Is Being Unitarian Good for Your Health? A reflection in dialogue between Kathryn Green (in black font) and Nazeem Muhajarine (in blue font) Delivered at the Unitarian Congregation of Saskatoon, May 22, 2016 When Nazeem and I heard that this month's theme was health, we thought, We ought to be able to say something about that, since we've each spent more years than we care to remember studying and working in the field of community health. The challenge quickly became deciding which aspect of this huge topic we should focus on in the short time we have this morning. What about health would be of most relevance and interest to a group of Unitarians? Well, how about this: We know there are many many things that influence health, from personal habits like smoking and exercising to societal-level factors, like how big a gap exists between rich and poor. One thing we here all have in common is that we are Unitarian, or at least we attend Unitarian services. Could there be something here that has an impact on our health? While you may not think about being part of the Unitarian congregation as something you do for your health, in fact, a large and growing body of research evidence indicates that religion is positively associated with health both physical and mental. But religion is another big, multifaceted concept that can mean so many things. What are you really talking about when you say it's related to health? You're right, it's complicated, given that there are so many different kinds of religions, and individuals engage with their religion in a variety of ways. In particular, Unitarianism is distinct from most other religions in that we don't have a creed or statement of beliefs that we expect all our members to accept could that mean that the research on religion and health doesn't apply to us? I'm going to condense a whole lot of research here and focus on the three main pathways through which religion is thought to affect health. The first is the most obvious, and that's health practices. Many religions have some kind of expectations around personal behaviours that can influence health, in particular, drinking alcohol, smoking, and using other drugs, as well as sexual activity, and in some cases, diet. (It's interesting that I couldn't find any religious teachings about exercise probably because that wasn't a problem back when most religions originated they are more concerned with taking time to rest!) Not surprisingly, then, we find that people who are religious have much lower rates of substance use. Those religions that have more comprehensive health codes show substantial health benefits. Mormons, for example, who are instructed to not smoke or drink alcohol and to eat a largely plant-based diet, live on average 10 years longer than non-mormons. So how does this apply to Unitarians? Well, you may have noticed that we DON'T have a principle that affirms the importance of getting at least 150 minutes of moderate to vigorous physical activity every week and eating 5-10 servings of fruits and vegetables daily. We don't tell people what to believe, and we certainly don't tell them how they should live. But don't you think Unitarians have healthier lifestyles on the whole than the average Canadian? Just look at our monthly potluck lunches they're full of legumes and whole grains! I agree, but this isn't because of our religion; it's that the kind of person who is drawn to Unitarianism also tends to be more health-conscious and perhaps to have the resources to choose a healthy lifestyle. We all tend to be influenced by those we spend time with, so if we hang out with others who like to eat whole foods and have an active life, for example, that will make it easier for us to do the same. Belonging to a religion that says God wants you to practice or avoid certain behaviours gives you that social support along with a strong additional reason for doing so. So I would say Unitarianism scores some health points 1
in terms of us being generally more health-conscious than average, but because we support freedom of lifestyle as well as freedom of religious thought, Unitarianism doesn't provide as much encouragement/pressure as some other religions (and I think we are probably okay with that!). So that's one pathway: what are the other two? They are a little less clear-cut in terms of how they affect health. The first is internal our spiritual beliefs and practices and the second is external being part of a religious community. (And since I know 'spirituality' is a contentious concept for some Unitarians, to be clear, I am defining it simply as 'the search for the sacred.') So how can our spiritual beliefs affect our health? Many would say that religion developed to help people make meaning of their world and cope with difficulties like illness, war, and death. All the major world religions provide ways of understanding and coping with suffering; and many people turn to religion when they are under stress. For example, in the week following the terrorist attacks of 9/11, Bible sales in the US rose 27%. But the question remains: Are spiritual beliefs actually helpful in dealing with life's challenges? Well, the majority of studies find that religious involvement is associated with a number of indicators of better mental health, such as: less anxiety and psychoses; lower rates of