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Healthy body, healthy soul

17 October 2014

An ageing population and lifestyle-related diseases challenge the Church's approach to health, says Paul Holley


"LOSE 14 lbs in 3 weeks." The Methodist chapel in Bolton had, for years, posted Bible verses on hoardings to inspire passers by. Now, its message was altogether different. Not so much save the soul as trim the body.

Church halls have hosted weight-loss groups for years. They are a cheap and cheerful space for hire at the heart of communities, where diet disciples can strengthen themselves through confession, grace, and sacrifice to forgo a world of temptation, and avoid the perils of obesity.

And avoid them they must. The national body-weight index has now ballooned to crisis proportions. Some churches are taking a more serious look at the shapes and sizes of the bodies around them. And, while weight-loss franchise groups might once have been seen as a moneyspinner (to keep the church hall in paint and roof tiles), now, the aerobic sessions and public weigh-ins seem like the front line for the health of the nation.

The health think tank the Kings Fund suggests that "Sixty to 70 per cent of premature deaths are caused by behaviours that could be changed." This figure does not distinguish between mental and physical health: indeed, it includes accidents, and the effects of environmental factors such as pollution, and allows for the impact of housing and employment on the general well-being of a person.

By losing weight, moderating our drinking, and spending more time on our feet, we reduce the risks of disease. The health-promotion activist Dr David Katz says: "Not only do we add years to our lives: we also add life to our years."

The medical profession will still strive to meet the challenge of our sicknesses, but it will be our personal and collective embrace of health which will save us: prevention rather than cure.

The urgency of the task should not be understated. With so much media attention focused on the funding and reorganisation of the NHS, we too easily miss the big picture. Demand for health services is rising rapidly - hospitals experienced a 5.6-per-cent increase in GP referrals in the year to July 2014; elective procedures increased by 3.5 per cent.

With an ageing population, and the rise in lifestyle-related diseases, the NHS may never catch up. The chief executive of NHS England, Simon Stevens, recently declared: "Obesity is the new smoking gun, and it represents a slow-motion car crash in terms of avoidable illness and rising health-care costs."


OTHER pioneering initiatives demonstrate that churches are adopting proactive, participative approaches to the health of the person. Many of these work on the basis that if people address health in conjunction with spirituality, the capacity to change behaviours is increased. They will become healthier.

The Daniel Plan - devised by an American pastor, Rick Warren, and a stellar line-up of celebrity doctors, in response to his realisation that most people in his church were obese - is one new intervention, and it is now available in the UK. St Jude's, Plymouth, has this year launched its preliminary Daniel Plan weight-loss courses.

The plan, published by Zondervan, recalls the successful vegetarian diet of the Old Testament character. Its mix of biblical inspiration and congregational programming opens up a bold new model for living: it has an integrated concept in which body, mind, and spirit gain equal attention.

The latest dietary advice and fitness plans are backed up by the motivation offered by small-group and congregational-peer support. Those preparing for their next Lenten fast will find that the programme conveniently provides "40 days to a healthier life". And, despite the implication of the plan, omnivores are welcome.

A more British phenomenon, the healthy-living centre, caught the attention of both politicians and clergy under New Labour's reign. They were designed to encourage participation in health and well-being activities among members of hard-to-reach communities. After the ground-breaking example of the Bromley by Bow Centre, the model was exported to other churches. St Edmund's, Dartford, was among the most prominent. It has a new church building that seeks to integrate its pastoral, liturgical, and health-related functions.

Art classes, community cafés, complementary therapies, music groups, and formal health services are all common features of the remaining centres. They support people in reorientating their perspective to healthy patterns of life.

Other churches, such as St Peter's, Harrow, host GP surgeries and help to generate community participation in health-promotion activities. Many Christian GP practices work with church congregations to expand the breadth of health-related activities.

Karis Medical Centre, Birmingham, pioneered chaplaincy for its practice, as well as a city-wide community-based sports programe, Sport4Life. Working with churches led to the establishment of the Karis Neighbour Scheme, which enables volunteers to care for people in a wide variety of ways.

