Religion, spirituality and belief: introduction
Religious involvement may be part of a person’s past (e.g. raised in a religious family) or they may be currently practising a religion, or of course both. Religion, like ethnicity (see our ScotPHO Ethnicity section), may influence health-related behaviours and beliefs, and gender roles. ScotPHO quotes Bhopal’s definition of Ethnicity, which makes reference to religion:
"the social group a person belongs to, and either identifies with or is identified with by others, as a result of a mix of cultural and other factors including language, diet, religion, ancestry and physical features traditionally associated with race". Bhopal (2004) (133KB)
The pages in this section focus on particular religious groups. However some evidence (Pargament (2013)) suggests that holding any religious or spiritual view of life can be associated with a better ability to cope in adverse circumstances. The Royal College of Psychiatrists has produced a leaflet on spirituality and mental health, which discusses the distinction between spirituality and religion (RCPH 2009).
The ScotPHO report Dimensions of Diversity (2010) gives examples of potential health impacts associated with religion:
- high smoking levels in West of Scotland Catholics,
- the varying gender gaps in mental health in different religions,
- varying levels and gender gaps in self-assessed health,
- the protective effects of the low value placed on excess consumption in most religions, and, generally,
- the social benefits of the group structures based around religions.
Religions offer behavioural guidance, and as Dimensions of Diversity (2010) suggests, this is generally seen as positive for health, as no religion mandates smoking, drinking to excess or over-eating. Religion may have other positive effects on health such as the reduction of anxiety, (Coruh et al (2005) ) and also reduced mortality (Millard et al (2015) ; McCullough et al (2000) (1.2MB) . It appears likely that some positive effects may be mediated by social support provided through religious organisations (Debnam et al 2012) .
Religion may also negatively affect health. We can classify the possible negative influences of any religious involvement in three main groups:
1. The direct consequences of religion-driven behaviour
The health of males and females may be affected in different ways within a single religious group. Women with Buddhist, Roman Catholic or no religious affiliation are more likely to score highly for mental distress than women in other religious groupings (see Dimensions of Diversity (2010)). The extent to which such patterns are directly attributable to or mediated by religion is unknown. Some traditional religious practices are harmful to health and wellbeing (for example female genital mutilation (Simpson et al,(2012)).
2. Impacts resulting from the mismatch between specific religious beliefs and the processes used by the social institutions of the society the person lives in
Health service access can be compromised for those who hold health beliefs that are not valued or recognised by the health systems of the country they live in. Mental health services, because they involve ‘talking therapies’ may pose belief-based barriers for cognitive treatments offered to people of another religion. For example members of other religions may use symbols and metaphors in talking about their issues that are difficult to interpret for therapy staff (Bache et al,(2011) ;Koo et al,2012). Beliefs may also limit physical actions taken (e.g. where women of some religions may not be allowed by their religion to be examined by a male doctor, but may have no practical other option). Therefore beliefs about modesty may prevent physical examination (Banning et al, (2011)).
3. The effects of discrimination arising from the ways others perceive the members of a particular religion
Discrimination against certain religious groups by the wider society may affect mental and physical health, see Kelly et al (2013) and Leiba et al (2012) . Discrimination based on religion can affect health through limiting life opportunities, for example in employment and education. As Dimensions of Diversity (2010) notes, “some religious interpretations may lead to particular expectations or attitudes (e.g. towards gender equality or of acceptable forms of sexual expression) that could create tensions in the pursuit of equality across all strands.” A different aspect of this may be seen where individuals do not comply with the behavioural guidance offered by their religion (for example, on sexual orientation and behaviour, and alcohol and drug use). The resulting psychological tension and social stigma may have implications for mental health, as suggested by Knifton et al (2010) and Hatzenbuehler et al (2013). More generally, religious discrimination can affect community cohesion and safety, see Dimensions of Diversity (2010).