THE DEVELOPMENT AND IMPLEMENTATION OF A
HEALTH AND WELLNESS MINISTRY AT THE
OPEN DOOR CHURCH OF LOUISVILLE
IN LOUISVILLE, KENTUCKY
______
A Project
Presented to
the Faculty of
The Southern Baptist Theological Seminary
______
In Partial Fulfillment
of the Requirements for the Degree
Doctor of Ministry
______
by
Dalton Eugene Holt, Sr.
May 2011 APPROVAL SHEET
THE DEVELOPMENT AND IMPLEMENTATION OF A
HEALTH AND WELLNESS MINISTRY AT THE
OPEN DOOR CHURCH OF LOUISVILLE
IN LOUISVILLE, KENTUCKY
Dalton Eugene Holt, Sr.
Read and Approved by:
______T. Vaughn Walker (Faculty Supervisor)
______Timothy K. Beougher
Date______To Arie,
my encouraging wife,
and to
The Open Door Church of Louisville family
TABLE OF CONTENTS
Page
LIST OF TABLES ...... viii
LIST OF FIGURES ...... ix
PREFACE ...... x
Chapter
1. INTRODUCTION TO THE PROJECT ...... 1
Statement of Purpose ...... 3
Statement of Ministry Goals ...... 3
The Context of Ministry Project ...... 4
Rationale for Project ...... 12
Research and Methodology ...... 13
2. BIBLICAL, THEOLOGICAL, AND HISTORICAL FOUNDATIONS FOR THE DEVELOPMENT OF A HEALTH AND WELLNESS MINISTRY OF THE CHURCH ...... 15
Biblical Foundations ...... 15
The Old Testament ...... 16
The New Testament ...... 21
Theoretical and Theological Foundations ...... 24
Historical Foundations ...... 29
The Contemporary Church ...... 40
iv Chapter Page
3. DEVELOPING A HEALTH AND WELLNESS MINISTRY MODEL AT THE OPEN DOOR CHURCH OF LOUISVILLE ...... 42
African American Health - An Introduction ...... 42
African American Health Status ...... 43
Health Status of African American Women ...... 52
Health Status of African American Men ...... 53
Elderly Issues in the African American Community ...... 54
An African American Health Directive ...... 55
The Road to Creating a Health and Wellness Ministry ...... 56
Examining Models for a Health and Wellness Ministry ...... 57
New Horizon United Methodist Church Champaign, Illinois ...... 58
Canaan Christian Church Louisville, Kentucky ...... 59
Mount Sinai Missionary Baptist Church Orlando, Florida ...... 61
Northminster Church Columbia, South Carolina ...... 62
Cable Baptist Church Louisville, Kentucky ...... 62
Glide Memorial Methodist Church San Francisco, California ...... 64
Shiloh Baptist Church Waukegan, Illinois ...... 65
v Chapter Page
Apostolic Church of God Chicago, Illinois ...... 66
Assessment of Churches Discussed in the Project ...... 67
Limiting Factors to Consider ...... 67
The Model for The Open Door Church of Louisville ...... 67
4. IMPLEMENTATION OF THE PROJECT ...... 69
Administering the Focus Group and Health Evaluation Questionnaire ...... 70
Administering the Pre-Questionnaire ...... 70
Planning the Health Fair ...... 71
Health Education Lessons ...... 72
The Last Class Meeting ...... 79
Project Summary ...... 79
5. EVALUATION OF THE PROJECT PROCESS ...... 81
Evaluation of Ministry Project Objectives ...... 81
Personal Reflection ...... 84
Theological Reflection ...... 85
Conclusion ...... 87
Appendix
1. ASSESSMENT QUESTIONNAIRES AND RESULTS ...... 88
2. PRE/POST QUESTIONNAIRES AND RESULTS ...... 95
vi Appendix Page
3. HEALTH FAIR PHOTOS ...... 101
4. CLASS HANDOUTS ...... 102
5. DEFINITIONS ...... 142
BIBLIOGRAPHY ...... 143
vii LIST OF TABLES
Page
Table
A1. Pre/Post Questionnaires Results ...... 97
viii LIST OF FIGURES
Page
Figure
A1. Health Status of Participants by Age and Gender...... 92
A2. Health Condition of Participants by Age and Gender...... 93
A3. Weight Status of Participants by Age and Gender...... 94
ix PREFACE
I thank God almighty for His favor. I wish to acknowledge, with gratitude,
those individuals who have been chosen by God to assist me along my spiritual and
ministerial journey with their prayers, friendship, and guidance.
First, my wife, Arie, thank you for your patience and encouragement. You
never allowed me to hold my head down too long. It seems that God gave you the right
words to heal my pain and kept me moving forward. Thank you for lending me your
typing skills, “I never would have made it without you.”
I want to thank my professor Dr. T. Vaughn Walker for not allowing me to
give up when my life was plagued with trials and turmoil. You helped me keep my eyes
on the prize and for that I am forever indebted to you.
I am also grateful to The Open Door Church of Louisville for your participation and sacrifice in the completion of this work.
Lastly, I want to thank Dr. Charles Lawless for the leadership that he provides
to the Billy Graham School of Missions and Evangelism and especially the moments of
grace he provides to all of his students. May God forever bless you.
Dalton Eugene Holt, Sr.
Louisville, Kentucky
May 2011
x CHAPTER 1
INTRODUCTION TO THE PROJECT
Health means different things to different people. In the past health referred to curing people’s illnesses. Today, health can be defined more inclusively to denote healing and wellness of the whole person -–body, mind, and spirit. Abigail Evans describes the biblical definitions of health as wholeness and sickness as brokenness reflecting health as an integration of body, mind, and spirit—inner and outer harmony, shalom.1 Each person is empowered to assume responsibility for his/her own health.
Healing and restoring people to wholeness are as much a part of congregational life in worship as it is to the way we live our lives. Congregational communities become more vital and enlivened when congregates are mobilized to care for one another through a health and wellness ministry.
Today, hospitals continue to treat the most acutely ill people in our society.
However, there is not much emphasis placed on maintaining healthy living through health promotion and prevention. Access to medical care for many people has declined.
The cost for services has escalated and too many people are falling between the cracks in institutional health care today. Many health outcomes are within the control of
1Abigail Rian Evans, The Healing Church: Practical Programs for Health Ministries (Cleveland: United Church Press, 1999), 141.
1 2 individuals and the community through early-prevention screenings and education. The present situation urges local congregations to assume a significant role in managing the health of its people. The church is the only institution to represent all socio-economic strata of people from birth to death. Furthermore, many people trust the church more than they do a health care institution. Trust is the starting place for making changes in unhealthy behaviors. The state of health for African Americans is especially precarious.
Chronic disease has an excessive impact on minority populations. According to Dr.
Jawanza Kunjufu, African Americans are 12 percent of the population, but have the highest incidence of prostate cancer in the world. African American males have a 50 percent greater chance than White males to have prostate cancer, and 181 per 100,000
African American males will have prostate cancer. One in three African American males suffers from high blood pressure, versus one in six whites. African Americans have a 20 times greater chance than whites of suffering with kidney failure. Twenty-eight percent of all dialysis patients are Africa Americans. Diabetes is the third leading killer among
African Americans, while it is the sixth leading killer among whites. Ten percent of
African Americans have diabetes, but once they become 55 years of age, 25 percent of
African Americans will suffer from diabetes.2 Many of the health issues that confront
African Americans could be lessened through prevention, early detection, education, and
good dietary practices. It is in light of the above situations that plans were carried out to
develop and implement a health and wellness ministry at the Open Door Church of
Louisville in Louisville, Kentucky.
2Jawanza Kunjufu, Satan, I’m Taking Back My Health! (Chicago: African American Images, 2000), 153. 3
Statement of Purpose
The purpose of this project was to develop and implement a health and
wellness ministry at the Open Door Church of Louisville in Louisville, Kentucky. This
ministry informed and educated the congregation as well as the 6th District of Louisville which comprises the neighborhood communities of California, Old Louisville and
Russell in prevention, early detection, and maintenance of health issues that are common but not explicit to African Americans.
Statement of Ministry Goals
This ministry accomplished four goals. The first goal was to discover and
analyze the health and wellness needs of the congregation. This assessment afforded
concentration on specific issues confronting the congregation.
The second goal was to explore creative ways to inform and educate the
congregation and the various neighborhoods of the 6th District on prevention, early detection, and maintenance methods for the assessed health issues.
The third goal was to implement a ministry of health and wellness in the Open
Door Church of Louisville. The implementation involved the structuring of a formal
auxiliary within the church.
The fourth and final goal was to develop the concept that God is a wholistic
God who is not only concerned with spiritual wellness but also physical wellness. In his
prospectus Establishing a Wellness Clinic at International Baptist Church in Memphis,
Tennessee, the author, Wrex Kermit Hauth, Jr., writes that “Many Christians do not
understand that God wants them to enjoy a lifestyle that will keep them healthy and will
honor Him. By being stewards of their physical bodies, Christians can enjoy a better 4 quality of living that will put them in a frame of mind conducive to spiritual growth.
Also, being healthy and feeling good helps people maintain a positive mental attitude, and a higher self-esteem.3
The Context of Ministry Project
The journey of city life in America has come full circle. Nearly desolate
America’s cities have survived and are moving toward a brighter future. Over the past
half-century, urban decay has been the flip side of suburban growth. City life became
synonymous with crime, poverty, and disinvestment; urban became a negative term.
Throughout the first half of the twentieth century, the federal government helped make
suburban living attractive and accessible to many Americans. The lack of a similar package of incentives for city living limited investment in city neighborhoods and discouraged the development of new urban single- and multi-family housing. Growing economic prosperity, a severe housing shortage, a rising marriage rate, and the availability of affordable automobiles, fueled the explosive growth of suburban subdivisions in the post-war years. Technological advances, social trends, and lifestyle changes helped prompt suburbanites to turn away from cities for employment, shopping, and entertainment.
African Americans of all income levels encountered severe economic discrimination and racial segregation. In the great migrations of 1916-1930 and 1946-
1970, African Americans moved from the rural South to the urban North, crowding
3Wrex Kermit Hauth, Jr., “Establishing a Wellness Clinic at International Baptist Church in Memphis, Tennessee” (D.Min. project, The Southern Baptist Theological Seminary, 1998), 1. 5 strictly bound neighborhoods of increasingly substandard urban housing. As the Civil
Rights movement began to break down the walls of discrimination and segregation, the white exodus to the suburbs gained momentum. Many middle-class blacks joined middle-class and wealthy whites and moved out of inner cities. Businesses followed, and many poor blacks were left behind – with only a few leaders, jobs or services and worsening schools. Worst of all poor blacks lost their role models. With middle-class blacks living far away, poor blacks never saw other blacks who were successful.
Hopelessness set in and with it crime. During the latter decades of the twentieth century, government has slowly begun to implement policies intended to support urban growth and increase housing options. These policies, some of which are still evolving, have made city living and commerce more attractive to residents, businesses, and investors.
Open space, identity, community, and mass transit are among the assets offered by cities that contribute to a good quality of life. Often neglected or little valued over the past half-century, these assets are being rediscovered, revitalized, and preserved, helping to make cities attractive places to live and work once again. While urban problems are still prevalent, a number of cities are returning to a brighter future.
The city of Louisville, Kentucky, located in the northwestern part of the state in Jefferson County, is characteristic of the typical American city. Although its decline was at a much slower pace than many of the nation’s larger cities, it too has come full circle. The Open Door Church of Louisville is located in Louisville, Kentucky. Open
Door serves within the 6th District of Metro Louisville. The 6th District is comprised of the neighborhoods of California, Russell, and Old Louisville. The church has chosen
California and Old Louisville as its target areas. 6
The Old Louisville and California neighborhoods are located in the central part of the city. Old Louisville is bounded south of Kentucky Street, north of Avery Street, west of I-65, and east of the CSX railroad tracks. California is bounded from Broadway to Oak on the north and south and from Ninth to 26th Streets on the east and west. Few records exist that chronicle California’s beginnings, but the Louisville Encyclopedia says
the neighborhood was settled by Germans around the time of the 1849 Gold Rush.4
After emancipation, blacks who wanted to live in Louisville were permitted to live in two areas. One was the Smoketown community, just southeast of downtown, and the other area was to the west of downtown, from 14th to 18th streets and from Broadway to Oak
Street. The area then was called Delaney Woods. Legend has it that land was sold
cheaply to blacks in the area, prompting many to move there and that phenomenon often
brought comparisons to California’s Gold Rush. So even though the neighborhood was
officially called the Henderson subdivision in the 1870’s, the working class blacks and
whites who lived in the area’s shotgun cottages began to call the area California, the land
of opportunity.5 For possibly 100 years, the West End and near East End were the
industrial heartlands of Louisville. The neighborhoods surrounding them were vibrant
and prosperous. During the 1950s and early 1960s, manufacturing companies began
consolidating and merging. They moved to other cities or to new, modern facilities in the
suburbs, or they simply closed after being purchased. The heartland became an economic
4Sheryl Edelen, “Historical Marker Sought for California to Boost Pride,” Louisville Courier- Journal, 3 November 2004, Neighborhoods, p. 1.
5Michael Days, “California Neighborhood Building Toward a New Beginning,” Louisville Courier-Journal, 15 August 1982, Neighborhoods, p. 1. 7 wasteland. When the jobs moved, many residents who could did so too. Neighborhoods lost their economic vitality and their prosperity. Today many of these neighborhoods are the most distressed in the city. And a high percentage of the industrial and commercial property in them is abandoned, unused or underutilized. 6 Years ago, California was a
bustling area with row after row of neat houses. There were all kinds of stores, groceries,
hardware store, department store, and a movie theater. Many businesses that came to the
eastern section of the California neighborhood were heavy industries such as Brown-
Forman, Prescotech, Philip Morris Inc, and Louisville Bridge and Iron Company. The
neighborhood’s decline in the past decades may be rooted in the proximity of the plants
and warehouses. Over the years, the area has lost many residents who worked in its plants
and provided stability and even a measure of prosperity for the neighborhood. In a 1981
newspaper article, Milford Reid wrote that the California community had the largest
population decrease of any section of Jefferson County when it lost nearly 40 percent of
its population. 7
In an interview with Dr. Derrick Miles, pastor of the Greater Friendship
Baptist Church, Dr. Miles described the neighborhood as a community with quite a few
single-parent homes mostly headed by women who are welfare recipients. There is a
great mix of family structures. The neighborhood is made up of older individuals who
are dying off and as they die off more of the transitional type people are moving into the
6Roger Kennedy, “Turning Brownfields to Economic Greenfields” [on-line]; accessed 27 February 2004; available from http://www.louisville.bizjournals.com/louisville/stories/1996/11/18/ focus.html; Internet.
7Milford Reid, “Withered California Was Once Bustling,” Louisville Times, 3/4 June 1981, Neighborhoods, p. 1. 8 community who possess a rental mentality and therefore the community loses some of the stability that homeowners bring to a community.
Although today Louisville’s west end has a reputation for high crime and deteriorating abandoned structures and lots, the California residents are working hard to reestablish and preserve. Today community advocates are waging a campaign to help
California overcome crime, poverty and urban decay. Over the years, various nonprofit organizations and commercial businesses such as the 10,000 plus-member St. Stephen
Baptist Church, Brown-Forman Corporation, and New Directions, Inc. have been involved in the redevelopment of this area.
Old Louisville is the home of the largest historic preservation district of
Victorian homes. Despite its name, Old Louisville was actually built as a suburb of
Louisville starting in the 1870s nearly a century after Louisville was founded. The name old Louisville did not come until the 1960s. It was initially called the Southern
Exposition which opened in 1883. The Southern Exposition, an industrial and mercantile show, covered forty-five acres south of where Central Park now exists. In addition to material goods, the exposition featured the grand display of 4,600 incandescent lights invented by the then-Louisville resident Thomas Edison.8 The Southern Exposition
ended in 1887 which made room for development in that area. Some of Louisville’s
wealthiest residents constructed grand homes and by the late 1800s, Old Louisville had
8John C. Pillow, “Old Louisville,” in A Place in Time—The Story of Louisville’s Neighborhoods, ed. Nina Walfoort (Louisville: The Courier-Journal and Louisville Times Co., 1989), 84- 85. 9 become the most popular district among the wealthy who were building Victorian-style mansions all along the neighborhood’s streets.
The area gradually declined as the affluent moved to newer streetcar suburbs or built estates in areas east of Louisville recently connected by the railroad. Accelerated by the Great Depression, many of the large homes were converted to boarding houses during the 1930s. The Ohio River flood of 1937 caused a great number of the remaining wealthy households to move above the flood plain. The gradual flight by the wealthy was a reflection of changing lifestyles brought by technology. Many of the mansions required several servants to maintain. Because of the relatively high wages offered by manufacturing jobs, servants were no longer affordable but to the wealthiest families.
During the span between World War I and World War II, many of the old mansions were hastily converted into apartments.9
During the late 1960s and early 1970s Urban Renewal, which was designed to help inner-city, displaced numerous poor residents in other areas in the city who moved into small apartments in Old Louisville. The area’s crime rate increased and was considered drug ridden and undesirable. The area made a comeback through the efforts of J. Douglas Nunn, a Courier-Journal urban affairs reporter, the Neighborhood
Development Corp, and the people of the neighborhood. Through re-zoning, establishing the area as a historic preservation district, and raising property values, Old Louisville is now one of the most desirable places to live in Louisville appealing to a high number of college students and young professionals. Today, Old Louisville is one of the most
9Carl E. Kramer, Old Louisville a Changing View, (Louisville: The Old Louisville Neighborhood Council, 1982), 20-21. 10 ethnically and economically diverse in Louisville. One of the residents, Edward Hart says, “It is neither white nor black, neither rich nor poor. It is just Old Louisville.”10
“Making Connections: Louisville Neighborhoods 2000 Census Population
Profiles” reports the California-Parkland community as home to 10,742 individuals of which 94 percent are African American. This same report documents that the
Downtown-Old Louisville-University community is home to 15,865 individuals of which
41 percent are African American.11
The Kentucky Population Research Urban Studies Institute University of
Louisville prepared a Fall 2000 study of Louisville’s neighborhoods. In both the
California and Old Louisville communities there were fewer children to drop out of
school. An overwhelming majority of high school graduates in both communities has
successfully made the transition to work or additional schooling. The health of
neighborhood residents in both communities seems to be improving as the percentage of
pregnant women receiving early prenatal care has increased over the past fifteen years
indicating that more women in the neighborhoods have access to important medical care.
In the areas of economic opportunity and safety, the residents of each neighborhood still
face challenges. Almost half of the children lived in poverty.12 The Open Door Church
of Louisville has only served in the 6th District for a short time. Open Door is the result
10Ibid.
112000 Census of Population and Housing – PL 94-171, 2001, produced by Kentucky State Data Center [on-line]; accessed 19 October 2010; available from http://ksdc.louisville.edu/Neighborhoods/ Neighborhood_pl2000.pdf; Internet.
12Making Connections: Neighborhood Profiles of Child and Family Well-Being Louisville and Jefferson County, Kentucky, comp. Kentucky Population Research Urban Studies Institute University of Louisville, (n.p., 2000), 20-22. 11 of a church plant which was organized and incorporated on March 3, 2005. The current senior pastor is Rev. Dalton E. Holt, Sr. He was installed as senior pastor June 1, 2008.
Under his leadership, the church has grown to roughly sixty members.
The congregation consists of a diverse age group with the average age being thirty-eight to fifty-five. Today it is comprised of 75 percent female. Open Door Church brings together educators, nurses, business managers, IT professionals, with factory workers, truck drivers, and single mothers and fathers.
Tex Sample discusses, in his book entitled U. S. Lifestyles and Mainline
Churches, what he terms as the three broad lifestyles that characterize people in the
United States. Of these three lifestyles, the congregation of Open Door and the community in which it serves would be characterized as the cultural right model.
Individuals of the cultural right model which is the largest lifestyle grouping in the
United States are made up of the lower middle class, the working class, and the poor.13
Sample goes on to write that people of the cultural right model enjoy service projects and
appreciate opportunities to help people in need.14 This description exemplifies the characteristics of Open Door. Open Door seeks to serve wholistically. Open Door is mission-minded and seeks to serve mind, body, and spirit.
As senior pastor at Open Door, my leadership style can be characterized as having a diverse approach. There is much flexibility shown except when it comes to core values such as doctrine and pastoral vision. I am extremely team-oriented and have no
13Tex Sample, U.S. Lifestyles and Mainline Churches, A Key to Reaching People in the 90’s (Louisville: Westminister/John Knox Press: 1990), 59.
14Ibid., 144. 12 problem with delegation. I am a hard worker who does not mind rolling up his sleeves as the task warrants.
Rationale for Project
This project was prompted by a growing concern for the health issues in the
African American community. When one considers a particular ethnic group who is twice as likely as the majority population of being diagnosed with a pernicious disease such as diabetes, there is reason for alarm.15 There are barriers that have prevented
African Americans from obtaining better health. First of all, there has been a lack of
access to sufficient health care. Traditionally, in the 1940-1950 era, segregation kept
African Americans out of most medical centers and the type of general labor job most
African Americans performed did not come with health insurance. This is changing; as
more African Americans are getting more skilled jobs, health insurance is becoming
more available.16 There is also the barrier of exclusions from large scale medical studies.
Thousands of large scale medical treatment studies are done each year across the USA
and Europe. Many of these studies determine how we treat heart disease, cancer,
diabetes and other illnesses. In the past, numerous African Americans and other
minorities were excluded from these studies.17 In addition, there is a common practice
among African Americans called crisis medicine. This is when a person waits until he or
15U.S. Department of Health and Human Services, The Office of Minority Health, “African American Profile” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/ templates/browse.aspx?lvl=3&lvlid=23; Internet.
