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Donkin et al have highlighted the constructive steps being taken to implement policy change facilitating the Social Determinants of Health (SDH) across the globe 1. Although progress is not universal, what has been achieved deserves praise.
We write, however, to highlight one key omission from the standard SDH model: religious faith. This deserves greater recognition as a social determinant of health for two reasons. First, is scale: a recent study demonstrated that 84% of the world’s 7.4 billion people affiliated themselves to a religious group 2. Second is the impact of religious faith on health, shaping both health beliefs and use of healthcare services 3.
Theories of supernatural causation of illness are ancient and diverse. They are also universal: a 1980 study of health belief systems worldwide found evidence that supernatural causes of illness “far outweigh” natural ones 4. Of course many such models may be counter to the Western biomedical model. They should, however, still be acknowledged, not least because when believers encounter Western biomedicine the two models typically become mixed without any sense of conflict.
The close link between healthcare services and religion is evident in both the historical (for example, medieval Christian hospitals in Europe) and contemporary (e.g. faith-based non-governmental organisations worldwide) contexts. The relationship between religion and healthcare is not confined to simple delivery. Religious fait...
The close link between healthcare services and religion is evident in both the historical (for example, medieval Christian hospitals in Europe) and contemporary (e.g. faith-based non-governmental organisations worldwide) contexts. The relationship between religion and healthcare is not confined to simple delivery. Religious faith can influence the way individuals approach and access healthcare services available 3.
If evidence of the importance of religious faith is required, one need look no further than social and psychological resilience. Religious faith features powerfully in the stories of some of the most vulnerable populations, for example survivors of military conflict and torture. Faith is also recognised as an independent protective factor against depression and suicide 5. Increased rates of migration, conflict, and the epidemiological transition towards chronic physical and mental conditions are likely to make religious faith more relevant to health on a national and global level.
We argue that faith operates beyond social capital and may not be captured through other secular social concepts such as community, social cohesion or culture. Researchers and policymakers are unlikely to harness positive aspects of religious faith if its status as a key social determinant of health is unacknowledged. Such recognition is also important to ensure that the influence of religious faith – positive and negative – is incorporated in undergraduate and postgraduate medical curriculums.
We hope that this letter serves as a stimulus to greater recognition of religious faith within the social determinants of health.
1. Donkin A, Goldblatt P, Allen J, Nathanson V, Marmot M. Global action on the social determinants of health. BMJ Glob Health. 2018;3(Suppl 1):e000603.
2. The Changing Global Religious Landscape. Pew Research Center; April 5, 2017.
3. Shenouda JEA, Cooper MJF. "One Big Family": Pastoral Care and Treatment Seeking in an Egyptian Coptic Church in England. J Relig Health. 2017;56(4):1450-9.
4. Murdock, GP. “Theories of Illness. A world survey”. University of Pitsburgh Press, 1980 page 26.
5. Norko MA, Freeman D, Phillips J, Hunter W, Lewis R, Viswanathan R. Can Religion Protect Against Suicide? J Nerv Ment Dis. 2017;205(1):9-14.