Harold G. Koenig, M.D.
**This article first appeared in the Vol. 20, No. 3 issue of Christian Counseling Today magazine.**
In John 10:10 (NIV), Jesus said, “The thief comes only to steal and kill and destroy; I have come that they may have life, and have it to the full.” The King James Version says, “… I am come that they might have life, and that they might have it more abundantly.” Do actively practicing Christians experience a fuller, more abundant life compared to everyone else? Do they have greater well-being or find life more satisfying than others? Are they happier? Many wonder about this, especially those who are called to counsel Christians who often appear to be suffering terribly from depression, anxiety, or other forms of emotional distress. There seems to be so much unhappiness in the Christian community, despite the promises in Scripture of a more abundant life for the faithful.
Scientific research has the ability to shed light on such questions from an objective standpoint, one that is not influenced by theological opinion, bias or hearsay that may be circulating around the Church. Admittedly, the scientific method has its limitations here, especially given the complexity of the relationship between faith and well-being, the difficulty in accurately measuring faith, and the changing nature of faith and well-being over time. Nevertheless, systematic research is one source of information on the question of whether Christians (or those with strong religious faith and an active religious life) experience greater happiness and well-being than those not engaged in this way.
So, what does the research say about Jesus’ statement that His coming would give us a fuller, more abundant life? Although the answer is qualified (as all scientific answers are), the research says… YES! Indeed, those who are more actively involved in a Christian life experience greater life satisfaction, more happiness, and greater well-being than those who are less actively involved. This is also true for other constructs such as optimism, hope, meaning and purpose, gratefulness, and numerous positive emotions and virtuous traits. That fullness of life also goes beyond mental health to include relational health, and possibly even physical health. Here is a summary of the research we systematically reviewed in the Handbook of Religion and Health (2nd edition, Oxford University Press, 2012). Bear in mind that this was a systematic review, meaning we covered every study published in the English language in a health science journal that measured religious or spiritual involvement and health outcomes in a quantitative way (i.e., assessed using numbers and statistical analysis, not simply subjective reports). This systematic method is extremely important since it removes much of the bias that could otherwise influence the results.
Emotional Well-being
Research has repeatedly found that committed religious belief and devout practice are related to higher levels of emotional well-being, happiness, and life satisfaction. As of mid-2010 when our systematic review was completed, 326 separate studies had examined these relationships, and the overwhelming majority (79% of all studies and 82% of studies with better research designs) reported statistically significant positive relationships. Less than 1% (three studies) found lower well-being among those who were more religious. Note that 301 of those 326 studies (92%) were in Christian-majority populations. Many other studies published since 2010 report similar findings. The same is true for research examining optimism (83% reporting significant positive associations), hope (73%), and having a sense of meaning and purpose (93%). Objective research, then, documents beyond argument that religious or spiritual involvement is related to more positive emotions (over 90% of that research being done with Christian samples).
Relational Well-being
What about support from friends, neighbors and family members? How about stable, satisfying marital relationships? The research again confirms that those who are more engaged in their faith tradition have more support from friends and better marriages. Indeed, 82 of 104 studies (79%) find that those who are more religious report significantly greater social support than those who are less religious. As the methodological rigor of the study increases, the findings are even more consistent (i.e., 93% of studies with the best research designs report this result).
Sure, you may say, “I can believe that devout Christians have more friends and social connections.” That makes sense, but does it also translate to better marriages? Christian counselors who provide marital therapy may be even more dumbfounded by such research. Well, of the 79 quantitative studies measuring religiosity and marital satisfaction and stability, 68 (86%) reported significant positive connections. Those who are more religious have better marriages based on existing research. What about surveys that indicate born again Christians have the same divorce rate (35%) as those who are not born again (35%)? The reality is that devout Christians are more likely to get married and less likely to live together unmarried. The divorce figures do not include the latter. If they did, then Christians would be less likely to divorce or separate than those in the secular world. Nearly nine out of 10 objective quantitative studies by health researchers published in peer-reviewed science journals (including some very comprehensive studies, as well as longitudinal research with married people) find that religious devotion is associated with more stable, more satisfying marriages.