16Robert Sessoms, “Barriers” [on-line]; accessed 9 February 2003; available from http://www.afromed.com/barriers.htm; Internet.
17Ibid. 13 she is deathly ill to see a doctor. Many times because of the delay in seeking medical help it is too late to reverse an illness’ damage because it has progressed too far and the individual finds that he/she is beyond simple treatments.18
Then there is also a dietary issue among African Americans. During slavery,
African Americans were forced to eat the worst food available. Pork was used at every
meal, and every part of the pig was used including the guts which are call chitlins. It was
during this era that African Americans were forced to be as creative as they could with
the worst food provided. So called soul food may taste very good, but it is not good for
you. Soul food primarily consists of pork, a lot of fried food, and pounds of sugar.19
It is believed that the development and implementation of a health and wellness ministry will benefit the congregation and the community in addressing health issues through education, early detection, and prevention.
Research and Methodology
The focus of this project was to develop a health and wellness ministry at The
Open Door Church of Louisville that hosted an annual health fair to inform and educate the congregation, the California, and Old Louisville neighborhood communities in the prevention, early detection, and maintenance of health issues that are common to African
Americans. In keeping with the goals of this project, research focused upon ascertaining the respondents’ initial/post awareness and attitude of the common health issues affecting the African American community. In addition, the research obtained how the
18Ibid.
19Kunjufu, Satan, I’m Taking Back My Health!, 153. 14 respondents currently receive information about health issues in the African American community, the biggest challenges/barriers that the respondents face in receiving adequate information, and the respondents’ attitude toward preventive care and maintenance. Furthermore, the research gathered information about the religion and spirituality in the respondents’ life.
The instruments used for evaluating the aforementioned areas were questionnaires and a focus group. A volunteer questionnaire was administered to recruit fifteen to twenty individuals to formulate the focus group. The focus group was established to plan and implement the ministry. A Likert four-point scale consisting of fifty-four health related questions was administered to the group. A pre-questionnaire was administered prior to any activities to gain initial responses. A post-questionnaire was administered at the conclusion of all activities to gauge any changes. The results of the questionnaires were evaluated statistically. CHAPTER 2
BIBLICAL, THEOLOGICAL, AND HISTORICAL FOUNDATIONS FOR THE DEVELOPMENT OF A HEALTH AND WELLNESS MINISTRY OF THE CHURCH
Biblical Foundations
“Beloved, I wish above all things that thou mayest prosper and be in health,
even as thy soul propserth” (3 John 1:2 AV). It is clear that Jesus included healing as an
essential part of His earthly ministry. Matthew’s Gospel informs us, “Jesus went about
all Galilee, teaching in their synagogues, and preaching the gospel of the kingdom, and healing all manner of sickness and all manner of disease among the people” (Matt 4:23).
Luke further helps our understanding of Jesus’ ministry in his account of
John the Baptist’s imprisonment. Two of John’s disciples came to Jesus on a fact- finding mission. “Art thou he that should come?” Jesus’ response was “Go . . . tell
John . . . the blind see, the lame walk, the lepers are cleansed, the deaf hear, the dead are raised, to the poor the gospel is preached” (Luke 7:20-22). While Luke’s Gospel informs us that Jesus has come “. . . to seek and save that which was lost” (Luke 19:10), it is also evident that He has come to heal those who are broken through sickness. This is what is unique about the master’s ministry. It was wholistic in its approach. This wholistic approach is a major theme that has run through scripture both in the Old and
New Testaments.
15 16
The biblical record unveils God’s love for humanity. A common theme throughout traces God’s efforts to return humanity back to the intentional state of wholeness. The Fall affected humanity in two major ways–spiritually and physically.
Paul explains the effect this way: “Wherefore, as by one man sin entered into the world and death by sin; and so death passed upon all men, for that all have sinned” (Rom
5:12).
In this writing the term wholistic is rooted in a Christian perspective of integrated health care of mind, body, and spirit with God as the source of all healing.1
Thus wholistic is understood to mean the consonant balance between the physical, mental, and spiritual elements of an individual. The individual is viewed as being a unit of mind, body, and spirit. It is not possible to change one element without affecting the others. The authors of the holy writ have left valuable hints as to God’s concern for the health of human beings.
The Old Testament
The Old Testament embodies numerous commonsense principles of good health. As for the Israelites, good health was a matter of relationship with their God.
If you will listen carefully to the voice of the Lord your God and do what is right in his sight, obeying his commands and laws, then I will not make you suffer the diseases I sent on the Egyptians; for I am the Lord who heals you. (Exod 15:26 NLT)
And the Lord will protect you from all sickness. (Deut 7:15 NLT)
1Abigail Rian Evans, The Healing Church: Practical Programs for Health Ministries (Cleveland: United Church Press, 1999), 33.
17
God further revealed His relationship with His chosen people during their wilderness experience after their deliverance from bondage. Philip G. Ryken writes of this relationship:
The Israelites already knew him as the Great I Am, the eternal and self-existent God. They had also come to trust him as the God who hears, the God who rescues, and the God who provides. Now God revealed himself as Yahweh-rophe, the God who heals.2
In addition Ryken points out that the term rophe as used in the Old Testament
refers to wellness and soundness, both physically and spiritually. “It means to restore, to
heal, to cure . . . not only in the physical sense but in the moral and spiritual sense also.”3
However, one of the vivid examples of Israel’s adherence to God’s law can be seen in
Daniel’s deportation to Babylon.
Leon Wood describes the decision of Daniel and his three friends not to defile
themselves with the king’s meat and wine as an act of faith. According to Wood their
justification would have been basically two thoughts. First, it was conceivable that the
food would contain meats declared unclean by the Law of Moses, and second, it would
regularly be food first offered to the Babylonian gods. Wood makes it clear, in the first
instance to eat the food would have been to disobey God’s direct command in the law; and as to the second, it would have been to give recognition, though in an indirect way, to the existence of Babylon’s false deities. It is fair to conclude that Wood’s argument is
2Philip Graham Ryken, Exodus: Saved for God’s Glory, Preaching the Word, ed. R. Kent Hughes (Wheaton, IL: Crossway Books, 2005), 421.
3Nathan Stone, Names of God (Chicago: Moody Press, 1944), 72, quoted in Ryken, Exodus, 421.
18 based on these four men’s alliance to the dietary laws found in Leviticus 11 and
Deuteronomy 14.4
Consequently, part of the Bible, particularly the Old Testament, has been
referred to as a book of laws. Nevertheless, it is not written as a purely legal book. Its
concepts are eminently more progressive than a mere legal code. Paul remarked that
God’s law existed before the Bible was written. He noted, “The law is spiritual” (Rom
7:14). God’s laws encompass relationships.
The Bible is a book about relationships expressly how people are to relate to
God. God provides guidelines for developing a relationship with Him. He says to Israel,
“I the Lord, am the one who brought you up from the land of Egypt to be your God. You
must, therefore, be holy because I am holy” (Lev 11:45). This passage gives plenty of
clarity as to what God expected from those who would choose Him as their God. In the
case of Israel the holiness of God was to serve as an archetype. Holiness includes the
whole of life. It influenced what went on in the kitchen, the maternity room, the
sickroom and the bedroom as much as what went on in the sanctuary.5
Holiness was not something just practiced in the confines of religion, but God
looked for wholeness, completion, and separateness in every aspect of one’s life-style.6
Holiness expresses that God’s people will always live in a way that is distinct from those who do not follow their God. For Israel the differences were seen in the dietary laws, as
4Leon Wood, A Commentary on Daniel (Grand Rapids: Zondervan Publishing House, 1973), 36-37.
5Derek Tidball, The Message of Leviticus: Free to Be Holy, The Bible Speaks Today, ed. Alec Motyer and John Stott (Downers Grove, IL: InterVarsity Press, 2005), 141.
6Ibid., 155.
19 well as in other ways.7 To this end in the book of Leviticus, particularly chapters 11
through 15, Allen Ross expounds on the problem of defilement, making categorical
distinctions between clean and unclean in the major areas of life. Ross points out that the
main focus of chapter 11 is food, chapter 12 is childbirth, chapters 13-14 are skin
diseases, and fungus, and chapter 15 is bodily discharges.8 Ross goes on to inform us that the office of the priesthood was established primarily to distinguish between clean
and unclean, between holy and unholy. Under the applicability of law, everything was
classified according to the categories of holy or unholy, with only the holy being allowed
in the presence of God. However, most people’s condition fell under two subcategories
clean and unclean. Consequently, that which was declared clean could be elevated to
holy through sacrificial ritual but it could also be degraded to unclean by pollution or
sinfulness.9 Sin was incontestably classified as unclean, tāmē, and when sin was the
reason, the ritual essentially required confession and forgiveness as part of the
purification process. Usually unclean described what was contaminated, diseased, or
impure, and when defilement was the reason for someone being unclean, no forgiveness
was required. All that was needed was washing for cleansing and the sanctifying ritual
for reentry into the sanctuary. Whatever the reason for being declared unclean, the
person or thing was not permitted in the presence of the holy God.10
7Ibid.
8Allen P. Ross, Holiness to the Lord: A Guide to the Exposition of the Book of Leviticus (Grand Rapids: Baker Academic, 2002), 243.
9Ibid., 244.
10Ibid.
20
Conversely, clean tāhôr implied pure, but this indicated that anything not tāhôr is impure which was not always the case. Some things were permanently unclean and so nothing could be done except to avoid them. But most things became temporarily unclean through contact, such as a corpse, childbirth or wrongful intercourse. Thus, the purification now served as a warning against actions, conditions, or contacts that rendered a person tāmē--unclean. The faithful Israelite assayed to obtain the standard of the holiness of God; anything leading in the direction toward sin, disease, illness, defilement, or contamination was supposed to be avoided, especially in anticipation of going to the sanctuary.11
In any event the Lord made the provision for the people to return to His
holiness, but the people had to show their faith by complying with His laws and
performing the prescribed ritual. After Jesus’ crucifixion on the cross, a new covenant
community came into existence that included devout believers from the old covenant as
well as many Gentiles.12
From the old covenant, the temple, sacrifices, purifications, feasts, and priests
were all part of the Levitical system of the law that was fulfilled in Christ. To be clear,
note that only the ritual of the law came to an end in Christ not what the law revealed.
The regulations were particularly for Israel and were temporary, but the revelation of
God’s holiness and what it demands remains applicable for all. Without a doubt,
Christians have been sanctified or made holy by the blood of Christ.13
11Ibid., 246.
12Ibid.
13Ibid., 246-47.
21
The New Testament
Lloyd Ogilvie explains that a pellucid understanding of who Jesus is helps us to comprehend what He did to make men and women whole during His ministry in
Palestine. He ministered to people as persons, caring for their minds, emotions, and bodies, as well as their souls. When Jesus laid His hands on the sick, deranged, or troubled, they were healed. The blind received sight, the lame walked, and the mentally disturbed were liberated.14
Furthermore, Ogilvie describes three words used in the New Testament
specifically to recount what Jesus did. The word sōzō is used for salvation and healing.
The noun form is sōtēria, meaning deliverance from danger, suffering, sin, and sickness.
This word points to the eternal salvation for which Jesus lived, died, and rose from the
dead. Jesus explains His essential healing ministry in John 3:17, “For God did not send
His son into the world to condemn the world, but that the world through Him might be
saved.” Here the word sōzō is used. He came to liberate us from the bondage of sin,
sickness, death, and to make us whole again. The second word used for healing is iaomai
which means “to heal” and “to make whole.” It is used twenty-two times in the New
Testament to describe physical healing. The healing of the daughter of the Canaanite
woman is an example of this: “And her daughter was healed from that very hour” (Matt
15:28). The word is also applied to spiritual healing as in Christ’s words quoting from
Isaiah 61:1-2 to declare His purpose: “He has sent me to heal the brokenhearted” (Luke
4:18). James makes use of sōzō for the healing of both physical and spiritual needs well
14Lloyd John Ogilvie, Why Not? Accept Christ’s Healing and Wholeness (Old Tappan, NJ: Fleming H. Revell Company, 1985), 23-24.
22 or whole. Jesus made use of the word hygiēs in His question to the man by the pool of
Bethesda, “Wilt thou be made whole?” (John 5:6)15
We can conclude from this that all three uses of these words are very
descriptive of Jesus’ healing ministry. It is important to note that Jesus understood His
ministry as wholistic. He gave evidence of this in His manifesto given at the synagogue
in Nazareth. Jesus quoted from Isaiah 61:1-2, “The Spirit of the Lord is upon me because
He hath anointed me to preach the Gospel to the poor; He hath sent me to heal the
brokenhearted; to preach deliverance to the captives; and recovering of sight to the blind;
to set at liberty them that are bruised; to preach the acceptable year of the Lord” (Luke
4:18-19). Jesus’ concerned was for the whole person. He healed people physically,
emotionally, spiritually, and socially.
The scope of diseases that Jesus healed is very extensive. There seemed to be
no boundary to His healing ministry. Nothing was too small or too large. He cured
Peter’s mother-in-law of a fever (Mark 1:29-31) and raised Jairus’ daughter from the
dead (Mark 5:21-43). Jesus cured bodily afflictions, such as blindness, deafness,
lameness, fever, epilepsy, dumbness, and leprosy. Richard J. Beckmen adds that in a
spiritual scene, Jesus proclaimed God’s forgiveness not just in terms of guilt, but He
accepted and affirmed the poor and outcast, thus healing their shame and sense of
alienation.16 Jesus made His healing available to all types of persons. He healed the rich
and the poor, the young and the old. He healed Jews, Samaritans, Romans, and
15Ibid., 24-25.
16Richard J. Beckmen, Intercessory Prayer: Praying for Wholeness and Healing (Minneapolis: Augsburg Fortress, 1995), 46.
23
Canaanites. Jesus’ healings were an indication of God’s grace and mercy for the entire human family.17
Morris Maddocks adds a refreshing and insightful twist to Jesus’ understanding of His earthly mission. According to Maddocks, Jesus did not come on any self-proclaimed mission. He always kept Himself secondary to His cause. “I seek not My own will but the will of Him who sent Me” (John 5:30 NAS). To put it more plainly, Jesus’ cause is the cause of God, the cause of establishing God’s will and role in the world. Jesus came to further God’s purpose of putting things right. Jesus’ coming was the inauguration of “The Kingdom of God.” Mark adds in his writing, “the time is fulfilled and the kingdom of God is at hand: repent and believe in the Gospel” (Mark
1:15).18
Continuing to build on Maddocks’ argument, the kingdom of God refers to
God reigning, actively ruling in power, and visiting and redeeming His people. It means
that God is in a right now mode of saving human beings from sin, sickness, evil, and
establishing a new order of things. Therefore, Jesus furthered God’s cause by making the kingdom of God the central theme of His public proclamation.19
Jesus consequently showed by His words and actions that He believed He had come to inaugurate the kingdom of God. The unconditional grace and goodness of God was now particularly available to the abandoned and destitute, the sick who needed the
17Ibid.
18Morris Maddocks, The Christian Healing Ministry, 3rd ed. (London: SPCK Holy Trinity Church, 1981), 17.
19Ibid., 18.
24 physician, the simple ones, and the poor. Maddocks states that Jesus looked upon the kingdom as a new end of blessing for the poor. He invited those who labour and are heavy laden to come to Him. Jesus used these terms in the prophetic sense of those who are oppressed and thrown completely on God’s mercy. For Jesus, they are the hungry, those who weep, the sick, those who labor and bear burdens, the least and the simple, and the lost and sinners. It is these who need health and salvation from the physician of life, not those who are well (cf. Mark 2:17). For Jesus the kingdom of God meant the compassionate love of His father present and active in His creation. The coming of the kingdom would mean its final healing.20
Theoretical and Theological Foundations
An old debate continues to this very day among theologians and lay persons as
well, focused around the question, “Is sickness caused by sin?” Analysis of the evidence
offered by either camp may result in one still walking away scratching their head. The
story in John 9 serves as an exemplary illustration of the complexity of this issue. The
story encompasses a question asked of Jesus by His disciples concerning a man born
blind, “Rabbi, who sinned; this man or his parents that he was born blind?” Jesus’
response was, “Neither this man nor his parents sinned . . . but this happened so that the
work of God might be displayed in his life” (John 9:2-3 NIV).
It is clear that this question is framed around the belief that an embryo could
sin while in the mother’s womb. “Surely, I was sinful at birth, sinful from the time my
mother conceived me (Ps 51:5 NIV). On the other hand could it have been the sinful
20Ibid., 19-21.
25 lifestyle of the parents that prompted God to chastise them by blinding their unborn child? Jesus dismisses both of these theories in His response:
Neither this man nor his parents sinned, but that the works of God should be revealed in him. I must work the works of Him who sent me while it is day; the night is coming when no one can work. As long as I am in the world, I am the light of the world. (John 9:3-5 NKJV)
God had a much higher purpose in the case of the man born blind, that is, the redemptive work of Christ.
F. F. Bruce agrees with this trend of thought. He states, “The purpose of his blindness was that a divine work should be wrought in him and the divine glory be revealed.”21 Bruce holds that this does not infer that God intentionally caused the child to be born blind so that in some point in time God would be glorified by his healing,
Bruce claims, “to think so would again be an aspersion on the character of God.”22
Furthermore, Bruce contends,
It does mean that God overruled the disaster of the child’s blindness so that when the child grew to manhood, he might by recovering his sight, see the glory of God in the face of Christ, and after seeing this work of God, might turn to the true light of the world.23
R. C. H. Lenski also supports this argument with some insightful comments.
Lenski argues that Jesus’ response “neither did this man sin nor his parents” was to
rectify his disciples’ conception of sin. Lenski maintains that
they must not consider every serious affliction the penalty for some equally marked and serious sin. The disciples are not to look back, in every case of suffering, to
21F. F. Bruce, Gospel of John (Grand Rapids: Wm. B. Eerdmans Publishing Company, 1983), 209.
22Ibid.
23Ibid.
26
find a possible cause of sin but to look forward to the divine purpose which God may have in providentially permitting such suffering to come upon a person.24
William Hendriksen’s explanation regarding this man’s blindness further clarifies this point of view. According to Hendriken,
Jesus rules out the man’s personal sins and the sins of his parents as causes to which his blindness can be traced. If a cause must be mentioned, the sin of Adam, our representative head, would be the answer. However, Jesus is not interested in this at the present time. For the backward look of the disciples, He substitutes the forward look. They had asked, “How did it come to be?” Jesus answers, “It happened with a purpose; namely, that the works of God should be displayed in him.” All things, even afflictions and calamities, have as their ultimate purpose the glorification of God in Christ by means of the manifestation of His greatness.25
In a final note on this part of the issue, Herman Ridderbos maintains that
Jesus himself flatly rejects such a direct connection. In Luke 13:2-5 and John 5:14, Jesus does not reject the connection between sin and suffering, but instead warns against a superficial application of it. But here He subsumes suffering under a totally different viewpoint, namely that of God’s purpose: “so that the works of God might be made manifest in Him” (cf. 11:4). The clause beginning with “so that” is implicit. Materially it refers back to the blindness of the man about who the disciples have asked. Still we do not explicitly read: “This man was born blind so that . . ” Hence, as far as God’s hand and works are concerned, the emphasis is not on what caused the blindness but on what will happen to the blind man now (cf. vs.4). This does not answer all questions about God’s involvement with the blindness of people born blind; but for Jesus’ disciples it opens a perspective from which they may and must view people born blind; the perspective of the manifestation of the works of God, which are the works that the Father has charged Jesus to accomplish (5:19f., 36). For in those works, God is made manifest in his glory (11:4).26
In viewing the Jewish people’s rationalization for calamity and adversity,
Israel Gerber writes that it was first thought that transgressions kindled divine rage.
Suffering is thus punishment for sin. Gerber points out that there were two major
24R. C. H. Lenski, The Interpretation of St. John's Gospel (Minneapolis: Augsburg, 1943), 676.
25William Hendriksen, New Testament Commentary Exposition of the Gospel According to John: Two Volumes Complete in One (Grand Rapids: Baker House, 1953), 73.
26Herman N. Ridderbos, The Gospel of John: A Theological Commentary, trans. John Vriend (Grand Rapids: Wm. B. Eerdmans Publishing Company, 1997), 333.
27 problems with this theory. Innocent suffering and God did not always punish all transgressions, but does what seems right to Him (2 Sam 10:12).27
In response a more modified theory advanced. The basic premise of the earlier
formula was reserved; however, it was reintroduced to fit the new theory which presented
ethical terms to denote what pleased and displeased God. Moral goodness gratified Him; moral evil offended Him. Consequently, people’s good fortune presumes their virtue; misfortune presumes their wickedness. All misfortune presupposes the existence of sin and is therefore deserved. This holds true for nations as well as individuals (Amos 1:3-2:16).28
The purpose of suffering is to prompt the sinner to repent (Ezek 18:21-23).29 David
Atkinson states that this seems to be Elihu’s argument to Job. Elihu tells us that God’s purpose in suffering is both preventive and affirmative: to turn back his soul from the pit, that the light of life may shine on him (Job 33:30 NIV). God allows His child to suffer to bring back his soul from the pit; that is, to check him when he is on the wrong path; and that he may see the light of life—to bring him back on to the right path. In contrast to
Eliphaz, Bildad, and Zophar, Elihu has a more positive view of suffering. He is not seeing the situation in terms of past sins and Job’s need for repentance. He is open to the possibility that God is doing some positive work in Job. Even though Job could not see it, God is using Job’s suffering creatively.30
27Israel J. Gerber, Job on Trial: A Book for our Time (Gastonia, NC: E.P. Press, 1982), 105-06.
28Ibid.
29Ibid.
