What impact does spirituality have on physical and mental health? This question has been a matter of debate for as long as human beings have thought about life. Even today those from cultures steeped in pantheism or animism have no doubts as to the influence of the spiritual world on health. To practise medicine without reference to the spirit world may be regarded by them as crass ignorance and dangerous interventionism.

In the fourth century BC Hippocrates was at pains to release the practice of medicine from the shackles of magic and sorcery. He challenged the prevailing view that epilepsy was of spiritual cause describing it as no more 'sacred' than any other disease. He argued that it had 'specific characteristics and a definite cause'[1] and only those akin to the modern day witch doctors and charlatans would regard it as a primarily spiritual problem.

One thousand years before Hippocrates, Moses learnt something of the positive relationship between godliness and health when God exhorted him to listen to his voice and do what was right in his eyes. In return for this, God promised, 'I will not bring on you any of the diseases I brought on the Egyptians, for I am the God that heals you'.[2] Long before even this episode, in the Garden of Eden, Eve learned the hard lesson of the painful effects of sin.[3] All of this reminds us that the relationship between spirituality and health is not a simple one.

The scientific background

A great deal of work has been done in this field over the last ten years. Most of this lies in the arena of social science and human behaviour, and is based on observation rather than experimentation. Nevertheless, there is much cumulative evidence for a positive correlation between faith and health. One of the most comprehensive reviews is that of Professor Harold Koenig.[4] Over 1,200 studies were analysed and a 60-80% correlation between religion, spirituality and health parameters was found.

These studies cover a wide range of 'spirituality' but the preponderance is for the Judeo-Christian faith. Positive correlation is found in varied fields such as heart disease, immunological dysfunction, cancer pain and disability. One major weakness in these types of studies is the inherent difficulty in controlling for confounding characteristics, such as a healthy lifestyle, which can weaken the quality of the research.

In research specifically targeted at the Christian population, Strawbridge et al [5] in a report of 7,000 people over a 30 year period found that frequent church attenders had lower mortality rates. This study had the benefit of a measurable factor (frequency of church attendance) rather than the less easily defined 'Christian faith' found in many studies.

Lastly, Culliford [6] in a 2002 BMJ review article compared spirituality to nutrition and stated 'Inadequate nutrition is costly. If people are not fed properly, resistance weakens and wounds do not heal. Evidence is growing in volume and quality that this holds for spiritual sustenance too.' In the same article, he also quotes the World Health Organisation as saying: 'The reductionist or mechanistic view of patients is no longer satisfactory. Patients and physicians have begun to realise the value of elements such as faith, hope and compassion in the healing process.'

Biblical perspectives

None of this should surprise us as Christians. We know already from biblical revelation that faith in God is good for you. We are told in Exodus 23 that by worship of God 'his blessing will be on your food and water'. He promises to 'take away sickness' from the Israelites if they remain faithful to him.[7] Even on the bio-mechanical model, to follow maker's instructions is the way to get the best out of any machine. Making our own instructions is destined to fail.

Interestingly, the Bible is more guarded in its statements than some modern researchers. It observes and reports correlation but less often makes direct 'cause and effect' claims. Psalm 32 describes the beneficial effects of transgressions forgiven: 'Blessed is the man whose sin the Lord does not count against him'.[8]

We are also told in Romans 5 of the justification that comes through faith, of the hope that comes eventually through suffering, and of God's love which comes into our hearts through the gift of the Holy Spirit.[9] These gifts of faith, hope and love are powerful medicines. In addition, we have the supportive value of a faith community, such as that found in Philippians 2 where its members 'welcomed' brothers in the Lord and took care of each other's needs.[10] Taking all these privileges together, we as Christians have a powerful therapeutic armoury.

Are we asking the right questions?

Historically, a portion of healthcare research (both Christian and non-Christian) has assumed that 'health' in all its parameters and long life are the ultimate goods. The Bible, especially the New Testament, would challenge this view point. We see this in Matthew 16 [11] where Jesus challenges his disciples to deny themselves and take up their cross in order to follow him. 'What good will it be for a man if he gains the whole world, yet forfeits his soul?'

In many parts of the world, and throughout history, following Christ has involved some distinctly unhealthy lifestyle choices. We only have to look at the gruesome experiences of historical Christians listed in Hebrews 11 [12] to gain an appreciation of the sufferings of our fellow brothers and sisters in Christ.

There are three categories of these 'negative' health outcomes of faith in God:

Following Christ may lead me into danger

Historically, faithfulness to Jesus often led to an early death. It may do the same for me or my family. The average life expectancy for European missionaries to West Africa in the mid-19th century was six months from the time of arrival. Despite this knowledge, missionaries still went to replace those who had fallen.

Following Christ will lead me into conflict

This may be within the family, amongst colleagues, or in the world at large. Conflict at the human level is generally a negative health predictor. Hidden conflict in the spiritual world can have more devastating effects, such as that seen in Job 2 where the Lord allows Satan to afflict Job with 'painful sores from the soles of his feet to the top of his head' in order to test his allegiance to God.[13] Radical discipleship of Christ comes with its own distinct health warnings. This is seen in John 15 where Jesus warns his disciples to expect persecution, just as Christ himself was persecuted: 'If they persecuted me, they will persecute you also', and in the subsequent verse: 'They will treat you this way because of my name, for they do not know the One who sent me'.[14]

Following Christ will produce inner tensions

This may be because our expectations for 'a good life' have not been realised. It may also be related to unrealistic expectations over divine healing. Perhaps there are issues of false and unresolved guilt. We may feel the strain of commitment to work, family and church. Biblically, some of these issues are covered in the words of Psalm 73[15] where the psalmist laments 'the prosperity of the wicked' as they 'scoff, and speak with malice'. He envies their wealth, their health, and their lack of burdens as he himself struggles to keep trusting the Lord. We have all been there.

Where do we go from here?

We have seen that faith in Christ may lead to less than perfect physical health in this world. We wrestle with the joy of knowing Christ, and the conflict and tensions this produces in an imperfect and sinful universe. Surely as Christians we should see this life in the context of eternity? Not as what we are but what we shall be when we meet God face to face. We remember the rich young man in Mark 10 [16] who asked Jesus, 'What must I do to inherit eternal life?' This is the question that we as Christians should be asking as, like Paul in his letter to the Philippians, [17] we press onwards to win the prize for which God has called us heavenwards in Christ Jesus.