Re: Religion as a social force in health: complexities and … – The BMJ

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Intended for healthcare professionals
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Dear Editor,
We were pleased to read this insightful article (1) examining the influence of religion on health outcomes and highlighting the relationship between religion and health, both in public health messaging and in the development of health projects globally. We fully agree with the analysis and conclusions of Idler et al. Religions’ ethical and spiritual teachings have, throughout the ages, been a powerful impulse for generosity and for selfless and charitable actions.
However, we believe the role of religion to be much more far-reaching. By virtue of its character-building and unifying capacity, religion has the potential to transform individuals and societies. It can give individuals tools to create just and equitable societies and empower them to build communities (2), and with it a world where society can work together to resolve problems – of any scale – that impact individual and population health.
The concept of ‘fundamental causality’ (3,4) advanced to describe the relationship between social determinants of disease and health outcomes is well-known. It is widely acknowledged that technological advances alone are insufficient to prevent disease and that social determinants are primary contributors to health inequity. Clinicians are unable to make the desired changes to the circumstances of their patients in the face of overwhelming societal challenges. Indeed, scientists and public health practitioners to date largely feel powerless to address the societal issues that impact disease and are often limited to describing the problem, or quantifying their effects on traits and diseases, designing specific interventions to influence individual risk factors, or engaging in limited public health advocacy.
The pervasive impacts of greed and materialism on health are evident, whether through poverty, environmental toxins, climate change, or pandemics. The remedy today for many of the world’s ills is the application of the spiritual principles of unity and justice to the problems of our society. By recognising that all humanity has been created ‘from the same dust’ (5) whatever their race, religion, or nationality, we can finally overcome the paralysis that is stopping us from coming together and addressing the complex and inter-related problems facing our planet.
It can be argued that religion has the driving power and influence to address the root causes of societal inequality and eliminate the most pervasive social determinants of ill-health. Put simply, if those who profess a religion follow its ethical and spiritual tenets and apply the virtues enshrined therein to their private and public lives, if they work together collaboratively, they can transform social relationships at the local level and globally. Furthermore, networks and connections across countries and continents can strengthen cooperative action on an international scale and support the kind of global institutions and governance that are imperative for tackling global issues such as pandemics and the climate crisis. The health of any population is dependent on the relationship between three protagonists: the individual, community, and institutions. Faith impacts all levels (2,6).
Idler et al., quantify the vast numbers of peoples engaged in religious communities worldwide and suggest that ‘religion is here to stay’. Why not then harness this power, so readily available to us at the grassroots, for the good of our global health?
Dr Nasim Mavaddat
Senior Research Associate MBBS PhD MPhil PhD
Department of Public Health and Primary Care,
University of Cambridge,
Cambridge UK
Dr Nahal Mavaddat MBBS FRACGP Pgdip(Cogsc) PhD
Associate Professor, Head of Discipline of General Practice, School of Medicine,
University of Western Australia, Perth, WA
Professor Peymané Adab MD, MPH, MBChB, FFPH, FHKCCM
Professor of Chronic Disease Epidemiology & Public Health,
Institute of Applied Health Research,
University of Birmingham, UK
Dr Shirin Fozdar PhD, MBChB, MRCGP
Ridgeway View Family Practice,
Wroughton, Swindon, UK
(1) Idler, E., Jalloh, MF, Cochrane, J. et al. Religion as a social force in health: complexities and contradictions. BMJ 2023;382:e076817
(2) Baha’i International community (
(3) Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;Spec No:80-94. PMID: 7560851.
(4) Lutfey, K., & Freese, J. Toward some fundamentals of fundamental causality: Socioeconomic status and health in the routine clinic visit for diabetes. American Journal of Sociology, 2005: 110(5), 1326-1372.
(5) Baháʼu’lláh (1858). The Hidden Words of Baháʼu’lláh (6)
Competing interests: No competing interests


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