence. Benjamins's 2007 study conducted in Mexico questioned 9,890 subjects and found that religiosi ty is related to the use of blood pressure screenings and cholesterol screenings, and that religious attendance and social act ivity was the best determining variable for blood pressure and diabetes awareness screenings (Benjamins 222). Benjamins noted that Mexico is one of the top ten countries in the world to have high numbers of religious persons, and that between 81 and 89 percent of people consider themselves to be part of the Catholic religion while only 3% report no religious conn ection (Ibid). In explaining the results of his study, Benjamins credited the social model as th e most influential aspect, and he added that the growing awareness of methods through which preventive services are used most frequently spreads through word of mouth within Mexico's religious communities (Ibid 223). At this point, it is worth mentioning that cr itics state that the self-presentation bias may be involved in such statistics. Dr. Richard Sloan believes it is worth considering that religious individuals may have a tendency to inflate their frequency of church attendance (Sloan 1999 5). This idea should not necessarily be seen as a di scouraging factor because individuals who would desire to inflate church attendance ar e still likely to benefit from some of the perceived religious advantages. Overall, studies examining religious attendance are one of the most beneficial methods to use in designing studies to unde rstand the effects of religion on health. Social Networking Religions association with preventive health appears to function through social support in three related ways. First of all, Oman states that religious social s upport is associated with positive health behaviors, such as a reduction of drug and alcohol abuse. This idea coincides with
29 moral values and may be linked to the prevention of serious diseases, such as liver disease and pulmonary disease (Oman 2002 371). Secondly, the reduction of stress is another preventive benefit that is the result of the positive psychol ogical states encouraged by religious networking. Several studies have associated reduced stress speci fically with the prevention of gastrointestinal disturbances, including stomach and bowel di sease and ulcers. Finally, social support is associated with disease detection and treatment merely because of the care and concern inherent in the social network. Positive health behaviors include a variety of factors, and the avoidance of risky behaviors and drugs and alcohol is merely one aspect to consider. Adolescence is one of the most difficult periods of development because it is a time associated with potentially dangerous behaviors and inability to discern among choi ces. For this reason, adolescents can benefit particularly well from religious promotion of pos itive behaviors. In 2006, a team of researchers in the United Kingdom analyzed risk and prev entive factors for meningococcal disease (Tully 445). The study found that intimate kissing with multiple partners was a significant risk factor in the development of meningococcal disease while religious observance was nearly as strong a preventive factor as vaccinat ion (Ibid 447). The authors reco gnize the results as surprising because vaccinations are considered one of the best preventive efforts of modern day medicine. For the findings to reveal that the social factor of religion can play as strong of a role as medicine is truly revolutionary. Positive health behaviors extend to providing benefits for all age groups. Koenig conducted a study among elderly persons in wh ich he examined the relationship between cigarette smoking and religious activities (1998 426). Over six years, his team evaluated 3,968 persons over the age of 65 for religious participation and cigarette sm oking. Higher participation
30 in religious activities revealed a positive correlation with reduced cigarette smoking. In subjects who both participated in religious actions daily, such as prayer and the reading of religious texts, as well as weekly attendance at a religious institution, cigare tte smoking was found to be 990% less likely. Koenig explains that while religious actions are beneficial, it is with the combined support of the community that th e strongest motivation is found to avoid such risky behaviors.13 As Koenig noted, such actions have been show n to correlate with a longer lifespan (Ibid). Strawbridge noted several similar results in his 1997 study conducted among 5,000 adults of various ages (957). He found th at religious individua ls were more likely to succeed in the difficult action of quitting cigarette smoking. Because cigarette smoking is known to be associated with reduced lung cancer, hypertension, co ronary artery disease, and other diseases of the bronchial system, the avoidance of cigarette smoking is a strong factor in preventive health. His hypothesis indicates that the social suppor t found within churches and other places of religious gatherings creates the necessary st ructure to successfully stop smoking (Ibid 959). A reduction of these risky behaviors is what Koenig describes as part of a healthy lifestyle (1999 72). To maintain this type of lifes tyle, the support of others within the religious community is critical. Koenig notes that all the established religions discourage behaviors such as drunkenness, risky sexual behavior, and any ha bit or activity that is harmful to the human body. Through incorporating social s upport, this lifestyle becomes more than merely a part of religious law or strict doctrine. Individuals within the community encourage each other to follow religious principles regarding the human body and continually reinforce th e doctrinal idea that the body is a type of holy ground. Social networks of religious indivi duals find strength in understanding that the body has been given indi vidualized meaning in the Universe by a higher power (Ibid 93).
31 Christian scriptures concis ely explain the idea of body as temple in a New Testament verse. What? know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? (1 Corinthians 6.19). But Hindu spirituality recognizes this same theme and understands that man can only reach a higher level of Karma through making the best use of his current phy sical body (Embree 257). Even rituals of world religions, such as Shamanic dances, are a celebration of the holiness emanating from the human body (Ketchell 50). This consistency across all religions helps to explain the results of Alexander and Duff's study on persons raised in a religious household. They found that the teac hings of treating the body as holy led to lower rates of alcohol and to bacco-related illness as well as less sexually transmitted diseases when compared to persons not raised with such teachings (Koenig 1999 72). Such results indicate that religi ous teachings taught in childhood carry significant benefits even if rejected later in lif e. In fact, the method for furthering th e religious benefits is based on the social structure inherent in the religious teachings, revealing yet again the importance of religious socialization. The application of stress re ducing techniques promoted by re ligious ideas also carries many components, ranging from ment al and physical to social suppor t. Social psychologist Alan Radley notes that emotionally s upportive relationships are related to lower incidence of stress as well as disease (1994 9). He emphasi zes that disease often is the di rect result of stress, and that by maintaining relationships this stress is kept to a minimal level. Monroe and Steiner's study in 1986 confirms that positive social and family relationships reduce stress, leading to reduced illness and a longer lifespan (Butcher 144). Such preventive efforts have also demonstr ated direct effects on physical health through 13 See appendix, Figure 3
32 the social network created by religious systems. For example, Demieville's studies indicate that Buddhist monks and nuns were given the command to guard one another against illness (Demieville 31). This type of awareness regarding physical hea lth is inherent to closely connected communities. Because the religious system is based on relationships with others within the community as well as a relationship with a higher power, the religious model o ffers a greater social system than any other institution through appealing to the spiritual and mental needs of the individual. In fact, holistic practitioners note that while the spiritual relationship cannot be fully understood, it is consistently associated with reduced amounts of stress (Frohock 30). In addition to spiritual suppor t, the religions of the world support counseling in order to reduce feelings of stress. The Hebrew Bible en courages the support of others to reduce the element of frustration, which is considered by psychologists to be the primary category of stressors (Butcher 140). In f act, Proverbs 15.22 states, for want of counsel purposes are frustrated; but in the multitude of counselors they are established (Tanakh). Psychologists are in agreement with this reasoning, and add that co unseling sessions may aid in the prevention of illness, especially when an inte rdisciplinary field is employed (Butcher 13). Pastoral counselors are specifically trained in such a way and mu st have both a ministerial background as well as training in psychology (Ibid 11). Alan Radley also states that our ideas about staying healthy are influenced by the individuals around us (1994). Disease is more likely to be detected wh en external factors, such as social relationships, provide individuals with higher awareness of their own condition. In addition to this fact, the caring relationships established within the religious community provide a situation more likely to result in compassiona te suggestions regarding maintenance of health