30David Atkinson, The Message of Job: Suffering and Grace, The Bible Speaks Today, ed. J. A. Motyer and John R. W. Stott (Leicester, England: Inter-Varsity Press, 1991), 124-25.
28
On the other hand, another view expressed by Lloyd Ogilvie is that original sin acted as a catalyst that allowed pestilence, diseases, germs, sickness, and eventually death into the world.31 Paul gives some clarity to this train of thought:
Therefore, just as through one man sin entered the world, and death through sin, and thus death spread to all men because all sinned . . . nevertheless death reigned from Adam to Moses, even over those who had not sinned according to the likeness of the transgression of Adam who is a type of him who was to come. (Rom 5:12, 14)
Furthermore, because God has granted human beings with freewill one may choose evil over good. For example, a mother may choose to smoke crack cocaine while being pregnant and because of her drug use her child is born an addict. In another
instance a father continues to drink alcohol against the advice of his doctor and the end
result is cirrhosis of the liver. In both of these situations one could surmise that sin was
the principle cause of sickness in both the unborn child and the father. Furthering this
issue, Ogilvie writes this, “Through Adam’s sin and centuries of humanity’s rebellion and
hostility against God, we are susceptible to pain and disability.” In addition, he states
that the true definition of sin is separation from God, missing the mark, and willfully
seeking to run our own lives.32 Ogilvie concludes,
Sin is not just what we do wrong, but what we become when we are not in fellowship with God and under the guidance of His spirit. This separation makes us vulnerable to distorted thinking, confused emotions, and inordinate in our bodies.33
It is not the intension of this writing to exhaust this issue but to give some meaningful insight. Therefore, in response to the question is sin the cause of sickness--
31Ogilvie, Why Not?, 135.
32Ibid., 136.
33Ibid.
29 yes and no. There are particular situations that have a divine purpose in allowing sickness or suffering and on the other hand the sinful nature that we inherited could be at the root cause of our sickness or suffering.
Historical Foundations
Church history has been a vital part of the cultural history of every nation through the centuries. Volumes of writings have been penned and published recounting the rich heritage of the church and how its existence has affected the countless lives of individuals from the time of Christ and the apostles to the present day. Health, healing, and the care of the sick have indeed played an integral part of this rich heritage. In
Healing in the History of Christianity, Amanda Porterfield introduces healing as a persistent theme throughout the history of Christianity, threading its way over time through ritual practice and theological belief, and across the varied terrains of Christian community life and missionary activity.34 The theological emphases of Jesus’ healing
ministry; the apostolic and patristic periods; the founding of hospitals during the Middle
Ages; and the medicine/religion split of the Reformation period have all influenced the
church’s healing ministry. This writing intends to glean highlights from these periods
with particular concentration on how these events demonstrate the Western church’s
involvement in healing and healthcare. By examining this historical account, diverse
factors reveal how the once strong belief in healing began to falter and eventually become
virtually ignored.
34Amanda Porterfield, Healing in the History of Christianity (New York: Oxford University Press, 2005), 3.
30
“And Jesus went about all Galilee, teaching in their synagogues, and preaching the gospel of the kingdom, and healing all manner of sickness and all manner of disease among the people” (Matt 4:23). Jesus’ mission consisted of a three-fold ministry of preaching, teaching, and healing. Healing played a major role in Jesus’ ministry. The
Gospels recount scriptures after scriptures of how Jesus gave sight to the blind, repaired limbs to the lame, and hearing to the deaf. At the onset of forming His church Jesus empowered and commanded His disciples and followers to go into the far corners of the earth not only to preach and teach, but also to heal, to make sound, well, whole, healthy just as He had done during His earthly ministry.
After Jesus’ Ascension, the first generation disciples carried out the work of the church continuing to do what Jesus had done (i.e., preaching, teaching, and healing).
The healing ministry was an ordinary component of the early church. Peter, John, and
Paul healed in Jesus’ name people suffering from a variety of ailments. New Testament scriptural recordings of the early healing ministry include: Peter and John healing the lame man at the gate of the temple which is called Beautiful (Acts 3:1-8); Peter healing with no more than his shadow (Acts 5:15); Peter healing Aeneas of an eight-year battle with palsy (Acts 9:33-34); Peter raising Dorcas (Acts 9:36-42); Paul healing a crippled man at Lystra (Acts 14:8-10); Paul’s clothes healing the sick (Acts 19:11-12); Paul raising Eutychus from an accidental death (Acts 20:7-12); and Paul healing Publius’ father of a fever and dysentery (Acts 28:8). These first generation apostles were instrumental in the rapid expansion of the church where men and women accepted and shared their beliefs in Jesus Christ throughout the Roman Empire and even beyond it.
31
Morton Kelsey suggests that the church experienced a time of great vitality during the first 200 years after the apostolic period.35
The patristic period extended from A.D. 200 to around A.D. 400 and is most
notably known as the point in time where the doctrines and practices of Christianity were
established. Scholars such as Justin, Clement of Alexandria, Origen, and Tertullian
began the process of clarifying and recording church doctrine. “These early church
leaders accepted a view of the world in which healing was evidence of creative spiritual
power.”36 And so the wholistic perspective of healing continued as healing was widely
practiced in the church during the patristic period, from praying in God’s name and
signing of the cross to exorcism, laying on of hands and anointing with oil.37
The epistle of James became the model for healing activity of the church. The
early church regarded the ministry of healing as central to the life and work of the church
because the goodness of the body was affirmed. The human being was a unity of body,
mind and spirit. Healing in the early church was aimed toward restoration of the sick to
complete health of mind, body, and spirit. The clergy and laity anointed the sick with oil
blessed by a bishop for the purpose of evoking God’s healing presence. Healing became
sacramental and was combined with anointing and exorcism.38 It was sacrament in the
35Morton T. Kelsey, Healing and Christianity: In Ancient Thought and Modern Times (New York: Harper and Row Publishers, 1973), 131.
36Kenneth L. Bakken and Kathleen H. Hofeller, The Journey toward Wholeness: A Christ- Centered Approach to Health and Healing (New York: The Crossroad Publishing Company, 1988), 15.
37John Crowlesmith, ed., “Non-Medical Healing from the Age of the Fathers to the Evangelical Revival,” in Religion and Medicine (London: Epworth Press, 1962), 20 cited in Evans, The Healing Church, 5.
38Evans, The Healing Church, 6.
32 broad sense because it symbolized the healing power of the Holy Spirit. And so to the already healing olive oil was added the church’s blessing and hope for spiritual healing.
Around 313, Emperor Constantine I made Christianity a state-approved religion and some years later in 381 his successor Theodosius I adopted Christianity as the official religion of the state.39 Christians no longer had to fear persecution.
Constantine’s proclamation contributed to the rise of the Christian church as thousands of
people rushed into the church to gain favor with the Emperor. Constantine’s
endorsement brought an influx of new converts, along with wealth, influence, and
support for new institutions and organizational structures. However, this blanket
conversion brought in many people with little or no understanding of their new faith of
Jesus Christ. The committedness to this new religion for many of these converts was
without a true change of heart and in name only. Jeffrey Russell writes that
The establishment of an officially Christian society promoted and enforced the spread of Christian values with society, but at the same time it encouraged the adjustment of these values to those arising from other sources of society.40
The healing ministry of the official church of the Roman Empire was now
influenced politically, culturally, and theologically. As Christianity vastly spread into
different parts of the ancient world, it attracted people from a varied background and
encompassed varied influences. The Jewish had their ideas of a God of justice and mercy
mingled with Persian ideas about a contest between good and evil, with Neoplatonic ideas about ideal reality and the immortality of the soul with Egyptian ideas about
39Porterfield, Healing in the History of Christianity, 43.
40 Jeffrey Burton Russell, A History of Medieval Christianity: Prophecy and Order (Arlington Heights, IL: Harlan Davidson, 1968), 88.
33 immortality and bodily resurrection and with Greco-Roman ideas about sacrifice, stoicism, and individual virtue.41 The effect on the healing ministry was disastrous.
These cultures blurred with Christianity, causing the use of relics, magic, and
superstition. The church began to be influenced by the secular thought of the period as it
became filled with spiritually unconverted pagans who continued to have heathen ideas
and follow pagan practices. Although healing stories were told to prove the divine origin
of Christianity, the content was far removed from the context and the heart and soul of
healing declined. The influence of Gnostic and Manichean philosophies taught that the body was bad and people should ignore it. These philosophies caused Christians to doubt the validity of the healing ministry.42 No longer did the church minister to the whole
person.
Constantine’s Edict of Milan and Theodosius’ declaration plunged the church
in the midst of Roman politics. The church became as structured as the Roman Empire.
Pagan practices became incorporated into the structured church rituals. The church
joined with the power of the Roman government and became an authoritative institution.
This alliance led to the formation of the Roman Catholic Church and through the
centuries to follow caused the church to refine its doctrines and develop its structure in a
way that best served the purpose of the Roman government.43
41Porterfield, Healing in the History of Christianity, 46.
42Paul Felder, “The History of Christian Healing” [on-line]; accessed 12 August 2010; available from http://www.centerforinnerpeace.com, teaching.html; Internet.
43Got Questions Ministries, “What was the Protestant Reformation?” [on-line]; accessed 8 February 2011; available from http://www.gotquestions.org/protestant-reformation.html; Internet.
34
Political support for Christian institutions advanced the organization of
Christian philanthropy and made possible the creation of the first hospitals in the fourth and fifth centuries.44 During the Middle Ages, hospitals became an integral part of the church. Many hospitals were established by rulers or by wealthy Romans who had
converted to Christianity. By 500 most large cities in the Roman Empire had erected
hospitals.45 Hospitals during this period consisted of monasteries and convents. In the
early Middle Ages, most of the medical practitioners were monks. It was the monks who
copied out manuscripts of the works of Hippocrates and other Greek or Latin medical
writers. Many practiced the medical knowledge they obtained as scribes. Some
monasteries had herbal gardens which provided medicines for the infirmary. These
monastic hospitals served as a place of lodging for travelers, dispensaries for poor relief,
clinics and surgeries for the injured, and homes for the blind, lame, elderly, and mentally
ill. Medical practice among clergy continued throughout the Middle Ages. “In the late
Middle Ages members of several nursing orders devoted their lives to caring for the
destitute ill.”46
The Western Roman Empire faltered and in 476 the empire collapsed.
Barbarians invaded the empire destroying entire cities including the economy and
governments. The church was the only remnant of the old world. With the fall the
44Porterfield, Healing in the History of Christianity, 44.
45George D. Pozgar, Legal Aspects of Health Care Administration, 10th ed. (Sudbury, MA: Jones and Bartlett Publishers, 2007), 2.
46Maggie, Krzywicka, “Education,” Medieval Medicine 2000 [on-line]; accessed 3 October 2010; available from http://www.intermaggie.com/med/education.php; Internet.
35 monasteries were the centers for social services. People’s lives fell apart and their outlook on life was dismal. Many saw little use in bodily healing. Their thoughts of religion were no longer of health or being healed but in making preparation for the life after. For many, death seemed the only escape. Nearly 400 years would pass after the fall of the Western Roman Empire before Europe was again a place of peace and stability.
During the eighth and ninth centuries, the changing attitude toward healing was reflected in the sacrament of unction. The prominence of healing in the early church gradually became liturgically reserved only for the dying. The sacrament of anointing changed from being a vehicle of healing to a preparation for death. In her work on The
Healing Church, Abigail Evans notes the following:
During this period, the healing ministry was replaced by elaborate rites for the dying. They consisted of five parts: (1) visitation of the sick with the priest and family gathered around the bed in prayer; (2) confession of sin and absolution; (3) sacrament of extreme unction; (4) the last Holy Communion, that is, food for the journey (viaticum); and (5) the watch with the dying person and the commendation of the departing soul.47
The healing ministry further diminished over the centuries to follow. The church furthered its decrees hindering medical healing as well. During the Middle Ages most of the European medical parishioners were monks; canon laws were created in order to regulate or limit the practice. The Councils of Reims in 1125 and Lateran in 1129
forbade the clergy from practicing medicine. Later in 1163, the session at the Council of
Tours forbade physicians from practicing surgery at all. This session historically marked
47Evans, The Healing Church, 11.
36 the separation of medicine from surgery. Kenneth Bakken, in his work The Journey
Toward Wholeness, adds that the growth and practice of secular medicine was aversely affected by the church as all universities were subject to the clerical control and that human dissection was generally forbidden by the church until 1300.48 By 1551 healing
legally no longer was declared a rite in the Western church as the Council of Trent during
its fourteenth session issued a decree that only an individual near death could be anointed
with oil. Abigail Evans notes from Rev. Schroeder’s work in The Canons and Decrees of
the Council of Trent that by this decree the church felt that the needs of the soul were in
conflict with the needs of the body. Consequently, the disparity between medicine and the church widened.49
Opposing the church was the same as opposing the Roman government which often resulted in excommunication and sometimes even death. Corruption and greed in leadership was common place. Through the years several individuals tried to reveal the abuses of the Roman Church, but all had been silenced in one way or another. The unbiblical teachings of the Roman Catholic Church were openly confronted in the sixteenth century when Martin Luther posted his 95 theses against these unbiblical teachings on the Castle Church door in Wittenberg, Germany. Luther’s actions gave birth to the Reformation movement. John Calvin another reformer among many participated in the movement from Geneva. The movement rapidly gained momentum in many countries in Europe and was later referred to as Protestantism. Protestantism and
48Bakken and Hofeller, The Journey toward Wholeness, 35.
49Rev. H. J. Schroeder, trans., The Canons and Decrees of the Council of Trent, 13.8 (Rockford, IL: Tan Books and Publishers, 1978), 78, quoted in Evans, The Healing Church, 12.
37
Protestants refer to the movement and individuals who protested against Roman Catholic orthodoxy. Protestantism gave birth to Lutheranism, Reformed Churches, Anabaptists,
Anglican, and the Free Church. The Free Church includes Methodists, Quakers, Baptists,
Congregational Churches, and Pentecostalism.
Still and all Protestantism had little effect giving credibility to the healing ministry as the reformers were more concerned about the corruption within the Roman
Catholic Church rather than about miracles and healings. In fact Luther and Calvin, the two most noted reformers, did not give any merit to miraculous physical healing.
Bakken wrote, “The Protestants adhered to the doctrine of dispensationalism: Jesus performed miracles such as healing in order to convince nonbelievers that He was the
Christ.” He also noted that “since contemporary men and women did not need such proof, one could no longer expect healing.”50 Evans informs us that
Luther and Calvin did not believe in miraculous physical healing but continued the medieval teaching of sickness as a chastisement or an occasion for moral teaching and death as an opportunity for release from the suffering of this world.51
From Luther and Calvin’s teachings, we can understand how these influences were very damaging to the Christian healing ministry since the reformers had a great influence on the churches established out of the Reformation. It can be said that this is why many Protestants even today do not believe in the power of Christian healing through prayer.
50Bakken and Hofeller, The Journey toward Wholeness, 23-24.
51Evans, The Healing Church, 13.
38
Prior to the Reformation most hospitals and monasteries were staffed and managed by the church. The closing of monasteries during the Reformation caused many hospitals and inns to close. The communities of the monastic dissolution were suddenly without any principle organized system of relief. There was a complete withdrawal of medicine from the monastery to the university. More and more secular physicians were trained in the universities. Abigail Evans notes that “following the division of the church after the Reformation, there was also a growing split between religion and medicine.”
She adds that “healing by the church fell into disuse as the church yielded healing to the medical profession. The two became independent professions; specialization was mandated for both in the Western church.”52 In England this separation was formalized by the mid-nineteenth century with the Medical Registration Act which excluded the practice of medicine to all but qualified doctors.
Evans enlightens us with these remarks regarding the movement in the United
Kingdom:
In the nineteenth century those of the Reformed faith emphasized public health measures and certain standards of living and lifestyles as producing good health. The professionalization of both ministry and medicine that had resulted in the rift between them yielded in the 1960s and 1970s to a strong cooperation. . . . Health as a social justice issue was emphasized in organizations such as the Christian Medical Commission of the World Council of Churches, which introduced community-based health care as essential and provided an international network of those interested in wholistic health. . . . However, these cooperative endeavors between medicine and religion declined in the late 1970s and 1980s.53
In addressing the movement in the United States, Evans reports,
In the 1970s there were hundreds of groups, now there are thousands, engaging in health ministries. In the United Kingdom, reference is made to the healing ministry;
52Ibid., 14.
53Ibid., 25.
39
in the United States, it is to health ministry programs. This highlights the distinction between the Anglican Church’s emphasis on sacramental and spiritual healing as historically practiced versus the programmatic emphasis of U.S. churches on education and direct health care services. . . . There is a greater opportunity for cooperation with medicine than ever before; we should refer to the healing ministry of the church not as an alternative therapy but as a complementary one. . . . The Health Ministries Association, founded in 1989 with a few dozen members, now has 1,100 members throughout the United States and in several other countries. Its membership grows weekly as new churches begin health ministries programs; . . . which reflects the growing interest in religion and health.54
With time the church has as, Darrel Amundsen writes, turned more towards the
philosophy that humanity in fact is damned but God has provided for people to be
sustained through the proper use of nature and that all healing really comes from God in one way or another and that medicine is just a vessel for God’s will, not a deviation of faith.55
Pondering over the church’s rich history in healing and health, the church
needs to more aggressively take its rightful position as a major health care provider.
The Contemporary Church
Today, we are witnessing a new paradigm among contemporary churches
around the country. In an attempt to address the health issues of their membership and
communities, many churches are building family life centers and multipurpose buildings.
These centers come equipped with gymnasiums, indoor tracks, and weight rooms. Some
of these facilities have fully equipped commercial kitchens that can and should be used to
encourage good dietary habits. These centers are used to promote physical fitness
54Ibid., 26.
55Darrel W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore: The Johns Hopkins University Press, 1996) 135, quoted in Krzywicka, “Education.”
40 through exercise classes, basketball leagues, weightlifting classes, walking, and jogging on the indoor tracks. Churches also address social and economic needs by using these facilities as affordable daycare centers for their congregation and the community at large.
It is safe to say that many contemporary churches have finally come under the conviction for the need of wholistic ministry. As the church we must minister to more than just the spiritual. Humanity needs are spiritual, physical, social, emotional, and economical.
Humanity needs are wholistic and the church must equip itself to minister to the wholeness of humanity. Jesus said,
I was hungry, and you fed me. I was thirsty, and you gave me drink. I was a stranger, and you invited me to your home. I was naked, and you gave me clothing. I was sick, and you cared for me. I was in prison, and you visited me. . . . Lord . . . When did we ever see you sick or in prison, . . . when you did it to the least of these my brothers and sisters, you were doing it to me. (Matt 25:35-40 NLT)
CHAPTER 3
DEVELOPING A HEALTH AND WELLNESS MINISTRY MODEL AT THE OPEN DOOR CHURCH OF LOUISVILLE
African American Health
An Introduction
African-American history begins in the seventeenth century with slavery and
progresses to Barack Obama as the forty-fourth and current President of the United
States. Between those milestones there were other events and issues, both resolved and
ongoing, that were faced by African Americans. One such ongoing issue is the health disparity within the African American community. Although the health status of the
American population has improved over the last few decades, not all Americans have shared equally in these improvements. African Americans tend to have a poorer health status than the majority population and suffer most from chronic diseases. Whether it is cancer or heart disease, obesity or diabetes, hypertension or high cholesterol, blacks fare worse.1
African Americans originated from Africa with most being brought to the
United States as slaves from the West Coast of Africa. A number of blacks immigrated
1U.S. Department of Health and Human Services, The Office of Minority Health, “African American Profile” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/ templates/browse.aspx?lvl=3&lvlid=23; Internet.
41 42 to the United States voluntarily from African countries, the West Indian Islands, the
Dominican Republic, Haiti, Panama, and Jamaica. Black communities in America include groups with multiple histories, languages, cultures, religions, beliefs, and traditions.2 It is understood and noted that the African American population in the
United States is comprised of a diversity of ethnicities and cultures and that this segment of the population is not monolithic in their beliefs and behaviors. The focus here is on
the commonalities taking into consideration the heterogeneity with the population. The
African American profile as taken from The Office of Minority Health website reports that in July 2008, 41 million people in the United States, or 13.5 percent of the population, were African Americans. African Americans account for the second largest minority population, following the Hispanic/Latino population.3
African American Health Status
The Office of Minority Health reports that in 2005, the death rate for African
Americans was higher than the majority population for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, obesity and homicide.4 It further
reflected these statistics:
African Americans are twice as likely to be diagnosed with diabetes as non- Hispanic whites. In addition, they are more likely to suffer complications from diabetes, such as end-stage renal disease and lower extremity amputations. Although African Americans have the same or lower rate of high cholesterol as their non-Hispanic white counterparts, they are more likely to have high blood
2Vernellia R. Randall, Dying While Black (Dayton, OH: Seven Principles Press, 2006), 89.
3U.S. Department of Health and Human Services, The Office of Minority Health, “African American Profile” [on-line].
4Ibid. 43
pressure. In 2006, African Americans were 2.3 times as likely as non-Hispanic whites to die from diabetes.
African Americans adults are 1.7 times as likely to have a stroke than their white adult counterparts. Further, men are 60 percent more likely to die from a stroke than their white adult counters.
African American adults are less likely to be diagnosed with coronary heart disease; however, they are more likely to die from heart disease. Although African American adults are 40 percent more likely to have high blood pressure, they are 10 percent less likely than their non-Hispanic white counterparts to have their blood pressure under control.