depression and faster recovery from depression; lower rates of suicide; better adaptation to bereavement, and more hope and optimism. So are you saying ALL spiritual beliefs are health-promoting? No, and that's a good point. For example, if you believe you are destined for the fiery pits of hell because you're a worthless and unredeemable sinner, or if your religion tells you some essential aspect of who you are is perverted and abnormal, that's probably not good for your mental health. If a crisis leads you to feel that God has abandoned you, or that God is punishing you, you may end up suffering more than an atheist or non-theist who believes God has nothing to do with it. How does Unitarianism stack up here? Our fourth principle affirms and promotes a 'free and responsible search for truth and meaning'. As Unitarians, we don't have an authority that tells us the answers to life's big questions rather, we are encouraged to figure out what feels right to each of us, to make sense of the world in our own way. How well our beliefs help us cope with difficulties, then, may vary from person to person. If Unitarianism doesn't provide comforting solutions to life's problems like many other religions do, what does it offer that could support mental health? I think that one of the key ways in which being a Unitarian can benefit our health is in helping us find meaning one of the three elements in our mission statement that we use as our chalice extinguishing words every Sunday. The fact that we don't have predetermined answers doesn't mean that we don't think the questions are important. One of the reasons we adopted a theme-based approach a couple of years ago is that other congregations who did so found that this helped them to 'go deeper' and to develop a better theological grounding. It's more complicated that just handing out answers, but I think that's why we are all here and not in some other place of worship. Spiritual practices like prayer and meditation are often included in this category. They have traditionally been taught and encouraged as part of an organized religion, but increasingly, individuals are drawing on these practices outside of religion. For instance, mindfulness meditation, derived from Buddhist teachings, is practiced by millions of people who are not Buddhist. The health benefits of meditation of all types are well documented, and other spiritual practices that quiet the mind seem to have similar helpful effects. It's not entirely clear whether these practices gain added power if they are connected to the sacred, for example, meditating with a sacred mantra vs just a sound. So maybe we should pause here for five minutes of meditation? That might well be better for everyone's health than listening to the rest of what I have to say. But again, as Unitarians, we don't prescribe spiritual practices. We are meditation-friendly we host several meditation groups in our building, we've held sessions for adults and children on meditation and even prayer but we leave it up to each person to decide what, if any spiritual practices to follow. So just as in 2
the case of more traditional health behaviours like avoiding smoking and drinking, we don't provide as much direct support for spiritual practices that can benefit health compared to other religions. What about the third pathway you mentioned? Yes, this is the one that I think is especially important, and where Unitarianism has a lot to offer. It's the social support and sense of belonging and connection that comes from being part of a religious community. Feeling connected to something larger than oneself seems to be crucial for wellbeing. Many people find that through a relationship with the Divine; others find it through a sense of connection with other people; and some find the two together, through involvement in a community, like our congregation, that is focused on more than just mundane, everyday activities. There's a ton of research showing the importance of social support for mental and physical health. Just think about what you get from the people in your lives: you share warmth and affection; you laugh and have fun together; you keep each other company; you exchange ideas, information, and resources; you help each other out in practical ways. And it's the exchange that's important we need to help others, as well as having people who will help us. I can think of many instances in which I've experienced all these kinds of support through my involvement in this congregation. One small example that's stuck with me: Years ago, when our kids were small, a committee that I was on started talking about who you could call in an emergency. I was thinking in particular of what I would do if Nazeem or I needed to go to the ER in the night we have no family here, who could we phone to come and stay with our children? Two people immediately said, You could call me, and I knew they meant it. They weren't people I was friends with, especially we hadn't socialized outside the congregation, but they volunteered without hesitation. I think that says something about the kind of people who come here, and the way we relate to each other. Being there for each other is a big part of what the congregation is about. N: That's a personal anecdote: What about some solid scientific research? There are a lot of studies out there