Leading researcher says evidence is increasing for spirituality affecting physical well-being
When Dr. Harold G. Koenig began researching the link between spirituality and health in the mid 1980s, like others in the field, he was going it alone with little backing. Only in the last 10 years, he says, have well-funded studies explored a connection between religious observance and physical well-being.
Koenig, co-founder of the Center for Spirituality, Theology and Health at Duke University Medical Center in Durham, North Carolina, United States, is considered by many as the world’s leading researcher on the subject. Last month he encouraged and offered advice to similar researchers as the keynote speaker for the Australian National Conference on Spirituality and Health in Adelaide. The conference was sponsored mainly by Seventh-day Adventist Church entities.
A prolific author and pundit, Koenig is a professor of psychiatry & behavioral sciences and associate professor of medicine at Duke. He cautions that some people take health principles too far—the first commandment of having no other gods should include health, he says.
He recently spoke with Adventist News Network about the increased popularity of linking spirituality and health, how science can measure spirituality, and why he likes what Seventh-day Adventists have to say about health. Excerpts follow:
Adventist News Network: You’ve debated your critics on live national television. Do you have supporters?
Dr. Harold G. Koenig: “When I started out in the mid 80s there weren’t too many supporters and you just had to blaze through this. The people who are suffering and in pain and sick and disabled, they’re the supporters. They’re the ones who are going to tell you their faith makes a difference in their lives and they’re alive because of it. And when you got patients telling you that, it’s tough to intellectually argue with them.”
ANN: In 2005, Duke hosted a panel discussion on spirituality and health with top medical school deans, including Harvard, Johns Hopkins and Stanford. You’ve said just having that discussion was progress. Are there any other factors that indicate the link between spirituality and health is gaining popularity?
Koenig: “The sheer number of research studies and articles that are now appearing in the medical, nursing and public health journals. A 25-page feature in the Southern Medical Journal is devoted to religion, spirituality and medicine every three or four months. For that to happen is really unheard of. Other journals are devoting an entire issue to the subject. Other places are discussing this—it’s coming from all over the country, all over the world.”
ANN: Are there enough studies to support the connection of spirituality and health?
Koenig: “I acknowledge that the many studies—there may be almost 2,000 by now—of those there are probably at least 1,800 that are poorly done. But if you’ve got 200 good studies, you know, where there’s lots of smoke, there’s usually fire. If you had this much evidence for other factors, it would probably be a normal part of medicine by now.”
ANN: Can science measure spirituality?
Koenig: “We can measure religious practices. We can ask people how often they go to church or synagogue or mosque, we can ask them how often they pray, we can ask them how often they read religious scriptures, we can assess their intrinsic religiosity—the extent to which their lives and their decision-making is based on their religious faith. We can measure all those things, not perfectly, but we can assess them, at least generally. And we can certainly assess mental, physical and social health. So because of that, there’s good reason to study these things.”
ANN: Two years ago you said “We’re close to proving [that religious involvement results in better health].” If it hasn’t been proven, how can you say you’re closer to proving it?
Koenig: “You can never say anything proves something. When you’re doing observational research you can show they’re connected, and that one appears to lead to, or predict another characteristic. Now with regard to mental health, there have been a series of about a half dozen randomized clinical trials in which religious persons with depression or anxiety or bereavement, were randomized to either get traditional psychotherapy or psychotherapy that took into account the religious beliefs and the faith of the person and used those as part of the therapy. The majority of those studies do show that the group that got the religious intervention as part of their psychotherapy got better faster. That would suggest, given that these were randomized, clinical trials, that the religious intervention actually caused the difference between the groups.”
ANN: How do you respond to your critics?
Koenig: “Up until 10 years ago, there was no funding for research in this area and people did it on their own. And sure, there were plenty of weaknesses in some of those studies because there were no resources. But nowadays many of those criticisms have been addressed, in terms of being very careful in controlling for other factors. It’s not just one place that’s finding this, it’s many reputable research groups. I think the criticism is sometimes taken a little too far.”
ANN: Why are scientists generally less religious than the rest of the population?
Koenig: “About seven percent of members of the U.S. National Academy of Sciences believe in God compared to 96 percent of the U.S. population. This difference in religious belief and involvement dates back to when science kind of departed from religion. For a long time, theology was known as the queen of the sciences. That changed with the French Revolution and then with science becoming the dominant mode for actual research. Then the science of psychology and sociology, and medicine in many respects, began to emerge in contrast to religion. ‘We are not religious, we are hard science; anything you can’t observe doesn’t exist.’ And that became the model for the sciences. There remains this strong divide, particularly because of the tremendous gains science has given us. Religion is seen as un-objective, or un-verifiable. So it’s not surprising, that among the best scientists in the world, they’re part of a cliquish kind of a group that has a world view in which religion plays no part.”
ANN: What are your thoughts on the Adventist Health Study that’s being funded in part by the National Institutes of Health?
Koenig: “I’m a consultant on that for the sub-study on spirituality. I think it’s very exciting. I think that there are few samples of this size that are so well selected, that have such depth of biological measures. The only concern I have is that many Adventists are people of such strong faith, that I’m worried that you don’t have enough non-religious people on this. Many Adventists will participate in this study because they want to do well, and part of that is a reflection of their faith. I do think it’s an exciting study because of the size and because it has a history of 30 to 40 years.”
ANN: What interests you about what Seventh-day Adventists have to say about health?
Koenig: “They’re one of the few faith groups that are saying anything about health. That’s exciting to me. The Brethren and the Mennonites, they see this also as important factor, and to some extent my church, the Catholics. But there’s no question that Adventists have gone the furthest, actually involving the [church executives] in their medical system. I was able to sit with [Adventist Health CEO Don] Jernigan and his crew. I’ve never sat with senior executives in a health system and talked about religion and health. I was able to show them research and talk about clinical applications and have them really be excited.”
ANN: Why have you chosen to make this your life’s work?
Koenig: “Probably a series of coincidences. I was fortunate enough to have gone through enough trauma in my own life to be able to recognize it in other people’s lives. That’s nothing compared to what many people have gone through. Maybe I’ve just got a louder voice, or maybe I’m positioned in a way that I can speak for others who have been through more in their life but don’t have a voice.”
