Table Of ContentReligion, Spirituality and Health: A Social Scientifi c Approach
Doug Oman Editor
Why Religion and
Spirituality Matter
for Public Health
Evidence, Implications, and Resources
Foreword by Sandro Galea
Religion, Spirituality and Health:
A Social Scientific Approach
Volume 2
Series Editors
Alphia Possamai-Inesedy, University of Western Sydney, Penrith,
New South Wales, Australia
Christopher G. Ellison, The University of Texas at San Antonio,
San Antonio, Texas, USA
Editorial Board
Amy Ai, Florida State University, Tallahassee, USA
Maureen Benjamins, Sinai Urban Health Institute, Chicago, USA
Alex Bierman, University of Calgary, Calgary, Canada
Matt Bradshaw, Baylor University, Waco, USA
Alexander Broom, University of Queensland, Brisbane, Australia
George Fitchett, Rush University, Chicago, USA
Paul Heelas, Lancaster University, Bailrigg, UK
Terrence Hill, University of Arizona, Tucson, USA
Ellen Idler, Emory University, Druid Hills, USA
Harold Koenig, Duke University, Durham, USA
Neal Krause, University of Michigan, Ann Arbor, USA
Jeff Levin, Baylor University, Waco, USA
Pranee Liamputtong, Latrobe University, Melbourne, Australia
Keith Meador, Vanderbilt University, Nashville, USA
Doug Oman, University of California at Berkeley, Berkeley, USA
Kenneth Pargament, Bowling Green State University, Bowling Green, USA
Crystal Park, University of Connecticut, Storrs, USA
Jenny Trinitapoli, Pennsylvania State University, State College, USA
The relationship between religious/spiritual belief or behaviour and health behaviour
has been explored over several decades and across various disciplines. Religious
variables have consistently been found to have a direct relationship to physical and
mental health. At the same time - research has also indicated potential societal
tensions that can exist between religion and health – we have seen this in relation to
family planning, HIV/AIDS, and reproduction. This book series aims to uncover the
impact of religion on individual health behaviours and outcomes but also the
influence of religion on health practices at the community level. This book series
uncovers the impact of religion on individual health behaviors and outcomes, as
well as the influence of religion on health practices at the community level. It
consists of volumes that are based on multi-methodological approaches, provide
quantitative and qualitative forms of analysis, and advance the understanding of the
intersection between religion and health beyond the correlation of religious belief
and health outcomes. Building on earlier research, the series explores the direct
relationship between religious variables and physical and mental health, as well as
the potential societal tensions that have been shown to exist between religion and
health – for example in relation to family planning, HIV/AIDS, and reproduction.
Spoken values are often shared within religious communities; however, religious
influence can at times be extended outside of the community in instances of service
provisions such as hospital ownership, various research active think tanks, political
action, and the development of community mores.
More information about this series at http://www.springer.com/series/13437
Doug Oman
Editor
Why Religion and
Spirituality Matter for Public
Health
Evidence, Implications, and Resources
Editor
Doug Oman
University of California
Berkeley, CA, USA
Religion, Spirituality and Health: A Social Scientific Approach
ISBN 978-3-319-73965-6 ISBN 978-3-319-73966-3 (eBook)
https://doi.org/10.1007/978-3-319-73966-3
Library of Congress Control Number: 2018936751
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Foreword
Public health is concerned both with improving overall health of populations and
with minimizing differences in health between groups within populations. There is
little question that in order to achieve these ends, public health should centrally be
concerned with the social, economic, and cultural factors that shape the health of
populations. These structural factors shape the behavioral and cognitive factors that
influence our daily lives; shape the food we eat, the water we drink, and the air we
breathe; and shape how we think, feel, and behave. There is abundant evidence for
the relation between a whole range of structural factors and the health of popula-
tions. We have now several shelves full of books discussing how social cohesion,
segregation, the urban environment, and public policies – to name but a few – influ-
ence health. This book is a worthwhile addition to that canon, focusing our attention
on the role of religion and spirituality (R/S) as determinants of the health of
populations.
Why a book about R/S?
