Do You Believe In?
Special, Guest-Edited Issue on Religion, Healing, ad Public Health
can't hide from religion in Georgia. If you don't go after it with
a positive agenda, it will come after you."
Director, Interfaith Health Program
understand our patients fully, we need to understand their beliefs,
or we will not be effective as their healers."
Lori Arviso Alvord,
Assistant Professor of Surgery and Associate Dean for Student Affairs,
Dartmouth Medical School
Perspectives on Health and Healing
Can Science and Religion Work Together?
A three-pronged approach to health, healing, and spirituality
P. Venugopala Rao, Associate Professor of Physics
Carla Gober, Registered Nurse and Doctoral Candidate, Graduate Division
and Modern Medicine
Science on a wing and prayer?
Patient and Healer
Four anthropological observations
a medical anthropologist, I teach about such topics as cross-cultural
medical care, the social constructions of biomedicine, and “ethnomedical”
systems, or medical systems of non-western cultures. The connections
between religion, healing, and health are, therefore, not a new
area of intellectual inquiry for me. With my interest in biocultural
evolution, I tend to think that religion, as a cross-cultural universal,
must have old and adaptive functions in our species’ prehistoric
In many societies, it is impossible to separate religion from medicine
(or ethnomedicine) because they intertwine beliefs and practices
aimed, in large measure, towards curing and maintaining health.
Indeed, hidden within the center of the modern and scientifically
sophisticated edifice of biomedicine is the ancient and powerful
social interaction of patient and healer, which is based on knowledge,
trust, and the ritual manipulation of symbols of curing. The anthropologist
and physician Arthur Klienman has called this therapeutic interaction
between healer and patient “medicine’s symbolic reality.”
No matter how complex the science of biomedicine becomes, from the
patient’s point of view there is nothing quite as powerful
as his belief in the doctor’s knowledge, experience, and connections.
With that background in mind, I was aware as a participant in last
fall’s faculty seminar on Religion, Healing, and Public Health
of the cross-cultural narrowness of much research on religion and
health (and the opportunities for medical anthropological research
in this regard). It was therefore a pleasure to explore critically
the current research along with faculty and graduate students from
variety of fields. Our discussions inspired me to think about four
related topics: the problems of definitions, the material conditions
of health, the creation of meaning for our existence, and the taboo
on personal spiritual issues in the academy.
I was not surprised that academic discussions of the problems of
definitions—particularly of health and of religion—were
central to the seminar. The definitions of both religion and health
are slippery. Each re-search project we considered could be subjected
to strong criticism of the compromises of operational definitions.
Can church attendance be used as a measure of religiosity? Is survival
time after a diagnosis a measure of health? One theologian in the
seminar proposed, “health is really the ability to accept
the situations that have been given us,” and that it had little
to do with objective medical conditions. Part of the research question
is whether there should be a dose-effect in the religion-health
connection. Members of the seminar agreed that sometimes people
carry religion to unhealthy extremes, often under a charismatic
leader. But the response to historical examples was that they were
perversions of religion. As an anthropologist, I sometimes suspected
that questions of the definitions reflected unconscious ethnocentrisms.
Perhaps in part because of these problematic definitions, the material
prerequisites for health often went unmentioned in the research
we considered (most of which involved particular types of societies
in the United States), and the relationship between inequality and
health was taken for granted. In approaching these topics, it is
important to reiterate continually the necessary material conditions
for health. These conditions include secure access to appropriate
food, clean water, adequate housing and hygiene, and basic health
services and knowledge (both preventive and curative). Because ours
is such a rich society, we easily take these things for granted.
But high levels of disease are correlated everywhere with poverty,
socioeconomic inequality, and “structural violence.”
As such, the quest for improved population health must first involve
the struggle for social justice and human rights. Historically,
religious institutions have played a variety of roles (both helpful
and harmful) in efforts to decrease poverty and increase social
justice—prerequisites for health.
One reason for this historical involvement of religious institutions
may be that humans need to create meaning for their existence. Since
this need is universal, it is probably evolutionarily old and genetically
driven. We share our systems of meaning with our social group, and
we pass them down to our children. An old-fashioned anthropological
definition of religion is the “belief in supernatural beings
or forces and the rituals associated with those beliefs.”
These beliefs help us explain, understand, and survive through misfortune,
illness, and death. They benefit society in terms of cohesion and
cooperation. At the same time, these beliefs and rituals provide
an outlet for personal anxiety, as well as a source of hope and
optimism, which have biological benefits. It is not surprising to
read research results that say it is unhealthy to be without a raison
d’etre; such individuals are socially isolated, psychologically
depressed, and vulnerable to disease. We as humans need to create
an illusion of control over our lives and environment, and rituals
allow us to create such illusions. The question is, does it matter
what we believe in? Does it matter which social groups we belong
to? Are religion and faith communities better in regard to the promotion
of health and hope than corporations, bowling leagues, fan clubs,
or even the Ku Klux Klan?
Finally, hearing the personal narratives—of intellectual trajectories
and life experiences—that seminar members shared (see examples
in this issue) provided some of the most interesting moments in
the seminar and made me reflect on our own social group in the academy.
These statements explained “how I came to this seminar table,”
and I realized how little I knew about the religious beliefs, backgrounds,
and practices of my colleagues. It is almost as if in the culture
of the modern academy (or at least my little corner of it) discussions
of personal spiritual issues are taboo. There is an assumption that
most of us working in the university are atheists or agnostics—and
certainly not regular church-goers. In this regard, academic work
has an assumed secular culture, which might influence our epistemologies
in unrecognized ways. Personally, I was surprised by my own lack
of introspection about how my religious upbringing and socio-spiritual
experiences had influenced my academic career and my current intellectual
worldview. The topic “Religion, Healing, and Public Health”
is a low prestige area of medical and health research because investigators
are assumed to have an ideological agenda. The research is suspect;
the operational definitions difficult; and funding agencies are
not necessarily supportive. The situation is unfortunate, because
this is a rich and important area for exploration into the intersection
of health, culture, and society.