Cancer is the second leading cause of death for most racial and ethnic minorities in the United States. African Americans have the highest mortality rate of any racial and ethnic group for all cancers combined and for most major cancers. Death rates for all major causes of death are higher for African Americans than for whites, contributing to a lower life expectancy for both African American men and African American women. In 2006, 63,082 African Americans died of the disease. Cancer hits African Americans particularly hard. African American men are over twice as likely to die from prostate cancer as whites. African American women are 36 percent more likely to die from breast cancer.5
The above findings are striking and clearly reflect a persistent lag in the health
status of African Americans as compared to the majority population. Although the
reasons for these health disparities are complex and often poorly understood, the consensus is that these disparities are the result of a wide range of interconnected
contributing factors. The editorial note in the U.S. Centers for Disease Control (CDC)
Morbidity and Mortality Weekly Report (MMWR) newsletter reports that the multiple
factors include lifestyle behaviors, socioeconomic factors, social environment, and access
to preventive health-care services.6 Yet another couple of related factors are
5Ibid.
6U.S. Department of Health and Human Services, The U.S. Centers for Disease Control, “Health Disparities Experienced by Blacks or African Americans—United States,” Morbidity and Mortality Weekly Report, 14 January 2005:54(01); 1-3 [on-line]; accessed 18 November 2010; available from http://www.cdc.gov/mmwr/preview/mmwrhtml/ mm5401a1.htm; Internet. 44 discrimination and racism. In Ethnic Diseases Sourcebook, Joyce B. Shannon reports that racial discrimination and racism have remained significant operative factors in the health and health care of blacks and that as early as 1867 black spokespersons concluded that racism was a major contributor to the poor health of black Americans.7
Racial discrimination has limited the access of blacks to higher incomes, improved health care, adequate housing, and better education—all of which are necessary
to achieve modern levels of health and mortality.8
Statistics indicate that the African American lifestyle is a culprit in premature deaths. “Our life-style seems to be a principal cause of many illnesses,” Kenneth L.
Bakken points out in The Call to Wholeness. 9 The 1979 U. S. Surgeon General’s report
suggests that unhealthy behavior or lifestyle accounts for half of the annual number of deaths in the United States; 20 percent are due to environmental factors, 20 percent to
genetics and 10 percent to inadequate medical care.10 Although experts have deemed
lifestyle behaviors as being modifiable, it must be noted that there are systemic influences such as poverty and racism that can dictate a lifestyle. Racial discrimination influences not only lifestyle, personal behavior, psycho-social behavior, physical environment, and
7Joyce Brennfleck Shannon, ed., Ethnic Diseases Sourcebook, Health Reference Series (Detroit: Omnigraphics, 2001), 365.
8Douglas C. Eubank, “History of Black Mortality and Health Before 1940,” in Health Policies and Black Americans, ed. David P. Willis (New Brunswick, NJ: Transaction Publishers, 1988), 100-28, quoted in Ethnic Diseases Sourcebook, 366.
9Kenneth L. Bakken, The Call to Wholeness: Health as a Spiritual Journey (New York: The Crossroad Publishing Company, 1985), 12.
10U.S. Department of Health, Education, and Welfare, Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention (Washington, DC: U. S. Government Printing Office, 1979), quoted in Thomas A. LaVeist, ed. Race, Ethnicity, and Health: A Public Health Reader (San Francisco: Jossey-Bass, 2002), 413. 45 biology, but also economics. Poverty affects housing choice, job choice, nutrition, and education. Vernellia Randall writes that while full participation in a society requires money, education, contacts, and know-how, it also requires good health. In fact, health is not only significant in itself, but one’s health also affects the availability of choices and the decisions regarding those choices throughout one’s life.11
The issue of lifestyle is a contributor to the general health status and for the
most part, African Americans have not adopted health-promoting behaviors of diet and
exercise. The deep-rooted dietary habits and economic issues that continue to affect
African Americans present great challenges regarding changing behaviors and lowering
disease risk.12 Individuals who are economically disadvantaged may have no choice but to eat what is available at the lowest cost. The choices people make about what to eat are
limited by the food available to them.13 The lack of private transportation and of
supermarkets in low-wealth and predominantly black neighborhoods suggests that
residents of these neighborhoods may be at a disadvantage when attempting to achieve a
healthy diet.14 Diet contributes to numerous health issues and is significantly associated
with health responsibility. Poor dietary patterns and a sedentary lifestyle can lead to
11Randall, Dying While Black, 26.
12M. Cristina F. Garces and Lisa A. Sutherland, “Diet of African Americans,” Nutrition and Well-Being A to Z [on-line]; accessed 30 October 2010; available from http://www.faqs.org/nutrition/A- Ap/African-Americans-Diet-of.html; Internet.
13N. Milio, Promoting Health Through Public Policy (Ottawa, Canada: Public Health Association, 1989), quoted in Thomas A. LaVeist, ed. Race, Ethnicity, and Health: A Public Health Reader (San Francisco: Jossey-Bass, 2002), 459.
14Ibid. 46 obesity. African Americans experience high rates of obesity, hypertension, type II diabetes, and heart disease which are all by products of an unhealthy diet.
Diet is very ethnic in origin. Many African Americans prepare and eat foods that reflect the long struggle to survive during the days of slavery where the meals consisted of leftover scraps from the slave owner’s meal. Historians maintain that during the eighteenth century most slaves managed to feed themselves with ham hocks, chitlins, and neck bones, paired with the vegetables grown from small gardens.15 The hard days
of slavery are reflected in the determination not to let anything go to waste. Rovenia M.
Brock suggests that “because during slavery we could not afford to waste anything, we
are still accustomed to finding ways to use every imaginable foodstuff, and a lot of what
we find is loaded with fat.” She goes on to point out that “from the pig alone we get not
just ham, bacon, pork chops, and roasts, but brains, neck bones, hog maws, hog jowls,
ham hocks for seasoning, intestines for chitlins, fat for cracklins and lard, and hog’s head,
feet, and tail for souse.”16 However, African American cooking can be healthy. Many of
the foods commonly eaten by blacks, such as greens, yellow vegetables, beans, and rice
are rich in nutrients. But due to the cooking methods and consumption of meats and baked goods, the diet is typically high in fat and low in fiber. Unlike the African
Americans of yesteryear, today many experience a more sedentary lifestyle; over time the
health problems associated with diet emerged. Busy families with hectic schedules
15Rovenia Brock, Dr. Ro's Ten Secrets to Livin' Healthy: America's Most Renowned African American Nutritionist Shows You How to Look Great, Feel Better, and Live Longer by Eating Right (New York: Bantam, 2004), 96.
16Ibid., 93. 47 find it easier to go through the drive-thru of a fast food restaurant than to prepare a home- cooked meal. Today the typical African American diet can consist of sugary, high-fat foods with little or no exercise which leads to obesity. To combat this up and growing epidemic, health and wellness ministries through various churches and community centers around this country are taking a proactive role in educating congregants and the surrounding communities on all aspects of a healthy diet and lifestyle.
Other lifestyle behaviors such as lack of physical activity, alcohol intake, cigarette smoking and drug use represent a significant hazard to the overall health and well-being of African Americans. The impact that alcohol, tobacco and illicit drug use has on health is alarming. “The medical consequences of substance abuse among black people can be terrible: two blacks to every one white die from cirrhosis of the liver, which is caused primarily by alcoholism.17 Churches like Glide Memorial Methodist
Church of San Francisco, California are taking an active role in providing recovery services for those who fall into substance abuse.18
Family and friendship influence is an important resource for effective
prevention strategies and behavioral change. Wives, mothers, dads, uncles, aunts,
friends, and neighbors make up a support system that may be influential in bringing about
the behavioral change needed to prevent disease.
17James W. Reed, Neil Shulman, and Charlene Shucker, The Black Man's Guide to Good Health: Essential Advice for African American Men and Their Families, rev. ed. (Roscoe, IL: Hilton Publishing, 2001), 240.
18Abigail Rian Evans, The Healing Church: Practical Programs for Health Ministries (Cleveland: United Church Press, 1999), 225. 48
Religion is a defining and necessary part of life for many African Americans.
God is viewed as the source of both good health and serious illness and many have a belief in the healing powers of religion. In an article entitled “The Black-American
Community,” Victor and Kathy Fernandez write that the most common and frequently cited method of treating illness among African Americans is prayer and that the laying on of hands is described quite frequently. The Fernandezes find that the traditional African
American belief regarding health does not separate the mind, body, and spirit.19
Blacks have long used prayer and religiosity to cope with and treat health
concerns and, although blacks necessarily differ in their religious beliefs (Christianity and
Islam being only the most prominent), religion and religious institutions fulfill many
roles and often provide both spiritual and psychological support.20
As previously noted, socioeconomic and social environment factors which
include education attainment, neighborhood, employment status, work conditions, and
the inadequate income of the working poor affect the health profile of the African
American population. The working poor are the people whose full-time, year-round
earnings are so meager that despite their best efforts they cannot afford decent housing, nutrition, health care, or child care.21 It is suggested that these conditions promote stress,
19Victor M. Fernandez and Kathy M. Fernandez, “The Black-American Community” [on-line]; accessed 30 October 2010; available from http://www. culturediversity.org/afro.htm; Internet.
20M. Abruns, “Jesus Will Fix it After Awhile: Meanings and Health,” Social Science and Medicine 50 (1999): 89, quoted in Melissa Welch, “Care of Blacks and African Americans,” in Cross- Cultural Medicine, ed. JudyAnn Bigby (Philadelphia: American College of Physicians, 2003), 29-60 [on- line]; accessed 30 October 2010; available from http://books.google.com/books?id=K8tEqdFEEdwC&pg= PA29&lpg=PA29&dq=%; Internet.
21Randall, Dying While Black, 158. 49 depression and anxiety as these individuals constantly struggle to make ends meet and cope with work overload and family demands. Hazards in their living and working environments also detract from health as exposure to poor air quality and toxic landfills contribute to various respiratory problems including bronchitis, emphysema, and asthma.
The Canaan Community Development Corporation (CCDC) is one of many faith-based organizations that strive to combat the socioeconomic and social environment disparities in communities.
Canaan Community Development Corporation (CCDC), a non-profit organization founded in 1992 by CEO, Walter Malone, Jr., pastor of Canaan Christian
Church, seeks to bring economic empowerment to distressed communities. In the Metro
Louisville Area, CCDC engages in strategic partnerships and creative alliances with government agencies, for profit entities and other not-for-profit organizations to bring about changes in the community. The CCDC also addresses health, violence and education, bringing economic growth and social freedom to create sustainable employment.22
Access to quality care is vital to overall health and wellness. African
Americans are much more likely to be uninsured and underinsured and underserved and
may not seek care as often as whites. However, blacks of all economic levels experience
discrimination in health care.23 For many blacks, receiving health care is all too often a
degrading and humiliating experience. Often insults are subtle but nonetheless perceived
22Canaan Community Development Corporation [on-line]; accessed 12 December 2010; available from http://www.ccdcky.org; Internet.
23Welch, “Care of Blacks and African Americans,” 31. 50 by the black patient.24 “The history of medical care in the United States is replete with
examples of discriminatory practices that denied ethnic minorities access to services
based on skin color.” “Thus, the medical care system of the past is correctly described as
racist.” 25 According to Thomas LaVeist, the review of literature over the past several years reveals that racial and ethnic minorities often do not have access to health services
at the same rate as do whites. The literature shows that racial and ethnic minorities
frequently do not have the same access to medical treatment and other health services as
the majority white population. This is particularly true for African Americans.26
Delayed access to care may contribute to the observed increases in disease morbidity and
mortality in low-income and minority groups. Examples include the tendency of blacks to
use emergency departments when symptoms can no longer be ignored, often late in the
course of disease, and the tendency to seek peer, rather than professional, advice about
preventive screening such as mammography or HIV testing. The tendency to delay seeking treatment often until the advanced states of disease points to the need for early prevention efforts. There is an overall distrust by blacks of physicians and the health care
system which stems from fears of being unwitting subjects of medical experiments, often
in public clinics or hospitals. The Tuskegee Syphilis Study, which recruited African
American men with syphilis to be a part of a research project in which they were
promised but never given treatment, is a prime example.27
24Ibid., 32.
25Thomas A. LaVeist, ed., Race, Ethnicity, and Health: A Public Health Reader (San Francisco: Jossey-Bass, 2002), 187.
26Ibid.
27Randall, Dying While Black, 121. 51
Health Status of African American Women
It has been said that African American women are the glue of their communities and that they shape the life experiences of their children, but far more revealing are the reports that say that African American women have more health problems and higher disease risks than just about any other group of people in America except African American men. More than half of all African Americans are females.
The major health concerns of African American women include diabetes, high blood pressure, obesity, kidney disease, arthritis, HIV/AIDS, lupus, breast cancer, and maternal mortality.28 The health status of African American women is quite alarming. African
American women are more likely to die from cancer than persons of any other racial and
ethnic group. In 2002, cardiovascular disease, including stroke, caused the deaths of
56,721 black females. Fifty percent of adult African American women are obese.29
Being overweight or obese increases the risk factor of almost every chronic disease with
which African Americans struggle. These chronic diseases include type II diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, sleep apnea, osteoarthritis and some cancers. Black women are more often than not the single heads of households and outnumber black men in the workforce; however, many of these women earn poverty level wages.30 Quite often they carry a heavy load of work and
28Ibid.
29U.S. Department of Health and Human Services, The Office of Minority Health, “Health Status of African American Women” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/templates/content.aspx?ID=3723; Internet.
30Shannon, Ethnic Diseases Sourcebook, 362. 52 home responsibilities. For many, competing life priorities make it difficult to attend to personal health needs, and consequently, serious illness may only be diagnosed after significant morbidity develops. A health and wellness ministry with its many support groups and programs can step in to help women prioritize their own health needs.
Health Status of African American Men
There are approximately 17.3 million African American men in the United
States, representing 48 percent of all African Americans. Black men tend to have some of the worse health statistics of all racial/ethnic groups, male or female. African
American men can expect to live approximately 6.0 years less than white men.31 The prostate cancer incidence rate among African American men is 60 percent higher than the rate in White men and the prostate cancer death rate is more than twice as high among
African Americans as any other racial or ethnic group.32 African American men
frequently ignore symptoms and are reluctant to seek care until there is a crisis. Access
to care is a significant factor for black men. Black men are less likely than white men to
see a physician.33 Black men are more likely to say that their usual source of care is an
emergency room rather than to have had an office or outpatient visit. The poorer health
31U.S. Department of Health and Human Services, The Office of Minority Health, “Men’s Health 101” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/templates/ browse.aspx?lvl=3&lvlid=278; Internet.
32U.S. Department of Health and Human Services, The Office of Minority Health, “HHS Fact Sheet Minority Health Disparities At a Glance” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/templates/content.aspx?ID=2139; Internet.
33U.S. Department of Health and Human Services, The Office of Minority Health, “Men’s Health 101” [on-line]. 53 and health care indices of African American men have consequences for their families, their communities, and the nation’s economy.
Elderly Issues in the African American Community
The lower life expectancies for many ethnic minority groups and subgroups stem largely from their disproportionately higher rates of poverty, malnutrition, and poor health care. However, African Americans over seventy-five years of age represent the fastest growing segment of the American population. During the 1970 to 1980 decade,
African Americans age 65 and over increased 40 percent and whites increased by 25 percent. Whites are expected to live longer than African Americans. Both Black females and males tend to have a shorter life expectancy than their White counterparts up to age
65 and over. Then, for reasons that are not entirely clear, there is a reversal in the pattern.
The rational for the reversal has been described as the “crossover effect.” The mortality crossover effect is a pattern of selective survival in which the least robust African
Americans die at earlier ages and hardier ones survive to much older ages.34 This
suggests why life expectancy for whites exceeds that for African Americans at age 65,
but the reverse becomes true around age 75; that is, life expectancy for blacks exceeds
that for whites.35 This phenomenon is puzzling; and, unfortunately, there has been very
little research aimed at developing insights that might help to explain.
34Linda Wray, “Health Policy and Ethnic Diversity in Older Americans—Dissonance or Harmony?” The Western Journal of Medicine 157 (1992): 358, quoted in Ethnic Diseases Sourcebook, 420.
35Ibid. 54
African Americans have benefited from increased life expectancy but remain at a disadvantage relative to majority population. It is not unusual to see older blacks with multiple major chronic medical problems such as hypertension, cardiovascular disease, and diabetes. As long as they are capable of completing everyday tasks such self-caring shopping, many elderly blacks will delay seeking health care or deny discomfort and pain.36 There are varied issues that older African Americans experience in their communities which include poverty, isolation, lack of transportation and the risk in accessing health care systems to receive quality health care. Health care access is a real challenge in the twenty-first century and careful planning is needed to contribute effectively to the well-being of older Americans. Canaan Christian Church offers a
Simply Senior Fitness and an Adopt a Senior mentoring program that addresses many of the issues that the elderly experience.37
An African American Health Directive
African Americans can and must change their lives for the better by being
disciplined, organized, purposeful, goal oriented, and especially by pursuing good health,
in order to achieve meaningful goals. African Americans must pool their knowledge and
resources to improve their collective health. Once again, health and wellness ministries
across this country are engaging in opportunities to pool their knowledge and resources to
improve the overall health of their congregations and communities.
36Welch, “Care of Blacks and African Americans,” 39.
37Canaan Christian Church, “Simply Senior Fitness” [on-line]; accessed 12 December 2010; available from http://www.canaanchristian.com/; Internet. 55
The Road to Creating a Health and Wellness Ministry
A brief profile of the African American health status has been reviewed. Now on to how the church offers assistance through various types of health and wellness ministries. Health ministry is defined as any program that meets a broad base of health- related needs and is founded and supported by or related to a church or religious group or body.38
More broadly, health ministry involves empowerment, helping individuals, families, and communities help themselves and others through education, prevention, and advocacy. Health ministry is a church-based cooperative effort of individuals, hospitals, and other health agencies interested in an integrated understanding of health.39
Religious communities are being viewed as new collaborators, forming the basis for the unique role of the church in addressing lifestyle-related illnesses.40 The
church historically has been a strong force in urging health-enhancing lifestyles. Access to health care, nutrition, education regarding prevention and maintenance, exercise, substance abuse are only a few of the issues that churches are addressing in health care.
Churches are taking the opportunity to serve congregations and communities in health care. The church has essentially become a complementary therapy to medicine.41 There is a role in the health ministry for even the smallest of congregations.
38Evans, The Healing Church, 192.
39Ibid., 61.
40Ibid., 31.
41Ibid., 27. 56
Examining Models for a Health and Wellness Ministry
A health and wellness ministry is unique to the individual congregation and its assessed assets and needs. “No two ministries will be alike—nor should they be.”42
Each congregation is unique and has a set of resources and needs specific to it. There are many ways to organize a health and wellness ministry in the church. Even those in the congregation with no medical background can participate. Provide transportation to doctor visits, help coordinate efforts for a blood drive or health fair or simply visit with those who are lonely. In an effort to begin the implementation of a health and wellness ministry at the Open Door Church of Louisville an analysis was done on health and wellness ministries of a variety of different churches local and across the country. It was beneficial to study the various methodologies and understand which ones were most successful. Eight churches were examined. Of the eight churches three were predominately white and five were African American. Five had large congregations and three had medium-sized congregations. There was a mixture of denominations which included three Baptist, two Methodist, one Presbyterian, one Apostolic Church of God, and one Christian.
Following is the information collected on these churches which included a description of the programs and activities offered as a part of the health and wellness ministry as well as a brief profile of the pastor and the church.
42Ibid., 177. 57
New Horizon United Methodist Church Champaign, Illinois
United Methodist Churches in the Champaign/Urbana area launched New
Horizon in an effort to meet the needs of spiritually unconnected in the community.43
Out of that effort, New Horizon was founded on March 5, 1995 with 388 people
attending the first worship service at Centennial High School. Mark Jordan became the
lead pastor of New Horizon on July 1, 2010. Mark began his ministry in Charleston, IL and has served in some of the largest Methodist Churches in the Illinois Great Rivers
Conference. The Health and Wellness Ministry at New Horizon promotes the health and healing of the church community and beyond regarding body, mind, and spirit. It is a safe, growing, and biblically sound ministry providing the tools for people to become physically, spiritually, and emotionally healthier. Throughout the year, the Health and
Wellness Ministries has sponsored a Health and Wellness Fair, nutritional classes and
Spiritual Pampering Activities (SPA) Days. Parish Nurses are available for educational programs and resources. In addition this ministry offers programs such as Body and
Soul, Health and Wellness Morning, and The Body Walk. Health and Wellness Morning offers blood pressure screenings as well as head, neck and shoulder massages on the second Sunday of each month. Body and Soul is a fitness ministry for women who work out together, getting themselves physically and spiritually fit. The Body Walk program was adapted from the Illinois Nutrition, Education, and Training Program used in schools
43New Horizon United Methodist Church, “Health and Wellness Ministries” [on-line]; accessed 12 December 2010; available from http://www.newhorizonchurch.org/; Internet. 58 and various other organizations. The goal of this walk is to educate the young people as to how they can better serve God by taking care of their bodies.
Canaan Christian Church Louisville, Kentucky
On March 16, 1983, Reverend Walter Malone, Jr. and ninety-seven members came together to form the Canaan Missionary Baptist Church which was later renamed the Canaan Christian Church.44 The initial ninety-seven, who came from all walks of
life, raised $100,000 in less than a year toward the purchase of a one million dollar
facility including a parsonage and gymnasium. On February 6, 1984 the church family
traveled in a motorcade to the new facilities. In March of 1992 the Canaan Church broke
ground for a 1.2 million dollar expansion of the church facilities. In April of 1996 the
Canaan Church acquired a new church facility valued at 11 million dollars. Under the
visionary leadership of Walter Malone, Jr., Canaan has grown from ninety-seven people
to over 4,000.
