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Should Medicare Subsidise Your High Holidays Seat?

December 27, 2009 – 6:38 pm8 Comments
Will Dr Moses' tablets improve your health?

Will Dr Moses' tablets improve your health?

By Liz Paratz

This is the final instalment in the ‘Judaism Under the Microscope’ series, applying evidence-based medicine to 6000 years of Jewish practice. Here, Liz takes a look at whether religious people are healthier overall.

The question of whether being religious equates with being healthier is a hot one. Now, evidence-based medicine has come to the party to weigh in on whether a religious lifestyle results in medical benefits ; and if so, whether ‘religion’ should be an approved therapy in the medical landscape. After all, if religious attendance shows medical benefits, shouldn’t High Holiday seats be reimbursable on Medicare just like any doctor’s appointment?

Well firstly, there are many studies on the issue of increased life-expectancy in religious people.

A US national study of 21 000 adults documented a strong association between religious attendance and mortality. People who had never attended services had a 19 times higher risk of death over an 8-year period than those who attended more than once a week. Striking differences in life expectancy were also evident, with life expectancy at age 20 for religious people who attended services being, on average, seven and a half years longer than for the non-religious.

Another study specifically examining Israeli Jews used 16 years of mortality data comparing secular kibbutzim to religious kibbutzim. Overall, they found that mortality was significantly higher in the secular kibbutzim, associated with higher intake of meat, dairy products and coffee, less fish and much more smoking and reported stress.

Another article was provocatively titled ‘Religious Attendance :  More Cost-Effective Than Lipitor?’ (Lipitor is a widely-used cholesterol-lowering agent). It compared the increase in life expectancy noted in people who regularly attended religious services to the increase gained from statins, and then predicted cost-effectiveness. Cost was based on price of statins and the assumption that people would contribute 10% of their income to their religious community. The authors’ conclusion was that ‘the real-world, practical significance of regular religious attendance is comparable to commonly recommended therapies, and rough estimates even suggest that religious attendance may be more cost-effective than statins.’ So perhaps in this post-Marx age religion has become the poor person’s statin, rather than the opiate of the masses.

Other studies have focused on more short-term parameters. For example, being religious might improve life expectancy, but does it affect the course of your diabetes? Or your recovery from surgery or your risk of a heart attack? At this point, it would seem that the answer may be yes.

C-reactive protein (usually abbreviated to CRP) is a marker of inflammation in the body, and a raised CRP is usually not a good thing. In the context of diabetes, a raised CRP has been shown to be associated with increased risk of vascular complications like heart attack and peripheral arterial disease. The researchers in ‘C-Reactive Protein, Diabetes + Attendance At Religious Services’ examined a group of diabetics who were regular religious service attenders versus diabetics who did not attend religious services.

Impressively, even after adjusting for demographic variables, health status, smoking, social support, mobility, and body mass index, the diabetics who did not attend any religious services were still more than two times more likely to have a raised CRP compared to the religious diabetics. The researchers’ conclusion was thus that, ‘attendance at religious services has been linked epidemiologically to improved morbidity and mortality from cardiovascular causes’.

Religiousness has also been documented to be associated with shorter hospital stays in patients undergoing coronary artery bypass grafting, and longer walking distances at discharge in patients undergoing hip surgery.

However, the exact mechanism by which a religious lifestyle brings about an increase in life-expectancy and general health is still debated. In 2007, the Medical Journal of Australia dedicated a supplementary issue to the inter-relationship of religion and medicine, trying to elucidate how religiousness might bring health benefits and whether religion could even be recommended as another therapy.

Many of the researchers contended that most studies still fail to adequately control for confounding factors that differentiate a ‘religious’ group from a ‘non-religious’ group. Such oversights can be as basic as failing to consider, when examining the link between church attendance and mortality, the fact that healthy people are more likely to be capable of attending church while very sick people will be confined to a hospital bed.

Finally, a study published in 2000 in the New England Journal of Medicine neatly encapsulates the issues that come with considering religion as just another therapy. The authors point out that religion is a personal choice. As such, it falls into the category of several other activities that may yield health benefits, but may not be appropriate to prescribe as therapy.

For example, several studies have linked being married to better health status. Yet doctors don’t promote JDate the same way they do Quitline. Likewise, having babies at a younger age is now thought to decrease the risk of breast cancer. But again, it would be extremely out-of-place for doctors to push young female patients into having babies before they’re personally ready. It’s just definitely in a different category to encouraging regular exercise.

But ultimately, perhaps the best reason for not prescribing religion as therapy may be that to do so demeans religion itself. While religious people appear to be obtaining benefit from their choice of lifestyle, there’s no evidence suggesting benefit to atheists who adopt the accoutrements of a frum life.

Radically changing your chosen lifestyle in the hope of maybe increasing your post-op walking distance is a big move to make. And, when there are so many other simpler ways of improving your health – more exercise, better diet, drinking less, quitting smoking – becoming religious only for the health benefits looks a bit like climbing Mt Everest for a breath of fresh air.

* Image from http://img.dailymail.co.uk/i/pix/2008/03_01/mosesHeston2703_468x611.jpg

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