by Dharma Singh Khalsa, M.D.
The Integration of Health and Spirituality:
Report on a Groundbreaking Conference
Are religious practices and spiritual living good for your health?
The answer is “yes” according to research presented at The First International
Conference on the Integration of Health and Spirituality.
The conference, held on the campus of the National Institutes of Health (NIH) from April 1–3, 2003, featured ground - breaking presentations from many of America’s leading academic voices on this emerging topic. The International Center for the Integration of
Health and Spirituality (ICIHS), a 501-(3)-C not
for profit organization located in Rockville,
Maryland, sponsored the conference.
The late David B. Larson, M.D., MSPH, a
pioneer in the study of spirituality and
health, founded the ICIHS in 1991. Thanks
to his systematic reviews of research in the
mid-1980s, Dr. Larson, a board-certified psychiatrist
and epidemiologist, was the first to
bring recognition to the neglect of spirituality
in research and clinical health care to
the forefront of professional discourse. This
conference honored Dr. David Larson’s
vision.
In the last decade the research on the link
between health and spirituality has doubled.
Eighty-three percent of those research
studies found a positive relationship between
mental, physical and emotional health as
well as enhanced medical outcomes from
spiritual living or religious practices. One
very important point to emphasize is that
research discloses that at least 63 percent of
patients believe their doctor should talk to
them about their spiritual health, yet
according to conference presentation, only
about 10 percent do. The information I’ll
discuss in this article shows that health care
practitioners must embrace spirituality as a
healing mechanism in their patients.
The conference was divided into three
main topics, each of which was the subject of
a particular day. Day one covered spirituality
and physical health. Day two was about spirituality
and mental health and day three covered
the relationship between spirituality and
social health.
Ellen I. Idler, Ph.D., professor and chair of
the Department of Sociology at Rutgers
University, gave the opening keynote
address. She discussed how early studies of
religion and health noted both the association
of religious observance with health and
also potential causal mechanisms. Her key
point, in my view, was that up until now the
health benefits of religious practice were
inadvertent. That is to say, the one practicing
religion did so because s/he felt good about
it, not for any underlying agenda of reaping
positive health effects. The implication of
that may be that as physicians become more
aware of religion’s positive effects on health
and suggest that their patients follow their
spiritual inclinations, an improvement in
their well-being may follow. Taking this one
step further, perhaps spirituality and religiosity
may lower the financial burden for
both patient and insurers, including government
funding sources such as Medicare.
Beyond speculation, however, what is clear is
that according to strong scientific research,
some of it sponsored by the NIH, spiritual
and religious observance has lifelong benefit
and their effects are cumulative.
William Strawbridge, Ph.D., of the
University of California at Berkeley, presented
other important information the first
day. Dr. Strawbridge, a gerontologist, has
examined the data from the famous Alameda
County Study, a longitudinal study of health
begun in 1965. The purpose of this work was
to determine if good health behaviors could
be determined for those attending religious
services weekly as opposed to those attending
less often. The data showed that those
attending services weekly were more likely to
stop smoking or not start, to start exercising,
reduce heavy drinking, increase and maintain
friendships, marry and stay married and
improve or maintain good mental health.
Other important points made by speakers
the first day were that spirituality and religion,
especially via the practice of prayer,
meditation or other relaxation techniques,
markedly reduce the negative biochemical
effects of stress. Moreover, it was stated that
cancer patients have an increased quality of
life with spiritual practices. It was also
pointed out that religious and spiritual
coping markedly benefits chronic pain
patients. People living with HIV/AIDS, individuals
with cardiovascular disease, those
who are obese, or suffer from irritable bowel
syndrome, the research data show, all benefit
from spiritual practice and genuine religious
belief.