Walter Malone, Jr., is a native of Tennessee. He attended Fisk University and
later Nashville’s American Baptist College, where he earned his B.A. in theology. He
received his Masters degree and 28 hours above his Masters in religious studies at the
Southern Baptist Theological Seminary in Louisville, Kentucky, and received his Doctor
of Ministry degree from the United Theological Seminary. During his studies, Malone
also became a Samuel D. Proctor-Otis Moss, Jr. Fellow. Throughout the years, the
44Canaan Christian Church, “About Us” [on-line]; accessed 12 December 2010; available from http://www.canaanchristian.com/; Internet. 59 winning over of souls has been the greatest reward Malone could ask for. During his studies and mission work he has received several honors and recognitions. Malone has truly accomplished great things for the Lord. Today one of the accomplishments he is most proud of started over two decades ago, when he stepped out by Divine inspiration with ninety-seven people and became the founder and pastor of one of the fastest growing churches in Kentuckiana—Canaan Missionary Baptist Church—now Canaan Christian
Church.
The Health, Wellness, and Fitness Ministry at Canaan consists of programs and activities that foster improving the health of the congregation and the community.45 This
ministry caters to the whole individual, mind, body, and spirit. Through the Family Life
Center Ministries, families are ministered to through health and wellness, fitness,
recreational and family activities. All activities are open to both church members and
non-members. The activities are held throughout the year in a variety of forms and
venues. The Family Life Center is open all year to facilitate basketball, volleyball,
aerobics, racquetball, running, walking, weight lifting and various game room activities.
Membership is free to all members of the church. Non-members are welcomed. Program
fees may apply to specific activities. The Family Life Center is equipped with a fitness
center and a health and wellness resource center. The resource center is furnished with
several health publications, brochures, health ministry resource guides, and other vital
information that will help preserve health. There is also a desktop computer available to
look up health related information.
45Canaan Christian Church, “Family Life Center” [on-line]. 60
Mount Sinai Missionary Baptist Church Orlando, Florida
Mount Sinai Missionary Baptist Church was organized March 17, 1947 in
Orlando, Florida largely through the efforts, leadership, and guidance of the late Samuel
D. Jenkins.46 In its humble beginnings, Mount Sinai worshipped in a facility with a seating capacity of ten. Since that time Mount Sinai has constructed a new church facility and expanded it to its current seating capacity of 800. Larry G. Mills became the third pastor of Mount Sinai in 1988. Mills attended Wayne State University, University
of Phoenix, and Bethany Theological Seminary. He holds undergraduate degrees in
Business Management and Religious Education and Masters degrees in organizational
management and sacred theology, as well as a doctorate in sacred theology.
The Healthcare Ministry at Mount Sinai was established in 1973 and called the
Nurse’s Guild with nine members.47 In 2003, the name was changed to Healthcare
Ministry. The staff of this ministry is required to have first aid and CPR training. The
mission of this ministry is to provide spiritual care and support to the members of the
church in times of wellness, sickness, and grief; also providing the church and
community with education that focuses on health prevention. Mount Sinai’s healthcare
ministry utilizes community outreach organizations and nursing schools within the state
to organize health awareness events that are geared towards health issues affecting the
community. This ministry institutes health fairs and annual health events targeting low
socioeconomic groups at risk for chronic illnesses.
46Mt. Sinai Missionary Baptist Church, “About Us/History” [on-line]; accessed 12 December 2010; available from http://www.mtsinaimbccfl.org/; Internet.
47Mt. Sinai Missionary Baptist Church, “Health and Wellness” [on-line]. 61
Northminster Church Columbia, South Carolina
Northminster Presbyterian Church was organized in April 1969, with Rev.
Richard F. Dozier as its pastor.48 The Northminster Health and Wellness Ministry
addresses health issues of the church family and the community. The committee’s focus
is to create an awareness of health issues and concerns through education and
information. Occasionally, health professionals from the congregation appear on radio
talk programs to discuss issues concerning children’s health. The Health and Wellness
Ministry partners with other initiatives to sponsor the Greenview Health and Safety Fun
Day and works with health care providers to get information into the hands of people
who need care and service.
Cable Baptist Church Louisville, Kentucky
Rev. Anthony Middleton is a native of Jeffersonville, Indiana, but has resided
in Louisville for twenty years.49 Having completed high school in the Louisville public
school system, he went on to attend Jefferson Community college and Boyce Bible
College, and he is a graduate of Simmons Bible College. Presently Rev. Middleton is
pursuing a Masters of Divinity degree at the Southern Baptist Theological Seminary.
48Northminster Church, “Health and Wellness Ministry” [on-line]; accessed 12 December 2010; available from http://www.northminstercolumbiasc.org/index.html; Internet.
49Anthony Middleton, Pastor of Cable Missionary Baptist Church, Louisville, KY, interview by author, 21 July 2003. 62
After serving for ten years under the progressive and dynamic leadership of Kevin W.
Cosby, senior pastor at the St. Stephen Baptist Church, Middleton was called as pastor of
Cable Baptist Church in August, 1997.
The church is located in what is called the Smoketown area which borders on the boundaries of the Clarksdale/Phoenix Hill area of Louisville, Kentucky. The membership of the church is seven hundred strong basically consisting of the age group between the ages of 25-30.
Under Pastor Middleton’s visionary leadership, the Cable Church has grown and developed many ministries to meet the need of family, church, and community, included Cable life Community Enrichment Corporation ---the P.H.A.S.E. Program (The
Potter’s House After School Enrichment Program). In May 2002 the construction of the
Potter’s House Family Life Center was completed. The family life center houses a gymnasium, walking track, fitness center, game room, and nursery. Cable has a very active community ministry. They have a community development corporation called the
Potter’s House. It is through the Potter’s House that they built a family life center which houses a daycare, gym, an exercise room with the state-of-the-art equipment, a running track and kitchen area. Many of the community ministries are ran thought this center.
They sponsor a program entitled J.E.T. which is Job Empowerment Training. In addition they offer after school tutoring, computers classes and a summer program. They have purchased several houses that surround the church which have been converted into classrooms, clothes closet and meals are severed to the homeless from these houses. The
Cable Baptist Church health ministry believes that a healthy mind, body, and soul will 63 help all Christians to serve God to their fullest potential.50 The Health Ministry's mission
is to encourage Christians to improve their health by focusing on the following:
1. Disease: Education and/or prevention of diseases such as diabetes, heart disease, cancer, and epilepsy.
2. Nutrition: Improving eating habits by providing information regarding various topics such as reading food labels, proper serving sizes, and making healthier choices.
3. Fitness: Providing avenues for Christians to begin and/or maintain an active lifestyle through exercise.
Glide Memorial Methodist Church San Francisco, California
Glide Memorial is a six-story church in the Tenderloin District of San
Francisco.51 It reaches out to its immediate community of drug pushers and users,
prostitutes and pimps and people who felt beyond hope and recovery. The vision for this
ministry stems from Rev. Cecil Williams who has been laboring in the Tenderloin
District neighborhood for the past thirty years. He started Glide with a near-empty
church that had no connection to the neighborhood. As he walked the blocks that
surround the church and saw the hopelessness and addictive cycle of the local people’s
lives, he vowed the church would do something. The Addiction Recovery Program at
Glide is a seventeen-week program that maybe mandated by the court. The San
Francisco court system has recognized Glide for its effective work following initial
recovery. The ministry also includes job skills and career counseling programs, food and
50“Cable Baptist Health Ministry” [on-line]; accessed 12 December 2010; available from http://www.wix.com/cablebaptist/cablehealthministry; Internet.
51Evans, The Healing Church, 225-28. 64 shelter. Glide has plans to build a primary health care clinic and high-rise building next to the church which will offer housing and apartments to the homeless.
Shiloh Baptist Church Waukegan, Illinois
Shiloh Baptist Church was the first Negro Baptist church in Waukegan.52
Shiloh had its humble beginnings in 1916 as a house-to-house prayer band and the next
year was organized and named by Rev. T. R. Ricks who became the first pastor. The
church relocated several times from that storefront on Market Street to its present
location. Rev. Walstone E. Francis, a native of Nassau, Bahamas, is the current pastor of
Shiloh. , Pastor Francis received his elementary and high school education in Nassau.
Pastor Francis received his Bachelor of Theology and Bachelor of Arts Degrees from
American Baptist College of American Baptist Theological Seminary, Nashville
Tennessee. He received an Honorary Doctor of Divinity Degree from Selma University,
Selma Alabama in 1989.
The health and wellness ministry at Shiloh was organized in 1957.53 At that
time the members were required to attend basic first aid training; later CPR training was added. Members were qualified to give emergency first aid during the activities at the
church or in the community. Today, the ministry promotes good health through
education on prevention. The ministry offers blood pressure, cholesterol, and diabetes
screenings. Blood and bone marrow drives are among the annual events. Shiloh’s health
and wellness ministry reaches out to the congregation and community by hosting health
52Shiloh Baptist Church, “Shiloh History” [on-line]; accessed 12 December 2010; available from http://www.shilohbaptistchurchwaukegan.com/; Internet.
53Shiloh Baptist Church, “Shiloh Health Ministry” [on-line]. 65 heart seminars, teen workshops as well as CPR and first aid workshops. Home visits are also among the varied activities of this ministry.
Apostolic Church of God Chicago, Illinois
January 17, 1932, the Apostolic Church of God (ACOG) was founded by Elder
Walter M. Clemons.54 Over the years the church has grown from a membership of one
hundred. Byron T. Brazier is an ordained minister and the current pastor of the Apostolic
Church of God. Brazier received his Bachelor of Science Degree in Management from
Roosevelt University. He also received a Master of Arts Degree in Theological Studies and a Doctor of Ministry Degree from McCormick Theological Seminary.
The mission of the Health and Wellness Ministry of the Apostolic Church of
God is to assist the congregation with whole life principles that illustrate the integration of mind, body, and spirit.55 A major emphasis point is to positively affect the systematic
disparities of health that exist within the church and African American community at
large. The Health and Wellness Ministry provides individuals with important points of
interest to assist in staying informed about their health and wellness matters. Each month
the ministry will highlight important points of interests identified in the National Health
Calendar Observations and other areas important to the well being of the congregation
and community.
54Apostolic Church of God, “Church History” [on-line]; accessed 12 December 2010; available from http://www.acog-chicago.org; Internet.
55Apostolic Church of God, “Health and Wellness” [on-line]. 66
Assessment of Churches Discussed in the Project
The examination of the health and wellness ministries of the eight churches has revealed that each ministry is unique and that the activities proved to be very beneficial in developing a health and wellness ministry at The Open Door Church of Louisville. The eight churches have one mission in common and that is to address health physically, spiritually, and emotionally. The differences were governed by budget, facilities, number of volunteers to name a few.
Limiting Factors to Consider
Being a church plant with a congregation of sixty, the Open Door Church of
Louisville is limited by its resources to the services that it can provide. Open Door does not have the facilities to offer the activities that require housing such as a family life center or fitness center. However, there is much that this church could offer with the few resources at its disposal.
The Model for The Open Door Church of Louisville
Exposed to an assortment of ideas from the health and wellness model analysis, it was decided to implement a two-fold program consisting of an annual health fair and periodic health education classes. An annual health fair would serve as an effective outreach vehicle to the community and would be an achievable venture at Open
Door for a variety of reasons. Open Door has members who are medical professionals.
These medical professionals have the resources to enlist medical volunteers from outside the fellowship to assist. Open Door has access to ample grounds to host the fair. 67
Periodic health education classes would serve to educate the congregation and community as well as motivate the participants to adjust their lifestyle. CHAPTER 4
IMPLEMENTATION OF THE PROJECT
The goal of this project was to develop and implement a health and wellness
ministry for the Open Door Church of Louisville. This ministry was designed to inform and educate the congregation in prevention, early detection, and maintenance of health issues that are common but not explicit to African Americans. Every effort was made to enlist church members for this project. Announcements were placed in the church bulletin for several weeks prior to the start of this project and reemphasized from the pulpit as well. Participation in the project was voluntary. Twenty members volunteered to form a focus group whose responsibility was to plan and implement a health fair and complete ten weeks of health classes. Because of limited access to the rented facility where the church is housed, the health fair had to be conducted first and on the outside; therefore, warm weather was required. After the health fair, ten weeks of health classes were conducted.
During the first week a focus group volunteer questionnaire was administered along with a health evaluation questionnaire. The focus group questionnaire was used to measure the interest of the adult members who wished to participate in the project while the health evaluation questionnaire assisted in determining the health needs of the focus group (see Appendix 1).
68 69
The focus group was made up of 10 males and 10 females. The ages of the male participants ranged from 19-65, with 4 participants between 51-65, 4 between 36-
50, and 2 between 19-35. The ages of the female participants ranged from 19-over 65, with 1 participant over 65, 2 51-65, 6 36-50, and 1 19-35.
To measure the effectiveness of the focus group, a Likert four-point scale pre- questionnaire and post-questionnaire was administered. The pre-questionnaire was administered the second week, and the post-questionnaire was administered at the conclusion of the ten weeks of classes (see Appendix 2).
Administering the Focus Group and Health Evaluation Questionnaire
The pastor met with the focus group for ninety minutes each week. The purpose of the first session was to give an overview of the details of a health and wellness ministry and to administer the two questionnaires. The first questionnaire asked four basic questions. These questions asked of the group personal knowledge of the high risk of serious and often fatal diseases common but not explicit to African Americans. These included high blood pressure, diabetes, heart disease, stroke, obesity, and cancer. In addition the questionnaire asked for a personal commitment to complete ten weeks of health classes. The second questionnaire was administered and discussed for the purpose of evaluating the heath issues of the focus group.
Administering the Pre-Questionnaire
The second week, the pastor met with the focus group for ninety minutes. The purpose of the second session was to administer the pre-questionnaire. The pre- questionnaire consisted of fifty-four questions. At least 95 percent of the questions were 70 basically concerned with health issues. It took approximately thirty minutes to complete the questionnaire. After the completion of the questionnaire, the remaining time was spent in a question and answer session.
Planning the Health Fair
For the next five weeks, the pastor met with the focus group to plan for a health fair. It was discussed and agreed that a health fair would be the most effective method of outreach to the community and congregation on maintaining a healthy lifestyle which would be a valuable component of the health and wellness ministry.
During the first planning session, time was spent developing a budget. Once the budget was completed, the pastor divided the group into subcommittees and each committee was given a specific task toward completing the health fair. During the second planning session, the following tasks were addressed by the subcommittees. First was the recruitment of health care providers. The church was fortunate enough to have several heath care providers as members of the church who all volunteered to work the health fair. In addition six associate degree nursing students from the Jefferson
Community College volunteered to assist at the screening stations. During the third planning session, the group concentrated on ways to promote the health fair. An ad was placed in the American Baptist newspaper the week of the fair. Also, flyers were printed and passed out two weeks prior to the fair and again the week of the fair. Posters were placed in various businesses in the community. The fourth planning session dealt with plans for the infrastructure. A 30’ by 40’ tent was secured, and ten health stations 71 were set up. At six of the stations, testing was available for body mass index, blood pressure, diabetes, 02 saturations, and cholesterol. The four remaining stations were setup to distribute health information, pamphlets and brochures. The fifth week the health fair took place and was well attended (see Appendix 3).
Health Education Lessons
The purpose of the next ten weeks was to shine a light on the fact that African
Americans’ health has suffered because of lifestyle and disparities. If this trend is to turn toward a positive solution, African Americans must become efficient in three major areas: prevention, early detection, and maintenance. The goal was to meet the above three objectives through a series of healthcare classes. These classes were conducted over a ten-week period. Prior to each class a pop quiz consisting of ten multiple-choice questions was given over the material covered the previous week. This was done for the purpose of measuring comprehension and retention (see Appendix 4). There are certain diseases that affect African Americans at a greater rate than others who make up the U.S. population.
The object of these next ten weeks was to increase the awareness of the focus group concerning diabetes, heart disease, stroke, cancer, hypertension, obesity, and nutrition. Nearly 3.2 million African Americans over the age of twenty or 13.3 percent of all African Americans have diabetes.1 The most frightening statistic of all is that more than half of all people with diabetes do not even know they have it.
1U.S. Department of Health and Human Services, The Office of Minority Health, “Health Status of African American Women” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/templates/content.aspx?ID=3723; Internet. 72
Week 8, Session 1
In this session the first objective was to help the participants get a better understanding of the major risk factors of type II diabetes. The second objective was to inform the participants how to recognize the early warning signs of type II diabetes.
Heavy emphasis was put on the fact that early detection can save life and the quality of life. The third objective was to assure the participants that having type II diabetes was not the end of life. Popular maintenance can be as simple as sustaining a diet of foods that are low in fat and cholesterol, high in fiber, and moderate in protein, whole grains, fresh vegetables, and fruits. However, it was stressed that diet must be accompanied by exercise.
Week 9, Session 2
In this session the participants were exposed to information on heart disease.
Two in five African American adults suffer from heart disease. According to the
Medline Plus Medical Encyclopedia, younger African Americans between the ages of 35 and 44 had almost twice the rate of heart attacks, strokes, or heart failure as compared to their white peers.2
The first objective of this session was to emphasize prevention. It was stressed
that the best prevention effort would be a combination of healthy diet with regular
exercise. It was pointed out that prevention requires reshaping one’s plate. Staying away
2Robin Wood-Moen, “Genetic Factors of Heart Disease in African Americans” [on-line]; accessed 1 January 2011; available from http://www.livestrong.com/article/261727-genetic-factors-of- heart-disease-in-african-americans/; Internet. 73 from fast foods and high-sodium foods, including processed, cured and smoked meats, cheeses, seasoning salts, and canned soups reduces the risk for heart disease.
The second objective underscored the importance of early detection. The first sign or indication for many is chest pain. The pain is usually located in the front and center of the chest just beneath the breastbone or to the left or right of center. However, it may also be felt in other areas of the body, such as in the jaw, arm, or back. It was underlined that chest pain may suddenly occur at anytime of the day or night, but classically it occurs in the early morning, just when you are getting out of bed. The pain may come when you are active, but it can also occur when you are at rest. It may even awaken you from sleep which is a particularly ominous sign.
Week 10, Session 3
The third session focused on stroke. In general older individuals are more susceptible to strokes. The goal during this session was to expose the participants to the most prevailing method of preventing a stroke. The participants learned that reducing stress is the most prevailing method of preventing a stroke.
The second objective was to point out the importance of early detection.
Because of its nickname the silent killer, recognizing the warning signs could be a matter of life and death. The American Heart Association reports that an individual can possible avert or lessen the damage of a stroke by identifying the following warning signals and seeking immediate medical attention:
sudden blurred or decreased vision in one or both eyes; numbness, weakness, and paralysis of the face, upper or lower limbs on one or both sides of the body; 74
difficulty speaking or understanding; and dizziness, loss of balance, or unexplained falling.3
The third objective was to assure the participants that having a stroke was not the end of life. The quality of life depends on individuals’ willingness to maintain an active role in their healthcare. Monitoring blood pressure, controlling blood sugar and cholesterol through diet and exercise can prevent trouble in the future.
Week 11, Session 4
In the next four sessions the target subject was cancer. African Americans are not only more likely to get any type of cancer than their white counterparts, they are most likely to die from it.
The fourth session focused on the effects of lung cancer on African American men. Black men are at least 50 percent more likely to develop lung cancer than white males and are 36 percent more likely to die from the disease according to the American
Lung Association.4
Environmental hazards such as asbestos or chemicals used in factories can cause lung cancer; however, the reality is that 90 percent of lung cancers are caused by smoking. This means that 90 percent of all lung cancer diagnoses and deaths among black men is preventable.5
3James W. Reed, Neil Shulman, and Charlene Shucker, The Black Man's Guide to Good Health: Essential Advice for African American Men and Their Families, rev. ed. (Roscoe, IL: Hilton Publishing, 2001), 96-98.
4Andrea King Collier and Willarda V. Edwards, The Black Woman's Guide to Black Men's Health (New York: Warner Wellness, 2007), 168.
5Ibid. 75
Week 12, Session 5
During this session prostate cancer was discussed. Prostate cancer is the most common form of cancer for men in the United States. Black men have the highest rates of prostate cancer of any men in the world and sadly due to late diagnosis and treatment, black men die from the disease at a rate that is double their white counterparts.6
The first objective of this session was to emphasize a preventive strategy for prostate cancer. This involves avoiding diets of fatty, fried foods. Rather one must add more fruits and vegetables to the diet. Foods that are high in fiber or rich in antioxidants like lycopene found in raw or cooked tomatoes, leafy greens, and vegetables like cabbage, broccoli, and sprouts are good additions to a cancer preventative diet.
The second objective focused on recognizing the symptoms of prostate cancer
such as dull pain in the lower pelvic area, difficulty starting urination, weak urine flow,
and dribbling, blood in the urine, and general pain in the lower back, hips, or upper
thighs.
Week 13, Session 6
In this session the issue of colorectal cancer was addressed. Colorectal cancer
affects both the colon and rectum. If left undiagnosed, colorectal cancer is one of the top
cancer killers in the United States.
Approximately 3,400 black men die annually from this disease mostly because they do not get screened or treated until the cancer is in its advanced stages. Colorectal
6Ibid., 178. 76
cancer is the third leading among cancer deaths of both black men and black women. The unfortunate factor is that colorectal cancer is commonly undiagnosed, but is truly preventable.7
The main objective of this session was to highlight the warning signs. It was
pointed out that recognizing early the warning signs can make the difference in life or
death. The three most common signs were presented. A change in bowel habits that lasts
more than a few days, such as diarrhea; constipation or narrower stools than usual; any
fresh or dried blood in or on the stool; and cramping or abdominal pain was discussed.
Week 14, Session 7
In this session breast cancer was the topic. Black women are one and one half
times more likely to be diagnosed at a late stage of the disease which is one of the reasons
breast cancer death rates are almost 15 percent higher than those of white women.8
The objective of this session was to show that the key to being cured is early
detection. Breast cancer is a very terrifying disease because it surprises you. However, some of the pessimism that individuals experience regarding breast cancer is unwarranted because early breast cancer is curable.
