One of the most fascinating things about studying health and longevity is the ability to take a wide view of factors which impact your optimal health. One of the least discussed is a strong faith. When I sit down with patients to discuss their overall health and how to improve it, I specifically ask about their spiritual practices. The responses I receive are sometimes surprising.
I am often struck by media conversations around religious beliefs, spirituality, health and longevity. While I often discuss the 4 pillars of health (nutrition, movement, sleep and mental resiliency) I find it a rarity that any of the ‘big names’ in the field of longevity bring this up. It is as if they are avoiding the topic.
I found it most amusing when I was listening to one podcast interviewer, appropriately, bring up the impact of faith during the interview and the ‘expert’ gave a very general answer, acting as if they were trying to move past the line of questioning as quickly as possible. But why? If we are going to explore things which contribute to our health and longevity, shouldn’t we be putting everything on the table?
When I start this part of the discussion with my patients, I always give some context. First, there is pretty clear evidence from the medical literature that people with a strong faith live longer. Second, while I am clear to state that particular faiths are more commonly studied than others, spiritual practices obviously come in many versions. Third, the importance of contemplating meaning and purpose in our lives is an important part of how we frame our health and life.
Let’s look at each of these as part of this discussion. First, the evidence.
Evidence on faith and longevity
One of the largest and respected databases in existence is the Nurses Health Study (NHS). It is an ongoing study (there have been NHS, NHS 2 and NHS 3 -these are data from NHS 2) of almost 75,000 nurses regularly surveying factors impacting health and mortality since 1992.
From 1992 to 2012, they were regularly asked about their religious services attendance. What did they find? Among the 74,534 women participants, there were 13,537 deaths, including 2,721 owing to cardiovascular deaths and 4,479 owing to cancer deaths. After multivariable adjustment for major lifestyle factors and risk factors, attending a religious service more than once per week was associated with 33% lower all-cause mortality compared with women who had never attended religious services (hazard ratio, 0.67; 95% CI, 0.62-0.71; P < .001 for trend).
They broke out risks specific to heart disease and cancer and found 27% and 21% lower rates of death, respectively, for those who regularly attended religious services.
To state those numbers again: attending a religious service more than once a week lowered your risk of dying from all causes by 33%, cardiovascular disease by 27% and cancer by 21% over those 20 years. For perspective, the use of statins and regular exercise after a heart attack lowers your risk of death (vs those not on statins) over time by 30%. That seem like a significant impact.
Further evidence comes from the Adventist Health Study (AHS) which compares Californians practicing the Adventist faith to the general population. AHS-1 found on average that Adventist men lived 7 years longer and Adventist women lived 4.4 years longer to other residents of California. While many of these benefits were attributable to lifestyle differences in diet and movement the baseline foundation of faith was also contemplated. Not coincidentally Loma Linda, California is home to the Adventists on the West Coast and a defined Blue Zone (places in the world with the healthiest, longest-living populations).
We should be discussing faith more in conversations about health
Why is this important to discuss this?
For one thing, the vast majority of Americans, 82%, identify themselves as being religious or spiritual according to this Gallup poll in 2023. Eighty-two percent!
While this overall number has decreased from 90% in 1999 it is still a staggering number. Specifically, 47% state they are religious, 33% spiritual but not religious and 2% are both. Just as interesting is the increase in religious beliefs and spirituality as we age, from 74% at 18-29 years of age to 89% when over 65 years of age.
Religious and spiritual practices act through many possible mechanisms. One way of framing this is through the three lenses of psychological, social and health behaviors as psychiatrist and author Harold G. Koenig wrote:
Psychological involves improvements in mental health through reinforcing resiliency during challenges in life. The exploration of meaning and purpose is a frequently spoken about virtue and has been popularized in many newer age spiritual practices. When we look back thorough most religious traditions, it is a foundational cornerstone of most faiths.
The strength of our social connections is a well-known driver of health and longevity. Having witnessed the impact of isolation of both our elders and school children during Covid made that abundantly clear. Most faiths provide a place for the community of believers to congregate. It is there where we reinforce our connections to one another and, in most cases, to the greater community through altruistic practices.
Many spiritual and religious practices follow similar health behaviors. There is often a focus on healthy eating, regular movement and avoidance of negative health impacting activities like smoking and excessive alcohol consumption. Fasting is also a frequent component of most faiths. The AHS referenced above clearly outlines many of these positive health behaviors.
My recommendation to patients
My encouragement to each of my patients is to find a religious or spiritual practice which works for you.
Most of us grow up with a particular faith and that is a good place to start your process of rediscovery. If you do not identify with a particular religious practice then find a way to connect spiritually to the universe. For some that is spending time in nature, be it the mountains or the beach, contemplating the important questions we often fail to ask ourselves. Questions like why am I here? What am I supposed to be doing to improve this world?
For me personally this life has been a journey of ongoing discovery. My personal faith has helped me navigate some of life’s most difficult times. It is also a reminder that regardless of how healthy you are at this very moment there will be a time when you are no longer on this planet. Spending that time, however long you have, trying to make it a bit better place seems like a very worthy endeavor indeed.