Annals of Behavioral Medicine

, Volume 24, Issue 1, pp 3–13 | Cite as

Spirituality and health: What’s the evidence and what’s needed?

  • Carl E. ThoresenEmail author
  • Alex H. S. Harris


In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order. One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health, yet one needs empirical evidence based on well-controlled studies that support these claims and conclusions. We hope to introduce the dismissing critic to suggestive data that may create tempered doubt and to introduce the uncritical advocate to issues and concerns that will encourage greater modesty in the making of claims and drawing of conclusions. We comment on the following questions: Do specific RS factors influence health outcomes? What possible mechanisms might explain a relation, if one exists? Are there any implications for health professionals at this point in time ? Recommendations concern the need to improve research designs and measurement strategies and to clarify conceptualizations of RS factors. RS factors appear to be associated with physical and overall health, but the relation appears far more complex and modest than some contend. Which specific RS factors enhance or endanger health and well-being remains unclear.


Behavioral Medicine Religious Coping Religious Service Religious Involvement Religious Attendance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. (1).
    Rosen G:A History of Public Health. New York: Johns Hopkins University Press, 1993.Google Scholar
  2. (2).
    Frank J: The faith that heals.Johns Hopkins Medical Journal. 1975,28:306–319.Google Scholar
  3. (3).
    Thoresen CE: Spirituality, health, and science: The coming revival? In Roth-Roemer S, Robinson SK, Carmin C (eds),The Emerging Role of Counseling Psychology in Health Care. New York: Norton, 1998, 409–431.Google Scholar
  4. (4).
    Larson DB, Sawyers JP, McCullough ME (eds):Scientific Research on Spirituality and Health: A Consensus Report. Rockville, MD: National Institute for Healthcare Research, 1998.Google Scholar
  5. (5).
    Dawkins R: You can’t have it both ways: Irreconcilable differences.Skeptical Inquirer. 1999,23:62–64.Google Scholar
  6. (6).
    Koenig HG:Is Religion Good for Your Health? Binghamton, NY: Haworth Pastoral, 1997.Google Scholar
  7. (7).
    Benson H:Timeless Healing: The Power and Biology of Belief. New York: Scribner’s, 1996.Google Scholar
  8. (8).
    Sloan RP, Bagiella E, VandeCreek L, et al.: Should physicians prescribe religious activities?New England Journal of Medicine. 2000,342: 1913–1916.PubMedCrossRefGoogle Scholar
  9. (9).
    Sloan RP, Bagiella E, Powell T: Religion, spirituality, and medicine.Lancet. 1999,353:664–667.PubMedCrossRefGoogle Scholar
  10. (10).
    Post SG, Puchalski CM, Larson DB: Physicians and patient spirituality: Professional boundaries, competency, and ethics.Annals of Internal Medicine. 2000,132: 578–583.PubMedGoogle Scholar
  11. (11).
    Shafranske EP, Malony HN: Religion and the clinical practice of psychology: A case for inclusion. In Shafranske EP (ed),Religion and the Clinical Practice of Psychology. Washington, DC: American Psychological Association, 1996, 561–586.CrossRefGoogle Scholar
  12. (12).
    Miller WR, Thoresen CE: Spirituality, religion, and health: An emerging research field.American Psychologist (in press).Google Scholar
  13. (13).
    Miller WR, Thoresen CE: Spirituality and health. In Miller WR (ed),Integrating Spirituality Into Treatment: Resources for Practitioners. Washington, DC: American Psychological Association, 1999, 3–18.CrossRefGoogle Scholar
  14. (14).
    Levin JS: Religion and health: Is there an association, is it valid, and is it causal?Social Science and Medicine. 1994,38:1475–1482.PubMedCrossRefGoogle Scholar
  15. (15).
    Levin JS, Chatters LM: Research on religion and mental health: An overview of empirical findings and theoretical issues. In Koenig HG (ed),Handbook of Religion and Mental Health. New York: Academic, 1998, 34–47.Google Scholar