33 and prevention of illness. Social psychologists consider this point to be most influential in the benefits of the religious model. Butcher addresses this issue in response to discussions regarding the power of stress to lead to personality disorders (Butcher 340). He states, such patterns may also influence physiological functioning. In fact death rates from various caus es, including physical disease, are markedly higher in people who have recen tly undergone marital problems or divorce. He cites a number of studies that demonstrate the esta blishment of a connection with others serves as a factor in positively influenc ing physical health. While much of the studies he report suggest the familial model, Butcher notes that a social system extending beyond the family is associated with even stronger preventive factors, such as lower blood pressure and better immune functioning (Ibid). The findings demonstrated through these studies help to explain why loneliness predicts vulnerability to vari ous causes of illness and death (Ibid). Butcher's suggestion for a social system beyond the family is one of religion's most appealing features. In fact, re ligious individuals often report feeling as though the community has become an extended family (Koenig 2001 150). In light of the multiple studies demonstrating the benefits of such a social model, it appears that religion is a valuable resource in preventing illness and disease. Values Beyond the moral values already presented in the above section, religion promotes values such as care and compassion. Such values are in tertwined with positive social interaction and can consequently be found within religious ideas. Re ligious doctrines insti ll moral values at a young age, including honor and respect for parents and gua rdians. Koenig notes that such values may promote the future care of older adults as well as the motivation to continue taking efforts to
34 manage physical health (Koenig 1997 12). Daoism is strongly associated with kindness to others. The Five Sentiments of Gratitude appeared in fifth-century Daoism and is a rite used to repent for sins that are believed to cause disease (deBary 404). The First Sentiment states: Father and mother engendered me and gave me life, nourished me and nurtured me. Coming and going, they cradled me in their arms, soothed and comforted me, caressed and tended me. They damaged their health wi th anxiety and wore themselves out with worry. When I was unwell or fell ill, they were distressed and preoccupied on my account, their hearts burning as if on fire. Appr ehensive day and night they forgot their food and gave up their sleep...Enabled to beco me as I am now, I am mindful of their great, their immeasurable kindness. I sincerel y vow to repay the boundless beneficence of my parents! (Ibid 404-405) This passage reveals the contemplation of gratitude the Daoist religion promotes, as well as the importance of giving back. The other four sentiments promote similar ideals, including the distribution of excess wealth and the importance of both giving and taking from the world (Ibid 405). Buddhist doctrine teaches that there are two extreme ways of life which are to be avoided: the materialistic and the overzealous lifestyles. Inst ead, Buddhism teaches that the middle way is the desirable path (Embree 100). To accomplish this lifestyle, Buddhists lead a virtuous life modeled after the noble eightfold path. This doctr ine is comprised of Right Views, Right Resolve, Right Speech, Ri ght Conduct, Right Livelihood, Ri ght Effort, Right Mindfulness, and Right Concentration (Ibid 101). These eight paths are further di vided into three sections; one such section, Sila, concerns morality through sp eech, actions, and livelihood. The Right Speech
35 involves both truthful statements and non-hurtful speech. Right Actions must be wholesome and avoid harming others. Right Livelihood does not harm the self or others (Ibid). Christian virtues are listed in 1 Corint hians 13.13, which states, and now abideth faith, hope, charity...the greatest of these is charity (New International Ve rsion). Through teaching charity, Christianity promotes giving to the nee dy as well as the care of friends and family in need. The Old Testament also contains references to values, such as the commandments given to Moses by God in the book of Exodus. This collection of laws, often known as the Ten Commandments or the Decalogue, desc ribes ten laws. Five of these pertain specifically to laws regarding the treatment of others including the instruc tion to honor one's father and mother and the commandments not to lie, steal, kill, covet, and commit adultery (Exodus 20.1-17). Such values are taught at an early age with in both the Christian and the Jewish faith. The Jewish Tanakh guides parents to instill values into their chil dren as often as possible. Deuteronomy 11.19 states, and ye shall teach th em your children, talking of them, when thou sittest in thy house, and when thou walkest by the way, and when thou liest down, and when thou risest up. (JPS Tanakh). Through this continuous teaching, both Judaism and Christianity make a lifelong impact on children, which underlies their decisi ons made later in life. Catholic doctrine derives four cardinal virtues from writings of Plato and Socrates and became associated with the doctr ine of St. Thomas. These four virtues, temperance, prudence, fortitude, and justice, guide Catholics to attain well-ordered conduct in a disordered world (Catholic Encyclopedia 1). All of the values presented above have str ong connections to preventive health. Social psychologists have long recognized the effects of altruistic behavior on not just mental health but also physical health (Butcher 340). Butcher reports that hostile personalities are more likely to
36 develop cardiovascular disease as well as to report greater rates of anxiety and depression (Ibid). Furthermore, some therapists have begun to inco rporate programs that teach self-control and lifestyle alteration in order to relieve patients of stressrelated symptoms (Ibid 343). While these values are obviously associat ed with kindness and good deeds, these same religious ideas also promote mar ital stability. In a world in which two out of three marriages end in divorce, the religious institut ion offers guidance for marital satisfaction. Religious values encourage love and trust and disc ourage factors that invoke fee lings of strife (Koenig 1999 48). Several psychologists have explored the link between marital fulfillment and health, revealing findings that a correlation exists be tween the two variables. Strawbridges study found that religious persons were more likely to repor t a general feeling of marital satisfaction (1997 960). Hansen also notes that reli gion has consistently been consid ered a correlating variable in such a suggestion (190). He cites Thomas a nd Cornwall's 1990 study that found highly religious people report higher levels of satisfaction in ma rriage than those who ar e less religious (Ibid). Another study investigated marriage satisfacti on along with several ot her variables including socioeconomic status and family development char acteristics, and found re ligiosity was a better predictor than the othe r variables (Ibid 191). Koenig also stressed the importance of mar ital stability in shaping the lives of children (1999 49). He reported a study cond ucted by the National Center fo r Health Statistics which found that children living in homes that had been disrupted by divorce were nearly twice as likely as those in stable families to have developmental, learning, or behavioral problems. In fact, these variables were associated with higher rate s of adolescent pregnancy and juvenile crime and drug abuse. The study emphasized the magnitude of the impact of divorce on the children involved and stated that such delinquent behavior persists fr om infancy through adolescence,
37 affecting the lives of millions of children and t eenagers and burdening the schools, health care system, and juvenile justice system (Ibid). Summary The social elements of religion offer severa l health benefits that are of use in the preventive model. Through attendance at social institutions, social ne tworking, and doctrinal values, religion provides benefits offered by socialization as well as other elements associated with a healthy connection to others. Together, these elements reduce behaviors known to be associated with disease and poor health, such as smoking and overconsumption of alcohol. While the religious institution may be viewed as having direct e ffects on physical health, the indirect effects are equally valuable, including the e ffect on marriage and compassion for others. The most recent studies have had a profound influenc e on preventive medicine through revealing a link between religious saliency and the drive to undergo screenings and other preventive measures. Such practices are thought to occur in order to maintain optimal physical health needed for volunteering, evangelism, charity, a nd family involvement. Because holistic health considers socialization to be one of the three major elements vital to complete well-being, religious ideas are unquestionably important in the quest for prevention of illness and optimum physical health.
