Does Religion Make People Healthier?

I recently wrote about the health consequences of Scientology (Skeptic Vol. 18, No. 3). Scientology isn’t the only culprit. Other religions can be hazardous to health, too. I was forcefully reminded of that when a recent news article reported that 86% of holy water samples tested in Austria contained fecal matter (holy shit!).

Jehovah’s Witnesses refuse blood transfusions, preferring death to disobedience. The courts have intervened when believers have tried to reject lifesaving transfusions for their children.

Christian Scientists believe that sickness and death are illusions caused by mistaken beliefs, that prayer can correct those wrong beliefs, and that the entire material world is an illusion. Many Christian Science adults and children have died of treatable illnesses, leading to more than 50 prosecutions for manslaughter or murder. There have been several outbreaks of vaccine-preventable deaths in Christian Science schools and camps. Several studies have shown that Christian Scientists have a shorter than average life expectancy.

The Followers of Christ is a Pentecostal sect based in Oregon. Its members rely on faith healing and reject all forms of medical treatment. It has attracted attention due to a high mortality rate among its children: 26 times higher than in the general population. In 2008, 15-month old Ava Worthington died of untreated pneumonia and her 16-year old uncle Neil Beagley died from an untreated bladder obstruction when simple catheterization would have saved his life. Ada’s parents were tried for manslaughter and acquitted. Beagley’s parents eventually went to prison for criminally negligent homicide. In 2011, Timothy and Rebecca Wyland were convicted of first-degree criminal mistreatment for choosing faith healing over medical care for their infant daughter Aylana when an untreated hemangioma grew so large it engulfed her left eye and threatened to blind her. In June 2011, a new law in Oregon removed religious belief as a defense for homicide. Later that year Dale and Shannon Hickman were convicted of manslaughter in the death of their newborn son shortly after a home delivery; an expert witness testified that with medical care he would have had a 99% chance of survival. Instead of calling 911 for an ambulance, the father prayed and anointed his son with olive oil. Mrs. Hickman did not object because her church required her to defer to her husband.

Islam discourages but does not entirely prohibit treatment by a doctor of the opposite sex as long as strict guidelines are followed. Often the doctor is asked to examine a woman through her clothes. Under Taliban rule in Afghanistan, women often weren’t allowed to see doctors at all, and women doctors and midwives were not allowed to practice. When a male doctor had to treat a woman, he had to take a second-hand history through her husband, and he was not allowed to touch her. A high percentage of burqa-clad women are depressed, and the prohibition on leaving the home without a male relative has kept widows and others from earning money or even reaching food distribution centers, resulting in poverty and starvation. Afghanistan’s female life expectancy is the lowest in the world.

In 2003, mullahs in Nigeria opposed the polio vaccination campaign, claiming that the vaccine caused AIDS and sterility. The polio rate tripled in Nigeria and polio spread to several other countries where it had previously been eradicated. Without the opposition of religious leaders, polio might have been wiped off the face of the earth by now, just as smallpox was.

Christian obstetricians were once reluctant to relieve the pain of childbirth, considering it wrong for women to escape the pain of divine punishment for Eve’s transgression.

The Catholic Church prohibits birth control and abortion. Recently in Ireland there was public indignation over the preventable death of Savita Halappanavar, whose miscarriage in the 17th-week of pregnancy resulted in blood poisoning and who was denied surgery because the fetal heartbeat could still be detected, even though fetal death was inevitable.

Some Christian churches discourage vaccination, preferring faith healing. A recent measles outbreak in a Texas megachurch affected 21 people, most of them unvaccinated. Even after the church offered a vaccine clinic, Pastor Terri Pearsons stressed faith over vaccines, saying, “So I’m going to tell you what the facts are, and the facts are the facts, but then we know the truth. That always overcomes facts.”

Hinduism and other Eastern religions believe in reincarnation and karma; they believe illness is a consequence of bad actions in a previous lifetime, essentially blaming the victim and reducing compassion for them. Sacred cows roam the streets freely in India, interfering with sanitation.