  16. (16).
    George LK, Larson DB, Koenig HG, McCullough ME: Spirituality and health: What we know, what we need to know.Journal of Social and Clinical Psychology. 2000,19:102–116.Google Scholar
  17. (17).
    Powell LH, Shahabi L, Thoresen CE: Religion and spirituality: Linkages to physical health.American Psychologist (in press).Google Scholar
  18. (18).
    Koenig HG, McCullough M,Larson DB: Religion and Health: A Century of Research Reviewed. New York: Oxford University Press, 2000.Google Scholar
  19. (19).
    Thoresen CE, Harris AHS: Spirituality, religion, and health. In Raczynski JM, Leviton LL, Bradley L ({ededs}),Handbook of Health Psychology (Vol. 2). Washington, DC: American Psychological Association (in press).Google Scholar
  20. (20).
    James W:Varieties of Religious Experience. New York: Random House, 1902.Google Scholar
  21. (21).
    Simpson J, Weiner E (eds),The Oxford English Dictionary (2nd Ed.). New York: Oxford University Press, 1989.Google Scholar
  22. (22).
    Pargament KI: Psychology of religion and spirituality.International Journal for the Psychology of Religion. 1999,9:3–16.CrossRefGoogle Scholar
  23. (23).
    Thoresen CE: Spirituality and health: Is there a relationship?Journal of Health Psychology. 1999,4:291–300.Google Scholar
  24. (24).
    Walsh R, Vaughn F:Paths Beyond Ego: The Transpersonal Vision. New York: Plenum, 1995.Google Scholar
  25. (25).
    Pargament KI:The Psychology of Religion and Coping: Theory, Research, and Practice. New York: Guilford, 1997.Google Scholar
  26. (26).
    Woods TE, Ironson GH: Religion and spirituality in the face of illness: How cancer, cardiac, and HIV patients describe their spirituality and religion.Journal of Health Psychology. 1999,4:393–412.CrossRefGoogle Scholar
  27. (27).
    Shahabi L, Powell L, Musick MA, et al.: Correlates of self-perceptions of spirituality in American adults.Annals of Behavioral Medicine. 2002,24:59–68.PubMedCrossRefGoogle Scholar
  28. (28).
    Matthews DA, Koenig HG, Thoresen CE, Friedman, R: Physical health. In Larson DB, Swyers JP, McCullough ME (eds),Scientific Research on Spirituality and Health: A Consensus Report. Rockville, MD: National Institute for Healthcare Research, 1998, 31–54.Google Scholar
  29. (29).
    Comstock GW, Partridge KB: Church attendance and health.Journal of Chronic Diseases. 1972,25:665–672.PubMedCrossRefGoogle Scholar
  30. (30).
    Larson DB, Koenig HG, Kaplan BH: The impact of religion on men’s blood pressure.Journal of Religion and Health. 1989,28:265–278.CrossRefGoogle Scholar
  31. (31).
    Madalie JH, Kahn HA, Neufeld HN: Five-year myocardial infarction incidence: II. Association of single variables to age and birthplace.Journal of Chronic Disease. 1973,26:329–349.CrossRefGoogle Scholar
  32. (32).
    Harris RC, Dew MA, Lee A, et al.: The role of religion in heart-transplant recipients’ long-term health and well being.Journal of Religion and Health. 1995,34:17–32.CrossRefGoogle Scholar
  33. (33).
    Yates JW, Chalmer BJ, St.James P: Religion in patients with advanced cancer.Medical and Pediatric Oncology. 1981,9:121–128.PubMedCrossRefGoogle Scholar
  34. (34).
    Frankel BG, Hewitt WE: Religion and well-being among Canadian university students: The role of faith groups on campus.Journal for the Scientific Study of Religion. 1994,33:62–73.CrossRefGoogle Scholar
  35. (35).
    Idler EL, Kasl SV: Religion among disabled and nondisabled persons: II. Attendance at religious services as a predictor of the course of disability.Journals of Gerontology: Series B: Psychological Sciences and Social Sciences. 1997,52:S306-S316.Google Scholar
  36. (36).
    Idler EL, Kasl SV: Religion among disabled and nondisabled persons: I. Cross-sectional patterns in health practices, social activities, and well being.Journals of Gerontology: Series B: Psychological Sciences and Social Sciences. 1997,52:S294-S305.Google Scholar
  37. (37).