Week 15, Session 8
Hypertension was discussed during this session. According to The Black
Man’s Guide to Good Health, approximately 28 percent of all people on kidney dialysis machines are black although blacks make up only 12 percent of the population.9 The
7Ibid., 195.
8Sheree Crute, ed., Health and Healing for African Americans: Straight Talk and Tips from More Than 150 Black Doctors on Our Top Health Concerns (Emmaus, PA: Rodale Press, 1997), 54.
9Reed, Shulman, and Shucker, The Black Man's Guide to Good Health Families, 47. 77 dominant objective of this session was to teach the participants why high blood pressure is called the silent killer.
Both men and women can die of this disease without every knowing they have it. This is especially true among African American women. The death rate of high blood pressure is 290 percent higher for African American women than for their white counterparts.10 The most dangerous fact about high blood pressure is that it usually has no warning symptoms. The first symptom may be a stroke, heart attack, sudden death, kidney failure, or damage to other body organs.
Week 16, Session 9
Obesity was the topic of this session. Obesity and becoming overweight has become an American healthcare epidemic. Ninety-seven million Americans are obese which is defined as being 30 percent or more over one’s ideal body weight.11
The primary objective of discussion was to teach that obesity, in and of itself, is considered a risk factor for heart disease. The problem, however, is that obesity is almost always found with other risk factors for heart disease, such as hypertension, diabetes, hyperlipidemia, and smoking. When this happens, the risk of heart disease is even greater.
10Valiere Alcena, African American Woman's Health Book: A Guide to the Prevention and Cure of Illness (Fort Lee, NJ: Barricade Books, 2001), 49.
11Anne Taylor, ed., The African-American Woman's Guide to a Healthy Heart (Roscoe, IL: Hilton Publishing, 2004), 77. 78
Week 17, Session 10
In this final session the discussion was on nutrition. Eating right along with getting exercise is the best preventive medicine known to man. Almost every chronic disease with which African Americans struggle has a risk factor connected to their diet.
The human body is a machine, and just like a sleek, finely tuned car, it needs the right grade and quality of fuel to ensure that it keeps running in top notch condition.
The Last Class Meeting
After the completion of five weeks of planning and implementing a health fair and ten weeks of health education classes, a review and post-questionnaire was given. In the review, there was a discussion about how the health fair could be improved and when the next fair should be held. The months of August or September were suggested but no final decision was made.
The consensus of the focus group was to continue the health education classes.
The participants described the classes as beneficial and informative and all made a commitment to change their lifestyle. The pastor thanked each participant for sacrificing time and for their involvement in the project. The session was closed with a word of prayer.
Project Summary
This project has been very challenging and rewarding. Because The Open
Door Church of Louisville is a church plant, watching the church grow and develop ministries is an indescribable feeling. This project was very timely and beneficial. Those who attended the classes have a much better understanding of wholistic ministries. Those 79 individuals know that the church should be concerned with the physical as well as the spiritual. The focus group expressed excitement in the development of other ministries like the health and wellness ministry. In chapter 5 of this project, the results of the pre- questionnaire, the post-questionnaire, and the focus group are examined.
CHAPTER 5
EVALUATION OF THE PROJECT PROCESS
The intent of this chapter is to exhibit the effectiveness of the health and wellness ministry implemented at The Open Door Church of Louisville. The final outcome of the project was an overall success. Several research instruments were used to measure the results of the project’s goals.
Evaluation of Ministry Project Objectives
The aim of this project was to work with the congregation of The Open Door
Church of Louisville in order to implement a health and wellness ministry. This project had four objectives and these objectives served as the criteria for evaluating the effectiveness of this project.
The first goal was to discover and analyze the health needs of the congregation. To accomplish this objective a focus group was selected which represented one third of the congregation. The research instrument used was a health evaluation questionnaire. The results of the questionnaire show that 51 percent of the focus group suffers from high blood pressure, 20 percent suffers from diabetes, 10 percent suffers from heart disease, and 19 percent are free of any disease. When asked how they felt about their overall health status, 80 percent responded that their health was good, 15 percent responded that their health was fair, while only 5 percent responded that they were in poor health. When asked if they felt they were overweight, 65 percent
80 81 responded yes they were overweight and 35 percent responded no. For a more detailed breakdown of these statistics see Appendix 1.
The second goal was to explore creative ways to inform and educate the congregation and the various neighborhoods in the 6th District on prevention, early
detection, and maintenance methods for the assessed health issues. This objective was
achieved through the implementation of a health fair and ten weeks of health education
classes. The research instrument used to measure the results of these activities was a
pre/post four-point Likert questionnaire. An analysis of the pre/post questionnaire shows
that the health education classes and health fair proved to be quite effective and
especially beneficial.
In terms of the health classes notable interest is made to the difference between
the pre/post questionnaires answers for questions 6, 9, 12, 14, 49, 50, 51, and 54. The
difference between the pre/post questionnaires scores seem to indicate that the
participants have an increased awareness of prostrate cancer, breast cancer, blood
pressure, heart disease, and stroke. There was no change in the awareness of diabetes
although their knowledge of diabetes was exceedingly high at 90 percent. Question 10
states, “Healthier people are more productive Christians.” This question generated a 30
percent increase between the pre and post scores (i.e., 65 percent to 95 percent).
Question 37, “I am interested in learning more about how to improve my state of health,”
drew an overwhelming 100 percent. The results of the pre/post questionnaires scores are
a clear indicator that the second goal was achieved (see Appendix 2).
The third goal was to implement a ministry of health and wellness in the Open
Door Church of Louisville. The implementation involved the structuring of a formal
82 auxiliary within the church. An examination of questions 1, 29, and 39 shows strong support for a health and wellness ministry as an auxiliary of the Open Door Church of
Louisville. Question 1, “A health and wellness ministry will benefit the church and community,” shows a 5 percent decrease in the support for the ministry; however, support for the ministry remains at 90 percent. Question 29, “There is a need for a health and wellness ministry at The Open Door Church of Louisville,” shows a drop in support for a health and wellness ministry. The difference between the pre/post questionnaires indicates a 30 percent decrease (i.e., 90 percent to 60 percent). There are no clear indicators to explain the decline in support; however, 60 percent is a substantial foundation to build on for the future of this ministry. Question 39, “I would recommend other churches to start a health and wellness ministry,” has a decrease of 15 percent (i.e.,
90 percent to 75 percent). Once again, regardless of the decrease, there remains strong support with 75 percent of the group in favor of recommending the health and wellness ministry to other churches. The pre/post response to Question 8, “I don’t know what is meant by health and wellness ministry” is puzzling. It is not clear if the focus group understood the question. In this instance the column labeled disagree is actually the positive response to the question. The difference in the pre/post questions shows a 5 percent decrease in this column of the post questionnaire. One would have expected an increase particularly coming at the end of the project. A follow-up with the group is needed to clarify and understand the group’s response. Question 30, “The church should only be involved in spiritual matters,” falls into a similar category as question 8. Again, follow-up with the group is needed to clarify the response. Question 27, “The health fair is a good vehicle in providing information concerning health issues,” shows a decrease of
83
15 percent. This may be due to the high expectations of the focus group. Although the health fair was well attended, perhaps the attendance did not meet the expectations of the group.
The fourth and final goal was to develop the concept that God is a wholistic
God who is not only concerned with spiritual wellness but also physical wellness. To measure the achievement of this objective, questions 25, 33, 35, and 42 of the pre/post questionnaires were highlighted and evaluated. The response to question 25, “My health is a part of my spirituality,” is exhilarating because the goal of the project was to amplify the concept that God is a wholistic God. To receive a 95 percent positive response is evidence that the message was received. Questions 33, 35, and 42 are all an indication that the focus group realizes that taking care of their health is part of their spiritual stewardship. Note that question 33, “God is concerned about both the spiritual and the physical body,” shows a 5 percent increase (i.e., 90 percent to 95 percent). Question 42,
“I consider my body to be the temple of the Holy Spirit,” shows a 10 percent increase
(i.e., 90 percent to 100 percent). Isolating the results of these questions demonstrates an acknowledgement that the participants view God as a wholistic God.
Personal Reflection of the Project
This project has given me the opportunity to share with the world a very personal experience. I was a M.Div. student at Southern Baptist Theological Seminary in
1995. I also was a volunteer basketball coach at Lyman T. Johnson Middle School,
Louisville, Kentucky. My team was in the championship game when I noticed something strange happening to me. During a time out, my vision began to deteriorate so that I could not make out my kids’ faces. After the game, I told my wife what had happened so
84 the next day we made an appointment with the ophthalmologist to have my eyes and glasses checked. The doctor began his examination and then stopped abruptly. He had me removed from his chair and rushed to the hospital. While at the hospital, the doctor informed me after the examination that my blood sugar level had reached 1000. I had diabetes and never knew it. Because of my ignorance of the symptoms of diabetes, I could have easily slipped into a coma, or worse, I could have experienced a stroke and died. My story is not an isolated one for there are many who could have avoided amputation, blindness, or a dialysis machine. The Scripture teaches that people perish for a lack of knowledge. This project has afforded me the opportunity to speak to this situation. The research done on this project has intensified my passion and has bought a new awareness among my congregation. This has been both challenging, but rewarding, and I look forward to doing further research in this area.
Theological Reflection
The value of having done theological and practical research before implementing this new ministry has been beneficial. Working with a church plant is demanding and offers new challenges each day. Watching God work with seasoned and new comers to the faith and seeing them develop and mature while working together to implement a new ministry into the church is quite amazing.
My first experience as a pastor was with a larger and well established congregation which consisted of individuals with a variety of talents from which to choose. God has shown me through working with this church plant that He can do much with little.
85
God has provided the church with an unusually good opportunity to make a difference in the community. With America’s conscience turned in the direction of health, Open Door Church of Louisville will continue to offer health and wellness initiatives in the future.
During the formative years of the ministry Open Door will be instrumental in promoting blood drives, getting out health facts through the church bulletin and posters, sponsoring shopping trips to the farmers’ market, and a host of other energetic activities.
One particular area of extreme concern is child obesity. The percentage of overweight children in the United States is growing at an alarming rate. Early childhood obesity leads to adult obesity which may lead to chronic health diseases. Open Door will place special emphasis on helping to eradicate this growing epidemic. The First Lady of
America, Michelle Obama, has announced the establishment of a nationwide program entitled “Let’s Move” which addresses the problem of childhood obesity. According to the Centers for Disease Control and Prevention (CDC), 16 percent of American children between the ages of six and nine are overweight or obese. Obesity is more prevalent among African American children than any other group of children.1 The numbers have
been steadily. If left unchecked, obesity can lead to heart problems, hypertension and
diabetes.
There are four key pillars to the campaign:
1. Better nutritional and exercise information for parents.
2. An increase in physical exercise for children.
1Michelle Obama: “Let’s Move” Challenges Childhood Obesity [on-line]; accessed 2 February 2011; available from http://elev8.com/health/yogaflava/michelle-obama-lets-move-challenges-childhood- obesity/; Internet.
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3. Improving the quality of food available in schools.
4. Making healthy foods readily available and affordable.2
A study conducted by the University of Kentucky in 2008 at Johnson
Elementary School in Fayette Country reports that Kentucky children suffer
disproportionally from obesity and obesity rates are highest in low-income, African
American and Hispanic populations. The report further states that obesity has its roots in childhood and Kentucky is seeing an alarming increase in childhood obesity.3 Obesity
typically starts in pre-school and early elementary school.
Open Door’s child obesity initiative will be modeled after the First Lady
Michelle Obama’s “Let’s Move” initiative. Open Door’s version will feature a summer program for pre-school and early elementary students and their parents. We will offer exercise classes where both parents and students will exercise together. Nutrition education will be held and in addition other healthcare providers will be invited in to hold seminars on child obesity. One of the main objectives will be to promote this initiative as a family project. Additional, Open Door will sponsor a mini health and wellness camp targeting the same age group and their parents. The camp will operate inside a local
YMCA where emphasis will be focused on physical activities such as swimming, basketball, walking and how to maintain a healthy diet. Another initative will be a bicycle club where participants would ride on the weekends. There will be a special effort to recruit seniors.
2Ibid.
3University of Kentucky Commonwealth Collaboratives, “2008 Johnson Elementary School Health and Education” [on-line]; accessed 2 February 2011; available from http://www.uky.edu/UE/CC/ edu/ johnson.php; Internet.
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Conclusion
I am excited about this new ministry and I believe that this research project accomplished much. The health and wellness ministry will serve as a foundation for how the church will continue to develop and implement other ministries. Overall the project was a success and it is my prayer that the church will continue to grow and mature in
Christ. The journey has been long but I enjoyed the opportunity of being a part of this
Doctorate of Ministry Program.
APPENDIX 1
The Open Door Church of Louisville Health and Wellness Ministry Focus Group Volunteer Questionnaire
The Health and Wellness Ministry needs your help! Did you know that African Americans are at high risk for many serious and often fatal diseases? These include high blood pressure, diabetes, heart disease, stroke and cancer. Did you know that African Americans are at higher risk for hypertension (high blood pressure) than any other race or ethnic group? Thirty-five percent of African Americans suffer from high blood pressure, which accounts for 20 percent of deaths among blacks in the U.S., twice the figure for whites.
Did you know that approximately 2.3 million African Americans have diabetes? The prevalence of diabetes among African Americans is about 70% higher than among white Americans. Did you know that with your help, we could be instrumental in turning this trend around through education, early detection and proper maintenance?
If you are interested in making a difference in your church and community, why not volunteer to be a part of the health and wellness focus group. This focus group will work as a team in the implementation of a health and wellness ministry here at Open Door where our mission is to inform and educate the congregation and the California and Old Louisville neighborhood communities in the prevention, early detection, and maintenance of health issues that are common to African-Americans. If you would like to participate as part of this focus group, please help us to learn about you by completing this form. Contact Information Name: ______Street Address: ______Zip Code: ______Email Address: ______Phone Nbr.:______Best Time to Call: Mornings Afternoon Evenings Availability When are you available? Week Days Evenings Weekends Specific Days/Times? ______Other Information (Please indicate) Gender - Male Female Age Range: Under 19 19-35 36-50 51-65 Over 65 Thank you for making a decision to help your congregation and community!
88 89
The Open Door Church of Louisville Health and Wellness Ministry Health Evaluation Questionnaire
Thank you for your interest in health promotion here at Open Door. We would like to learn more about your health condition and interest in wellness and health related activities. Your responses will be used in planning new programs and activities for the congregation and the community.
The first part of the questionnaire will focus on obtaining demographic information about the participants. The second part is concerned with health issues.
Please answer the background questions below:
What is your zip code? ______
Are you male or female? Male Female
What is your marital status? Single, never married Married Separated/divorced/widowed
Number of family members in your household? ______
What is your age? Under 20 years 40-49 years 20-29 years 50-59 years 30-39 years 60 years and over
Which of the following health concerns would you like to know more about? (Check all that apply) Diabetes Heart Disease Prevention Exercise/Fitness Healthy Eating High Blood Pressure Weight Management Management Breast Cancer Prostate Cancer Other ______
From which of the following sources do you currently get most of your health information? (Check up to three sources) Television, radio Reference books Newspapers, magazines Voluntary health organizations Doctors Friends, family and other resources Other health professionals Health promotion programs at work Internet
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There are many ways to get health information. Which of the following ways would you prefer? (Check all that apply.) Films and videos Talks by experts (Seminars) Discussion groups Screenings Classes or courses Pamphlets and other written Health Fair materials
How long should a health promotion activity last? (Check only one answer.) Less than 30 minutes 30-45 minutes 45-60 minutes Over 1 hour
Have you ever been diagnosed with any of the following? (Check all that apply) High blood pressure Diabetes Any type of cancer Any type of heart disease Breathing problems such as asthma
If the following were offered, which would you participate in? (Check all that apply.) Health Risk Assessment (health screening with questionnaire) Health screenings (blood pressure, cholesterol check, etc.) Educational classes (one hour or multiple-sessions) Walking program Weight loss program Smoking cessation program Health and wellness information provided on the internet Tasting parties Health fair Cooking demonstrations Other ______
Compared to other people your age, would you say that your health is (Check only one)? Excellent Very good Good Fair Poor
Which of the following is a good reason to go on a diet? Health Clothing Size Advice of the Doctor Other ______
Are you currently on any type of diet? Yes No
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If dieting is part of your effort to lose weight, which method are you using? Just not eating much Talks by experts (Seminars) Avoiding sugar Using a special diet (i.e., Atkins, South Beach, etc.) Avoiding fat Using a special weigh loss formula Using an appetite suppressant (i.e., Slim Fast) Using a prescribed diet from a I am not dieting physician
Are you a member of any type of health club? Yes No
How often do you exercise? Every day Every other day Once a week Once or twice a month Never exercise
Do you consider yourself overweight? Yes No I don’t know
Do you feel your health is a part of your spirituality? Yes No I don’t know
Do you feel God is concerned about both the spiritual and the physical body? Yes No I don’t know
Do you consider your body to be the temple of the Holy Spirit? Yes No I don’t know
Do you feel that staying in good health will increase your spirituality? Yes No I don’t know THANK YOU! You have just completed the questionnaire.
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Fair Good Poor Very Good
3
2.5
2
1.5
1
0.5
0 Poor
Fair 30-39 Female 50-59 19-Under Male 20-29 40-49
19- 60- 20-29 30-39 40-49 50-59 20-29 30-39 40-49 50-59 Under Over` Male Female Fair 111 Good 11 121 113 Poor 1 Very Good 11 111
Figure A1. Health status of participants by age and gender
93
HighBlood
HighBlood Diabetes HighBlood Heart None
2
1.5
1
0.5
0 None
HighBlood 30-39 Female 50-59 19-Under Male 20-29 40-49
19- 60- 20-29 30-39 40-49 50-59 20-29 30-39 40-49 50-59 Under Over` Male Female HighBlood 1211 1 HighBlood 22 Diabetes HighBlood 11 Heart None 11 111 111
Figure A2. Health condition of participants by age and gender
94
Y N
50-59
40-49 Male
30-39
20-29
60-Over`
50-59
40-49 Female 30-39
20-29
19-Under
00.511.522.53
Figure A3. Weight status of participants by age and gender
APPENDIX 2
The Open Door Church of Louisville Health and Wellness Ministry Pre/Post Questionnaire
Using the following scale, please circle the number that corresponds to your feelings in response to the statement.
1 - Strongly Agree 2 - Somewhat Agree 3 - Somewhat Disagree 4 - Strongly Disagree
1 A Health & Wellness Ministry will benefit the church and community. 1 2 3 4 2 I am satisfied with my current state of health. 1 2 3 4 3 I don’t think about health when deciding what to eat. 1 2 3 4 4 It is hard for me to get as much exercise as I should. 1 2 3 4 5 A health fair is a good method of outreach for the community. 1 2 3 4 6 I am informed about prostrate cancer. 1 2 3 4 7 I try to look for healthier foods, but usually eat whatever is available. 1 2 3 4 8 I don’t know what is meant by Health and Wellness Ministry. 1 2 3 4 9 I am informed about diabetes. 1 2 3 4 10 Healthier people are more productive Christians. 1 2 3 4 11 Paying attention to healthy eating and exercising is a lot of trouble. 1 2 3 4 12 I am informed about high blood pressure. 1 2 3 4 13 I know what it takes to lead a healthy lifestyle. 1 2 3 4 14 I am informed about breast cancer. 1 2 3 4 15 Whether or not to live a healthy lifestyle is completely up to the individual. 1 2 3 4 16 I maintain a healthy diet (no trans-fats, low sugar, fresh produce, and whole 1 2 3 4 grains) 17 I feel that I am physically attractive. 1 2 3 4 18 When I awake in the morning, I feel well-rested. 1 2 3 4 19 A health fair should be an annual event. 1 2 3 4 20 I have more than enough energy to meet all of my daily responsibilities. 1 2 3 4 21 I often engage in regular physical workouts (lasting at least 20 minutes) 1 2 3 4 22 I maintain physically challenging goals in my life 1 2 3 4
95 96
23 I am physically strong. 1 2 3 4 24 I am free of chronic aches, pains, ailments, and diseases. 1 2 3 4 25 My health is a part of my spirituality. 1 2 3 4 26 I am able to adjust my beliefs and attitudes as a result of learning from painful 1 2 3 4 experiences. 27 The health fair is a good vehicle in providing information concerning health 1 2 3 4 issues 28 I understand the causes of my chronic physical problems. 1 2 3 4 29 There is a need for a health and wellness ministry at the Open Door Church of 1 2 3 4 Louisville. 30 The church should only be involved in spiritual matters. 1 2 3 4 31 I believe that it is possible to change bad health habits. 1 2 3 4 32 My outlook on life is basically optimistic. 1 2 3 4 33 God is concerned about both the spiritual and the physical body. 1 2 3 4 34 I maintain peace of mind and tranquility. 1 2 3 4 35 Staying in good health will increase my spirituality. 1 2 3 4 36 I am interested in maintaining a healthy lifestyle. 1 2 3 4 37 I am interested in learning more about how to improve my state of health. 1 2 3 4 38 I am aware of and able to safely express fear. 1 2 3 4 39 I would recommend other churches to start a Health and Wellness Ministry. 1 2 3 4 40 I am aware of and able to safely express anger. 1 2 3 4 41 I have a good working knowledge of what a wholistic ministry entails. 1 2 3 4 42 I consider my body to be the temple of the Holy Spirit. 1 2 3 4 43 I have a high level of self-esteem and self-respect. 1 2 3 4 44 I actively commit time to my spiritual life and development. 1 2 3 4 45 I routinely take time for prayer, meditation, or reflection. 1 2 3 4 46 I feel that a health and wellness ministry should be a part of our church 1 2 3 4 budget. 47 I have the ability to forgive myself and others. 1 2 3 4 48 My experience with pain has enabled me to grow spiritually. 1 2 3 4 49 I know the symptoms of high-blood pressure. 1 2 3 4 50 I understand the symptoms of a stroke. 1 2 3 4 51 I know the warning signs of a heart attack. 1 2 3 4 52 I should prepare questions for each doctor’s visit. 1 2 3 4 53 I get routine medical checkups. 1 2 3 4 54 I have a good working knowledge of diabetes. 1 2 3 4
THANK YOU! You have just completed the questionnaire
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Table A1. Pre and post questionnaire results: Questions 1-52
Pre Post Strongly/Somewhat Strongly/Somewhat Change Question Agree Disagree Agree Disagree 1 A Health & Wellness Ministry will 95% 5% 90% 10% 5%↓ benefit the church and community. 2 I am satisfied with my current state 70% 30% 75% 25% 5%↑ of health. 3 I don’t think about health when 35% 65% 40% 60% 5%↑ deciding what to eat. 4 It is hard for me to get as much 70% 30% 75% 25% 5%↑ exercise as I should. 5 A health fair is a good method of 90% 10% 90% 10% No outreach for the community. Change 6 I am informed about prostrate 65% 35% 95% 5% 30%↑ cancer. 7 I try to look for healthier foods, but 75% 25% 90% 10% 15%↑ usually eat whatever is available. 8 I don’t know what is meant by 40% 60% 45% 55% 5%↑ Health and Wellness Ministry. 9 I am informed about diabetes. 90% 10% 90% 10% No Change 10 Healthier people are more 65% 35% 95% 5% 30%↑ productive Christians. 11 Paying attention to healthy eating 35% 65% 40% 60% 5%↓ and exercising is a lot of trouble. 12 I am informed about high blood 90% 10% 95% 5% 5%↑ pressure. 13 I know what it takes to lead a 90% 10% 95% 5% 5%↓ healthy lifestyle. 14 I am informed about breast cancer 85% 15% 100% 0% 15%↑ 15 Whether or not to live a healthy 95% 5% 95% 5% No lifestyle is completely up to the Change individual.