The second day of the conference was
equally as powerful. Harold G. Koenig,
M.D., an associate professor of psychiatry and
medicine at Duke University School of
Medicine, where he is the founder and
director of the Center for the Study of
Religion/Spirituality and Health, gave the
keynote. One of the most significant points
made by Dr. Koenig, which was published in
The New England Journal of Medicine, is that
since 9/11 ninety percent of Americans have
turned to religion and spirituality as a way of
coping with stress and grief. How else can
religion and spirituality affect mental health
positively? By impacting forgiveness, as well
as giving meaning, purpose, a sense of connectedness
to life. All of these are aspects of a
high level of positive mental health.
Another important presentation was that
by Neal Krause, Ph.D., a professor of health
behavior and health education at the
University of Michigan. Dr. Krause discussed
the importance of group/social support
in fostering positive health related
outcomes. My own review of the medical literature
has revealed that social and community
support are powerful healing factors.
According to research by Thomas
Oxman, M.D., patients who had a strong social support system showed a marked reduction
in death after open-heart surgery. Another
exciting finding presented by Michael
McCullough, Ph.D., an associate professor of
psychology at The University of Miami, was
that spirituality is highly correlated with positive
psychological attributes such as maintaining
an attitude of gratitude. Although this
may sound like “pop-psychology,” it has a very
good scientific base. According to research presented
by Dr. McCullough, positive character
traits, such as thankfulness, lower the level of
the stress hormone cortisol. This is important
because cortisol has many negative effects on
the immune system, the cardiovascular system
and the brain. Additionally, other traits such as
humility enable one to achieve greater happiness,
fulfillment and performance in a variety
of life domains.
A highlight of the second day
was the presentation by
Andrew Newberg, M.D.,
clinical assistant professor
of neuroradiology at the
University of Pennsylvania.
Dr. Newberg has done
breakthrough work in the emerging field of
neurotheology, which uses advanced x-ray
techniques to document the effects of spiritual
and religious practices on the brain. For
example, it is now possible by utilizing PET
scans and functional MRIS to anatomically
delineate the parts of the brain that are affected
by prayer and meditation. Beyond brain
imaging studies, Dr. Newberg has been able to
measure various hormone and neurotransmitter
changes in the particular brain locations
caused by these techniques.
Byron R. Johnson, Ph.D., gave the keynote
address for the third day of the conference,
which covered spirituality and social health.
Dr. Johnson is the director, Center for
Research on Religion and Urban Civil Society
at the University of Pennsylvania. In his
address he discussed the socioeconomic implications
of religious commitment. According to
Professor Johnson, we need to study rigorously
the effects of faith-based initiatives to discover
what type of studies are best suited “to analyzing
and evaluating the extent, efficacy and
cost effectiveness of competing faith based
programs, and what species of research projects
are most likely to measure and test how, if
at all, it’s the ‘faith’ in the ‘faith factor’ that
matters.”
Other presentations concerning spirituality
and social order covered adult and juvenile
crime and delinquency, religion and abstinence
from drug use among American adolescents,
minority health issues, marriage and the
family, spirituality and aging, end of life issues,
caregiving, ethics and altruism.
Of final note was a presentation
by Michelle J. Pearce,
M.S., of Yale University.
Her work concerns one of
the issues I mentioned previously
and that deserves
another reference: spirituality
and religion may be a very viable way to
lower rising health care costs in the United
States. The documented increase in spiritual
seeking by many Americans, both within and
without organized religion, may become an
important factor in helping to reduce the
financial burden of individuals and government
in the ensuing years. Studies show that
people who have a spiritual focus in their life
reduce the need for medical services by
adopting healthy lifestyles. Not smoking, not
abusing drugs or alcohol, exercising, practicing
prayer and meditation, having a broad social
support network, being altruistic and having
enhanced mental and emotional health may all
translate into lower health care expenditures.