    Idler EL, Kasl SV: Religion, disability, depression, and the timing of death.American Journal of Sociology. 1992,97:1052–1079.CrossRefGoogle Scholar
  38. (38).
    Hummer RA, Rogers RG, Nam CB, Ellison CG: Religious involvement and U.S. adult morality.Demography. 1999,36:272–285.CrossRefGoogle Scholar
  39. (39).
    Musick MA, House JS, Williams DR: Attendance at religious services and mortality in a national sample. Annual Meeting of the American Sociological Association. Chicago: 1999.Google Scholar
  40. (40).
    Oman D, Reed D: Religion and mortality among the community-dwelling elderly.American Journal of Public Health. 1998,88:1469–1475.PubMedGoogle Scholar
  41. (41).
    Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA: Frequent attendance at religious services and mortality over 28 years.American Journal of Public Health. 1997,87:957–961.PubMedGoogle Scholar
  42. (42).
    McCullough ME, Hoyt WT, Larson DB, Koenig HG, Thoresen C: Religious involvement and mortality: A meta-analytic review.Health Psychology. 2000,19:211–222.PubMedCrossRefGoogle Scholar
  43. (43).
    Strawbridge W, Shema S, Cohen RD, Kaplan G: Religious attendance increases survival by improving and maintaining good health behaviors mental health and social relationships.Annals of Behavioral Medicine. 2001,23:68–74.PubMedCrossRefGoogle Scholar
  44. (44).
    Sloan RP, Bagiella E: Religion and health [Letter to the editor].Health Psychology. 2001,20:228.PubMedCrossRefGoogle Scholar
  45. (45).
    McCullough ME, Hoyt WT, Larson DB: Small, robust and important: Reply to Sloan and Bagiella [Letter to the editor].Health Psychology. 2001,20:228–229.CrossRefGoogle Scholar
  46. (46).
    Ellison CG, Levin JS: The religion-health connection: Evidence, theory and future directions.Health Education and Behavior. 1998,25:700–720.PubMedCrossRefGoogle Scholar
  47. (47).
    Thoresen CE, Harris AHS, Oman D: Spirituality, religion, and health: Evidence, issues, and concerns. In Plante TG, Sherman AC (eds),Faith and Health. New York: Guilford, 15-52.Google Scholar
  48. (48).
    Chatters LM: Religion and health: Public health research and practice.Annual Review of Public Health. 2000,21: 335–367.PubMedCrossRefGoogle Scholar
  49. (49).
    WorthingtonJr. EL, Kurusu TA, McCullough ME, Sandage SJ: Empirical research on religion and psychotherapeutic processes and outcomes: A 10-year review and research prospectus.Psychological Bulletin. 1996,119:448–487.CrossRefGoogle Scholar
  50. (50).
    Kabat-Zinn J, Wheeler E, Light T, et al.: Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA).Psychosomatic Medicine. 1998,60:625–632.PubMedGoogle Scholar
  51. (51).
    Harris AHS, Thoresen CE, McCullough ME, Larson DB: Spiritually and religiously-oriented health interventions.Journal of Health Psychology. 1999,4:413–434.Google Scholar
  52. (52).
    Dossey L: Prayer and medical science: A commentary on the prayer study by Harris et al and a response to critics.Archives of Internal Medicine. 2000,160:1735–1737.PubMedCrossRefGoogle Scholar
  53. (53).
    Byrd RB: Positive therapeutic effects of intercessory prayer in a coronary care unit population.Southern Medical Journal. 1988,81:826–829.PubMedCrossRefGoogle Scholar
  54. (54).
    Sicher F, Targ E, Moore D, Smith H: A randomized double-blind study of the effect of distant healing in an advanced AIDS population.Western Journal of Medicine. 1998,169:356–363.PubMedGoogle Scholar
  55. (55).
    Harris WS, Gowda M, Kolb JW, et al.: A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit.Archives of Internal Medicine. 1999,159:2273–2278.PubMedCrossRefGoogle Scholar
  56. (56).
    Kirsch I, Lynn SJ: Automaticity in clinical psychology.American Psychologist. 1999,54:504–515.PubMedCrossRefGoogle Scholar
  57. (57).
    Oman D, Thoresen CE, McMahon K: Volunteerism and mortality.Journal of Health Psychology. 1999,4:301–316.CrossRefGoogle Scholar
  58. (58).
    Pargament KI, VandeCreek L, Cole B, et al.: The vigil: Religion and the search for control in the hospital waiting room.Journal of Health Psychology. 1999,4:327–342.CrossRefGoogle Scholar