Several religions have dietary rules that have a positive impact on health. The Jewish and Muslim prohibition of pork prevents trichinosis. Seventh Day Adventists are vegetarians who avoid alcohol, tobacco, and caffeine; they live 4-10 years longer than average. Mormons also have a longer than average lifespan; they avoid caffeine, alcohol, and tobacco, and try to eat a healthy diet with an emphasis on fruits, vegetables, and whole grains.

Islamic fasting during Ramadan causes a number of adverse health effects including dehydration, severe headaches, tachycardia, dizziness, nausea, vomiting, circulatory collapse, sleep disorders, daytime drowsiness, irritability, impaired cognition, interactions with medication, lower birth weights, and poorer nutritional status of lactating women. Counterintuitively, fasting doesn’t cause weight loss, because the feasting after dark compensates for deprivation during the day. Or more than compensates: some Muslims actually gain weight during Ramadan. During Ramadan there is a drop in blood donations, an increase in accidents, a disruption of emergency services, and an increase in violence against non-Muslims and non-observant Muslims.

Religious circumcisions may reduce the risk of human papillomavirus (HPV) infections, cervical cancer, and other sexually transmitted diseases; and they have a few other modest benefits like reduction of urinary tract infections in infants, but many people consider them to be unethical mutilation of children too young to consent. Some Jewish mohels put their mouth on the infant’s penis to suck away blood; in a recent New York case, a rabbi with herpes simplex type 1 transmitted his disease to several infants: one died, and another suffered brain damage. There have been several other reports of mohels transmitting herpes during a bris.

Studies have found a correlation between religion and lower death rates, fewer surgical complications, and a greater sense of wellbeing; but religiosity may impair mental health. It’s associated with guilt and is a factor in obsessive-compulsive disorders. Psychotic delusions often have religious themes. Those who believe misdeeds are punished in an afterlife often suffer agonies over their own sins or over their conviction that a non-religious loved one must spend all eternity burning in Hell. They may feel worthless because they believe they were born sinners or hopeless because they believe in predestination.

On the other hand, religion can be very comforting. Believers may tolerate adversity better if they see everything as the will of God. They may feel protected by a beneficent god or loved by a personal savior. They may feel relief after confessing their sins to a priest. When a loved one dies, grief is mitigated by looking forward to meeting again in Heaven (Julia Sweeney is an exception. In her monologue Letting Go of God, she protested, “You don’t know my family!”)

Prayer is the most popular alternative medical treatment, used by as many people as all the other alternative treatments put together. Sir Francis Galton was the first to study the efficacy of prayer, hypothesizing that the British Royal Family would live longer than average, since multitudes prayed for them in church every Sunday; but he found that their lives were actually shorter. Another early statistical study of ship disasters showed that missionaries were no more likely to survive than other passengers. Studies of patients in a coronary care unit found that patients did better when others prayed for them without their knowledge—but only as measured by a minority of the many factors they looked at. So the results may have been due to the sharpshooter fallacy (drawing the bulls-eye around wherever the bullet happened to hit). A controlled study of prayer for AIDS patients went awry because they intended to compare death rates, but during the period of the study effective anti-AIDS medications came into use and only one patient died. They went back and looked at other endpoints after the fact (that’s a no-no) and claimed to find positive results for some measures but not for others. A 2001 study of intercessory prayer for in vitro fertilization claimed to have found positive effects, but it was soon enmeshed in scandal.

One of the three authors admitted that he didn’t even know about the study until long after it was completed, another failed to answer any inquiries, and the third author was a parapsychologist, felon, and con man. We can’t be sure the reported data weren’t simply invented.

Study results varied widely; one showed worse outcomes in those who were prayed for. The most methodologically rigorous studies found no effect. An article in the British Medical Journal claimed to have found an effect of retroactive prayer (prayer years after discharge improved hospitalized patients’ health). The author described it as a lighthearted attempt to illustrate the importance of asking research questions that fit with scientific models.

Religion can impact health in good ways, but often it has a bad impact on the health of the believer and also on the health of others. I fully support the right of people to follow any religion or any belief system, but I don’t acknowledge their right to impose their beliefs on others. I draw the line when their beliefs cause harm or the deaths of innocent children or when they endanger public health.

This article was originally published as a SkepDoc column in Skeptic magazine.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine Blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.