Studies have demonstrated a correlation between spiritual practices and reduced risks of disease or illness — without explaining why. A national study, based at Harvard Medical School and Massachusetts General Hospital, seeks to find the answer.

​Research has long shown correlations between various spiritual practices and health. However, the biological mechanisms that explain these effects have been elusive. Teasing out underlying connections of this sort requires expensive studies, not yet undertaken, to track disease development in the same patients over many years. Such research could provide a fuller understanding of the relationship between spirituality and health, and even lay the groundwork for doctors to mobilize patient spirituality to improve disease prevention and management.

A team of researchers, led by Dr. Alexandra Shields, director of the Harvard/MGH Center on Genomics, Vulnerable Populations and Health Disparities, is now investigating these very questions.

Causality: A More Challenging Target Than Correlation

There are two things researchers now know: that excessive stress can lead to a variety of diseases, and that spiritual practices are often associated with health benefits for those who practice them. Instead of merely demonstrating these correlations, Shields’ research would be the most substantial to date to test whether religion and spirituality influence causal mechanisms known to contribute to risk of chronic illness.

The problem, Shields says, has been that researchers can’t answer the causality question with a single survey: “You need longitudinal studies where you collect high-quality data over time.”

To address this challenge, Shields oversees an ambitious suite of projects that will draw on results from five long-running health studies in the U.S. The project, supported by a $3.5 million grant from the John Templeton Foundation, will draw on longitudinal data from the National Consortium on Psychosocial Stress, Spirituality, and Health. The Consortium, involving five national longitudinal health studies, is an effort to track subject health across racial, ethnic, and gender lines. Ultimately, the Consortium study population will include data from more than 5,000 Black, South Asian, Hispanic/Latino, Native American, and White women and men across the U.S.

Through the Consortium, subjects in all five studies will receive a survey that allows Shields’ team to track nearly 90 religion and spirituality measures. The researchers, using specific biomarkers, will first measure the impact of psychosocial stress on various health outcomes. Then, they will assess the extent to which spirituality acts as a buffer against the adverse health impact of stress.

The team’s initial research has produced some of the highest quality results to date on how religious and spirituality practices influence risk of chronic illness. For example, the team followed thousands of women in the national Nurses’ Health Study and the Black Women’s Health Study over many years, demonstrating associations between specific spiritual practices (religious service attendance and religious coping) and reduced risk of hypertension. Now, Shields and her team are taking the next step to understand the causal mechanisms underpinning these associations.

Adding Spirituality to Existing Health Studies

Alexandra Shields

If the project demonstrates associations between religious or spiritual practices and reduction of biomarkers associated with increased disease, the project could encourage researchers to include these measures of religion or spirituality in future studies. In addition, it could initiate a significant shift in the ways that religion and spirituality are integrated into clinical practice.

“One source of resistance to research on religion or spirituality and health is that people can’t imagine it being used in any way other than a doctor ‘prescribing’ that a patient attend church,” Shields says. These studies indicate that scientifically rigorous information about spirituality and health might be tailored to improve patient outcomes. If a trauma patient needing psychotherapy were religiously oriented, for example, he or she might benefit from referral to a spiritually competent psychotherapist. Spiritually tailored public health interventions might also be developed to mobilize the power of individuals’ particular spirituality to more effectively reduce stress.

“The goal,” says Shields, “is to understand the framework people or patients are operating under, and what their resources for resiliency are, and how they can be nurtured to improve patient outcomes.”