Burrswood, a Christian hospital, recently introduced a counselling programme to address the emotional factors in weight gain. Shame and low self-esteem are typical symptoms facing those who exercise a healing ministry. The chicken-and-egg conundrum of declining self-esteem and increasing weight requires a gentle ministry of encouragement alongside the practical action required to modify diet and lifestyle.

As policy-makers agonise about how to organise social care in an ageing society, churches have again taken the lead. There are church-led initiatives that provide professional services to the elderly: some, such as Prama, in Dorset, utilise strong daily participation by their supporting churches to mix voluntary support with paid home-based care.

Rotherfield St Martin describes itself as a church-in-community charity. Its member-based voluntary association supports elderly and vulnerable people in the village of Rotherfield, near Crowborough, in East Sussex, with a comprehensive package of services to enable people to be able to stay in their own homes. Services provided for villagers include social activities, befriending, health promotion, computer training, dementia care, exercise, and volunteer drivers and dog-walkers, among others.

SO HOW does the Church articulate a theology of health? And how might this influence our mission? Clinicians and clergy share much in common: one profession assumes that the sick are seeking health; and the other assumes that the sinful are seeking salvation. Both contend with suffering. But, with the advance of medical science, clinicians have gained the lion's share of attention. The cure is a more tantalising prospect than the care; the focus is on this world rather than the next.

The medical profession, however, often fails to consider the whole person. The King's Fund refers to "patient activation", while the independent charity the Health Foundation has a programme on "self-management". These are technocratic references to what the "patients" can do for themselves to keep well. But these are far from offering a compelling account of healthy personhood.

The former Archbishop of Canterbury Lord Williams has suggested that true health is the reconciliation of flesh and spirit. This affirms the underlying nature of personhood. But we would want to know more about the value and purpose of flesh in that encounter. Even if we recognise flesh and blood in our eucharist, its meaning is rarely expressed through contingent bone and muscle.

The sheer optimism of life in the era of health demands a theology that celebrates the body and the mind, not simply the spirit.

Theologians such as the Revd Professor John Atherton and Professor Elaine Graham, who have responded to the happiness discourse set out by Lord Layard (New Labour's former "happiness tsar") and his associates, note that growing prosperity does not necessarily deliver improved well-being.

Their emphasis on health-promoting relationships and social capital provides insight into what might allow people to thrive, but the health implications are, as yet, underdeveloped. The challenge will be to provide theological pointers for the "good things" that we should actively pursue in order to bring resilience to mind and body.

"Health and wealth" Pentecostalists would argue that God provides these goods for those who ask (and give). But, even if we accept that the conditions for good health need to be apprehended by people through their own individual and collective efforts, can we say, with the authors of The Daniel Plan, that transforming our health is a divinely inspired vocation?

Harold Koenig, who is a veteran researcher into the effects of faith on health, notes that, while churchgoers gain many health benefits from their worship and fellowship, they tend to be a little more overweight than the average. Is this something to do with all those cakes and quiches served at church socials?

The Daniel Plan is thus a timely intervention. It is backed by huge resources, and could appeal to the aspirations of a large swath of British people. It could conceivably overtake the Alpha Course as an evangelistic strategy. More than just answering questions and touching spiritual sensitivities, it confronts what we are as physical persons. It addresses our capacity to live well.

The 2012 report to the General Synod Health Care and the Church's Mission highlighted the unintended trend away from local voluntary action for health. It noted that the formation of the NHS generated inexorable momentum for a centralised, state-led monopoly of care. The temptation amid the swirl of political debate is to conflate the health of the people with the capacities of the NHS.

As the contributors to Anglican Social Theology, edited by Malcolm Brown, point out, post-liberal and Evangelical theologies suggest a more varied and participative approach to the welfare of the people. Models of practice noted earlier suggest that these theologies are likely to lead us into the future.

Perhaps the language of the "health of the people" should become more audible in the Church, and thus become a driver for local participatory action. A substantial opportunity for mission could be before us.

The Revd Paul Holley is Co-ordinator of the Anglican Health Network, and Vicar of Christ Church, Colbury.


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