Abstracts – 2020s
Translational epidemiology refers to the practical application of population-health research findings to efforts addressing health disparities and other public health issues. A principal focus of epidemiologic translation is on the communication of results to constituencies who can best make use of this information to effect positive health-related change. Indeed, it is contended that findings from epidemiologic research are of greatest use only if adequately communicated to health professionals, legislators and policymakers, and the public. This paper details the challenges faced by efforts to communicate findings to the these constituencies, especially three types of miscommunication that can derail efforts at translation. These include perceived misinformation, perceived disinformation, and perceived censorship. Epidemiologists are ethically obliged to avoid these types of miscommunication, and, accordingly, are advised to place greater emphasis on messaging and media outreach to physicians, government officials, medical educators, and the general public.
Background: This study investigated the proportion of the U.S. population classified as healthy based on 10 common indicators, examined in two ways: (1) above or below (in the healthy direction) the sample median (termed “normal”), and (2) below diagnostic cut-off points for clinical caseness or high risk (termed “ideal”).
Methods: Data are from the 2017-March 2020 round of the National Health and Nutrition Examination Survey (NHANES). Sample sizes ranged from 3,956 to 8,961 for respective health indicators, with a total of 3,102 respondents for two weighted multi-item measures described below. Measures included the Alameda 5 health behaviors (smoking, drinking exercising, sleeping, and body mass index) and five standard biomarkers (systolic and diastolic blood pressure, resting heart rate, fasting glucose, and total cholesterol). Besides point prevalences for the normal and ideal categories for each indicator, we also calculated the proportion healthy for all 10 indicators, again calculated both ways, termed “meta-normal” and “meta-ideal.”
Results: The prevalence of meta-normality was 1.05%, suggesting that hardly any adult Americans are completely healthy according to population norms. Findings for meta-ideality showed that while most Americans are not clinical cases for any respective indicator, only 5.55% met the official criteria for being healthy according to all 10 indicators.
Conclusion: Most Americans appear healthy according to nearly all key health indicators and biomarkers, according to “normal” or “ideal” criteria. However, the proportion healthy according to all measures is extremely small. Relatively few U.S. adults are completely healthy according to clinical criteria (meta-ideal), and even fewer are completely healthy according to population norms (meta-normal). Results are interpreted through sociological writing on medicalization.
Jeff Levin. (2023). “Being in the Present Moment: Toward an Epidemiology of Mindfulness.” Mindfulness (online publication).
This paper is a commentary on Doug Oman’s article entitled, “Mindfulness for Global Public Health: Critical Analysis and Agenda,” published in this issue. The present paper lays out the parameters of how epidemiologists may go about investigating the population-health impact of practices and states of being related to mindfulness meditation. First, it discusses conceptual issues involved in researching mindfulness; second, it summarizes the empirical literature on mindfulness and population health; third, it proposes a new field of study around the epidemiology of mindfulness; and, fourth, it offers some suggestions regarding translation of epidemiologic research findings on mindfulness to public health. To this end, a series of questions is posed in order to provide a starting point for descriptive and analytic epidemiologic research on mindfulness, and the translation or application of such findings in pastoral, clinical, and public health settings is discussed, with examples given. Conducting epidemiologic studies is a natural next step in the emergence of mindfulness and meditation as a subject for health-related research. Moreover, public health can provide a new setting for mindfulness to demonstrate its salutary effects, not just on individual patients in clinical settings but at the population level, in terms of rates of physical and psychological morbidity.
Jeff Levin. (2023). “Nothingness, Oneness, and Infinity: Transcendent Experience as a Promising Frontier for Religion and Health Research.” Journal of Religion and Health 62:2065-2080.
