Review by Larry Dossey, M.D., executive editor of
Alternative Therapies in Health and Medicine.

God, Faith, and Health. Jeff Levin, Ph.D. New York, NY: John Wiley & Sons; 2001. 256pp, $24.95.

   Until recently, exploring the relationship between religion, spirituality, and health was not exactly the best way to advance your career in medicine. But today research in this field is booming, and entering this area is no longer professional suicide. Around 80 of the nation's 125 medical schools currently have courses exploring the spirituality-and-health connection, a dramatic indicator that the subject is no longer taboo. No one has been more instrumental in these changes than social epidemiologist Jeff Levin, Ph.D., M.P.H., author of God, Faith, and Health.

   I got wind that something was happening in this field in the late '80s, after stumbling onto research suggesting that people who followed a religious path--it didn't seem to matter which--lived longer and were healthier than people who did not. Nothing surprising there, I thought.  Religious folk take better care of themselves, such as by smoking and drinking less, so why shouldn't they live longer, healthier lives? But when epidemiologists teased apart these factors, they discovered that the beneficial effects persisted even after they controlled for behaviors such as smoking and drinking. What was going on here? I was hooked, and began to explore the religion-and-health literature. Immediately I bumped into Jeff Levin's work. I discovered that he jump-started this entire field and gave it a name: the epidemiology of religion.

   Over the years I have read most of his 110+ articles, chapters, and books, and my Levin, Jeff file is bursting at the seams. Nothing like going to the source, I told myself. Thus I have listened to his presentations at professional meetings and have pestered him with an unending stream of e-mails and letters over the years. I have assaulted him with ceaseless questions over salsa-and-enchilada meals in Santa Fe, where I live, when he comes to town to visit relatives. Jeff has become a mentor for me about the science underlying spirituality and health, and I was thus honored to write the foreword to this fine book.

   In God, Faith, and Health, Levin takes us on his personal journey, beginning in 1982 when he was a first-year graduate student in the School of Public Health at the University of North Carolina in Chapel Hill. In a course called Culture and Health, Levin had an experience that would set him on a professional path for the next 20 years. He discovered a virtually unknown research article that showed lower blood pressure in hundreds of adult men who frequently attended church services, even when controlling for age, smoking, and socioeconomic status.

   Intrigued, Levin combed libraries and computer databases during his nights and weekends for the next 5 years, searching for more evidence of a religion-and-health effect. "I did not come up for air until 1987," he relates. When he surfaced, he had identified more than 200 peer-reviewed articles reporting statistical findings linking religious involvement and health. "I felt like a nineteenth-century explorer or archaeologist who had discovered something that no one else knew existed," he states (p. 6). Levin's 1987 paper, "Is There a Religious Factor in Health?" was a seminal event in the development of the epidemiology of religion.

   What does this field look like? "There is scarcely a disease that has not been studied in relation to religion," he explains. "Moreover, the findings are remarkably consistent.  They identify significant religious or spiritual effects on rates of health and illness regardless of the age, sex, race, ethnicity, nationality, or religious denomination of the people studied, and independent of the study design used and of when or where these studies took place. These findings have been confirmed and expanded on by contemporary studies conducted by scientists like me" (p. 6).

   Each chapter of God, Faith, and Health begins with a case history. Levin's account of his own dramatic, rapid healing of several broken ribs, following the prayers of his mother and others, is stunning. He explores the similarities and differences between religion and spirituality; the health effects of religious fellowship, religious beliefs, worship, faith, and prayer; the physiological effects of mystical states of consciousness and the sense of union with the divine; the interplay between spiritual practices with healthy behaviors, emotions, thoughts, personality styles, social relationships, and placebo effects; and the possible supernatural or superempirical influences on health. In each chapter he offers Lessons to Consider and Questions to Reflect On. These features lend a personal tone to the book and make it extraordinarily reader friendly.

   Levin explains how some of the health benefits of religious practice can be understood
from a physical perspective: dietary precautions, sexual discretion, less smoking and drinking, and so on. Other benefits, he shows, make sense from a psychological point of view: a positive sense of meaning and purpose in life, social support, the comfort of belonging to a supportive community, and so on.

   But other phenomena such as distant, intercessory prayer cannot be understood within these contexts. Thus, Levin says, "the mind-body model seems almost as limited as the outdated, mechanistic, body-only model of contemporary medicine and science." Toward this end he proposes theosomatic medicine literally, a model in which the determinants of health are based on the apparent connections between God, spirit, and the body.

   One of the most frequent objections to the spirituality-and-health field is that it
promotes a sense of failure, guilt, and shame when people become sick, because they see themselves as spiritual failures. Levin meets this criticism head-on. He explains that spirituality does not guarantee good health and increased longevity. "Epidemiology deals with averages, and average findings produced by epidemiologists tend to hide or obscure the exceptions, such as people whose emotional well-being is harmed by religion. Further, the illness, suffering, or death of a particular person in no way should be or can be attributed to a lack of faith or not enough spirituality. Epidemiology is incapable of addressing such issues. What it can tell us and does, very clearly is that religious involvement deserves to be recognized as one of the most significant factors that promote health and well-being among many groups of people" (p. 8).

   Levin is stern with critics. "Despite the volume of research findings supporting a religion-health connection," he states, "the concept remains controversial. Many scientists and physicians still dismiss it outright. Others who are more sympathetic but unaware of existing studies often state that there are no grounds for sound conclusions one way or the other. They are wrong" (p. 8). Elsewhere he writes: "The weight of published evidence overwhelmingly confirms that our spiritual life influences our health. This can no longer be ignored" (p. 223).

   If you need a dose of hope about the future of medicine, the final chapter, "From Body-Mind to Body-Mind-Spirit," will be welcome. Levin discusses how the theosomatic model is already changing medical practice, medical education, and medical research. These changes will be profound and lasting, Levin predicts, because they are based in modern, scientific epidemiology, and are not likely to go away.

   God, Faith, and Health is an important book. It describes compellingly how religion and medical science interpenetrate one another and cannot be kept separate. We modern physicians have looked with disdain on those doctors, nurses, and healers of the past who believed that religious belief, faith, and prayer were important in health. As Jeff Levin shows, they knew a thing or two.

Reviewed by Larry Dossey, M.D., executive editor of Alternative Therapies in Health and Medicine.