The potential effects of religiousness on service
demands have important implications for
health care providers, institutions, patients,
clergy, researchers and taxpayers. While a
plethora of research still needs to be done, it
certainly appears that spirituality and religion
are indeed good for one’s health and
may go a long way toward improving life in
America. One thing is absolutely clear,
however. The research that we do have supports
health care providers addressing
patient’s spiritual and religious needs. To
the routine questions of, “How’s your heart,
how are your lungs and how’s your
memory?” should now be added, “How’s
your soul?”
social support system showed a marked reduction
in death after open-heart surgery. Another
exciting finding presented by Michael
McCullough, Ph.D., an associate professor of
psychology at The University of Miami, was
that spirituality is highly correlated with positive
psychological attributes such as maintaining
an attitude of gratitude. Although this
may sound like “pop-psychology,” it has a very
good scientific base. According to research presented
by Dr. McCullough, positive character
traits, such as thankfulness, lower the level of
the stress hormone cortisol. This is important
because cortisol has many negative effects on
the immune system, the cardiovascular system
and the brain. Additionally, other traits such as
humility enable one to achieve greater happiness,
fulfillment and performance in a variety
of life domains.
highlight of the second day
was the presentation by
Andrew Newberg, M.D.,
clinical assistant professor
of neuroradiology at the
University of Pennsylvania.
Dr. Newberg has done
breakthrough work in the emerging field of
neurotheology, which uses advanced x-ray
techniques to document the effects of spiritual
and religious practices on the brain. For
example, it is now possible by utilizing PET
scans and functional MRIS to anatomically
delineate the parts of the brain that are affected
by prayer and meditation. Beyond brain
imaging studies, Dr. Newberg has been able to
measure various hormone and neurotransmitter
changes in the particular brain locations
caused by these techniques.
Byron R. Johnson, Ph.D., gave the keynote
address for the third day of the conference,
which covered spirituality and social health.
Dr. Johnson is the director, Center for
Research on Religion and Urban Civil Society
at the University of Pennsylvania. In his
address he discussed the socioeconomic implications
of religious commitment. According to
Professor Johnson, we need to study rigorously
the effects of faith-based initiatives to discover
what type of studies are best suited “to analyzing
and evaluating the extent, efficacy and
cost effectiveness of competing faith based
programs, and what species of research projects
are most likely to measure and test how, if
at all, it’s the ‘faith’ in the ‘faith factor’ that
matters.”
Other presentations concerning spirituality
and social order covered adult and juvenile
crime and delinquency, religion and abstinence
from drug use among American adolescents,
minority health issues, marriage and the
family, spirituality and aging, end of life issues,
caregiving, ethics and altruism.
f final note was a presentation
by Michelle J. Pearce,
M.S., of Yale University.
Her work concerns one of
the issues I mentioned previously
and that deserves
another reference: spirituality
and religion may be a very viable way to
lower rising health care costs in the United
States. The documented increase in spiritual
seeking by many Americans, both within and
without organized religion, may become an
important factor in helping to reduce the
financial burden of individuals and government
in the ensuing years. Studies show that
people who have a spiritual focus in their life
reduce the need for medical services by
adopting healthy lifestyles. Not smoking, not
abusing drugs or alcohol, exercising, practicing
prayer and meditation, having a broad social
support network, being altruistic and having
enhanced mental and emotional health may all
translate into lower health care expenditures.
The potential effects of religiousness on service
demands have important implications for
health care providers, institutions, patients,
clergy, researchers and taxpayers. While a
plethora of research still needs to be done, it
certainly appears that spirituality and religion
are indeed good for one’s health and
may go a long way toward improving life in
America. One thing is absolutely clear,
however. The research that we do have supports
health care providers addressing
patient’s spiritual and religious needs. To
the routine questions of, “How’s your heart,
how are your lungs and how’s your
memory?” should now be added, “How’s
your soul?”.
Dharma Singh Khalsa, M.D. is the president/
medical director of The Alzheimer’s
Prevention International, in Tucson, Arizona
and a leading voice in the field of integrative
medicine. In May 2003, Dr. Khalsa was invited
to testify before Congress on his work on integrative
medicine and Alzheimer’s prevention.
He is also the author of four critically
acclaimed books. To discover more about his
work please log onto drdharma.com.
To learn more about the work of ICIHS go to
their Web site: ICIHS.org
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