Should doctors start prescribing religion for their patients?

I suspect even the most irreligious of us may mutter a silent prayer when faced by catastrophe or major illness. But is there any evidence that religious or spiritual practices can improve our health?

According to a study published last week, there may be. Writing in the American Medical Association journal Internal Medicine, researchers from Harvard University say that frequently attending religious services is associated with a lower risk of death for women from all causes, as well as specifically from cardiovascular disease and cancer.

They used the large and long- running Nurses Health Study in the US to extract data about attendance at religious services. Among 74,534 women at the 1996 study baseline with reported religious service attendance, 14,158 attended more than once a week, 30,401 attended once per week, 12,103 attended less than once per week and 17,872 never attended. Most of the study participants were Catholic or Protestant.

Women who frequently attended religious services tended to have fewer depressive symptoms, were less likely to be current smokers and more likely to be married.

Women who attended religious services more than once a week had a 33 per cent lower risk of death during the 16 years of follow-up compared with women who never attended religious services. Women who attended services weekly had a 26 per cent lower risk and those who attended services less than weekly had a 13 per cent lower risk.

The results suggest women who attended religious services more than once a week had a 27 per cent lower risk of death from cardiovascular disease and a 21 per cent lower risk of death from cancer compared with women who never attended.

Clinical trial

So does this mean doctors should start prescribing religion for their patients? Not quite. For that to happen would require a randomised clinical trial of attendance at religious services which is probably unethical and likely not feasible.

While the Harvard research is a well-designed secondary analysis we can only conclude that it found a strong association between attending religious services and reduced mortality. Observational studies can never imply a cause and effect.

Another limitation is the generalisability of the results. It excludes men and those of non-Christian faiths. The participants were almost all white, female and older. All were nurses who are likely to be more health conscious than most people.

The authors have not set out to offer a biological explanation for their findings as other researchers in the area have done. One such study of the importance of spiritual experience in protecting against the onset of depression found cortical thickening in certain regions of the brain.

Another more recent small study suggests that members of Alcoholics Anonymous who recited its sobriety prayer were better able to resist alcohol cravings when presented with tempting images. Interestingly, the researchers at New York University, using MRI scans, were able to demonstrate increased activity in brain regions that control attention and emotion during the experiment.

Some years ago Italian researchers compared breathing rates during normal talking with rates noted during the recitation of the Ave Maria and of mantras. Both recitations slowed breathing to about six breaths per minute, a rate that has a favourable effect on the rhythm of the heart. Slow respiration has been shown to reduce the harmful effects of heart attacks. Synchronising respiratory and cardiac central rhythms is thought to enhance natural physiological responses that protect the heart.

Rather than dismiss the Harvard findings it would seem wise to explore them in more depth. Medical science cannot address questions such as “Does God or any higher being exist?” but medical tyros have always been taught to consider the spiritual health of patients as well as physical and psychosocial aspects of wellbeing. Religion and spirituality are central to many people’s lives and their illness stories. Listening to and exploring this aspect of feeling unwell can only benefit patients and their carers.

mhouston@irishtimes.com

@muirishouston