Physical Well-being
Better emotional and relational well-being also translates into better physical health. Despite the tendency for people to become more religious as they become physically sicker (which interferes with the ability to document that those who are more religious have better health), study after study reports a positive connection between religion and physical health. This should not be surprising. We know that emotional and social health is a strong predictor of good physical health. In the past 20 years, more and more research has shown that the mind and emotions are intimately connected with the body. Our emotions are directly linked with the basic physiological functions responsible for health and healing (immune, endocrine, and cardiovascular systems). When we experience stress and negative emotions, those systems become compromised and altered, increasing vulnerability to illness. The opposite occurs with the experience of positive emotions such as joy, peace, hope, meaning and purpose. Therefore, if religious people have more positive and fewer negative emotions, have more social support, and live healthier lives (less smoking, drinking, drug use, etc.), then they ought to be physically healthier… and that is what has been found.
For example, devout religious involvement (or religious interventions) is associated with lower rates of coronary heart disease in 12 of 19 studies (63%) and lower blood pressure or hypertension in 36 of 63 studies (57%). It is associated with better immune function in 15 of 27 studies (56%), better endocrine functions in 23 of 31 studies (74%), lower rates of cancer or better prognosis in 16 of 29 studies (55%), and better overall self-rated health in 29 of 50 studies (58%). These findings help explain why those who are more religiously active live longer, particularly those who attend religious services on a regular basis. More than 120 prospective studies (studies that assessed religiousness at one point in time and followed individuals sometimes for many decades) have examined the effect of religious involvement on mortality. Over two-thirds (68%) reported significantly greater longevity among those who are more religious. Studies with more rigorous research designs have a greater likelihood (75%) to report such findings.
Yes, everything else being equal, religious people do have better physical health (and most of that research has been done in Christians). This does not mean those who become mentally or physically ill are less religious, do not pray enough, or do not have strong enough faith. The Book of Job proves that. The relationship between religion and health is a complex one that is affected by many factors, including genetic influences, environmental dynamics, age and gender, and other variables in which the individual has little or no control. Sometimes, it is not until a person becomes sick and goes through tremendous suffering that he or she develops a deep spiritual life.
Role of the Church
Given that a person’s engagement in spiritual practices and a church community appears to promote social and emotional well-being, and may even serve as a buffer against disease and illness, what role might the Church play in the future of healthcare in America? Furthermore, what might happen to the health of our population if society continues on its current trajectory of becoming more and more secular, ignoring or excluding the Christian values and morals on which this nation was founded? There may, indeed, be a cost to such future trends—both in terms of health and dollars needed for healthcare.
The Christian Church has an opportunity to play a vital role in preserving the emotional, social, and physical well-being of the population. First, churches must hold firm to, and defend, the Christian teachings, values, and moral standards that secularization threatens to destroy and instill these into children and young adults. Second, churches need to encourage healthy habits among their members, especially younger members whose entire lives lay before them. This includes the avoidance of excessive alcohol use, drug use, and cigarette smoking, as well as the promotion of regular exercise, a healthy diet, maintenance of optimal weight, and routine doctor visits and disease screening activities to detect and treat illness early before it advances. There is no organization in our society as widespread as the Church, with regular access to people of all ages and genders, making it an ideal avenue for disease prevention and health promotion. Third, churches must reach out to non-church members within the community who need help (financial, social, and spiritual) or healthcare. Churches have sent missionaries around the world to spread the Gospel and provide help to the lost. Those precious souls are now (or soon will be) people right in our backyards. All of this may seem obvious, but sometimes reminders and regular reinforcement are necessary through the pulpit, in the press, and at the counselor’s office.
Harold G. Koenig, M.D., is a Professor of Psychiatry and Behavioral Sciences, Associate Professor of Medicine, and Director of the Center for Spirituality, Theology and Health at the Duke University Medical Center in Durham, North Carolina. In addition, he is a Distinguished Adjunct Professor at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia.