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Churches as Primary Partners in Community Health


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In many communities churches are a primary partner in community health. By uniting the best practices of public health and congregational-based principles emphasizing wellness, wholeness, prevention, and education, churches can influence people's values and life choices, and enable them to assume responsibility for their own health. A survey conducted by the Congregational Health ReSource, in partnership with the Virginia Department of Health Office of Minority Health and Public Health Policy, will report the findings from four rural communities that participated in a pilot congregational health assessment.

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Churches as Primary Partners in Community Health

  1. 1. Changing Times, Changing Strategies Working together to strengthen the Safety Net Advocacy & Community Outreach Churches as Primary Partners in Community Health November 16, 2009 Reverend Andrea Lomboy
  2. 2. The Congregational Health ReSource, LLC (CHR) is a Judeo-Christian company and ministry devoted to improving health awareness from the perspective of “body, soul (mind, will, and emotions), and spirit” from a BIBLICAL approach. “Our desire is to bring together the promise of medicine with the power of faith to lessen the gap between the secular and the sacred, increasing synergies and infusing the potential to build healthier communities.”
  3. 3. Congregational Health Congregational health brings together the best practices of public health and faith-based principles and is a key resource in advancing public health. Over one half of Virginia’s population attends church. By leveraging the Commonwealth’s 7,000+ congregations (and nearly 3.8M members) as a force multiplier, the reach of public health can be much more extensive and effective. Churches have the distinct power to influence people’s values and personal life choices—and enable them to assume responsibility for their health. Your organization has an opportunity to maximize the capacity of public health efforts and help close the gap by supporting congregational health efforts.
  4. 4. Definition Congregational health is the focus of a congregation—an assembly of people who meet for worship and religious instruction in a designated locale—that is dedicated to being sound in body, soul, and spirit and to experiencing freedom from physical disease or pain. Congregational health unites the best practices of: 1. Public health–Protecting and improving community health through such means as applying preventive medicine, providing health education, controlling communicable diseases, and monitoring environmental hazards. 2. Faith-based principles–Relying on the belief that God is the Great Physician who has the ultimate power to heal and cure with or without the use of medical practices; using wisdom (applied knowledge) to make consensual and informed treatment decisions; turning to God-given resources such as health care providers, pharmaceuticals, hospital treatment services, and clinics as needed; and leveraging the network and support offered within the faith community. By understanding these best practices, we can improve the health of individuals and, ultimately, the community at large. Why?
  5. 5. Introduction “The church is the only community-based organization that is found in virtually every community in this country. It is able to reach people of all ages, races, and economic backgrounds and it can strongly influence people’s values and personal life choices. Because the church is generally more integrated into the life of individuals and communities than our modern medical establishment, it can better enable people to assume responsibility for their own health.” - Health and Welfare Ministries General Board of Global Ministries The United Methodist Church New York, New York
  6. 6. Office of Faith-based & Neighborhood Partnerships In 2001, then-President George W. Bush issued an Executive Order to help the federal government coordinate a national effort to expand opportunities for faith-based and other community organizations and to strengthen their capacity to better meet social needs in America’s communities. The top two goals identified focused on living a longer, healthy life with equality of access throughout the population mix. In the current administration, the program has been broaden and renamed as the Office of Faith-based and Neighborhood Partnerships.
  7. 7. “The particular faith that motivates each of us can promote a greater good for all of us. Instead of driving us apart, our varied beliefs can bring us together to feed the hungry and comfort the afflicted; to make peace where there is strife and rebuild what has broken; to lift up those who have fallen on hard times.” – President Barack Obama
  8. 8. Your Health Health – defined by Webster as: • the condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain: the general condition of the body • flourishing condition: well-being The World Health Organization states that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" including the ability to lead a "socially and economically productive life."
  9. 9. Simply put, these determinants affect the health of every member of your congregation. Each determinant should be considered as an “opportunity” to show the love of Christ and minister to the needs of your community.
  10. 10. Minority Populations 5 federally recognized minority populations in Virginia: African American/Black (19.44%) Hispanic/Latino (4.66%) Asian American (3.66%) Native Hawaiian or other Pacific Islander (.05%) American Indian and Alaskan Native (.26%) 70% White Non-Hispanic make up the majority population. This group includes: whites with origins in any of the original peoples of Europe, the Middle East, or North Africa as determined by the U.S. Census Bureau.
  11. 11. Leading Causes of Death Are similar for every race, but not necessarily in the same order… 1. Heart Disease 2. Cancer U 3. Stroke 4. Diabetes 5. Unintentional injuries 6. Homicide 7. HIV/AIDS 8. Chronic lower respiratory disease 9. Nephritis, Nephrotic syndrome, Nephrosis 10. Septicemia Source: Health, U.S., 2004, Table 31. Source: Unequal Health Access Across the Commonwealth, Virginia Health Equity Report, 20008.
  12. 12. Your Faith Faith Section - defined by Webster as: • allegiance to duty or a person : loyalty, fidelity to one's promises and sincerity of intentions • belief and trust in and loyalty to God and belief in the traditional doctrines of a religion, as well as, the firm belief in something for which there is no proof: complete trust • something that is believed especially with strong conviction: synonymous to BELIEF. It is without question. Hebrews 11:1 NKJ - Now faith is the substance of things hoped for, the evidence of things not seen.
  13. 13. Your Faith–Body, Soul & Spirit Body (physical dwelling) 1 Corinthians 3:16 - Don't you know that you yourselves are God's temple and that God's Spirit lives in you? 1 Corinthians 6:19 - Or do you not know that your body is the temple of the Holy Spirit who is in you, whom you have from God, and you are not your own? We were created in God’s image and we are a physical dwelling place for Him in lieu of the Holy of Holies as described in David’s Tabernacle. We should, therefore, honor and respect that which was given to us by God by caring for it in a way that expresses our love for Him.
  14. 14. Your Faith Soul - (mind, will and emotions) The O.T. Hebrew word is rendered as nepes. It appears 755 times in the Old Testament. KJV uses 42 different English terms to translate it. The two most common renderings are "soul" (428 times) and "life" (117 times). It is chiefly defined as a principle or living being The N.T. counterpart to nepes is psyche [yuchv] six hundred times in the Septuagint). Psyche, as its Old Testament counterpart, can indicate the person (Acts 2:41; 27:37). It also serves as the reflexive pronoun designating the “self” Luke 12:19. Expresses emotions such as grief (Matt 26:38, ; Mark 14:34), anguish (John 12:27), exultation (Luke 1:46), and pleasure (Matt 12:18).
  15. 15. Your Faith Spirit (inner man) The O.T. Hebrew word for "spirit" is ruah essentially meaning “breath or wind.” It is the breath of life that gave us the ability to live physically and spiritually. (Isa. 42:5) The N.T. Pneuma [pneu’ma] is the New Testament counterpart to the Old Testament ruah. While it occasionally means wind (John 3:8) and breath (Matt 27:50; 2 Thes 2:8), it is most generally translates "spirit“ an incorporeal, feeling, and intelligent being. (Luke 1:47, 2:40, John 11:33, Acts 18:25, 2 Cor 2:13, Matt 5:3) Ruah can also refer to a person’s will. Ezr 1:5, Num 14:24, Psalm 51:10. In the New Testament spirit is also seen as that dimension of human personality whereby relationship with God is possible (Mark 2:8; Acts 7:59; Rom 1:9; 8:16; 1 Cor 5:3-5).
  16. 16. Religion, Spirituality & Public Health Harold M. Koenig, MD., Professor of Psychiatry & Behavioral Sciences, Associate Professor of Medicine, Duke University Medical Center Religion, Spirituality & Public Health Testimony to US House of Representatives, September 2008. Examines relationships between religion/spirituality and the health of individuals and populations.
  17. 17. Religion, Spirituality & Public Health FACTS to ponder: The US is a very religious nation: 93% of Americans believe in God 89% of Americans report affiliation with a religious organization 83% of Americans say religion is fairly or very important to them 62% of Americans say that they are members of a church or synagogue 58% of Americans pray every day (and 75% weekly) 42% of Americans attend religious services weekly or almost weekly (and 55% at least monthly)
  18. 18. Religion, Spirituality & Public Health “If the religious congregations in America all had health programs, then two-thirds of the U.S. population would be exposed to disease detection, disease prevention, and health promotion efforts. Since persons of all ages participate regularly in religious congregations, this means that health education efforts would occur at all ages, from the young (focused on substance abuse prevention and character development) to the middle aged (focused on healthy eating, exercise, stress-reduction, etc.) to the elderly (focused on volunteering, mentoring and generative types of activities).” –Harold M. Koenig, MD
  19. 19. Religion, Spirituality & Public Health There is every reason to suggest that religious involvement is related to better health. Religious beliefs, practices, and rituals are shown to improve health. Some research has suggested that communities where high portions of the population are members of religious groups have better health in general, even the non-religious people who live in those communities.
  20. 20. 268,240 documented congregations with 176,477,348 adherents in a US population of over 300M **Estimated total including non-reporting congregations. *The data in these reports come from the Religious Congregations and Membership Study which is collected by the Association of Statisticians of American Religious Bodies ( They collect these data by asking denominations to submit counts at the county level of congregations and membership. Some denominations choose not to participate while others simply do not have the data required to participate. The latter is the case with most African-American denominations.
  21. 21. Virginia Statistics for Congregations and Memberships The Association of Religion Data Archives, Congregations Members
  22. 22. 45 Churches in Essex County These statistics are only for reporting churches.
  23. 23. Purpose The purpose of the congregational health assessments is to advance the congregational approach to health by: 1. Identifying Community-based Leaders • Develop health/faith public-private relationships and/or partnerships 2. Identify Community-based Assets • Uncover existing programs and assets within the community from materials to services • Educate the public about overall health issues while increasing awareness of prevention and treatment options 3. Developing a Community-wide Congregational Health Assessment • 5 survey tools were developed (civic, clergy, education, government and medical) • Illuminate root causes of existing health inequities, promoting social justice that could influence changes in funding policies • Use the pilot as a framework that can be replicated in other communities
  24. 24. Selection Process The following four counties were selected because of need and access to care challenges. They also were identified as having one or more of the following: • Virginia Medically Underserved Area (VMUA) • Mental Health Professional Shortage (MHPSA) • Primary Care Health Professional Shortage (HPSA) • Dental Health Professional Shortage (DHPSA) 3 Critical Access Hospitals (CAH) in Virginia (out of 7) • Bath Community Hospital, Hot Springs - Bath County • ValleyHealth Shenandoah County Hospital, Woodstock - Shenandoah County • ValleyHealth Page Memorial Hospital, Luray - Page County 1 SHIP Hospital (out of 24) was selected: • Riverside Tappahannock Hospital, Essex County
  25. 25. Federal Designations CAHs meeting the following requirements to receive the designator: • Located in a state that has a State Flex Program • Located in a rural area • Furnish 24-hour emergency care services • Provide no more than 25 inpatient or swing bed services • Have an average length of stay 96 hours or less • Located > 35 mi. from nearest hospital or > 15 mi. in areas mountainous terrain or only secondary roads SHIPs General acute care hospitals: • with fewer than 49 eligible beds and • that are located outside a metropolitan statistical area (MSA) or • located in a rural census tract
  26. 26. Surveys Five categories of community leaders were addressed: 1. Civic–local associations and business community leaders 2. Government–local mayor, county medical director, county executives 3. Medical and health services–hospitals, clinics, health departments, private-public doctors, and other health practitioners including psychiatrists and social workers 4. Education–principals, school counselors, school superintendents, and boards of education 5. Faith–pastors, clergy, lay leaders, congregational members
  27. 27. Methodology • Development of congregational health assessment tools was necessary and developed online through • 5 databases were developed for each survey type • A tremendous amount of effort was involved in the survey! • Methods of contact included: 1. Phone 2. Email 3. Door-to-Door Delivery 4. Direct to Community Leader 5. Leader to Leader 6. US Mail 7. Fax
  28. 28. Preliminary Survey Findings Final Survey Findings Essex Luray, Page 45 churches total: 30 churches total: 7 - Civic 2 - Civic 16 - Clergy 6 - Clergy 3 - Education 0 - Education 3 - Government 0 - Government 6 - Medical 2 - Medical *35 Completed Surveys 10 Completed Surveys Bath Woodstock, Shenandoah 30 churches total: 24 churches total: 9 - Civic 2 - Civic 9 - Clergy 9 - Clergy 4 - Education 0 - Education 4 - Government 3 - Government 6 - Medical 7 - Medical *32 Completed Surveys 23 Completed Surveys *Survey submission to be completed by 11/30/09 136 Counties, 7,736 reporting congregations
  29. 29. Non-Clergy Findings Sampled secular organizations said that they could provide the following resources to local churches: Funding Teachers (including volunteers) Medical Personnel Facilities Media & Advertising Partnerships Mailings Referrals Space Policy & Systems Change Programs & Services Medical Equipment Health Fairs Counseling Training Reduced Rates
  30. 30. Barriers The top barriers secular organizations face in providing products and/or services to congregations includes the following: • Lack of information about the needs • Lack of staff and volunteers to provide services • Lack of funding • Fear of violating separation of church and state laws Assistance In order to assist congregations, these organizations said they would need the following information in order to provide products and/or services: • Identifying information about the congregation • A list of needs • A clear, measurable plan to show the value of their contribution
  31. 31. Clergy Findings Every Clergy survey completed indicated that they “believed there is a connection between physical, emotional, and spiritual health.” The clergy also overwhelmingly felt that “religious institutions should play a role in helping its congregations be physically healthy.” Nearly 80% of those who felt that way said it was, “appropriate to offer health education and health services to their congregations.” Based on this response, the clergy were asked if they felt their congregations would use a “combination of both spiritual and medical resources to maintain and improve their health.” The same 80% “felt that they would use the resources.” Despite these findings, just over 10% said they have an active health ministry. *For the purposes of the survey, an “active” health ministry was defined as, “A ministry of a faith-based organization that provides health care services and/or health educational classes more than once a year.”
  32. 32. Clergy Findings The following list are ways in which the various congregations currently support the health of its members: Go with member’s to doctor’s Transportation to medical appointments appointments Help with health-related paperwork Prayer Provide meals Visit members who are sick Phone calls Run a health food store Pastoral care Pay for medical bills Health and preventative education Support local free clinics (time & finances) Anoint with oil Lay hands on the sick Use the Word of God to bring Fellowship nights that can be used to encouragement and comfort address health-related issues
  33. 33. Clergy Findings Top health concerns that “your” congregation is facing: • aging • heart disease • cancer • diabetes • high costs of medications • lack of insurance • obesity • affordable health care These concerns are not surprising and are consistent with major causes of death in Virginia.
  34. 34. Barriers The top barriers faith-based organizations face in providing products and/or services to congregations includes the following: • #1 response - Uncertain how to start one (48.3%) • #2 response - Lack of finances and resources - Lack of volunteers and/or leaders • #3 response - Lack of time • Lack of health care expertise • Lack of community partnerships The top cultural barriers that people face within their community are: 1. Racial biases 2. Fear of mistreatment or unequal treatment 3. Language barriers (cultural or linguistic) 4. Cultural beliefs 5. Perception of unequal treatment of persons
  35. 35. Barriers The top health care barriers that people face in their community: • #1 response - Lack of adequate and affordable insurance • #2 response - Lack of knowledge of resources that are available • #3 response - Lack of access to free clinics The top socioeconomic barriers that people face in their community are: 1. Lack of sufficient income to afford basic necessities 2. Lack of transportation (public and private) 3. Unemployment 4. Lack of vocational training The top social environmental barriers that people face in their community are: 1. Drug abuse 2. Poor social support network from within the community 3. Housing (non-availability, non-permissive cost, low-quality)
  36. 36. Rural Congregations In our broad-brushed analysis of the four counties in the pilot, the demographics reflect the following trend: • Membership average of 150 • Primarily composed of senior adults with a much smaller representation of youth and children • A predominant female majority of members • Have been in existence for more than 50 years • Have a single, salaried leadership staff • Significantly segregated • Few churches have “active” health ministries • Nearly all of the churches felt they play a role in helping its members be healthy • All of the churches actively support the health of its members in one way or another
  37. 37. How can you utilize the local church as a public health partner? According to VDH, a medium-level pandemic in Virginia could cause: • 2,700 to 6,300 deaths • 12,000 to 28,500 hospitalizations • 575,000 to 1.35 million outpatient visits • 1.08 million to 2.52 million people becoming sick
  38. 38.
  39. 39. Recommendations & Next Steps • Development of a model health ministry program at a statewide level • Health ministry toolkit/manual for congregations • Individual church member survey • Pilot model rural health ministry programs for congregations • Conduct further research Engaging the faith community in these recommendations is essential to program success. And, the development of persistent, sustained relationships with congregations are absolutely necessary.
  40. 40. By leveraging the strength of the faith community as a force multiplier in public health, community capacity can be significantly increased extending its reach, impact and value. Rev. Andrea Lomboy 703/581-4323