38 Chapter Three: Physical Behaviors Perhaps the most obvious application of re ligion to the preventi on of physical illness appears within the religious sugge stions regarding physical behavi ors. These suggestions include dietary guidelines such as vegetari anism and food prepara tion rituals, exercise such as yoga, and alternative therapies such as Ayurveda. Both scientists and physicians have displayed a growing interest in the applicat ion of religion's benefits to physical wellness as a resu lt of influential scientific research. Through numerous studies science has begun to explore the potential physical benefits various religions offer. Through multiple traditions and guidelines, physical behaviors promoted by religion assist in the cr eation of a holistic framework for health and illness prevention. Vegetarianism Much of complementary medicine falls und er religious categorie s, and the dietary practice of vegetarianism is one such area in which the benefits of religious ideas can be recognized with regard to healt h. Many religions promote vegetarian ism as either a spiritual ideal or part of a moral code (Food of the Gods 1). Eastern religions in pa rticular stand out as promoters of vegetarianism. Similarly, the larges t population of vegetarian s in the world can be found in India, in which 83 percent of the peopl e ascribe to the Hindu re ligion. As the health benefits of vegetarianism become more widely known, western religions have also begun to incorporate vegetarian practices into their religious doctrines. Hinduism, the oldest recorded Eastern religi on, teaches that vegetarianism is on the path to liberation and is the highest spiritual state (Fenton 64). On e of the scriptures of Hinduism, the Vedas, states, Only the animal killer cannot re lish the message of the Absolute Truth. The
39 Vedas also present the carnivorous lifestyle as a si n, considering that within the process of death and rebirth, carnivores will be eaten by the same creatures they had previously killed (Embree 144). The Vedas also introduced the principle of non-violence, known to Hindus as Ahimsa (Fenton 89). These scriptures teach Hindus that on e must understand the principle of life within lesser beings in order to understand the meani ng of life. The teaching of Ahimsa developed further within Hinduism encouragin g vegetarianism as a more desirable lifestyle. In fact, modern scholars attest that the health iest human diet of all time was to be found among Hindus of 1200 BCE. After this particular period of Hinduism, a religious sect that would become known as Jainism developed into one of the most r ecognizable vegetarian groups. Jainism held vegetarianism to be of far gr eater importance than most Hindus and heavily emphasized the idea that all animals desire and cherish their existence (Fenton 90). Buddhism also developed out of the Hindu religion and the teachings of the B uddha. Buddha described the eating of flesh as an ignorant craving, and he suggested that peacefulness and happine ss can be attained through the vegetarian lifestyle (Embree 170). Vegetarianism spread in China through the religious system of Da oism. Because Daoism views nature as sacred, and considers health to result from a balance of forces, vegetarianism is strongly encouraged among practit ioners. The Quanzen school was especially concerned with veganism (deBary 1999). This school, also known as the Complete Perfection School, describes the consumption of animals and animal products as harmful to health. Some of the western religions, including Christianity, Judaism, and Islam, do not explicitly forbid the consumpti on of meat. Still, some believers within these religions recognize
40 vegetarianism as a spiritual attainment. Furtherm ore, some sects explicitly define vegetarianism as of great importance. Such centralized groups have created excellent research opportunities, such as the Seventh Day Adventists, who have allowed scientists to visibl y study the benefits of the vegetarian diet (Sabate 111). Within Judaism, some forms of vegetarian ism have appeared that gain support through the scriptures. The Jewish commentator Rashi writes that YHWH intended mankind to only eat a vegetarian diet (JPS Tanakh). He is quoted as saying, God did not permit Adam and his wife to kill a creature and to eat its flesh. Only every gr een herb shall they all eat together (Genesis 1.29). Other Torah commentators agree with th is conclusion, includ ing Abraham Ibn Ezra, Maimonides, Nachmanides, and Rabbi Joseph Al bo. The commentators cite Genesis 1.29 as support: And God said: 'Behold, I have given you every herb yielding seed, which is upon the face of all the earth, and every tree, in which is th e fruit of a tree yielding seed--to you it shall be for food (JPS Tanakh). The commentators also consid er the omnivorous diet to be the result of the demand of the people and YHWH's tolerance. The Talmud states, The Torah teaches a lesson in moral conduct, that man shall not eat meat unless he has a sp ecial craving for it...and shall eat it only occasionally and sparingly. Islamic laws burden the meat eater and employ such practices as looki ng into the eyes of the animal being slaughtered (Food of the Gods 2). Through such rituals, followers of Islam ideally will minimize their intake of meat. Some sects within Islam, such as the Sufi and Bahai sects, choose vegetarianism as a component in achieving the highest level of spiritual fulfillment (Ibid). In spite of such sects, Is lam is overall not considered a ve getarian religion but rather semivegetarian with an emphasis on intermed iate steps towards a vegetarian diet. Although Christianity is not considered a vegetarian-promoting religion, many scriptures
41 seem supportive of the idea (Food of the Gods 3). For instance, w ithin the first chapter of the book of Daniel, vegetarianism of some variety appears through Daniel's refusal to partake of the meat of the Babylonian king. Daniel's request for vegetarian food was seen as radical, thus he sought to prove such a diet could be beneficial. Please test your servants for ten days: Give us nothing but vegetables to eat and water to drink. (Danie l 1.12). The ten days serves to improve Daniel's health, as seen in Daniel 1.15, At th e end of the ten days th ey looked healthier and better nourished than any of the young men who ate the royal food. Within Christianity, many sects held to a vegetarian diet including the Nazarenes, Therepeuts, Ebionites, Gnostics, and Essenes. In literal translations of Christian text s, there is no record of meat being encouraged; however, later scriptures permit the eati ng of meat in difficult scenarios. Other Christian sects encourage vegeta rianism more emphatically. Seventh-day Adventists are staunch vegetarians. On the official website, th eir position proudly boasts to have maintained a vegetarian lifes tyle for the past 130 years.14 This sect considers their belief system to be built on the holistic model of health and f eel that all that is done in eating or drinking should be done to the glory of God. Seventh-da y Adventists promote a form of vegetarianism known as the lacto-ovarian diet, which centers around whole grains, fruits and vegetables, legumes and nuts, and a moderate intake of low fat dairy products and egg whites. Although many studies have been conducted on the topic of vegetarianism and the inherent health applications, the Seventh-day Adventists are one of the most well docum ented religious groups with numerous studies indicating that the diet guidelines promote health. The 1999 study in the American Journal of Clinical Nutrition examined the vegetarian diet of 34,192 Seventh-day Adventist participants and demonstrated a positive correlation between health and a vegetarian diet (Fraser 1999 535). In data co llected from 1976 to 1988, the vegetarians had half the rate of
42 high blood pressure and diabetes, half the rate of colon cancer, and two thirds the average rate of Americans for rheumatoid arthritis and prosta te cancer (Ibid 532). Additionally, the males revealed a 38% reduced risk of heart disease, and both sexes maintained a BMI, or Body Mass Index, of two points lower than non-vegetarians (Ibid 534). Fraser reca lls his study in a later book, and he focuses on the shocking life expectancy differences of these Seventh Day Adventists. He compared the lifespan of California Seventh Day Adventis ts to other populations and found the lifespan to be 78.5 and 82.3 years for men and women, respectively (Fraser 2003 49). While these numbers are significantly highe r than other populati ons of the world, the vegetarian participants were f ound to live a full two years more.15 The study attributed the specific vegetarian diet of the Seventh-day Adventists, which in cludes the frequent eating of nuts, physical activity, lack of smoking, and lower body weight, as the factor driving such results (Ibid vii). As more studies have begun to examine vege tarianism, scientists have questioned the specific mechanisms through which vege tarianism benefits the health. In Vegetarian Nutrition one of the most notable as well as surprising bene fits of vegetarianism is demonstrated in the correlation between reduced osteoporosis in elde rly vegetarian women as opposed to omnivorous subjects (Sabate 110). Before this particular st udy, vegetarians had been thought to have lower amounts of protein than meat eat ers, which could negatively infl uence bone density as well as overall health. The book's author suggests that an imal protein's high content of sulfur amino acid may be partially responsible for calcium loss th rough the production of higher amounts of acid in the body (Ibid 116). The author also was careful to note the benefits of the lacto-ovarian diet are more generally stable, while persons avoiding dairy products may fall shor t of the recommended 14 The official Seventh-Day Adventist website can be found at www.adventists.org 15 See appendix, Table 4
43 calcium levels16 (Ibid 112). Adequate calcium intake th rough the consumption of dairy products in childhood and adolescent years was an importa nt marker for attaining peak bone mass and for the prevention of oste oporosis (Ibid 118-119). Vegetarian Nutrition also emphasizes that fruit and ve getable intake tends to be higher among vegetarians than omnivores (Sabate 121) In the Framingham Heart Study, diet and supplement use was compared to bone mass dens ity among elderly subjects. Higher intakes of fruits and vegetables were positively associat ed with bone mass density among both the men and women participants (Ibid). One proposal for explaining these findings assumes that, because fruits and vegetables contain higher levels of magnesium and potassium, persons who consume such foods are likely to expe rience less bone loss and fewer fract ures. Boron is another mineral known to be associated with bone health, and it is present in fruits, vegetables, nuts, and legumes: all common foods among vegetarians. Another health implication for vegetarianism involves the growing risk of diabetes. Type 2 diabetes has been rising in prevalence acro ss the United States. A known factor involved in type 2 diabetes is obesity, which is associat ed with up to 70% of the disease prevalence. Vegetarianism has been recognized as a valuable asset in the preventi on of type 2 diabetes through the association with a lower body mass index. A study conducted by Phillips found that non-vegetarians consume less dietary fiber and complex carbohydrates (Sabate 123). Together with the excess fat (most of which is saturated), the non-vegetarian diet may have unfortunate effects on long-term glucose tolerance. Th e aforementioned Seventh-Day Adventist study examining diabetes found a strong positive association between meat consumption and diabetes prevalence in both men and women (Ibid 124). Se veral other studies have found similar results, 16 As seen in the Seventh Day Adventists. Unfortunately, this statement is not conclusive, because often veganism is seen in countries of lower socioeconomic status, whose diet may be influenced by poor nutrition.
