What are some concrete examples of the health benefits that are thought to be linked to religious practice or spirituality?
A growing number of studies suggest that people who are more involved in religion tend to have better health because they are more likely to engage in positive health behaviors (e.g., maintaining a good diet) while avoiding negative or undesirable health behaviors (e.g., alcohol abuse) (Hill, Burdette, Ellison, & Musick 2006). This is important because an extensive literature suggests that adopting positive health behaviors lowers the risk of developing a wide range of illnesses and may even reduce the odds of dying as well (U.S. Department of Health and Human Services, 1992).
A good deal of the research on religion and health behavior focuses on the use of alcohol. A fairly large number of these studies suggest that greater involvement in religion is associated with either the moderate use of alcohol or the avoidance of alcoholic beverages altogether (e.g., Herd 1996). But the influence of religious involvement extends to other health behaviors also. For example, research by Idler and Kasl (1997) indicates that older adults who attend worship services more frequently have a lower probability of having ever used tobacco. However, one study on religion and health behavior stands out above the rest. This research was conducted by Hill et al. (2006). These investigators examined the relationship between the frequency of church attendance and twelve health behaviors. Their findings reveal that regular attendance at worship services (especially weekly church attendance) is significantly associated with eleven of the twelve health behaviors they examined. Included among these health behaviors was the avoidance of tobacco, the moderate use of alcohol, engaging in strenuous exercise, seat belt use, vitamin use, the utilization of preventive health-care services (e.g., physical and dental examinations), sleeping well, and walking.
As Hill et al. (2006) point out, many religions adhere to the notion that "the body is the temple of God." As a result, various religious groups advocate the use of certain types of health behavior while discouraging the practice of others (Sabate 2004). For example, the Seventh-Day Adventists strongly encourage the pursuit of sound dietary practices, while Southern Baptists strictly prohibit the use of alcohol. But it is not entirely evident how these religious teachings and beliefs are transmitted to rank-and-file church members. Undoubtedly, a number of mechanisms are involved (see Krause 2006f, for a discussion of several mechŽanisms), but the purpose of the discussion in this section is to argue that close companion friends at church may have something to do with it. Simply put, religious rules and teachings regarding health behaviors may be transmitted and reinforced through informal social interaction with like-minded companion friends. It is important to reflect on precisely how this takes place.
Some insight into the role that companion friends may play in the adoption of beneficial health behavior may be found in an intriguing paper by Rook (1990). She turned to the notion of social control to explain the relationship between social ties and health behavior. Social control is defined simply as interaction with significant others that involves influence and regulation (Lewis & Rook 1999). As Rook (1990) points out, the roots of this social control perspective go back to the work of Durkheim (1897/1951), who maintained that close social relationships involve enduring responsibilities and obligations, and that these responsibilities and obligations are thought to influence health behaviors. When a people feel bound to others, they are more likely to engage in better self-care, and they are more likely to avoid self-destructive behavior because doing so may create health problems that limit their ability to fulfill their obligations. But Rook (1990) takes this a step further by suggesting that other, more overt influences may be at work as well. More specifically, she maintains that significant others may take steps to prompt or persuade an individual to adopt health-enhancing behavior and discourage them from engaging in behaviors that comproŽmise health. This more overt influence may even take the form of threats and negative sanctions.
But it is not entirely clear from Rook's (1990) discussion whether anyone who is acquainted with an individual can exercise health-related social control or whether this function arises only in certain kinds of relationships. It seems likely that casual acquaintances may feel uncomfortable trying to exert this kind of influence, and if they did, it is even more likely that an older person would resist and even resent their efforts to do so. Instead, a person who is closely associated with an elder, one he or she can trust, is in the best position to exert this kind of influence. Simply put, close companion friends may be more likely to regulate health behavior overtly because this type of relationship possesses the intimacy and trust that are necessary for the exercise of effective social control. In fact, the high degree of contact and intimacy among close companion friends helps ensure that they will know which health behaviors an older person is practicing in the first place.
But it is still not entirely evident why efforts to influence the health behavior of older adults would be especially likely to come from close companion friends at church. There are two ways to address this issue. The first reason may best be found by using research on religion and alcohol use as an example. Earlier, based on the work of Herd (1996), it was noted that some denominations have strong prohibitions against the use of alcohol. For members of these congregations, avoiding alcohol is therefore a basic religious precept (i.e., a fundamental religious truth). If friendships are built on truth, as Emerson (1841/1983) maintains, then it follows that close companion friends at church should be especially likely to provide the impetus for reinforcing religious truths that form the cornerstone of their shared faith.
The second reason that close companion friends at church may be more likely to influence the health behavior of an older fellow congregant may be found in studies on controlling health behaviors that have been conducted in secular settings. For example, research done in secular settings by Tucker and Mueller (2000) suggests that a spouse is likely to resent efforts to influence his or her health behaviors if he or she believes that the partner has ulterior motives for doing so, such as the desire to control or manipulate. It seems that questionable motives such as these are less likely to arise in the church when both companion friends share a common faith that underscores the virtues of selfless helping. Nevertheless, the work of Tucker and Mueller (2000) and others helps signal the fact that attempting to control the health behavior of another is a delicate process. Consequently, researchers wishing to study the influence of companion friends in church on health behavior would be well advised to pay careful attention to the conditions under which such efforts are likely to succeed and when they may be likely to fail.
From Neal Krause, Aging in the Church: How Social Relationships Affect Health (West Conshohocken, PA: Templeton Foundation Press, 2008), 94-97.