Is healthiness next to Godliness? 'Yes' in America, 'not yet' in Australia

While US research has shown that greater participation in religious activities is associated with better health outcomes, more work is required in Australia to better understand the nature of Australian spirituality, its relationship to health and the spiritual needs of patients.

In the latest edition of the Medical Journal of Australia, Professor Hedley G Peach compares and contrasts the attitudes and associations of religion, spirituality and health in Australia and the United States.

Professor Peach reports that the considerable literature on the subject shows that in the United States:

• Most original research has found positive associations between increased spirituality and better health outcomes
• A significant proportion of patients would welcome doctors enquiring about spirituality
• Many US medical schools and some residency training programs include spiritual issues in their curricula, and
• There needs to be further research into the relationship between spirituality and health, particularly clinical trials of spiritual interventions on health outcomes, and recognition of the significance spirituality may play in clinical practice.

There is little Australian literature on the subject.

Based on 1980s statistics, 95 per cent of Americans believe in God, 78 per cent regularly pray, and 42 per cent attend religious services regularly. In Australia, 61 per cent believe in God other than just sometimes, 67 per cent pray, including only occasionally, and 25 per cent attend church monthly or more often.

While belief in God is holding up in the US at around 94 per cent, consecutive surveys and censuses in Australia have shown a gradual decline in both belief in God and a religious affiliation.

Professor Peach says that in the US most inpatients have religious needs, but physicians address them only occasionally and infrequently refer patients to clergy.

"US medical students are learning to do spiritual assessments and integrate the findings into patient management and this may reverse this trend in the future," Professor Peach says.

Because religion does not play as central a role in the lives of Australians as it does for Americans, the links between a broader definition of spirituality and health are particularly important for Australians and these are yet to be properly explored - but it is an area that needs exploring.

"Research is required to better understand the spirituality of Australians, its relationship to health, and the benefit, cost and acceptability of doctors enquiring into patient spirituality as opposed to leaving it to clergy, spiritual advisers and counsellors," Professor Peach says.

In an editorial in the same edition of MJA, Associate Professor Harold G Koenig from Duke University in the US argues that exposing medical students in Australia to the role that religion plays in coping with illness and the research connecting religion and health should not be delayed.

"There is ample evidence to support some cautious first steps in Australian medical schools," he says.

"Religion is a powerful factor that can influence health, wellbeing and medical decisions for better or worse.

"It should not be ignored or neglected by physicians."

Associate Professor Koenig says that according to more recent data, in 1998, 74 per cent believed in God, a higher spirit or life force (and in the 1996 census, only 1 in 2000 Australians were avowed atheists). These data are based on 1998 Australian Community Survey.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT: Professor Hedley G Peach (03) 5320 4077 B/H; (03) 5320 4015 A/H
Email: maxineT@bhs.grampianshealth.org.au

Associate Professor Harold G Koenig (0011) 1 919 681 6633 B/H; Email: koenig@geri.duke.edu (0011) 1 919 970 5106 A/H pager

Judith Tokley, AMA Public Affairs (0408) 824 306