44 such as Gear's study that found a positive asso ciation between meat consumption and blood glucose levels, as well as a study by Salmeron that found high-glycemic diets were 40% more likely to lead to diabetes (Ibid 125).17 The vegetarian lifestyle pr omotes the opposite of the highglycemic diet, emphasizing the slow-digesting beans, which are high in fiber, low in fat, and low on the glycemic index. Together, these multiple mechanisms of ve getarianism promote a healthier physical body and well-being. Because religion is one of the pr imary motivating factors to drive individuals towards the pursuit of the vegetarian lifestyle, it is one of the st rongest factors associated with the prevention of illness. Kosher Laws/Biblical Practices The Kosher Laws of the Jewish people pl ace a high degree of importance on the role of cleanliness (Sardi 21). The term kosher means clean, or fit for eating. Of the 613 prohibitions given within the Hebrew canon, 213 concern rules related to health (Ibid 21). Both the washing of hands and the washing of food were laws not to be violated. Additionally, dietary laws of the Tanakh prohibited the consumption of blood. Deuteronomy 12.16 states, only you shall not eat blood; you are to put it out on the ground like water. Another law regards the use of acidic vinegar to cleanse foods. Eat of the bread and dip thy morsel in vinegar (Ruth 2.14). Recent studie s have revealed that vinegar is a powerful antidote to bacterial food poisoning (Sardi 22). A si milar instruction was to consume bitter herbs with food (Numbers 9.11). The benefits of bitter herbs are manifold and have been found to kill or inhibit 29 of the most common food-born bacterium (Sar di 24). Another cleansing agent 17 High glycemic diets are low in complex carbohydrates and fiber. For example, white flour has been refined, removing the fibrous bran and nutritive germ contained in the whole plant. A diet cons isting of mostly meat and white bread is commonly found among meat eaters.
45 mentioned in the Tanakh is hyssop, which is in structed to be used for cleansing both the body and vessels in Numbers and Psalms. The suggestions regarding diet found within the Bible emphasize the consumption of foods recognized to have high antioxidant values The Old Testament describes the land of the Hebrews as, a good land, a land of brooks of water, of fountains and dept hs that spring out of valleys and hills; a land of wheat, and barley, an d vines, and fig trees, and pomegranates; a land of oil, olives, and honey; a land wherein thou shal t eat bread without scar ceness, thou shalt not lack anything in it (Deuteronomy 8.8). Another passage states, we remember the fish, which we did eat in Egypt freely; the cucumbers, and the melons, and the leeks, and the onions, and the garlic (Numbers 11.5). Surprisingly, all of the foods mentioned have higher antioxidant values than the fruits and vegetables bought with high frequency in the western world (Sardi 9). Leeks, onion, and garlic have 1.25 times the antioxi dant value of carrots and broccoli, red grape vines have 7.5 times the ORAC18 value, and pomegranates have 11.25 times the ORAC value of these commonly eaten vegetables (Ibid 12). Biblical practices also advocate a high consum ption of fish. The omega-3 values of fish may be linked to reduced disease and longevity (Boyle 104). Recent studies of omega-3 oils reveal a reduction in heart disease for persons maintaining a balanced ratio of omega-6 and omega-3 oils as is found in the composition of fish. Higher consumption of fish has been linked to lower blood cholesterol and triglyceride levels as well as a reduction in cancer and inflammation (Ibid). Short periods of fasting are also encouraged by Biblical doctrines (Chliaoutakis 431). The practice of overeating is categori zed as giving in to fleshly de sires, while fasting helps to 18 Oxygen Radical Absorption Capacity a measure of the ability of a food to act against free radicals or oxidants in the body.
46 strengthen self-restraint. Fasting is not only bene ficial to the body in rem oving toxins, but it also serves as a model for religious individuals to appease their huma n passions and to influence the mind (Ibid 429). Chinese Medicine/Macrobiotics Chinese medicine is considered one of the oldest systems of medicine, appearing in a time in which religion and medicine were not se parate disciplines. As far back as 3000 BCE, Chinese doctrines record sugges tions for healing and preventive therapies thought to have been delivered to mankind from divine personalitie s (deBary 273). The notion of yin and yang, a prevalent theme in Daoism, is described as the balance needed in order to establish physical health (Ibid 274). To prevent a person from accu mulating too much of either the yin or yang aspects, Daoist writings taught that individuals must make proper food choices and connect with nature through forms of movement such as T'ai Chi (Guiness 230). Both acupuncture and acupressure were introduced by re ligious suggestions, and the goal of such treatments was to harmonize the energy in the body, also known as ch i, into the proper balance (Gottlieb 13). Because the teachings of Chinese Medicine sp read across Asia, it is not surprising that a similar system developed in Japan under the na me macrobiotics. Alth ough macrobiotics is not necessarily connected with a reli gion, much of macrobio tics is derived from the ideas of Daoism and hence is often considered to be a spiritual choice (Aihara 2). The gu iding concept behind the macrobiotic philosophy is the unifying principle. The Tao elements of yin and yang again serve as the model of this principle, and within macrobiotics, food is classified as falling within these categories (Ibid 3). Another religious element within macrobio tics concerns the Taoist idea that change must be accepted (Ibid 65). The macrobiotic diet emphasizes change based on climate and individual differences varyi ng from person to person. For inst ance, an individual residing in
47 a northern climate would eat more roots and nuts, foods higher in complex carbohydrates and omega oils, than an individual of the more sout hern countries, who would rely on starches and grains (Ibid 69). From a medical viewpoint, this suggestion make s practical sense in assisting individuals of different climates in meeting their nutritional need s. A foundational factor in the prevention of illness lies in the meeting of all vitamins and minerals, and not surprisingly, these religious systems have helped to contribute to health and longevity in China and Japan. In fact, according to statistics from the World Bank Group, Japan boasts the longest lifespan in the world, in which men live to the age of 78 and women live to the age of 85. The religious mentality of Daoism as it appears in Chinese me dicine as well as macrobiotics may thus be viewed as contributing to th e preventive health systems of both China and Japan. Ayurveda/Buddhism Ayurveda, a Sanskrit word meaning the science of life, outlines the principles of Indian medicine that originated 5,000 y ears ago (Gottlieb 25). Ayurvedic medicine was first associated with the Hindus, and it varies significantly fr om the allopatric approach to medicine. In traditional Ayurvedic medicine, health is more than the mere absence of disease; instead, true health is achieved through the balance of body, mind, and spirit (C hopra 1988 13). Illness is then a deviation from the balance. To prevent diseas e, three physiologi cal principles govern the steps an individual must take to maintain health (Got tlieb 26). These doshas are divided into vata, pitta, and kapha (Ibid 28). The va ta individual must take steps to prevent ailments of the lower body, including gastrointestinal disorders and restlessness. Pittas must focus on preventing imbalance in the abdominal region, such as di gestive and metabolic disorders. Kaphas must focus on the upper body such as the lungs and must also take steps to prevent obesity (Ibid 29). Although originally as sociated with Hindu India, Ayur veda later accompanied Buddhism
48 as it spread throughout eastern Asia (Demieville 77). The Buddha himself placed emphasis on maintaining bodily health in order to most effec tively ward off illness and consequently maintain quality of life (Flickstein 66). The ensuing restrictions on the diet of religious persons were thus meant to instill a gravitation to wards issues of higher relevanc e. The Buddha is said to have stated, We will take food neither for amusement nor for intoxication nor for the sake of physical beauty and attractiveness, but only for the e ndurance and continuance of this body, for ending discomfort, and for assisting the holy life (quoted in Flickstein 25). Buddhism also distinguished between the worldly and supernatural realm as connecting each to respective providers. The worldly physician thus fell into the material realm, which was not to be ignored in spite of its reduced importance (Demieville 2). Notably, after reaching Nirvana, while one may have reached the highest state attainable for the mind, the body was not immune to all earthly ailments (Ibid 89). For this reason, Ayurveda became a preferred method for preventing physical illness. The Ayurvedic principles were updated for the Buddhist religion with regard to the four noble truths, and likewise correlations were made to harmonize the religion with the medicinal system (Ibid 66). Buddha also proclaimed himself to be the ki ng of physicians (Ibid 14). He considered the job of the physician to remove poisoned arrows, a metaphor for the illness itself (Ibid 15) Again, this system is radically different from the westernized health care idea that approaches medicine with the intent of curing the ailment rath er than healing the individual. In this system, the source of the illness must be removed rather than merely treated symptomatically. Advocates for alternative therapies consider this principle to be the most important factor in Ayurvedic therapy and believe that such logic is key to success in both preven ting and treating illness.