This paper advocates for a renewed focus into the experiential domain of religious and spiritual expression in research on physical and mental health. Most studies, up to now, have investigated risk or protection associated with behavioral measures of religiousness, whether public behaviors such as religious attendance or private behaviors such as personal prayer. Religious attitudes, beliefs, and identity have been studied, as well, as have religious self-rating scales of various types, but, relatively
less emphasized have been subjective experiences, such as feelings of transcendence or unitive connection with the divine. There is good reason to believe that such experiences may impact on well-being, based both on previous studies and on theory and clinical observation. This paper suggests that although researching the domain of such seemingly ineffable experiences may present certain conceptual and methodological challenges, these would be worth facing in order to gain deeper insight into the human spiritual dimension and into connections among body, mind, and spirit.
Since the 1990s, research studies and theoretical work have made the case for altruistic and compassionate love as a psychosocial determinant of physical and mental health and well-being. Empirical findings and the deliberations of various conferences, working groups, and think-tank initiatives have laid the groundwork for a field that has been referred to as the epidemiology of love. This article provides a narrative history of this field, beginning with early work in psychology and in sociology. These precursors include decades of psychological studies of romantic, sexual,
affectional, and interpersonal bonds, preceded by the work of sociologist Pitirim Sorokin in the 1950s detailing his taxonomy of the multiple aspects and dimensions of altruism and love. More recently, research at the intersection of altruism, love, spirituality, and human flourishing has
emerged, including studies of physical and mental health. Currently, funded initiatives are developing applications of this research to global population health.
Jeff Levin. (2022). “Toward a Translational Epidemiology of Religion: Challenges and Applications.” Annals of Epidemiology 75:25-31.
This paper explores the concept of translational epidemiology in the context of epidemiologic studies of religious determinants of morbidity and mortality. Despite a research literature of, by now, thousands of published studies, many in top-tier medical and public health journals, some resistance remains to full acceptance of this work. A principal reason may be the failure of investigators to make the case for real-world applications of epidemiologic findings on religious risk or protection for subsequent personal or population health, in keeping with the definition of translational epidemiology. To remedy this, a case is made for a translational epidemiology of religion. Three types of translation are proposed. The first two recall the standard definition of translational medicine as “from bench to bedside,” in this instance two types of bedside encounters, pastoral and clinical. The third application is to public health practice, involving multiple public health professions and specialties. As with other substantive topics within psychosocial epidemiology, research on population-health outcomes of religious exposures provides information that can be applied to development of health promotion and disease prevention programs and formulation of health policy. But this can happen only if investigators give more attention to enumerating potential uses of their findings.
This paper discusses the concept of New Age healing. Its emergence into popular culture in the 1980s can be traced to burgeoning interest in human potential and holistic health in the 1960s and 1970s. These phenomena in turn, were rooted in the appearance of Theosophy, New Thought,
and spiritualism in the 19th Century. Rather than a social movement, or even a singular phenomenon, the New Age is characterized as a hodgepodge of several elements with a characteristic inclination
to borrow beliefs and practices from the other traditions and systems of belief and practice. These include mysticism, esoteric metaphysics, the occult, and self-actualization regimens. The rise of New Age healing has sparked converging conservative religious, secular-rationalist, and biomedical critiques of the phenomenon. Since the 1990s, the New Age label has mostly disappeared from popular usage, but associated beliefs and practices have been successful in seeding themselves into contemporary Western medicine and mainline religion, with implications for their intersection.
To examine the extent to which religious “nones” are actually not religious in their personal lives, data were analyzed from five recent U.S. population surveys—the 2018 General Social Survey, 2017 Values and Beliefs of the American Public Survey, 2012 Portrait of American Life Study, 2017-2020 World Values Survey, and 2018 Chapman Survey of American Fears. Consistent with some previous studies but contrary to widely-held assumptions, many individuals who report no religious affiliation or check “none” on surveys (as well as atheists and agnostics) display a wide variety of religious and spiritual practices and beliefs. Many attend religious services, pray, meditate, believe in God or a higher power, have religious experiences, and believe in heaven, hell, and miracles. Even though a growing proportion of people in the U.S. appear to be reporting no religious affiliation on surveys, there are many measurement-related, conceptual, and methodological reasons to question the assumption that these people are not religious, and scholars need to look more closely at the actual practices and beliefs of so-called nones. Further, use of phrases like religious none, no religion, and not religious to describe this group of individuals is inappropriate, inaccurate, and misleading since they may simply be institutionally unaffiliated or indeed affiliated but not with any of the list of categories provided. More focused research is needed before we will fully understand who the nones are, and whether religion is actually declining in the U.S., as well as around the world.