First, as the book makes clear, religion and spirituality are forces shared and
embraced by billions of people worldwide. They represent cultural experiences that
cut across countries and continents, across racial and ethnic groups, across ages.
That makes religion and spirituality near-ubiquitous features of the human experi-
ence. It is then virtually self-evident that R/S are going to critically influence popu-
lation experiences, behaviors, and health.
Second, our engagement with R/S within public health has, at least at the level of
synthesis and concept, substantially lagged behind our engagement with other
social and cultural forces of comparable import, despite the production of thousands
of papers that have shown an association between R/S and health, generally with
positive health. This book then fills that gap – and does so admirably – summarizing
the evidence ably and moving the reader to practical chapters that can guide engage-
ment with R/S to the ends of improving the health of populations.
Third, and perhaps most importantly, R/S represent cultural experiences that are
truly foundational to a whole range of other drives that shape the health of popula-
tions. R/S play an enormous role in shaping each and every one of our values, inten-
tionally or unintentionally. Values are what we choose to focus on, in a world of
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vi Foreword
limited time and resources. This choice is both necessary – if we are to get anything
done – and deeply revealing. Indeed, the philosopher José Ortega y Gasset once
wrote “Tell me to what you pay attention and I will tell you who you are.” Normative
ethics, the branch of ethics that assigns moral value to actions, suggests three ethical
theories that inform action: virtue, deontology, and consequentialism. Virtue ethics
are concerned with the moral character of the person or people performing an
action – i.e., are they good people acting in good faith? This means that, for an
action to be ethical, it does not necessarily have to produce positive results, as long
as it is performed by virtuous people. Deontology is concerned with the action
itself – i.e., is it the right step to take? Is it being performed correctly? Under this
system, intrinsically bad actions should be avoided, even if they may lead to positive
results. Consequentialism is concerned with outcomes – i.e., what did this action, in
the end, actually do? In all of these cases, values are defined by their relationship to
what we do. And in all cases, R/S can influence values, informing our moral charac-
ter, judgment of the right or wrong step to take, and an appraisal of the desirability
of different consequences. R/S shape how much we care about aspects of the world
around us. And, critically, when we genuinely care about something, particularly
when it is an injustice in need of correcting or a matter of lives to be saved, it is dif-
ficult to remain a spectator, or to limit our activities to the accumulation of knowl-
edge for its own sake. Our values then push us to guide our priorities, where we
invest our time, resources, and money.
At the collective level, it is values that shape the contours of our political deci-
sions, that help societies articulate our agreed-upon to-do lists, and that influence,
explicitly or implicitly, where we favor investing our collective resources. It is no
surprise then that political campaigns are waged about, won, and lost, over values.
Nor is it a surprise that leaders at all levels aim to conform to established values or
to shift values to serve a desired agenda. For millennia, R/S have been shaping and
shifting values, both explicitly as some religions have, for periods dominated public
conversations, norms, and behaviors, and implicitly as personal spirituality influ-
ences what many of us do on a day-to-day basis. Seen in this light, I would argue
that one of the – if not the – most foundational drivers of health, a determinant of
determinants, sometimes invisible, but nearly always there, is R/S.
It is with this in mind that I am enthusiastic about this book. Those of us con-
cerned with the health of populations have much to learn from the chapters in this
book, both from the point of view of understanding how R/S do exert their influence
and of learning how to engage them positively toward the end of improving health.
Insofar as this book can help us get there, it stands to be a step in the right direction
for population health.
School of Public Health Sandro Galea
Boston University
Boston, MA, USA
Preface
This volume aims to help and encourage the field of public health in responding to
the recent emergence of an increasingly well-organized interdisciplinary field
focused on the health implications of spirituality and religion. The primary audi-
ences toward whom the book is directed are researchers, students, faculty, and prac-
titioners in public health. For them, the book is intended as a “go-to” resource that
supplies key information for appropriately addressing religion and spirituality in
research, teaching, and practice, as well as for preparing compelling evidence-based
applications for funding. Beyond this foundational public health audience, the vol-
ume is also directed to physicians, psychologists, social workers, gerontologists,
nurses, and every other health professional aiming to inform his or her work by
taking into account population health perspectives.