49 Herbal Medicaments Herbs offer much more than merely fla vor for cooking purposes; in fact, the first medicines were herbs and modern medicines are of ten derived from herbs (Gottlieb 56). Norman Farnsworth, the director of the Program for Collaborative Research in the College of Pharmacy at the University of Illinois notes that at l east one-fourth of the medi cines currently used as prescriptions contain ingredients either deri ved or synthesized from herbs (Ibid). Not surprisingly, such historic medicaments can be traced back to multiple religious systems. Ancient Egyptians first employed the use of herbs in temples designed for priests and physicians to treat patients together (Ibid). Eb ers' papyrus is dated to 1552 BCE, and it is the oldest preserved medical document. The text is thought to have been given by Thoth, the god of medicine and pharmacy, and its descriptions of diseases and the functioning of the human body are reported with remarkable accuracy. The herbal therapies suggested in the text hold value even today. For example, Ancient Egyptians valued garlic as one of the most healthful herbs. Research today has revealed that garlic can lower blood pressure and cholesterol levels and can aid the body in preventing tumor growth (Ibid 58). The Buddha also recommended the use of herb s for healing, most of which stem from the Hindu origins of Ayurveda (Demieville 16). Indian Buddhists use a number of herbs associated with prevention in everyday cooking. Curry re cipes are prepared with turmeric, an herb containing curcumin, which has be en associated with health be nefits such as better immune system functioning (Mabey 128). Tibetan Buddhists also use ginger, an herb which aids in digestion and absorption of the nutrients in food (Ibid). Similarly, the Chinese employed herbs for preventive purposes as found in Daoist writings. Chinese herbalists still use the Yellow Emperor's Textbook as a source book for herbal
50 therapies (deBary 274). Ginseng is one of the most popular herbs in Asian countries, with some forms reportedly having a value greater than gold (Mabey 28). Because ginseng is thought to balance yin and yang, the Chinese co nsider it to have medicinal valu e in treating a wide range of ailments (Ibid192). Within recent years, the herbal remedies used within Ayurveda and other religions have begun to be recognized by modern science (C hopra 1988 24). Undoubtedly, the benefits of the principles of pure food and water as well as balanced nutrition are advantageous in the prevention of illness; however, the herbal reme dies are only beginning to be investigated by medical doctors and scientists (Ibid). While it is believed that the resear ch is not conclusive enough to record the potential for side effects and interactions with other drugs, a proper balance of herbs is acknowledged by nutritio nists to provide needed vitamins and nutrients essential to proper physical functioning (Mabey 16). Exercise Bodily exercise is recommended by doctors and dietitians for multiple preventive health purposes. Exercise is an excellent choice in the pursuit of the prev ention of obesity and maintenance of a healthy weight (Boyle 302). Exer cise is also known to allow the body to more efficiently utilize oxygen, thereby allowing fo r better lung and heart functioning (Ibid 312). More recent studies have even suggested that exercise may increase immune system functioning. Exercise is one of the more surprising religi ous aspects that has become incorporated into more secularized systems. Hatha Yoga, more frequently referred to as simply Yoga among westerners, is the Hindu disciplin e concerned with bodily exercise in order to prepare the body for a higher state of physical purification (Guinness 214). Within the past few decades, yoga classes have become prevalent in gyms across the western world. While the term yoga actually
51 refers to a complex religious ph ilosophy that aims to unite the pr actitioner with the gods through meditation and breathing, the term has now come to describe what is actu ally known as asanas, which are the specific poses and stretches whic h fall into the exercise category (Ibid 216). Yoga is inherently concerned with the achievement of optim al well-being. Traditionally, each yoga pose aims to improve the functioning of specific bodily organs. For example, the triangle pose, a pose in which pr actitioners lunge sideways wh ile reaching the arm above the shoulder, is said to stimulate abdominal or gans (Ivengar 66). Lung f unctioning can also be improved through the breathing techniques that ar e taught in conjunction with yoga poses (Ibid 36). These breathing techniques allow for deep breathing through the nose. This action allows only filtered air into the lungs, re sulting in the prevention of si nus and chest problems. Another benefit of yoga poses appears thr ough the posture enhanc ing effects that prevent back and spine problems. Iyengar writes on the benefits of Y oga poses, noting that through the movement and twisting of the body the organs are being compre ssed and decompressed in an almost massaging manner (Ibid 114). This movement causes the or gans to receive more blood, and ultimately strengthens the organs and the surrounding tissues. Ivengar even suggests the use of certain poses to benefit persons already experiencing health conditions, such as forward bending poses to regulate blood pressure (Ibid 59). The benefits of yoga have been documente d as displaying physical benefits through several studies. The Journal of Preventive Cardiology published a study stating that performing Hatha Yoga exercise two times a week impr oves cardiovascular strength (Tran 165). A study conducted by David Haber revealed that among 61 white elders practicing yoga for ten weeks, blood pressure was significan tly lowered (Haber 169). Exercise is also strongly encouraged within Christian organizations. Ray Merrill noticed
52 that the highest percentage of physically active adults in the Un ited States are located in Utah, and that Utah is also the city with the highest percentage of religious people (38). He conducted a study based on his observations between religious preference, church attendance, and exercise. The results, published in Preventive Medicine indicate that persons w ho attend church weekly are more likely to exercise th an persons of sporadic attendance (Ibid 44). For Merrill's study, Mormons accounted for many of the results, and also ranked their physical health in better condition than the non-religious subjects. Merr ill suggests that some connection between frequent church attendance and higher exercise ma y be due to the influence of the need to care for the physical body (Ibid 42). His conclusions ar e consistent with another study also published by Preventive Medicine (Chliaoutakis 431). The authors interviewed 250 persons in the Athens area and found a connection between Greek Or thodox Christianity and higher amounts of exercise. The authors contribute such results to what they call, the desire to live the Ecclesiastical lifestyle (Ibid 428). The authors also credit th e Greek Orthodox approach to use of holistic medical concepts in dealing with health-related issu es, and quote philosophical and spiritual factors as influen tial in the development of such holistic views (Ibid 429). Summary While some of the health practices presente d in this chapter are specific to particular religions, the physical suggestions appear across all th e religions. While diffe rent religions may use different names to describe these systems, the end result is always the same. In short, religion promotes the same physical behaviors recomme nded by physicians and nutritional scientists: a balanced diet, healthful food choices, and exercise. Additional supplements and therapies may be promoted by specific religions, but the goal is always to achie ve the proper vitamins and minerals necessary to maintain optimal health. Wh en examined together, the conclusion is that
53 such choices are effective in the aim of preventing illness.