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Table A1. Continued
16 I maintain a healthy diet (no trans- 60% 40% 85% 15% 25%↑ fats, low sugar, fresh produce, and whole grains) 17 I feel that I am physically 70% 30% 70% 30% No attractive. Change 18 When I awake in the morning, I 55% 45% 75% 25% 20%↑ feel well-rested. 19 A health fair should be an annual 85% 15% 80% 20% 5%↓ event. 20 I have more than enough energy to 70% 30% 85% 15% 15%↑ meet all of my daily responsibilities. 21 I often engage in regular physical 55% 45% 65% 35% 10%↑ workouts (lasting at least 20 minutes) 22 I maintain physically challenging 40% 60% 75% 25% 35%↑ goals in my life 23 I am physically strong. 60% 40% 70% 30% 10%↑ 24 I am free of chronic aches, pains, 45% 55% 60% 40% 15%↑ ailments, and diseases. 25 My health is a part of my 70% 30% 95% 5% 25%↑ spirituality. 26 I am able to adjust my beliefs and 95% 5% 85% 15% 10%↓ attitudes as a result of learning from painful experiences. 27 The health fair is a good vehicle in 95% 5% 80% 20% 15%↓ providing information concerning health issues 28 I understand the causes of my 85% 15% 95% 5% 10%↑ chronic physical problems. 29 There is a need for a health and 90% 10% 60% 40% 30%↓ wellness ministry at the Open Door Church of Louisville. 30 The church should only be 30% 70% 45% 55% 15%↓ involved in spiritual matters. 31 I believe that it is possible to 95% 5% 95% 5% No change bad health habits. Change 32 My outlook on life is basically 85% 15% 70% 30% 15%↓ optimistic.
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Table A1. Continued
33 God is concerned about both the 90% 10% 95% 5% 5%↑ spiritual and the physical body. 34 I maintain peace of mind and 75% 25% 90% 10% 15%↑ tranquility. 35 Staying in good health will 80% 20% 80% 20% No increase my spirituality. Change 36 I am interested in maintaining a 100% 0% 100% 0% No healthy lifestyle. Change 37 I am interested in learning more 100% 0% 100% 0% No about how to improve my state of Change health. 38 I am aware of and able to safely 100% 0% 90% 10% 10%↓ express fear. 39 I would recommend other churches 90% 10% 75% 25% 15%↓ to start a Health and Wellness Ministry. 40 I am aware of and able to safely 80% 20% 85% 15% 5%↑ express anger. 41 I have a good working knowledge 50% 50% 70% 30% 20%↑ of what a wholistic ministry entails. 42 I consider my body to be the 90% 10% 100% 0% 10%↑ temple of the Holy Spirit. 43 I have a high level of self-esteem 90% 10% 85% 15% 5%↓ and self-respect. 44 I actively commit time to my 85% 15% 70% 30% 15%↓ spiritual life and development. 45 I routinely take time for prayer, 85% 15% 90% 10% 5%↑ meditation, or reflection. 46 I feel that a health and wellness 85% 15% 75% 25% 10%↓ ministry should be a part of our church budget. 47 I have the ability to forgive myself 90% 10% 85% 15% 5%↓ and others. 48 My experience with pain has 85% 15% 75% 25% 10%↓ enabled me to grow spiritually. 49 I know the symptoms of high- 85% 15% 95% 5% 10%↓ blood pressure.
100
Table A1. Continued
50 I understand the symptoms of a 80% 20% 90% 10% 10%↑ stroke. 51 I know the warning signs of a heart 75% 25% 100% 0% 25%↑ attack. 52 I should prepare questions for each 95% 5% 100% 0% 5%↑ doctor’s visit. 53 I get routine medical checkups. 90% 10% 85% 15% 5%↓ 54 I have a good working knowledge 80% 20% 80% 20% No of diabetes. Change
APPENDIX 3
The Open Door Church of Louisville Health and Wellness Ministry Health Fair
101 APPENDIX 4
The Open Door Church of Louisville Health and Wellness Ministry Class Handout
Nothing Is Sweet About This Sugar1
Learning to Take Charge2
irst it was her aunt’s leg, then her older brother’s foot. Diabetes and its most fear-some complication—amputation—had cut such a terrible swath through her family that Zelda Jefferson just knew that her younger brother Andre, who was diagnosed with the disease as a teenager, was in for a bill fall. “MyF ‘little’ brother had always been large; by the time he was 16, he was 6 feet 4 inches and weighed 310 pounds,” says Zelda, a soft-spoken computer technician who was born and raised in Miami. “But he’s such a teddy bear that I’ve always felt protective toward him.” When she learned that Andre had diabetes, Zelda braced herself for the worst. But the worst never came. Andre took the offensive against diabetes with daily walks and a more careful diet. Over time he lost so much weight that Zelda, who had moved to Los Angeles, didn’t recognize her own brother in a family photo. “It was amazing,” she recalls with a look of astonishment. “There were my parents and my other siblings, and I said to myself, ‘Who’s this guy?’ It was André.” But the best part was his blood sugar profile, which went from alarming to perfectly normal. “Let me tell you—when Andre phoned to tell me the good news that his doctor was taking him off insulin, I was too excited,” recalls Zelda. “It was one more sign that there’s nothing inevitable about poor health.”
1Sheree Crute, ed., Health and Healing for African Americans: Straight Talk and Tips from More Than 150 Black Doctors on Our Top Health Concerns (Emmaus, PA: Rodale Press, 1997), 110.
2Ibid.
102 103
Fact: Nearly 3.2 million African Americans over the age of
twenty, or 11.4 percent of all African Americans, have diabetes.3 Here’s the scariest statistic of all: more than half of all people with diabetes don’t even know they have it. Diabetes4
Diabetes is a disease in which blood glucose levels are above normal. Diabetes interferes with the way glucose which is the body’s principal fuel metabolizes. When sugary or starchy food is eaten, glucose enters into the blood stream to refuel everything from your heart muscles to your brain cells. Once the glucose is in the bloodstream, it needs help in reaching the millions of cells that need it. That helper is insulin, a hormone secreted by the pancreas. Insulin is what allows glucose to enter the cells and be converted to energy. There are two major forms of diabetes. Type I diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, usually first diagnosed in children, teenagers, or young adults. Type II diabetes, formerly called adult-onset diabetes or non-insulin- dependent diabetes, is the most common form of diabetes. People can develop Type II diabetes at any age. Type II diabetes is the most common among African Americans. Diabetes is more detrimental to the body because unlike other diseases such as heart disease, which affects one major organ, diabetes affects the entire body.
3U.S. Department of Health and Human Services, The Office of Minority Health, “Health Status of African American Women” [on-line]; accessed 8 November 2010; available from http://minorityhealth.hhs.gov/templates/content.aspx?ID=3723; Internet.
4Crute, Health and Healing for African American, 111-16.
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Affects African Americans with diabetes are more likely to develop additional medical complications such as blindness, kidney disease, amputations, heart attack, and stroke. These complications make diabetes the seventh leading cause of death in the United States. Other complications include nerve damage, impotency, skin disorders, and gum disease
Prevention
Prevention and education are central to reducing diabetes morbidity and mortality among blacks. The first step in prevention is to understand the disease and the affect of it. The following are the major risk factors for Type II diabetes: • You are overweight (more than ten percent over your ideal weight) • You have a family history of diabetes • You are sedentary • You have ever given birth to a baby weight nine pounds or more or had diabetes only during pregnancy
Early Detection Early detection can save life and the quality of life. The following are common symptoms of diabetes: • Recurring or sluggishly healing skin, gum, or bladder infections • Drowsiness • Blurred Vision • Numbness or tingling in the hands and feet • Itchy Skin • Frequent Urination • Excessive Thirst • Constant Hunger • Unexplained Weight Loss or Gain • Irritability • Fatigue and Weakness
105
Management and Maintenance Management of diabetes requires a close working relationship with a health-care team expert in the treatment of this disease. Popular maintenance can be as simple as sustaining a diet of foods that are low in fat and cholesterol, high in fiber, and moderate in protein, whole grains, fresh vegetables and fruit. However, diet must be accompanied by exercise. Fifteen to twenty minutes of aerobic exercise; walking, running, biking, swimming, anything that stimulates the heart and lungs.
The cornerstones of care: • Daily Blood sugar monitoring. • Nutritional guidelines that take into consideration your lifestyle, exercise habits and eating preferences. • Weight management
• Exercise • Medications Preventive Care Because of the complications of diabetes, it is chital that diabetic patients have the following preventative care. • Regular blood pressure checks
• Quarterly measurement of A1C • Regular tests of kidney function • Regular eye exams by an eye specialist • Regular tests of cholesterol and triglycerides • Good care of the feet to prevent sores that may not heal
106 Questions
Let’s see what you know about diabetes now. The statements are multiple choice. Circle the correct answers.
1. Approximately 3.2 million African Americans have diabetes. a. True b. False
2. There are at least four types of diabetes; Type A, Type B, Type I, and Type II. a. True b. False
3. Which of the following is a complication of diabetes? a. Blindness b. Kidney Disease c. Amputations d. Heart Attack e. None of the Above f. All of the Above
4. Just because your father an mother have diabetes doesn’t put you at risk of contacting the disease. a. True b. False
5. Which of the following is a symptom of diabetes? a. Redness of the Eyes b. Constant Nose Bleed c. Sudden Lost of Hair d. Blurred Vision
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6. A low fat diet and exercise can help you control your diabetes. a. True b. False
7. Diabetes is so detrimental to your health because it affects the whole body. a. True b. False
8. Which of the following is a good method of managing and maintaining your diabetes? a. Weight Management b. Exercise c. Daily Blood Sugar Monitoring d. None of the Above e. All of the Above
9. Itchy skin, frequent urination, fatigue and weakness are all signs of diabetes. a. True b. False
10. Diabetes is a male only disease. a. True b. False
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The Open Door Church of Louisville Health and Wellness Ministry Class Handout
Getting To The Heart Of The Matter
Steering Clear of a Killer5
arold Perkins was walking up on of San Francisco’s steepest hills on the way to a coffee house when he felt a burning sensation in his chest. “At first I thought ‘Is this what an ulcer feels like?’” recalls Harold, a theatrical producer and former dancer in his late forties who is still trim Hat 6 feet 1 inch and 180 pounds. “I was worried sick about a stage production I was having a hard time financing, so I just thought that the stress had done a number on my stomach.” The burning persisted during a dress rehearsal later that day. “It seemed to flare up when I was doing something strenuous, like helping the stage crew move some scenery,” he remembers. About 4:00 in the afternoon, after a particularly intense bout of burning chest pain, Harold decided he’d had enough. “I just suddenly felt that I was dealing with something more than an ulcer,” he says. Harold stopped the rehearsal and asked his director to drive him to a hospital. There doctors discovered that Harold had high blood pressure and a related condition called left ventricular hypertrophy, or LVH, in which one of the chambers of the heart is enlarged. LVH often leads to angina, a type of chest pain that is associated with heart disease and is a signal that the heart isn’t getting enough oxygen.
5Ibid., 206.
109
“When the doctor asked me how long I’d had high blood pressure, I told her it was news to me,” says Harold, recalled his surprise. “It was a little embarrassing.” But when the doctor explained that his out-of-control blood pressure could have led to an enlarged heart, which could cause sudden death, Harold realized that things could have been much worse. “When I heard that, I decided to change my lifestyle, make it back to the doctor’s office for every appointment, and worry a little more about my health and a lot less about the theater,” he says.
Fact: Two in five African American adults suffer from heart disease.
According to the Medline Plus Medical Encyclopedia, younger African Americans between the ages of 35 and 44 had almost twice the rate of heart attack, stroke or heart failure as compared to their white peers.6
Heart Disease
Coronary heart disease is the most common form of heart disease. It is a disorder of the blood vessels of the heart that can lead to a heart attack. A heart attack occurs when an artery becomes blocked preventing oxygen and nutrients from getting to the heart. Often referred to simply as heart disease, it is one of several cardiovascular diseases, which are diseases of the heart and blood vessel system. Other cardiovascular diseases include stroke, high blood pressure, angina (chest pain), and rheumatic heart disease.7
6Robin Wood-Moen, “Genetic Factors of Heart Disease in African Americans” [on-line]; accessed 1 January 2011; available from http://www.livestrong.com/article/261727-genetic-factors-of- heart-disease-in-african-americans/; Internet.
7U.S. Department of Health & Human Services, The Office of Minority Health, “Heart Disease 101.”
110
As recently as the 1940s doctors mistakenly believed that heart disease was as unusual in African Americans as membership in the local country club. The truth is that heart disease kills more Americans of all races—954,000 each year—than any other disease. And African Americans are especially prone to developing this killer. “We’ve got more heart disease than any other population group in the country,” explains Edward Cooper, M.D., professor emeritus of medicine at the University of Pennsylvania Medical Center in Philadelphia and the first African American President of the American Heart Association (AHA). Compared to the rates among whites, blacks’ death rates from heart disease are forty-six percent higher for men and an incredible sixty-nine percent higher for women.8 Coronary artery disease, or CAD, is the greatest killer of Americans. Each year, more than a third of the deaths that occur in the United States are caused by CAD, which, though it primarily affects people in middle to old age, also occurs frequent at younger ages. A heart attack occurs every 26 seconds in this country, and someone dies from one every minute. Fifty percent of men and sixty-four percent of women had no symptoms before their heart attack suddenly killed them. Though CAD occurs in both genders, each year more women than men die of heart attacks. Though CAD affects all races and ethnicities, it is disproportionately lethal in African Americans.9
Complications One of the most common complications of heart disease is heart failure. Heart failure occurs when your heart cannot pump enough blood to meet your body’s needs. Other complications of heart disease include heart attack, stroke, aneurysm, peripheral artery disease, and sudden cardiac arrest.
8Crute, Health and Healing for African Americans, 207.
9 Hilton M. Hudson II, Karol E. Watson, Richard Allen Williams, and Herbert Stern, The Heart of the Matter: Essential Advice for a Healthy Heart from Renowned Surgeons and Cardiologists, rev. ed. (Roscoe, IL: Hilton Publishing, 2008), 79.
111
Early Detection Attention to early warnings may save your life. The first indication of CAD for many is chest pain, which doctors have been calling by its Latin name, angina pectoris. In the case of angina, the heart muscle is not getting enough blood and oxygen to function normally and cries out its pain. The pain is usually located in the front and center of the chest, just beneath the breastbone or to the left or right of center. However, it may also be felt in other areas of the body, such as in the jaw, arm, or back. Angina can suddenly occur at any time of the day or night, but classically it occurs in the early morning, just when you are getting out of bed. The pain may come when you are active, but it can also occur when you are at rest. It may even awaken you from sleep, which is a particularly ominous sign. It has been described as a crushing pain, like someone has reached inside of your chest and is squeezing your heart. Angina can also start out like indigestion or “gas pains.” To confuse the picture even more, not everyone experiences any of the complaints just described. CAD can announce itself with the sudden occurrence of shortness of breath, profuse sweating, dizziness or being light-headed, nausea, vomiting, and palpitations. Prevention The best preventative effort would be a combination of healthy diet with regular exercise. Eating healthier helps us to restrict the calories in our diet. Exercise helps us to burn calories off. It is widely recognized that physical activity reduces the risk for heart disease and that walking is an excellent form of exercise. We must change or reshape our plate. There is no overestimation that a low-fat, low-sodium diet will help in preventing heart disease. Staying away from fast foods and high-sodium foods, including processed, cured, and smoked meats, cheeses, seasoning salts, condiments, salted snacks, pickled products, and canned soups, reduces the risk for heart disease. Replace fried foods with bake, broil, grill, sauté, or poach meats and seafood and eat lots of fresh fruits and vegetables.
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Try a few of these suggestions each day to keep your ticker in tip-top shape:
Degrease your grub: Instead of fatback, use smoked turkey, leeks, onions, garlic, shallots and peppers to flavor old favorites Ease off the salt shaker: Awaken the flavor of fish, chicken breasts, pork tenderloin and beef eye round roast with lemon and lime juices, vinegars, tomato sauces, herbs and sodium-free spices DASH to magnesium and calcium: Include calcium-rich foods, like low-fat milk, yogurt and cheese, and some types of tofu, and magnesium-rich fare such as mustard greens, brown rice and almonds in your diet on a daily basis; Fiber, fiber and more fiber: Include calcium-rich foods, like low-fat milk, yogurt and cheese, and some types of tofu, and magnesium-rich fare such as mustard greens, brown rice and almonds in your diet on a daily basis; Up the potassium: Eat five to nine servings each day of fruits and vegetables, like potassium-rich bananas, sweet potatoes, cantaloupe, oranges and watermelon.
113 Questions
Let’s see what you know about the heart. The statements are multiple choice. Circle the correct answers.
1. Coronary heart disease is the most common form of heart disease. a. True b. False
2. The death rate of blacks from heart disease is 46% higher for men and 69% higher for women then compared to whites. a. True b. False
3. Which of the following is are complications of heart disease? a. Stroke b. Heart Failure c. Heart Attack d. All of the Above e. None of the Above
4. Although someone dies every minute from a heart attack in this country, 50% of men and 64% of women had no symptoms. a. True b. False
5. The best preventative effort against heart disease would be a combination of a healthy diet and regular exercise. a. True b. False
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6. Eat lots of fresh fruits and vegetables.. a. True b. False
7. High-sodium foods include which of the following: a. Pickled Products b. Canned Soups c. Processed, Cured, and Smoked Meats d. None of the Above e. All of the Above
8. Which of the following is a warning sign of coronary artery disease or CAD? a. Nausea b. Vomiting c. Profuse Sweating d. None of the Above e. All of the Above
9. CAD is the abbreviation of Coronary artery disease. a. True b. False
10. Which of the following can help to keep your ticker in tip-top shape: a. Degrease your grub b. Up the potassium c. Ease off the salt shaker d. Fiber, fiber and more fiber e. None of the Above f. All of the Above
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The Open Door Church of Louisville Health and Wellness Ministry Class Handout
Different Strokes for Different Folks
Increasing the Odds in Your Favor10
argaree Crosby is a winner and she looks it. At 54, her body is trim and firm, and her caramel-colored skin is smooth and radiant. And she has a lot more going on than good looks. “I earned my Ph.D in educationM in Boston, and in 1955 I was the first African-American woman to be named a full professor at Clemson University,” Margaree says with a proud smile. But her hard-earned and well-ordered life was thrown into completed disarray on the sunlit morning of July 15, 1995. “I’d been on high blood pressure medication for two years, and I had been told to minimize the stress in my life, but I guess I didn’t do that very well,” Margaree explains. “That morning, I took a walk outside and returned holding my head. I had a strange feeling, and I went to bed and stayed there all day and night. The next morning I tried to move around, but I couldn’t walk without staggering. Finally, I asked my daughter to take me to the hospital.
10Crute, Health and Healing for African Americans, 428.
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“By the time we got there, I had lost the strength in my left side. The next day my speech was slurred. I had suffered a stroke. I was really scared,” she remembers. After 2 1/2 weeks in the hospital, Margaree was well enough to begin physical, occupational, and speech therapy. “I cried, but I knew I had to do what needed to be done. I’ve always been a survivor. I had to do this, too,” she says. She went to therapy as an outpatient. Activities to help her regain motor coordination became part of her everyday life. “I had to walk with a cane. I had to learn to drive again, and I could only say a few simple phrases. But in November, five months after the stroke, my daughter was married, and I walked down the aisle unaided. Now people don’t know I’ve had a stroke unless I tell them,” Margaree says.