For those in the field of public health, our goals are twofold. On the one hand, the
book is intended to help public health catch up with the significant strides that many
other health professions have made in addressing the implications of spirituality and
religion. Equally important, the volume is also intended to assist public health as a
field in discovering and delivering its own distinctive contribution to the interdisci-
plinary field of religion, spirituality, and health. The chapters in this volume do not
confine themselves to individual-level manifestations and implications of spiritual-
ity and religion, but emphasize that religion and spirituality are also group-level
phenomena that occur in the community, that generate community-level effects, and
that can inform community-level efforts to foster population health.
This volume emerged from two projects based in the School of Public Health at
the University of California, Berkeley, that were funded by the John Templeton
Foundation. Through these projects we assembled a working group of Berkeley
faculty who helped generate most of the empirical reviews that appear in Part I. The
funded projects also helped support additional work by the editor in assembling
Parts II, III, and IV, and helped sponsor some of the teaching efforts described in
Part III. We are very grateful to the John Templeton Foundation for making this
work and this volume possible (through “On the Viewscreen: Integrating Spiritual
Factors into Public Health Teaching & Practice,” grant # 43419; “Going National:
Addressing Spiritual Factors in Public Health Education,” grant # 55789).
vii
viii Preface
The editor also wishes to thank many, many other people who have helped make
this writing project possible. Extraordinary thanks are due to Len Syme, an unfail-
ing source of encouragement and feedback throughout the long process of learning
the field and then preparing this volume. Special thanks for extraordinary effort are
also due to Nancy Epstein, who supplied much helpful advice, feedback, and
encouragement, and authored two chapters. All of the contributing authors merit
many thanks and accolades for high-quality and timely contributions. Thanks are
also due to the Berkeley working group, which included many contributing authors
plus Denise Herd and Kristen Madsen; thanks are also due to Lara Hovsepian-Ruby,
numerous Berkeley staff, and other colleagues across the country who have helped
in carrying out these two projects. We are also grateful to the series editors at
Springer, Alphia Possamai-Inesedy and Chris Ellison, who provided much useful
guidance and encouragement, as well as to the anonymous external reviewers, and
to many others at Springer who helped shape the book and make it possible, includ-
ing Cristina Dos Santos, Anita Rachmat, Prasad Gurunadham, and KrishnaKumar.
More broadly, abiding thanks are due to the toiling scholars and research partici-
pants everywhere who have helped build up the interdisciplinary empirical field of
religion and spirituality and health, who are too numerous to name, and to whom
this book is dedicated. Last but not least, the editor wishes to express profound
gratitude to many others who have deeply influenced and supported his understand-
ing of spirituality and religion and their effects on health, including especially
Eknath Easwaran, Huston Smith, Carl Thoresen, Kenneth Pargament, and many
friends and neighbors who have patiently borne with the long task of preparing this
volume. Of course, any flaws in the fashioning of this volume are solely the editor’s
own responsibility.
School of Public Health Doug Oman
University of California
Berkeley, CA, USA
Contents
Elephant in the Room: Why Spirituality and Religion Matter
for Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Doug Oman
Part I Evidence Base
Reviewing Religion/Spirituality Evidence from a Public
Health Perspective: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Doug Oman
Model of Individual Health Effects from Religion/Spirituality:
Supporting Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Doug Oman
Religious/Spiritual Effects on Physical Morbidity and Mortality . . . . . . . 65
Doug Oman
Social and Community-Level Factors in Health Effects
from Religion/Spirituality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Doug Oman and S. Leonard Syme
Social Identity and Discrimination in Religious/Spiritual
Influences on Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Doug Oman and Amani M. Nuru-Jeter
Environmental Health Sciences, Religion, and Spirituality . . . . . . . . . . . . 139
Doug Oman and Rachel Morello-Frosch
Infectious Diseases, Religion, and Spirituality . . . . . . . . . . . . . . . . . . . . . . . 153
Doug Oman and Lee W. Riley
Public Health Nutrition, Religion, and Spirituality . . . . . . . . . . . . . . . . . . . 165
Doug Oman
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