54 Chapter Four: Integrating Science and Religion Throughout the previous three chapters, it has become apparent that preventive health measures are strongly promoted through religiou s beliefs and practices. A closer examination reveals that the framework created by religion is synonymous with the holi stic health approach. Within the dimensions of the physical body, the mind, and the social network, religious beliefs and practices add more depth and purpose to the quest for optimal health and the prevention of illness. In considering the future development of preventive health measures, the beliefs and practices described throughout th is paper can be advantageous on many levels. Unfortunately, such ideas are not currently common knowledge despite the fact that some individuals have been promoting these ideas for decades. A synthesis of sc ience and religion is thus vital to health care professionals seeking to achieve the greatest po tential in motivating and prescribing preventive practices. To best conceptualize a plan for integrati ng scientific and religi ous health practices, several steps must be taken to insure maximum be nefits. First, the current research must cease to exist as separate suggestions and must unite in to the preventive model described herein. Next, the methodology of holistic suggestions must be evaluated from an empirical standpoint and found to be in agreement with orthodox ideals, resulting in the complementary approach. Finally, individuals on three levels must recognize their roles in developing this plan. Through these three steps, preventive health suggestions will be empowered through the motivation of religion and backed by the scientific method. Criticisms
55 A proper starting place in making suggestions is an examination of the opposing view. Use of religion within the health care field has be en criticized by multiple scientists and authors for centuries. Freud may have been one of the original critics and is remembered today for stating that religion is more of a crutch than an empowerment system. Modern criticisms facing religious ideas in health issues ra nge from potentially fa tal physical issues, su ch as the refusal of treatment, to negative psychologica l feelings, such as a feeling of spiritual rejection. By thinking strictly in terms of preventive health, ma ny of the problems faci ng religious advocates disappear. For this very reas on, Frohock notes that physicians who have been unwilling to consider alternative and religious healing methods may be more re ceptive of the same strategies in preventive health (4). Even the more contr oversial alternative medical doctors consider the options for healing illness as opposed to preventing illness to be much more complex and often useless (Ibid 17). Nonetheless, the idea of incorporating re ligious beliefs into a health care model may bring much benefit to certain individuals, but of course religion cannot be considered the cure all for all people. Obviously, atheists and othe r nonreligious persons woul d not have any use for the religious systems found within health and co uld potentially be offende d by a doctor or health care workers' use of such ideas. Also, using the wrong religious system could be viewed as offensive by patients who feel set in their specif ic religious beliefs. For these reasons, it is the responsibility of the medical do ctors and clinicians to use proper judgment in integrating scientific and religious concepts. For example, open-ended phrasing, such as the term higher power, allows patients to understand religious suggestions in their own belief system without pressing the physician to spend time eval uating patients' religious backgrounds. Flannelly has been the most recent critic of research on religion and health. In 2004, he
56 analyzed the methodological issu es he found within hundreds of st udies on this subject. He pointed out four major ways in which religion co uld potentially have a ne gative affect on health (Flannelly 1232). His most str ongly stated reasoning was that religion could promote coping practices that are maladaptive or problematic (Ibid). Because some religions teach that individuals must surrender cont rol to a higher power, persons may demonstrate passivity and lack of responsibility for their own actions. In other words, a pe rson may not feel as driven to take care of his or her body because the future is beyond his or her control. Flannelly also felt that if religious people do become sick, they may experience feelings of divine abandonment (Ibid). Other religious people, who do not e xperience passive feelings, may instead feel personally responsible for their ow n sickness as well, attributing th eir ailments to feelings of divine judgment or punishment Finally, religious people wh o feel abandoned may also experience anger towards the higher power (Ibid). Flannelly reports empirical studies that have connected these negative feelings to detrimen tal outcomes, including elevated depression and anxiety, poor rates of recovery, and increased risk of death (Ibid 1234). Flannelly also reports that feelings of failed religious beliefs may result in doubt, which has also been linked to health problems (Ibid 1232) Because the individual experiencing feelings of doubt feels a loss of certainty about his or he r beliefs, such an individual becomes more prone to stress. Furthermore, feelings of guilt or embarrassment may prevent the individual from sharing his or her feelings, resulting in an accu mulation of negative emotions. Flannelly admits the research supporting such conc lusions is lacking, but he cite s three studies that attribute religious doubts to psychological distress a nd a decline in physic al health (Ibid). To dispute such criticism, the benefits of re ligion must be viewed as part of a package. Richard Eckersley first used this term in desc ribing religion as a package that contains the
57 ingredients for health and wellness (Eckersley 2). Indeed, this term perfectly describes the function of religion. Religion provides the meaning and purpose to take actions that would lead to wellness. Religion forms the backbone of soci al support groups and the coinciding moral code necessary to remove behaviors that negatively impact health. Religion even provides laws and suggestions regarding nutrition and other physical health sugg estions, all which aid in the prevention of illness. This idea is presented best through a 1995 collaborative study conducted by the National Institute on Aging and the Fetzer Institute. Spec ialists from the fields of psychology, sociology, public health, and other health fields recogni zed ten potential methods through which religion benefits health. These dimensions are as follows: affiliation or membership, participation in services and activities, beliefs and values, privat e religious practices such as prayer, meditation, and reading of sacred texts, commitment, motiv ation for relationships, social support, coping, history in upbringing, and emoti onal experiences (Flannelly 1233). These factors have all been conveyed throughout this thesis, and it is important to recognize that each of these dimensions is a separate but connected component of religious systems. Without any one of these dimensions, the religious package would be incomplete. C onsequently, it may be said that religion as a whole offers a complete package, but when individually viewed, problems may manifest due to an incorrect understanding of the reli gion or flawed doctrinal beliefs. The question then becomes, is religion pow erful enough to benefit from an integration of religious ideas with science in the health care industry? Eckersley's terminology helps make this idea difficult to contest. Health care prof essionals in the fields of psychology as well as medicine are certain to agree that the above suggestions for health maintain strong benefits. Even the nutritional guidelines advo cate balance and moderation, a key to the establishment of good
58 health. Controversial therapies are not the high light of the religious package, and in fact, orthodox medicine is not seen in a negative lig ht. In truth, the worl d religions share no opposition to modern medicine, but are instead in perfect harmony with basic orthodox principles and with the agreeable position of holistic medicine. Ultimately, the above criticisms are all easily prevented through proper analysis of individual patients. Because of th e complexity involved with bri nging religious aspects to health care, doctors and clinicians must question patients beforehand if th ey wish to utilize any of the practices suggested herein. With the proper guidance for individuals of different religions, optimum counseling can reduce or eliminate negativ e feelings as well as discover what aspects of each religious system may be out of balance. Advocates For Religion and Health One of the most recent landmarks in modern medical care appears in the teachings of several physicians in implementing the holistic approach. These physic ians recognize the shortcomings of the treatments they had been trained to use. Rather than accepting such limits, they sought to discover alternative methods to be st treat their patients, and consequently have become some of the leading advocates of the holistic approach. Their suggestions are powerful but must be incorporated into a larger holistic model. However, gathering knowledge from all of these advocates of religion and health can ai d in the arrival of a thorough understanding of religion's potential within the integrative approach. Harold Koenig is perhaps the most well-known advocate for the advancement of religion in the medical field. Initially, Koenig began c onducting research and participating in over 150 studies that appealed to physic ians and other health professionals. He authored ten books including the vast Handbook of Religion and Health which explores a multitude of studies and
59 possibilities crossing these two fi elds (2005). In hopes of attrac ting the general population to his findings, Koenig published The Healing Power of Faith: Science Explores Medicine's Last Great Frontier in 1999. He opens this book by explaining the history of his involvement in these two very different fields (Koenig 1999 11). He admits that such interests did not seem linked in any fashion. Natural science, with its immutable laws and formulae, is the foundation of modern medicine, while religion, by definition, deals with inexplicable supernatural powers and events (Ibid). But Dr. Koenig admits that it was his at tentiveness to his patients that allowed him to make the connection between religion and health Koenig explains, Nothing I'd been taught in four years of medical school or the first two years of my reside ncy even hinted that religious faith could break the grip of addiction, shield pe ople from depression, or calm them at times of emotional trauma...but I also knew that every breakthrough in medicine had begun with such random observations that led to hypotheses, which eventually stood up to the stringent testing of the scientific method (Ibid 19). The observati ons he speaks of have now been given the necessary scientific backing in th is thesis, and demonstrate that there is no better time to bridge together such suggestions with orthodox medicine. Koenig's research has allowed scientists to access the value of religion through empirical observations and concrete data. He is now the head of Duke University's Center for the Study of Religion/Spirituality and Health. Hi s research has revealed the poten tial benefits of religion, and has even recognized the division of religion/health research as including a category of Illness Prevention (as well as Illness Recovery and Treatment/Health Services Use). Unfortunately, Duke University studies have mos tly remained limited to studies involving JudeoChristianity, and while Koenig has not dismissed the potential for ot her religions to instill health benefits, his center is unable to cover all grounds within the religio n/health field. For this reason,