Background: The enduring presence of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy is an ongoing impediment to the global response effort to the current pandemic. This study seeks to identify determinants of skepticism and vaccine hesitancy in U.S. adults.
Methods: Data are from the Values and Beliefs of the American Public Survey, conducted in 2021 by the Gallup Organization in conjunction with Baylor University. The survey used stratified random probability sampling of the U.S. adult population (N = 1,222). Outcome measures were respective single items assessing COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy. Exposure variables included political, religious, and sociodemographic indicators, and moderators assessed personal history of COVID-19 and losing a relative or close friend to COVID-19.
Results: Skepticism and vaccine hesitancy were strongly associated with conservative and Republican political preference and conservative religious beliefs, and less so with socioeconomic status. Personal experience with COVID-19 did not mitigate the effect of politics on skepticism and barely reduced the odds for hesitancy. Results confirm that attitudes toward COVID-19 are politically and religiously conditioned, and are especially a product of conservative political preference.
Conclusion: Skepticism about COVID-19 and hesitancy regarding SARS-CoV-2 vaccination are highest among the political and religious right. Efforts to increase immunization through public education may be inadequate; resistance appears ideological. Other solutions may need to be considered, which risk widespread pushback both politically and religiously motivated.
Throughout the ongoing COVID-19 pandemic, religious people and institutions have played a significant role in responding to the challenges that we all have faced. In some instances, religion has been a source of great harm, hindering the global response. Many religious leaders have promoted misinformation and disinformation; others have promulgated messages of hatred and blame, especially hindering efforts to prevent infection and community transmission and to promote immunization. This has occurred throughout the world, across cultures, religions, and nations. In many other instances, however, the faith sector has been a source of great help, ministering to the lives of suffering and fearful people both emotionally and tangibly. People of faith, including clergy and faith-based organizations, have contributed positively to the global response effort by fulfilling the pastoral, ethical, and prophetic roles of religion. Expressions of spirituality, both personal and institutional, have thus contributed to great flourishing in the midst of a terrible public health emergency.
(Commentary.)
(Commentary.)
Religion, in both its personal and institutional forms, is a significant force influencing the health of populations across the life course. Decades of research have documented that expressions of faith and the practice of spiritual pursuits exhibit significantly protective effects for physical and mental health, psychological well-being, and population rates of morbidity, mortality, and disability. This finding has been observed across sociodemographic categories, across nations and cultures, across specific disease outcomes, and regardless of one’s religious affiliation. A salutary religious effect on health and well-being is especially apparent among older adults, but is also observed across generations and age cohorts. Moreover, this association has been persistently found for various religious indicators, including attendance at worship services, prayer and other private practices, subjective feelings of religiosity, and numerous measures of religious behaviors, attitudes, beliefs, and experiences. Finally, a protective or primary preventive effect of religion has been observed in clinical, epidemiologic, social, and behavioral studies, regardless of research design or methodology.
Faith-based organizations also have contributed to the health of populations, in partnerships or alliances with medical institutions and public health agencies, many of these dating back many decades. Examples include congregational health promotion and disease prevention programs and community-wide interventions, especially targeting the health and well-being of older congregants and those in less well-resourced communities, as well as faith–health partnerships in healthcare delivery, public health policymaking, and legislative advocacy for healthcare reform. Religious denominations and institutions also play a substantial role in global health development throughout the world, individually and in partnership with national health ministries, transnational medical mission organizations, and established nongovernmental agencies. These efforts focus on a wide range of goals and objectives, including building public health infrastructure, addressing ongoing environmental health needs, and responding to acute public health challenges and crises, such as infectious disease outbreaks. Constituencies include at-risk populations and cohorts throughout the life course, and programming ranges from perinatal care to maternal and child healthcare to geriatric medicine.