  59. (59).
    Keefe FJ, Affleck G, Lefebvre J, {eaet al.}: Living with rheumatoid arthritis: The role of daily spirituality and daily religious and spiritual coping.Pain (in press).Google Scholar
  60. (60).
    Bergin AE: Religiosity and mental health: A critical reevaluation and meta-analysis.Professional Psychology: Research and Practice. 1983,14:170–184.CrossRefGoogle Scholar
  61. (61).
    Gartner J, Larson DB, Allen GD: Religious commitment and mental health: A review of the empirical literature. Spirituality: Perspectives in theory and research.Journal of Psychology and Theology. 1991,19:6–25.Google Scholar
  62. (62).
    Asser S, Swan R: Child fatalities from religion-motivated medical neglect.Pediatrics. 1998,101:625–629.PubMedCrossRefGoogle Scholar
  63. (63).
    Exline JJ, Yali AM, Lobel M: When God disappoints: Difficulty forgiving God and its role in negative emotion.Journal of Health Psychology. 1999,4:365–380.Google Scholar
  64. (64).
    Galanter M: “Moonies” get married: A psychiatric follow-up study of a charismatic religious sect.American Journal of Psychiatry. 1986,143:1245–1249.PubMedGoogle Scholar
  65. (65).
    Pargament KI, Smith BW, Koenig HG, Perez L: Patterns of positive and negative religious coping with major life stressors.Journal for the Scientific Study of Religion. 1998,37:710–724.CrossRefGoogle Scholar
  66. (66).
    Booth L:When God Becomes a Drug: Breaking the Chains of Religious Addiction and Abuse. Los Angeles: JP Tarcher, 1992.Google Scholar
  67. (67).
    Miller WR: Diversity training in spiritual and religious issues. In Miller WR (ed),Integrating Spirituality Into Treatment: Resources for Practitioners. Washington, DC: American Psychological Association, 1999, 253–264.CrossRefGoogle Scholar
  68. (68).
    Puchalski CM, Larson DB: Developing curricula in spirituality and medicine.Academic Medicine. 1998,73:970–974.PubMedCrossRefGoogle Scholar
  69. (69).
    Plante TG, Sherman AC (eds):Faith and Health. New York: Guilford, 2001.Google Scholar
  70. (70).
    Miller WR (eds):Integrating Spirituality Into Treatment. Washington, DC: American Psychological Association, 1999.Google Scholar
  71. (71).
    Miller WR, Thoresen CE: Spirituality, religion, and health: Definitions and constructs [Special issue].American Psychologist (in press).Google Scholar
  72. (72).
    Ellison CG, Levin JS: The religion-health connection: Evidence, theory, and future directions.Health Education and Behavior. 1998,25:700–720.PubMedCrossRefGoogle Scholar
  73. (73).
    Hilliard RB: Single-case methodology in psychotherapy process and outcome research.Journal of Consulting and Clinical Psychology. 1993,61:373–380.PubMedCrossRefGoogle Scholar
  74. (74).
    Richard TA, Folkman S: Spiritual aspects of loss at the time of a partner’s death from AIDS.Death Studies. 1997,21:527–552.CrossRefGoogle Scholar
  75. (75).
    Keefe FJ, Affleck G, Lefebvre JC, et al.: Pain coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis.Pain. 1997,69:35–42.PubMedCrossRefGoogle Scholar
  76. (76).
    Gallup G:The Gallup Poll: Public opinion 1995. Wilmington, DE: Scholarly Resources, 1995.Google Scholar
  77. (77).
    Myers D:Spiritual Hunger in a Land of Plenty. New Haven, CT: Yale University Press, 2000.Google Scholar
  78. (78).
    Putnam R:Social Capital Community Benchmark Survey, 2001. Retrieved from Scholar
  79. (79).
    McCullough ME, Pargament KI, Thoresen CE: The psychology of forgiveness: History, conceptual issues, and overview. In McCullough ME, Pargament KI, Thoresen CE (eds),Forgiveness: Theory, research, and practice. New York: Guilford, 2000, 1–16.Google Scholar
  80. (80).
    Calaprice, A.The Quotable Einstein. Princeton NJ: Princeton University Press, 1996.Google Scholar

Copyright information

© The Society of Behavioral Medicine 2002

Authors and Affiliations

  1. 1.School of EducationStanford UniversityStanford

Personalised recommendations