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ex, politics, and religion were once polite- conversation no-no's. but as Victorian sensibilities gave way to modern ones' society has loosened up. leaving few value-laden topics taboo. government's regulatory grip on health care has made any comprehensive discussion of medicine incomplete without some mention of politics. Epidemic rates of AIDS and sexually transmitted diseases have forced medicine's participation in debates about sexuality. But religion has remained pretty much a nontoxic, scientifically speaking until recently.

Although religion continues to be a force in hot-button topics such as futile care and abortion, it has been considered inherently unsuitable for scientific-method verification and therefore unworthy of scientific research. Now, religion and spirituality are apparently making some inroads into medical thinking. Local and national conferences devoted to the spiritual aspects of health are popping up around the country. Older studies are being given second looks, and new ones are being designed that explore how religious beliefs affect general health and patient outcomes.

Its not the existence of God, necessarily, that such research has set out to study or prove, but whether or not people who believe in God or practice a religion benefit health wise. According to some studies, religious people are healthier than nonreligious people. Some observers predict that once the cost-effectiveness of religious belief for maintaining or improving health is taken into account, spiritual interventions may be offered as part of routine care.

Texas Medicine asked physicians of different faiths how they think religion affects their patients' health. A few said they have seen proof enough of religions value not only in their own lives, but in their patients' lives as well. Whether or not they personally believe in God, they agreed that any-thing that helps their patients is alright by them.

In God we trust
hat researchers are looking into the connection between faith and health is not surprising given this country's level of interest in  religion. The Gallop Organization has surveyed Americans about their religious beliefs numerous times since the late 1930s. In 1986, 94 percent of Americans said they believed in God, a percentage that has not changed much since 1944, when the figure was 96 percent.

Another relatively constant figure since 1939 has been
church attendance, at 40 percent in 1993. And even though less than half of Americans attended church regularly in 1993, 66 percent said they considered religion to be either the most important factor in their lives or a very important factor, with just 12 percent reporting religion as not very important to them.

Because Christianity is still America's majority religion
— 81 percent of Americans in 1991 reported either a Protestant or Catholic religious preference, according to the US Census Bureau — more Christians wind up being research subjects than individuals of other faiths.

Just the facts, ma'am
alling religion an untapped clinical resource, psychiatrist and epidemiologist David Larson,MD,MSPH,director of the National Institute for Healthcare Research has spent about 15 years combing through the data about religion’s effect on health. While he's convinced religious faith can be a powerful force in preventing and treating illnesses, he doesn't fault medicine for having ignored it.

"I think in academic circles we remain very squeamish about it, because it often leads to controversy and argument," Dr Larson said. "But what we have seen is that the inclusion of spirituality in medicine improves care and reduces costs, and that religion is highly neglected in the medical and mental health sciences, especially given its personal and clinical relevance to patients."

Dr Larson says he started compiling and analyzing published research expecting to find that religion had a negative effect on health. "That's actually how I got into this. I was trying to look for harm because as a psychiatrist in training I was told it was harmful." Unexpectedly, he found the opposite effect in a wide range of studies varying in size and complexity. As a rule, most studies have focused on the practice of religion as measured by church attendance and prayer.

One of the most significant good-health indicators seems
to be church attendance. One survey of almost 92,000 Maryland residents found church attendance significantly coincided with reduced morbidity and mortality. Weekly churchgoers died 50 percent less often from heart disease, more than 50 percent less often from . emphysema and suicide and 74 percent less often from cirrhosis

Church attendance also coincided with reduced hypertension, according to a 1989 study where men who attended church regularly and who said religion was very important to them had lower diastolic pressures (nearly 5 mm) than infrequent churchgoers who said religion was unimportant. Men older than 55 who said religion was important to them had diastolic pressures 6 mm lower than those who said it somewhat important or unimportant (2).

In a recent study of elderly heart patients, the degree of strength patients said they received from their religious faith was the most significant indicator of survival following elective heart surgery. Six months after having the same surgery, 21 of the 232 patients had died, but none had died who had described themselves as deeply religious. The researchers said that those without any strength or comfort from religion had almost three times the risk of death as those who had at least some comfort or strength (3). "Now that has play, because the cardiac status variables were not as critical as religious variables," Dr Larson said. "So when you start talking about death and the cost of very expensive procedures, people start taking notice."

After analyzing hundreds of studies, Dr Larson says the findings show that practicing religion is beneficial more than 70 percent of the time and harmful less than 10 percent of the time. Dr Larson and two other researchers have compiled hundreds of such studies, many of which appear in their series of annotated bibliographies, “The Faith Factor,” and he and his wife have published an educational module called The Forgotten Factor. 'In studies that included church attendance alone, 80 percent showed a relationship with better health."

Dr Larson says he has been pleasantly surprised at medicine’s response to his and others' trailblazing in what he calls the antitenure track of research. "They have every right to have reservations, given their nervousness about rigid conservatives, and what I call the 'big F' word — fundamentalist. But where you have data and where you talk about the data, I have found tremendous openness in professional communities."

Docs as God's instruments
lthough the practice of medicine is necessarily bent toward scientific data and proof, many of its individual practitioners believe science is just a part of the healing process and that religions impact on health deserves attention. 

A common thread running through dialogues with religious physicians who hold vastly different theological perspectives is their belief that religion is good for their patients. Some take little credit for their patients' healing. "As a physician, the action is in your hand, but not the fruit of the action," said San Antonio internist Vijay Koli, MD, a Hindu. "In Hinduism, we are taught to be humble and to accept that we physicians haven't cured, but the Lord has allowed us to be His instrument in the art of healing." As a Hindu, Dr Koli believes in a pantheon of gods, or multiple deities, which are the various manifestations of one supreme being. Hindus believe human souls are reincarnated. Whatever happens in one life, including injury and sickness, is related to actions in previous lives (karma).

Although he doesn't think adherence to one religion over another makes a difference in patient outcomes, he says religious faith in general helps patients face health crises better. When he has done all he can do for his patients, he says he tells them that final authority rests on the supreme being. "There is a power beyond us," he said. "Ultimately, what the Lord has in mind, we don't know."

(Article from Texas Medicine December 1995)