This article, the second in a two-part series, continues an exploration of Western esoteric healing, with special reference to its sources of therapeutic knowledge. First, the taxonomy introduced in the first paper is applied to a selection of representative esoteric healing systems, traditions, or organizations. These include respective groups whose therapeutic knowledge originates in and is transmitted via channeling, initiation, or empirical observation or validation, as well as groups whose knowledge comes through a combination of sources. Discussion is provided of Western esoteric traditions with substantial therapeutic and/or diagnostic teachings exemplifying these sources of knowledge. This entails a detailed unpacking of a wide range of medical and health-related information originating in historical and primary-source material on more than a dozen healing traditions. Recommendations are offered for follow-up investigation, including historical and social-historical, ethnographic, and medical and health-related research.
This article, the first of a two-part series, explores the subject of Western esoteric healing. First, conceptual background is offered on Western esotericism and traditions of esoteric healing. Second, the concept of therapeutic knowledge, which emerged from the philosophy of medicine and medical anthropology, is introduced and described in detail, including its application to the study of esoteric healing. Third, a taxonomy is proposed for sources of such knowledge in respective esoteric healing systems, traditions, or organizations. These sources are channeling, initiation, and empirical observation or validation. In the second article, examples will be given for each category of the taxonomy, followed by recommendations for further study.
Human flourishing has recently emerged as a construct of interest
in clinical and population-health studies. Its origins as a focus of research are rooted in philosophical writing dating to Aristotle’s concept of eudaimonia, in the work of contemporary psychologists, and in studies by epidemiologists, physicians, and social and behavioral scientists who have investigated religious influences on physical and mental health since the 1980s. Inasmuch as human flourishing has been characterized as multidimensional or multifaceted, with hypothetically broad antecedents and significant outcomes, it may be an especially valuable construct for researchers. For one, it would seem to tap something deeper and more meaningful than the superficial single-item measures that often characterize such studies. This article surveys the rich history of the
concept of human flourishing in its multiple meanings and contexts across disciplines, proposes a conceptual model for assessing the construct, and lays out an agenda for clinical and population-health research.
The current outbreak of the SARS-CoV-2 virus is a critical moment in time for institutional religion in the U.S. and throughout the world. Individual clergy and congregations, across faith traditions, have been sources of misinformation and disinformation, promoting messages and actions that engender fear, animosity toward others, and unnecessary risk-taking. But there is a positive role for religion and faith-based institutions here, and many examples of leaders and organizations stepping up to contribute to the collective recovery. Personal faith and spirituality may be a source of host resistance and resilience. Religiously sponsored medical care institutions are vital to healthcare response efforts. Ministries and faith-based organizations are source of religious health assets that can help to meet community-wide needs. There is a pastoral role for clergy and laypeople who are instrumental in providing comfort and strength to the suffering and fearful in their midst. The outbreak presents an ethical challenge to all of us to step outside of our own preoccupations and to be present and of service for others. This includes having the courage to represent the highest values of our faith in speaking out against religiously motivated foolishness and hatred and in calling for political and public health leaders to be truthful and transparent in their messages to us.
This paper outlines a hypothetical six-dimension doctrine for military intelligence-gathering in the Akashic domain. The Akashic records are described by esotericists and mystics as a permanent record of all thoughts, feelings, and actions, stored in a kind of cosmic memory bank outside of space and time. Psychics, clairvoyants, and other intuitives purport to read the records, suggesting that development of an operational strategy for accessing such information may be possible. Command oversight, however, would present significant moral challenges, as “hacking” into this information would be a personally intrusive invasion of privacy with serious repercussions for the operators and state sponsors.