The doctor as God's mechanic? Beliefs in the Southeastern United States
Introduction
Americans are very religious. The Gallup polls consistently report that 95% of Americans believe in God and 42% say they attend church weekly (Gallup, 1990). Some believe that there is a faith factor in health and that spirituality may have a role in determining one's health and life span. Such claims are speculative but a growing literature describes direct associations between religion and health (Levin & Schiller, 1987; Levin, Larson, & Puchalski, 1997; Matthews et al.,1998). Validity of a faith factor notwithstanding, faith is an important dimension of many patients’ lives. Physicians seldom, however, consider the role that a patient's faith may have in their health or the healing process (Jones, 1990; King, Sobal, Haggerty, Dent, & Patton, 1992; Maugans & Wadland, 1991). Perhaps physicians and other caregivers would be more sensitive to this important dimension of human nature if they better understood religious beliefs in the population, and how strongly and widely those beliefs are held.
In this paper, we describe important spiritual practices and beliefs related to medical care among people of rural eastern North Carolina. Though this region is demographically unique nationally, it is representative of the southeastern United States. We examine the practice of personal prayer for healing and whether people discuss spiritual concerns with their physician. We assess beliefs in miracles, that God acts through religious healers, that God's will is an important factor in the healing process, and that God acts through physicians to cure disease.
We then use a composite index to examine the extent to which religious faith in healing varies across race, age, denomination, education, income, and health status. We also examine the salience of factors thought to predict belief that God acts through physicians and whether a patient ever discusses spiritual concerns with a physician. Finally, we explore whether people want spiritual guidance when ill and specifically whether they would want their physician involved in the discussion of spiritual concerns. We conclude by suggesting how practitioners can acknowledge, and perhaps incorporate, the spiritual beliefs of their patients in the physician–patient relationship.
Section snippets
Background
Literature on the relationship between religion and health is abundant but conflicting. Durkheim believed that religion had a positive effect on health (Durkheim, 1915) and Weber (1963) thought it was important for the social integration of the individual. Marx saw it as an opiate of the proletariat (Marx & Engels, 1964), while Freud viewed it as a coping behaviour, at best, and an “obsessional neurosis of humanity” at worst (Strachey, 1962).
More recently, many empirical studies describe
Methods and measurement
The data for our study were drawn from a random-digit-dial telephone survey of adults (age⩾18) in 1052 households in eastern North Carolina. The survey was conducted in 1997 and had a sampling error of ±3%. The sampling frame included all households in a 41-county region with telephones (91% of all households). A similar survey conducted in 1996 guided our specification, classification and measurement of variables, as well as the formation of the a priori hypotheses in this study. Interview
Findings
Proportional responses to the eight spiritual-faith-in-healing variables are described by race in Table 2. Nine of ten people in Eastern North Carolina (93.1%) pray for guidance, help, or healing for themselves or others. Almost three-quarters of this population (70.8%) say that they pray often. More than two-thirds (69.7%) report praying for healing of their own medical problems, but less than half said that they pray often for their own healing (44.5%). Discussion of spiritual concerns with
Conclusions
We have found that spiritual beliefs in healing are strong, that prayer for healing is a common practice, and that people are inclined to seek spiritual counsel when seriously ill. We have also found how those beliefs, practices, and intentions vary across important sociological dimensions. The principal limitation of this study is that it is based upon a regional population with a distinctive culture and heavy burden of poverty. The strong patterns of spiritual practice, belief and intention
Acknowledgements
The authors wish to thank Ken Wilson, Ph. D., Claudia Williams, and all of the students who conducted the survey through the East Carolina University Survey Research Center, as well as Paul Vos, Ph. D. for his advice on logistic regression. East Carolina University funded the survey.
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