showing that the social support and feeling of belonging and connection that people get from being part of a religious community makes a difference in their health so much so that it can be difficult to tease out the influence of the other pathways, especially beliefs. A solid body of evidence shows the value of faith-based communities for mental and physical health, and in this regard, Unitarian congregations clearly have as much to offer as any other religion. I could describe the studies in detail, but then you wouldn't have any time to talk about the topic you want to address. So I'd better turn it over to you! While Kathryn has focused on the benefits of being part of a religious community like our congregation, it's clear that this is not the only way to get social support. All of us have more than one community that we are part of. For example, in addition to the Unitarian congregation here, I am part of several communities through my work; also, I regularly interact with others at my gym; and, I am part of the Nutana neighbourhood where we have lived for over 20 years. My neighbourhood community is important, obviously, because that is my home community, my base. A question that I've been very interested in through my work in Community Health & Epidemiology is how neighbourhoods promote (or harm) the health of their residents. I will try to unpack this issue a bit now. How neighbourhoods affect health has been the subject of a lot of research in recent times. For example, in our own city, when you compare the health of residents in the lowest income neighbourhoods with the most affluent neighbourhoods, the hospital rates of suicide attempts are 16 times higher, for diabetes it is 13 times higher, for mental health disorders 4 times higher, and I could go on. When it comes to children s health, we have shown that Saskatoon children in better resourced neighbourhoods are almost three times more ready for school than children in poorly resourced neighbourhoods. In another study here in Saskatoon we have shown that single mothers have better birth outcomes if they live in a neighbourhood they feel deeply connected to, compared to single mothers who do not feel that type of connection to their neighbourhoods. But how do you know that it's the neighbourhood that hurts or helps people's health? The people who live in affluent neighbourhoods tend to be better educated and have higher incomes than people in low- 3
income neighbourhoods doesn't that have a big effect on their health? Yes, this work is hard to do because as we all know, people do not randomly choose their neighbourhoods. They self-select into neighbourhoods they want to live in for many reasons. It's possible, for example, that people who like to walk or bike rather than drive choose to live in neighbourhoods close to where they work or with a lot of amenities close by. And of course, many people who live in neighbourhoods that are unhealthy and unsafe would prefer to live somewhere else, but that's what they can afford. So how do you get around this problem? One way is to do a social experiment where you give incentives for people to move into a neighbourhood of a certain type and and track how they are doing over time. This type of study was done called Moving into Opportunity in five large cities in the US in the 1990s. About 4500 very low-income families living in public housing projects were randomly assigned to one of three groups: the experimental group, which allowed families to use a voucher, a financial incentive, to move into low-poverty neighbourhoods; the second group of families, which received a financial incentive they could use to live in any neighbourhood; or the third group, the control group, which did not receive any incentive. So what did they find? There were some clear health benefits to living in better neighbourhoods and this couldn t be explained by self-selection. Very-low income women who moved from high-poverty neighbourhoods into lower poverty areas were one-fifth less likely to be extremely obese, or to have diabetes, than those who did not receive vouchers, as many as 15 years later. This is just one example of research showing that where you live matters to your health even after accounting for individual differences, or innate characteristics. So how is it that neighbourhoods influence people's health? It turns out, as you could imagine, that this is a really complicated question, and researchers are busy trying to find answers. Before I offer some possibilities, I want to ask you to think about your own neighbourhoods. Do you know your neighbours? Can you call on your neighbour in a time of emergency? Is there a grocery store that serves a variety of healthy food that you can walk to? Do you walk in your neighbourhood for pleasure? Do you see children playing outside? We look forward to hearing some of your answers in the second hour. In simple terms, there are two ways how neighbourhoods affect health let me just say these are structural, or root causes, and proximal, or more immediate causes. So the root causes are those causes we all know, that keep people apart: for example, social class divisions, ethnic or cultural divisions, or historical differences. These differences, in turn, influence how, or even whether, we relate to each other, and also how we relate to