Q&A with Jeff Levin, Ph.D., about his book Healing to All Their Flesh: Jewish and Christian Perspectives on Spirituality, Theology, and Health

Jeff Levin, Ph.D. M.P.H.

Research about the relationship between religious involvement and personal and population health has burgeoned in recent years. But something is missing - even in the best of scholarly work, says Jeff Levin, Ph.D., University Professor of Epidemiology and Population Health Director in the Program on Religion and Population Health in Baylor University's Institute for Studies of Religion.

Most of the research exists in a "theological vacuum," he says, and in this question-and-answer session, he talks about what that means and about the book he co-edited with Keith G. Meador, a professor of preventive medicine at Vanderbilt University.

Q: What do you mean by the term "theological vacuum"?

A: Thousands of studies have been conducted by medical and social scientists, most seeking to understand if and how personal faith or spirituality impacts on people's physical or mental health or overall well-being. As in any research, these studies are only as good as quality of the assessments - the questions that are asked. But in this field you have the unusual situation of physicians and sociologists and psychologists and epidemiologists presuming to assess "religiousness", usually without consulting anyone who might know something about the topic. This would never happen in studies of other potentially health-impacting variables, like, say, environmental toxins. You'd consult an environmental scientist to make sure you were assessing the right things in the right way. But for religion this typically doesn't happen. As a result, in many of these thousands of studies "religion" is not defined or assessed in a meaningful way. Or when it is-and, to be fair, there are many very well designed studies in this field - findings are misinterpreted. We wrote this book as an effort to step back and say, wait, what questions should we be asking and what might the resulting findings really mean.

Q: How have scholars generally defined "religious involvement" for the purposes of this type of research? How should it be defined?

A: Early on, religious assessment was very simplistic: "what religion are you?," "do you go to church?," yes or no, that kind of thing. Over the past 20 years, assessment has become more sophisticated, with the kind of validated scales and indices that one finds throughout the social and behavioral sciences. But the challenge remains for doctors and biomedical people to become aware of these measures and know how to use them. Today, there are probably more than 200 good measures available of all sorts of religious behaviors, beliefs, attitudes, values, feelings, experiences, and so on. The "father" of the modern assessment of religious involvement, incidentally, is Baylor's own Dr. Rod Stark, (co-director of the Institute for Studies of Religion). But just because good measures are available doesn't mean they're always used, especially since medical researchers may not be familiar with work in the social or behavioral sciences.

Q. What are some of the findings of recent research, and do you think some are flawed because of the "theological vacuum"?

A: It's pretty well understood by now that having a faith commitment or a regular religious or spiritual practice, broadly defined, is associated on average and at the population-wide level with better mental health and even physical health outcomes. Less depression, less anxiety, less physical symptomatology, higher overall self-ratings of health, even somewhat greater longevity. Like any epidemiologic finding, such as the relationship between cigarette smoking and lung cancer or between exercise and myocardial infarction, this finding exists on average and all things being equal. Of course there are folks who smoke and never get sick or who never exercise a day in their life and do just fine. But, on average, we know that smoking and sloth are risk factors. In the same way, we have evidence that for some segments of the population lack of a spiritual life can serve to elevate one's risk of bad mental or physical health outcomes. Even though, obviously, there are great people of faith who suffer health challenges and also nonbelievers in God or religion who live perfectly fine, healthy, and long lives. This is one of the challenges of communicating epidemiologic findings, incidentally: how to convey that we are identifying population-wide averages and not absolutes that apply to everybody.

As far as the quality of the findings themselves, a lot of outstanding studies have been done, and I believe the findings speak for themselves. The "what" of this research and the "who," "where," and "when" are pretty well accepted-the data themselves. But what I'd call the "how" and "why" of this work, that's a very different thing. There are all sorts of questions that we should be asking in light of this huge volume of statistical findings, but, for the most part, these questions aren't being asked. For example, do the great faith traditions themselves assert that spirituality should impact on health? What is it about faith is healing, that is restorative, that is redemptive? Are we even looking at the right outcomes- i.e., personalized measures of health or wellness? Is the faith-health relationship rather a matter of communal responsibility? That is, is the ability of communities of faith to come together to work for constructive social change that will impact on people's lives or to weigh in on important bioethical issues a better marker of a faith-health connection than whether people who go to religious services more than once a month have, say, less of some psychiatric diagnosis than people who go less frequently? These are more existential questions than we scientists and doctors are used to thinking about, and it would behoove us to invite folks into the conversation who are familiar with canon, theology, praxis, and the way that religion expresses itself in the lives of human beings.

Q: The book description mentions that there are unrealistic and dangerous expectations about how/whether faith influences health. Hasn't that always been the case?

A: Sure, but the proliferation of news stories about these studies in recent years has served to exacerbate this problem. Faith is now treated like some neat little thing that you can plug into your life style, like a fad diet or Pilates or transcendental meditation, and get results now, by golly, lose inches, improve your sex life, be happy, live to 100, whatever. Religion is pitched as something that's "good for you," whatever that might mean. Conversely, if you're sick, you must have not been spiritual enough or have not prayed correctly or God is punishing you. Of course, and this should go without saying, the published research doesn't even remotely convey anything like this at all. But because these very nuanced epidemiologic findings aren't been interpreted in a reasonable fashion, these very unrealistic and unfortunate messages are getting out and spreading and causing a lot of people a lot of distress.

Q: The names of some of the scholars whose writings are included in this book may not be immediately recognizable to everyone. Would you give an idea of the variety of people whose works are included?

A: Some of the leading Jewish rabbinic scholars and Christian theologians have contributed to this book. For example, we have a wonderful chapter on Jewish bioethics by Rabbi Elliot Dorff, perhaps the preeminent Conservative Jewish thinker in the world. Among Christian contributors, we were fortunate to be able to include a chapter by Stan Hauerwas, from Duke University, who has been referred to as the leading Protestant theologian in the country. We also have chapters from Stephen Post, one of the world's preeminent bioethicists, as well as by John Swinton, who holds the chair in divinity at Aberdeen.

To interview Dr. Levin, contact Terry Goodrich, 254-710-3321; or the Office of Media Communications at (254) 710-1961.