60 his research must be added to the research of other religions in order to best demonstrate the effect of all world religions on health. If Koenig represents the integration of the western perspective of re ligion and health, then Dr. Deepak Chopra has brought the eastern perspective into the fo refront. As an endocrinologist originally from India, Chopra's Hindu roots rema ined at the heart of his studies (Chopra 1988 14). Although Chopra carried these views with him throughout his education and into his professional career, it was not unt il his patients began responding to his religious ideas that he recognized the potential of inte grating his relig ious background into his work (Chopra 1989 17). Chopra writes, for me, the goal of Ayurveda is to transform the patient's personal reality, which means taking his subjective viewpoint as seri ously as I take his physical condition (Chopra 1988 ix). He has since become the executive dire ctor of the Sharp Heal thCare Institute for Human Potential and Mind/Body Medicine in San Di ego and is continuing to impact individuals through his life-changing approach. While Chopra's suggestions are powerful, his concern with revol utionary ideas has isolated him from orthodox medical care and ha s limited his audience. Unfortunately, many of his less controversial ideas are lost due to the stronger claims associated with his name. Chopra would be better received by ort hodox medicine if he limited hi s suggestions to preventive medicine. Medical doctors have repeatedly stated that they are receptive to preventive health suggestions but feel that or thodox methods are better in the treatment of the sick.19 While future research offers much opportunity for explori ng the implementation of religion in treatment situations, the evidence for preventive health is cu rrently clear, scientifically-based, and available for health care advocates to successfully share. Other holistic revolutionaries have not recogn ized the potential for the term religion in
61 describing their ideas and suggestions. Bernie Si egel, M.D., a Cornell graduate and surgeon, has dedicated much time and research to sharing his revolutionary ideas with his fellow health care professionals. In his book, Love, Medicine, & Miracles he describes his journey to a better understanding of his patients' n eeds (Siegel 19). He writes, Med ical education does not deal with many of the difficulties physicians must c onfront in themselves and their patients. Physicians need to be good technicians and know how to prescribe, but for healing to occur they also need to incorporate philosophy and spiritu ality into their trea tment (Siegel ix). While not explicitly stated, Siegel's notion of philosophy and spirituality does not have to exist separately and is in f act intertwined within religion. By bringing the religious system into Siegel's recommendations, his statements not on ly are easier to grasp, but are also more concisely demonstrated. For instan ce, Siegel suggests reflection a nd visualization along with the establishment of a stronger will to live (Siegel 148). As demonstrated re peatedly, the religious system incorporates all of these aspects th rough prayer, meditation, and meaning. By offering religious phrasing, the transition fo r patients and health practitioners to implement the integration of holistic practices is more smooth and sensible. From analyzing the above physicians, it has become clear that the research and work conducted by these medical doctors has prepared the health care community to embrace religious suggestions. Still, their work is incomplete and re quires more effort from other fields as well as scientific investigation into the potential for religion beyond prevention. Until such unorthodox remedies can be confirmed, modern advocates of religion and health must be willing to accept the limitations of prevention in order to allow the beginnings of any relig ious ideas to develop within the modern health care industry. 19 See discussion of Frohock.
62 Examination of Orthodox Methods To best make use of religious principles for preventive health purposes, persons from all fields, whether holistic medicine, orthodox medici ne, or psychological care, as well as the individual desiring to lead a healthy life, should be aware of the complementary approach. Because orthodox medicine must not be discarded in the quest for holistic practices, the most optimal perspective is that of complementary health. Complementary preventive practices would then include vaccinations as well as vitamin s upplements; support of the religious community as well as counsel from psychologists and other hea lth care professionals; hospitalized care when needed and alternative therapies when possible. At the present moment, science has begun to accept complementary ideas. Perhaps no other field best utilizes the multi-dimensional a pproach than nutrition science. While vitamin and mineral supplementation was previously limited to herbal medicine, nutritionists have now isolated many of the components found in foods a nd designated them as the various vitamins and minerals. These vitamins and minerals are organic compounds required for essential metabolic reactions and are pres ent in functional foods20. Science has now been able to identify the specific chemicals acting in vitamins and even to synthesi ze these substances for availability in pill form. This transformation from herbal remedies as a folk medicine practice to an acceptable scientific idea is exemplary of the fact that re ligion is already beginning to be integrated in nutrition science. Because many of the religious practices promote the eating of healthful foods, including functional foods, such mindful eating help s to ensure the indivi dual is consuming an adequate amount of vitamins and minerals. 20 Functional foods is a relatively new term describing foods that are said to offer health benefits beyond nutritive values. For example, research on cranberries has led advocates of functional foods to implement cranberry supplementation in treating urinary disease (Boyle 194).
63 Chinese medicine and Ayurveda have br ought much knowledge to the world concerning the value of herbal remedies. Chin ese medicine, with its stance to, use medicine as a last resort only when food fails, has based herb choices on yin and yang principles for thousands of years (Guinness 50). Herbal remedies have now spread beyond China and are employed in complementary medicine by holistic doctors wo rldwide. Scientific documentation has even begun to uncover some of the valuable benefits from the natural world. Fo r instance, the Chinese herb St. John's Wort has been found to be a natural supplement helpful for the mildly depressed patient (Boyle 189). Valerian, a plant often used by Shamans to induce meditative states, has been proven to have anti-anxiety effects offeri ng potential for use in treating nervousness and insomnia (Ibid). These example illustrate a method for a mental health diagnosis to be used in conjunction with complementary medicine grounded in religious ideas. Some forms of exercise are al so beneficial to patients who have been diagnosed with debilitating disease. Tai Chi is now recommended by many medical doctors for patients diagnosed with conditions such as arthritis (Guinness 230). Yoga has also become a religiouslybased practice that is now suggested for preventiv e health to a mainstre am audience (Ibid 214). The preventive approach must utilize the be st available knowledge found in all areas of health care. For this reason, while the orthodox approach has been criticized by many holistic practitioners, it must nonethele ss be recognized for the multipl e benefits it offers. Without question, much of the current health system is in debted to modern revolu tionary discoveries. For example, immunization has eradicated illnesses that were previously a great threat. Both smallpox and polio are nearly unh eard of and measles, diphtheria, rubella, and pertussis have dropped significantly from levels of concern. To utilize the benefits of orthodox medicine, religious health enthusiasts should consider
64 the complementary approach. The religious system offers a tremendous advantage to health by incorporating preventive practi ces into daily life. Combined with orthodox practices when needed, such as in cases of severe illness, this system offers a solution to the legal and political dilemmas of the application of religion to health. Verweij's ideas on prevention allow for development of such a model. He subdivides prevention into three categories: primary, s econdary, and tertiary (Verweij 13). Primary prevention aims to prevent illness through m eans such as the promotion of hygiene and encouragement of vaccinations. Secondary preventi on eliminates further development of disease through detection, such as the de tection of breast cancer. Tertiary prevention aims to reduce the risks of a diagnosed disease or any further deterioration. Verweij's division allows most religious ideas to remain within primary preventive health. Because religion offers a package deal that appeals to mental health, psychosocial stability, and physical health, there is little reason that religion cannot work in conjunction with physicians who recognize the benefits of the co mplementary approach. With merely routine checkups from an orthodox physicia n, the religious inst itution offers the threefold model of health through varying means aiding to prevent the onset of illness. Secondary prevention is heavily influenced by both the social intricacy of religion as well as the religious institutions themselves. Mass scr eenings of cancers have even been promoted by religious institutions. Perhaps the social factor is most at work in secondary prevention because the drive to seek out a diagnosis can instigate feelings of fear (Verweij 32). However, if the drive is pressed by fellow caring individuals within the religious community, the best of orthodox treatment can step in and not only contain a diagnosis such as cancer, but may also be a factor in the longevity and enjoyment of the individual's lifespan.