institutions. These differences also drive differences in the type of neighbourhoods we live in that promote or undermine health, e.g. quality and type of housing, whether there are grocery stores offering healthy food options, or whether there are environmental hazards nearby. Another example: local zoning laws may determine how amenities, services or opportunities are distributed between neighbourhoods. The debates surrounding gentrification and mixed-income development are other examples of the underlying structural forces that may promote or worsen people s health between neighbourhoods. In contrast, more immediate processes at play are those interactions between people and their neighbourhoods. For example, social interactions and support between and among people, whether you trust your neighbours and can turn to them for help; whether you have groups within your neighbourhood that support you to be healthy, like a walking group; basically whether you feel that your neighbour has your back. These are all examples of the ways in which where you live can fundamentally matter to your health and wellbeing. So your health is affected by where you live as well as where (and whether) you worship, and we can get social support from our neighbours as well as our congregation. But there are obviously some important differences between neighbourhoods and faith communities, right? 4
Yes, this is a key point. Faith communities, like the Unitarian congregation here, are an example of people brought together by shared interests and values. But these values and shared interests are much deeper and more fundamental for forming an identity, than, say, belonging to a service club or sports team, which also brings people of shared interests together. Neighbourhood communities, on the other hand, share a common geography, which is their primary identity. They include people with many different interests and values. As I mentioned at the outset, however, people juggle being part of multiple communities all at the same time, and similarly, no community is exclusively one or the other. For example, our faith community here is also part of this neighbourhood, Buena Vista, and therefore is very much part of the fabric, an institution, of this neighbourhood. This is why we collectively try to be good neighbours in this neighbourhood (like not parking in front of people's driveways!). So which is better for your health: to be part of a supportive religious community, or to live in a healthy neighbourhood? Yeah, I was expecting that question, Kathryn 'Just cut to the chase and tell me which is healthier!' Unfortunately, I wish I could give you a straight answer, but it is not that simple. I will tell you, though, that I spend way more time in my neighbourhood than here in this building. But, again, that doesn t mean that I stop being a Unitarian when I leave this building that is the whole point of coming to this community: to test my ideas, to figure out who I am, and then to live my life out there, whichever communities that I am part of. I think this is what you meant when you were talking about the internal/external pathways of how being a Unitarian can be good for your health. So, sorry, there is no easy answer here. Maybe this is a question to the rest of these good people as well. I can see what a neighbourhood has to offer at least if you are able to live in the right kind of neighbourhood! You and I are fortunate that we have friendly, helpful neighbours, our neighbourhood is pretty safe, and we can walk to shops, to the river, and to this congregation! That all contributes to our wellbeing. But I do feel there's something different about this congregation, compared to other social networks, and I think that's because of the nature of a religious group even if it is Unitarian! To cite another of our principles: we affirm and promote acceptance of one another and encouragement of spiritual growth in our congregations. Although we may be quite diverse in our beliefs, compared to other religions, we come together because of a shared desire to explore the questions together, to talk about deep issues like morality, faith, reconciliation, and grief. Because of this focus, I find that I can quickly feel more connected with people here, through the depth of our discussions, and the experiences we share on Sunday mornings and at other times. To sum up in a classical academic way, then, while more research needs to be done, we can conclude that both religious communities and neighbourhoods can support health through several different pathways. We are social animals, and being in community is essential to our wellbeing. Religion can promote health in additional ways by encouraging healthy lifestyles, beliefs and practices. And of course, academics, like Unitarians, like asking questions perhaps even more than answering them. So we invite you to consider these questions, which we can talk about in the second hour, with those who'd like to stay: In light of the evidence that religious communities can contribute to their members' health and well being, are we doing all we can in this congregation to provide social support, to encourage healthy living and helpful spiritual practices, and to help each other develop spiritually? What more do you think we could be doing? We look forward to hearing your thoughts. 5