65 Tertiary prevention should undoubtedly utili ze the services of the orthodox physician more heavily than primary preven tion. In the event of diagnosis, patients must become educated as to the biological understandings of their condition. Complement ary medicine may still be of use to patients considering some of the suggestio ns offered by religious institutions. Ultimately, studies on religion and health have not yet reach ed the level of tertiary prevention, but the possibility is certainly available for future research. Suggestions The ideas associated with religion and h ealth can be of use to three groups: the individual, the physician, and the health care i ndustry. The individual is able to recognize the health aspects promoted by his or her persona l religion and benefit fr om a thorough knowledge regarding preventive health strategies. Physicians must be aware of their patient's beliefs and must offer a supportive view regardless of his or her own beliefs. Finally, the health care industry needs to recognize health practices associated with religious ideas in order to provide possible medical options as well as to meet insurance demands. The integrative approach described herein ha s not been an attempt to convert readers to the beliefs of a specific religion nor has it been an attempt to convin ce the nonbeliever in the existence of some extraordinary power. Inst ead, throughout the previ ous chapters, it has examined the various religions and pointed out multiple instances of religious applications to preventive health. In examining the evidence fr om a scientific and non-theological view, it is almost surprising to note such consistency of results. The empirical evidence is overpowering in demonstrating a link between religion a nd health throughout all areas of life. Consequently, the reader may infer that religious ideas may be of great use in the quest for optimal well-being. In devisi ng a personal plan for health, th e individual need not feel
66 incapable of making advancements on his or he r own. According to Koenigs studies, most people are religious, and personally connecting relig ious ideas to health practices can offer the preventive benefits demonstrated throughout this paper (Koenig 1999 233). While this connection has been looked down on by health professionals for decades, the evidence supporting religious ideas is a strong enough fact to provide patients with the scientific evidence in favor of the connection. Another important but controversial fact lies in determining the exact measures of each religious system's approach to health. Siegel has often encouraged a spiritual mind without a specific religious system in order to implement the suggestions from various religions; however, differing opinions need not provide a barrier. In other words, it is not necessary for a person of one belief system to become discouraged over the benefits of another religious view, but rather that person should bring the ideas into his or he r own faith. For example, Christians have been adapting vegetarian practices into their own beliefs while simulta neously discovering that their own religion is in favor of such a practice, albeit in a less direct manner. This fact has been repeatedly demonstrated in this paper, such as through the universal use of meditation and communication with the higher power. Using this knowledge, the individual can employ preventive health strategies ba sed in different religions within his or her own belief system, thereby leading to an ideal health system agreed upon by health care practitioners. Furthermore, it is critical fo r the individual to recognize th e unfortunate fact that many doctors and clinicians will not suggest religious strategies. While studies show that 66% of medical patients depend on their religious belief s in making a decision, and family and patients rate religious beliefs and faith as second in importance in making decisions, clinicians most frequently placed religious faith last. Ultimately, while science has made strong advancements in
67 the last few decades, the individual is still respon sible for incorporating the benefits of his or her religion into a preventive plan for health. Physicians also must make efforts to utili ze the benefits of religious health suggestions. At the present moment, doctors have no require ments regarding either classes in nutrition, religion, or psychology. This fact is unfortunate because such classe s are critical in the holistic perspective as well as complementary medicine. To offset this fact, doctors must make efforts to educate themselves regarding th ese highly influential factors. While it is hardly feasible to suggest that all medical doctors should learn the methodology of all the world's relig ions and their specific ideas on health, there is much to be said for the support a physician may offer. A nother examination of th e mental effects of encouragement, especially from an authority fi gure, reveals that patien ts who feel support in devising a plan to establish health are far more likely to experience positive outcomes. Unfortunately, medical training tends to teach only the opposing view, and trains upcoming physicians to discourage patients from religious ideas a nd thoughts. Certainly, there is a fine line for physicians, such as recognizing the da ngers of refusing treatment. In spite of this fact, a physician with only a basic amount of religious training can recognize that such practices are not suggested by religion, and may even direct such uncooperative patients into recognition of genuine religious practices utilized within their ow n belief system, such as seeking counsel and taking steps to manage the temple of the body. Suggestions of this nature should not require much time or effort from the physician. The key to such ideas has been and always will be bala nce in all areas of life, whether that is through the presentation of the religious package or through the secular view. No matter what the mechanism may be, the role of the physician is al ways to treat the patient and advise the patient
68 to seek optimal health with the knowledge a nd authority to provide guidance on an individual basis. Perhaps the greatest opportunity for change exists within the health care industry as a whole. While the health care industry has begun to accept some of the preventive strategies associated with religious beliefs, it has mostly failed to recognize that such ideas are based in religion. This fact is because the western worl d often does not often see the overall value in religious ideas. This is a tremendous tragedy brought on by a more narro w view that is still occasionally present within modern religious systems. While some religious individuals may recognize the value of their own belief-based strategy, other ideas stemming from other religions may be overlooked. Such mindsets do not have to occur. The preventive strategies presented in th is paper can apply to various religious backgrounds without posing problems. Vegetarianism is an excellent example of a cross-cultural health practice grounded in religion, and is one such area in which the industry would benefit from a more thorough investigation. Thus far, th is paper has revealed that vegetarianism is promoted by several religious organizations. The common denominator in these ideas is a reduction of meat. Again referring to orthodox medi cine in the form of nutrition, various studies have linked reduced consumption of meat to better health. Without making any claims for specific mechanisms upon which vegetarianism can be based, it is clear that reduced meat intake can have preventive health benef its. This example reveals that in order for the health care industry to make use of different religious principles, the curren t attitude towards religion must cease to be seen in such a negative light and must be considered for the proven benefits religious doctrines and teachings can instill. Another major error on the part of the health industry lies in the fact that insurance does
69 not always meet the demands of the individual. W ithin the application of religion to health, this idea presents itself quite strongly. For instance, mo st insurance companies fail to support holistic ideas such as vitamin therapy a nd herbal treatments. Such fields offer tremendous potential for preventive health and would even best serve the insurance companies by reducing the amount of treatment needed in the future. The holistic model brings a ll of the above suggestions in to one category. It is an unfortunate fact that few insu rance providers support this sy stem, and individuals desiring holistic treatment are typically denied care by their insurance co mpanies. In addition, the high cost of health has left individuals with a grea ter financial responsibility to make co-payments. This fact may inspire the individual to take more responsibility for his or her health in terms of prevention; however, it also means individuals must take steps to educate themselves. Insurance companies could offer lower premiums or offer a lower co-payment to individuals who take classes taught by health experts or who actively demonstrate a will ingness to take responsibility for general health by maintaining a healthy we ight, exercising frequently, not smoking, and developing a positive mental and spiritual outlook. Psychological counsel is another universal idea connected to religion th at can be explored more in depth and promoted by the health care industry. While religious individuals often seek counsel from authority figures within the church psychologists have the sc ientific knowledge to accompany religious teachings. Interestingly, while a religious person may often suggest prayer or meditation, psychologists share similar sugges tions. The health care in dustry has not yet made the connection between psychological health an d religion, thus while pastoral counseling remains free, psychological care is often costly an d may be partially covere d or not covered at all depending on the insurance plan. This fact is hi ghly unfortunate because physical health is so
70 strongly dependent upon good mental health; still, insurance companies seem more willing to provide physical health care than mental health counsel. Again, this is another component of the holistic model that should be accepted by the health care industry in order to best prevent the occurrence of illness. Summary The integration of science and religion for preventive health reasons may seem a monumental task. Indeed, such an idea involves much additional education and time spent understanding individual needs a nd personal belief systems. Stil l, the human body is the most important asset a person can ever have in his or her life, and no material aspiration can possibly compare to the maintenance of the physical body. With more unity in the medical system as well as an internal motivation from individuals, su ch an idea can move from being a dream to a reality. The revolutionary research presented th roughout this thesis shoul d not deter any health care practitioner or individual but should instead create a feeling of excitement the possibilities posed through the integration of prevention and religion can extend not only life itself but also the quality of life. Without que stion, the additional time and energy spent in seeking this integration is far outweighed by the benefits of a healthy and balanced body, mind, and spirit throughout the journey of human life.
71 Appendix of Figures and Tables 1. Effects of religion in the holistic model 2. Results of intercessory prayer 3. Relationship among cigarette smoking, religio us attendance, and religious activities 4. Expected length of life at birth and at ag e 65: California Adventists compared with international population
72 Figure 1 Effects of religion in the holistic model Source: Koenig, H.G., M.D. (1999). The healing power of faith: Scie nce explores medicine's last great frontier. New York: Simon & Schuster. pp. 262.
73 Source: Byrd, Randolph (1998). Positive Therapeutic Effects of Intercessory Prayer in a Co ronary Care Unit Population. Southern Medical Journal 81(7): 826-829. pp.827
74 Figure 3 R g, religious attendance, and religious actions. gh, M. E., & Larson, D. B. (2001). Handbook of religion and health New York, NY: Oxford University Press. pp. 369. elationship among cigarette smokin Source: Koenig, H.G., M.D., McCullou
75 Source: Fraser, G. F. (2003). Diet, life expectancy, and chronic disease: Studies of seventh day adven tists and other vegetarians. New York, NY: Oxford University Press pp. 49
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