Fact: In general, the older you are the higher your stroke risk becomes. After
you turn 55, the risk doubles.11 Reduce stress. African Americans have a different kind of stress. We are disproportionately represented among the poor, our education levels are often low, which reduces our opportunities, and then we deal with racism. All that stress can send your blood pressure soaring, which can increase your chance of having a stroke. Try meditation, and other relaxing activities such as dancing, reading, walking, or listening to music. Stroke
A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain.
11Ibid., 431.
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There are several types of strokes: Arteriosclerotic or ischemic stroke, Lacunae stroke, Embolic stroke, Hemorrhagic stroke, Ruptured aneurysms, and Bleeding arteriovenous Malformations. In black women, arterioslcerotic-type strokes and hypertension-associated strokes are the two most common types seen. It is one of the leading causes of death. The combination of salt sensitivity, salt and water retention, and the resulting high blood pressure is largely responsible for such a high incidence of stroke. Arteriosclerotic disease of the brain occurs in a large percentage of black women. The reasons for this high percentage of brain arteriosclerotic disease are: hypertension, obesity, diabetes mellitus, hyperlipidemia. Frequent use of birth control pills, racial discrimination and the stress associated with it; poverty and all the bad conditions associated with it, including a poor diet with too much fat, too much salt, and too much carbohydrate.12 Hypertension cause strokes in two ways:13 1. Increased blood pressure in the vessels within the brain damages the inside part of these vessels overtime. The damaged areas trap platelets and other material from blood as it passes through. 2. A nidus (cavity where bacterium develops) forms with these vessels and the end result is plaque formation. The formation of plaques narrows vessels impeding blood flow. When a clot is superimposed on the plaque it can close off a vessel resulting in a cerebrovascular stoke.
12Valiere Alcena, African American Woman's Health Book: A Guide to the Prevention and Cure of Illness (Fort Lee, NJ: Barricade Books, 2001), 28-29.
13 Ibid.
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According to the American Heart Association, young African Americans have a two to three times greater risk of ischemic stroke, and are 2.5 times more likely to die of a stroke than their white counter parts. (Ischemic strokes are caused by an oxygen deficiency that can be caused by a constriction or obstruction in the blood vessel that supplies that part of the brain.) They also report that when considered separately from other cardiovascular diseases, stroke ranks as the third leading cause of death in the United States. Strokes claimed 159,791 lives in 1997, and are also a leading cause of serious, long-term disability. Approximately 600,000 people in the United States have stroke every year.14 Early Detection and Warning Signs15 Your risk of having a stroke is greater if you are black, male, over 65 years of age and have diabetes, or if you or someone in your family has already had a stroke. Unfortunately, these are risk factors that you cannot change. However, other risk factors that can change are lifestyle, diet, poor access to medical care, lack of awareness and research in the area of black men’s health, and racial discrimination. There are many signs and symptoms of an impending stroke. The American Heart Association reports that you can possibly avert or lessen damage from a stroke by recognizing the following warning signals and seeking immediate medical attention: Sudden blurred or decreased vision in one or both eyes.
• Numbness, weakness, and paralysis of the face, upper or lower • limbs, on one or both sides of the body. • Difficulty speaking or understanding. • Dizziness, loss of balance, or unexplained falling
14James W. Reed, Neil Shulman, and Charlene Shucker, The Black Man's Guide to Good Health: Essential Advice for African American Men and Their Families, rev. ed. (Roscoe, IL: Hilton Publishing, 2001), 94-95.
15 Ibid., 97-98.
119
• Difficulty swallowing • Headache or an unexplained change in the pattern of headaches.
Having heart disease or even a stroke does not mean your life is over. The quality of your life depends on your willingness to maintain an active role in your health care. Monitor your blood pressure, control your blood, and cholesterol through diet, exercise, and eat a healthy diet to prevent heart disease from striking some time in the future. .
120 Questions
Let’s see what you know about strokes now. The statements are multiple choice. Circle the correct answers.
1. The reason(s) black women have a high percentage of brain arteriosclerotic disease is/are: a. Hypertension b. Obesity c. Diabetes d. None of the Above e. All of the Above
2. Arterioslcerotic-type strokes and hypertension-associated strokes are the most common strokes found in black women. a. True b. False
3. Which of the following is a type of stroke? a. Ischemic b. Embolic c. Hemorrhagic d. All of the Above e. None of the Above
4. African Americans have a two to three times risk of stroke than their white counterparts. a. True b. False
5. The older you are the higher your stroke risk becomes. a. True b. False
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6. Ischemic strokes are caused by: a. Over Eating b. Drinking Too Much Alcohol c. Smoking d. Oxygen Deficiency
7. The lack of awareness and research in the area of black men’s health and racial discrimination can play a role in your risk of a stroke. a. True b. False
8. Which of these signs are symptoms of an impending stroke? a. Difficulty Swallowing b. Dizziness, Loss of Balance c. Difficulty Speaking or Understanding d. None of the Above e. a and c Only f. All of the Above
9. Your risk of having a stroke is greater if you are: a. Black b. Male c. Over 65 Years Old d. Have Diabetes e. All of the Above f. None of the Above
10. One way of lessening your chances of a stroke: a. Change Your Lifestyle b. Diet c. Regular Checkups with the Doctor d. All of the Above e. None of the Above
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The Open Door Church of Louisville Health and Wellness Ministry Class Handout
Crabby Cancer
Increasing the Odds in Your Favor16
ilhelmina Grant is 39, but she looks and moves like a young girl. The tall, lithe flight attendant, karate expert, and health advocate is known for her boundless energy and her wide, frequent smile. W“After my breast cancer diagnosis, I created a job description for myself. I decided to get the message out to other African American women that breast cancer does not only affect middle-aged White women. I tell sisters, you, your mother, and your cousin are also at risk, so you need to be proactive in seeking health care. Bone up on the issues and get your mammograms as prescribed by your doctor,” she says in a voice filled with determination. She knows the importance of high-quality medical care. Wilhelmina, a volunteer outreach coordinator for SHARE Self-Help for Women with Breast or Ovarian Cancer, a New York City—based nonprofit organization that provides emotional and social support services for women, their friends, and families, shudders to think what might have happened had she not had a minor mishap in karate class. “I was in a sparring match and my opponent inadvertently hit my breast. The unexpected pain brought my attention to a tumor that had been growing undetected in
16Crute, Health and Healing for African Americans, 53.
123
that spot for who knows how long,” she explains. A visit to a doctor confirmed Wilhelmina’s fears—she did indeed have breast cancer. After undergoing a lumpectomy, chemotherapy, radiation, and hormone therapy she is cured. She’s also convinced that the karate incident was no accident. “It’s that divine intervention thing,” Wilhelmina says. “Now here I am doing outreach work and helping protect other women from dying of cancer,” she says.
Fact: African Americans are not only more likely to get any type of cancer
than their white counterparts; they are most likely to die from it. Cancer
Cancer is a group of many related diseases in which abnormal cells develop, divide uncontrollably and have the ability to infiltrate and destroy normal body tissue. Normally, cells grow and divide to produce more cells as they are needed to keep the body healthy. Sometimes, this orderly process goes wrong. New cells from when the body des not need them and old cells do not die when they should. The extra cells form a mass of tissue called a growth or tumor. Not all tumors are cancerous; tumors can be benign or malignant. Benign tumors are not cancer. They can often be removed and in most cases they do not come back. Cells in benign tumors do not spread to other parts of the body. Most importantly, benign tumors are rarely a threat to life. Malignant tumors are cancer. Cells in malignant tumors are abnormal and divide without control or order. Cancer cells invade and destroy the tissue around them. They can also break away from a malignant tumor and enter the bloodstream or lymphatic system. The lymphatic system carries lymph and white blood cells through lymphatic vessels to all the tissues of the body. By moving through the bloodstream or lymphatic system, cancer can spread from the primary cancer site to form new tumors in other organs. The spread of cancer is called metastasis.
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Lung Cancer17 Black men are at least 50 percent more likely to develop lung cancer than white males and are 36 percent more likely to die from the disease, according to the American Lung Association. Through environmental hazards cause lung cancer, such as asbestos or chemicals used in factories and plants, the reality is that 90 percent of lung cancers are caused by smoking. Which means that 90 percent of all lung cancer diagnoses and deaths among black men is preventable. At over 163,000 deaths each year lung cancer kills more people in the United States than breast, prostate and colorectal cancers combined. A recent study suggests that two-thirds of all cancer deaths could be eliminated if black men would give up tobacco. The five-year survival rate for a man with lung cancer, who is diagnosed before it has spread to other parts of the body, is fifty percent. Unfortunately only fifteen percent of lung cancers are found in their early stages. The good news is that when lung cancer is caught in its earliest stages and early surgery can be performed, the survival rate goes up to eight-five percent. Prostate Cancer18 The prostate is a sex gland. When it is normal, it is about the size of a walnut. It is located between the bladder and the penis and in front of the rectum. The urethra, the tube that carries urine from the bladder and out of the body through the penis, passes through the center of the prostate. Thank of the prostate as the gateway for a man’s reproductive and urinary system.
17Andrea King Collier and Willarda V. Edwards, The Black Woman's Guide to Black Men's Health (New York: Warner Wellness, 2007), 169.
18Ibid., 178.
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Prostate cancer is a series of small cancerous tumors that form in the cells of the prostate gland. As long as the cells are contained in the prostate and have not spread to other organs, the cure rate with treatment is at ninety percent. Without treatment, experts estimate that it takes approximately fifteen to seventeen years to cause death. Prostate cancer is the most common form of cancer for men in the United States. In fact, more men contract prostate cancer than women develop breast cancer. Black men have the highest rates of prostate cancer of any men in the world and sadly due to late diagnosis and treatment they die from the disease at a rate that is double their white counterparts. It’s rare for a man to develop prostate cancer if he is under age fifty. Eighty percent of all prostate cancers are diagnosed in men over sixty-five, with numbers that seem to spike in men over seventy. But black men have a higher incidence of developing prostate cancer in their fifties. Therefore, screenings for black men should begin at age forty particularly if there is a family history of prostate cancer. One prevention strategy is to avoid diets of fatty, fried foods. Rather add more fruit and vegetables to their diet. Foods that are high in fiber or rich in antioxidants like lycopene found in raw or cooked tomatoes, leafy green vegetables like cabbage broccoli, and sprouts are good additions to a cancer-prevention diet. Nutritionists and medical researchers seem to think that by adding soy products that contain isoflavones like soy milk and soy nuts, to the diet, a man may be able to keep his testosterone levels under control and reduce the risk of cancer. Because prostate cancer feeds off testosterone, isoflavones may reduce the risk and progression of the disease. The following is a list of prostate cancer symptoms: • Dull pain in the lower pelvic area • Urgency of urination • Difficulty starting urination • Pain during urination • Weak urine flow and dribbling • Intermittent urine flow • A sensation that the bladder is not • Frequent urination at night empty immediately after urination • Blood in the urine • Painful ejaculation during sex • General pain in the lower back, • Loss of appetite and weight in com- hips, or upper thighs bination with the other symptoms • Persistent bone pain
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Colorectal Cancer19 Colorectal cancer, which is cancer that affects both the colon and rectum, if left undiagnosed is one of the top cancer killers in the United States. Nearly 8,000 black men get a new colorectal cancer diagnosis each year. And approximately 3,400 black men die annually from the disease mostly because they do not get screened or treated until the cancer is in its advanced stages. Colorectal cancer is the third leading among cancer deaths of both black men and black women. The unfortunate thing is colorectal cancer is truly preventable. If you are a man, you have a one in sixteen chance of getting colon or rectal cancer in your life time according to the American Cancer Society for women; the odds are one in seventeen. Although men’s odds of getting colorectal cancer are slightly higher, women are slightly more like to die from it. Overall, African Americans are not only more likely to get any type of cancer than their white counterparts; they are most likely to die from it. One difference in survival rates can be attributed to delayed diagnosis, inadequate health insurance that often keeps them from making expensive visits to a doctor and a terrible fear that hospitals and surgery are the beginning of the end. Recognize early as the warning signs can make the difference of life or death. There are three very common signs of colorectal cancer according to the American Cancer Society: • A change in bowel habits that lasts more than a few days, such as diarrhea, constipation, or narrower stools than usual. • Any fresh or dried blood in or on the stool • Cramping or abdominal pain Other signs of colorectal cancer are unexplained weight loss and constant tiredness.
19Ibid., 194-95.
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Breast Cancer20 While newspapers, television, and magazines focus on the fact that white women develop breast cancer at a higher rate than black women, Raymond B. Wynn N.D. assistant professor in the Department of Radiation Oncology at the Louisiana State University Medical Center in New Orleans qu4stions this assumption. When measured by race, the number of new cases is only slightly lower in black females. The incidence rate is 112 per 100,000 white women and 95 per 100,000 black women says Dr. Wynn. For African American women even bigger problems arise after the diagnosis. Black women are one and one half times more likely to be diagnosed at a late stage of the disease, which is one of the reasons breast cancer death rates are almost 15 percent higher than those of white women. Since the key to being cured is early detection, more African American women need to adopt a can-d0-attitude when it comes to preventing and treating breast cancer. Breast cancer is a very terrifying disease because is surprises you. However, some of the pessimism that people experience regarding breast cancer is unwarranted because early breast cancer is curable. Understanding your risk can save your life. • The chief breast cancer risk factor is being a woman as less than 1% of victims are men. • Age is the next most important risk factor. The 1- in-8 risk rate refers only to women who are 85 and over. At age 35, your risks is rally about 1 in 622. • If the women in your immediate family –your mother, sister, or daughter—have had breast cancer, you have an increased chance of developing it. • If your periods began when you were 11 or younger, your risk is 20 percent higher than if they began at 19 or older.
20Crute, Health and Healing for African Americans, 54-59.
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• If you delay childbearing until after age thirty or never have children, your risk is two to three times that of women who become pregnant before age twenty. Early menstruation and late child bearing increase a woman’s lifetime exposure to estrogens, which some scientists believe could promote cell division in breast tissue and possibly increase the change of cancer. While no one has figured out how to stop breast cancer, there are certain lifestyle changes that you can make to help protect yourself. • Make exams a habit. Monthly breast self-examinations are the most powerful weapons against breast cancer. Many cancerous lumps are found by women, not by doctors or screening tests. • Get a mammogram. Self-exams are critical, but so is having a regular mammogram once you are past the age of forty, even if you have no symptoms. • Healthy eating. Many studies have suggested that a low-fat diet protects women against breast cancer. • Keep your weight down. Study and study of post-menopausal women show that increased weight is associated with increased risk of breast cancer. • Stay fit. A study done by researchers at the University of Southern California in Los Angeles found that pre-menopausal women who get four hours of exercise per week can reduce their risk of breast cancer by 58 percent. • Watch the booze. According to researchers from the Harvard School of Public health, alcohol is the best-established dietary risk factor for breast cancer. In their study, consumption of an average of one drink a day increased the risk of breast cancer 11 percent, and the risk increased about 11 percent for each additional daily drink. Breast cancer in men is rare, but id does happen. Out of the new breast cancer diagnoses in 2005, only 1,700 of those were men. Many people do not realize that men have breast tissue and that they can develop breast cancer. Like all cells of the body, a man’s breast duct cells can undergo cancerous changes. Early detection improves the chances that male breast cancer can be treated successfully.
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Some men ignore breast lumps or attribute them to an infection or some other cause, and they do not get medical treatment until the mass has grown significantly. Also, some men who think breast lumps occur only in women are embarrassed about finding one and worry that someone might question their masculinity. This attitude may also delay diagnosis and reduce a man’s odds for successful treatment. .
130 Questions
Let’s see what you know about cancer now. The statements are multiple choice. Circle the correct answers.
1. Which of the following is a symptom of prostate cancer? a. Dull pain in the lower pelvic area b. Difficulty starting urination c. Blood in the urine d. Persistent bone pain e. All of the Above f. None of the Above
2. Black men are at least 50 percent more likely to develop lung cancer than white males and are 36 percent more likely to die from the disease. a. True b. False
3. Prostate cancer is the most common form of cancer for men in the United States. In fact, more men contract prostate cancer than women develop breast cancer.. a. True b. False
4. African Americans are not only more likely to get any type of cancer than their white counterparts; they are most likely to die from it.. a. True b. False
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5. Black women are one and one half times more likely to be diagnosed at a late stage of the disease which is one of the reasons breast cancer death rates are almost 15 percent higher than those of white women. a. True b. False
6. Colorectal cancer is the third leading among cancer deaths of both black men and black women. The unfortunate thing is colorectal cancer is truly preventable. a. True b. False
7. Which of the following is a warning sign of colon cancer? a. A change in bowel habits that last more than a few days b. Any fresh or dried blood in or on the stool c. Cramping or abdominal pain d. All of the Above e. None of the Above
8. The chief breast cancer risk factor is being a woman. a. True b. False
9. Monthly breast self-examinations are the most powerful weapons against breast cancer. a. True b. False
10. Breast cancer does not occur in men. a. True b. False
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The Open Door Church of Louisville Health and Wellness Ministry Class Handout
You Are What You Eat
Eating to Win21
bout three weeks into my new eating plan, the change really caught me by surprise,” says Sheila Thomas. “Ever since I was a teenager, you had to practically tilt the mattress and dump me on the floor to get me out of the bed,” she says, laughing. “Then one morning I got up an hour before theA alarm, turned on my favorite morning DJ, and hit the shower. When I stepped out of the bathroom, raring to go, and it was only 6:45, I said to myself, ‘Check this out! Nap used to be my middle name, and now all of sudden I’m Miss Morning Person.’” Sheila was into staying in shape, so she had always found a way to get to the gym for occasional workouts. But the source of her new-found energy was her diet. “A trainer who I was sort of. . . well, really flirting with at my gym noticed that I would do things like work out and then eat a candy bar on my way out the door., My motto was, ‘If I’m not fat, what’s the difference? I’m only 32,’” says the Milwaukee-based administrative assistant. “He said the difference would eventually show up in my cholesterol levels, and even if the sugar and fat I consumed didn’t fatten me up, it would tire me out. “I didn’t get a date, but he gave me a copy of a healthy eating plan that laid out all the basics of good nutrition,” she says. “And I’ve got to say, the difference is really something. It was hard limiting sweets, especially, but I feel great, and I dropped a couple of pounds in the bargain.”
21Crute, Health and Healing for African Americans, 310.
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Fact: Approximately twenty-eight percent of all people on kidney dialysis machines are black although blacks make up only twelve percent of the population!22
Hypertension (High Blood Pressure)23
Hypertension (high blood pressure) is called “the silent killer” for good reason. Both men and women can die of this disease without every knowing they had it. This is especially rue among African American women. The death rate from high blood pressure is 290% higher for African American women than for their white counterparts. Blood pressure is the force generated by the heart to pump blood throughout the body. When blood vessels are elastic (complaint) less force is required. When they are stiff, greater force is required to pump blood though. While this greater force may get blood circulated through stiff, resistant blood vessels, the excess force can eventually damage large and small blood vessels, and in that way damage organs that these blood vessels supply. High blood pressure also requires the heart to work harder and can cause heart enlargement and finally heart failure. High blood pressure usually has no warning symptoms. Your first symptom may be a stroke, heart attack, sudden death, kidney failure, or damage to other body organs.
22Reed, Shulman, and Shucker, The Black Man's Guide to Good Health, 47.
23Taylor, The African-American Woman's Guide to a Healthy Heart, 49-53.
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Black males are forty percent more likely to suffer from high blood pressure than white males, and usually develop more serious complications, such as kidney failure, as a result. Approximately twenty-eight percent of all people on kidney dialysis machines are black although blacks make up only twelve percent of the population! High blood pressure kills black men about fifteen times more often than it does white men, and one in three blacks has high blood pressure. Up to thirty percent of all deaths in hypertensive black men may be due to high blood pressure. Hypertension is more common among younger men than younger women; however, in middle age, more women than men have hypertension, perhaps because of the effects of menopause. Symptoms of high blood pressure can include sudden temporary blindness, chest pain, dizziness or severe pounding headaches. The first components of high blood pressure management are lifestyle modifications. These include:
.
1. Decrease the salt in your diet
2. Reduce stress
3. Increase your potassium intake
4. Avoid licorice and chewing tobacco
5. Prevent and treat obesity
6. Begin an exercise program
135 24 Obesity
Obesity and becoming overweight has become an American healthcare epidemic. Ninety-seven million Americans are obese, which is defined as being thirty percent or more over one’s ideal body weight. The prevalence of being over- weight and obese is much higher in African American women compared to the rest of the population, with some thirty-seven percent of African Ameri- can women being obese. Obesity, in and of itself, is considered a risk factor for heart disease. The problem, however, is that obesity is almost always found with other risk factors for heart disease, such as hypertension, diabetes, hyperlipidemia, and smoking. When this happens, the risk of heart disease is even greater. Weight reduction can improve cardiovascular risk in the following ways: it helps to reduce blood pressure, improve blood sugars for those who are diabetic, and results in reduced cholesterol and triglyceride levels. In addition, weight reduction can help prevent diseases from developing. For those with a family history of diabetes, maintenance of normal body weight and exercise may prevent or delay the development of diabetes.
24Ibid., 77-88.
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Treating obesity normally centers around reducing and managing weight. Weight control contributes to the control of cardiovascular risk factors, such as hypertension, diabetes and high cholesterol. Treatment of obesity, therefore, should focus on producing substantial weight loss over a long period of time and include:
1. Behavior modification to reduce food intake 2. Low calorie diets 3. Exercise and increased physical activity 4. Medications and/or surgery in selected cases
Keep in mid that weight loss is a process requiring a combined approach of decreased energy (food) intake and increased energy expenditure. It also requires commitment to a permanent change in diet and exercise in order to maintain weight loss. Therefore, a weight management program should be put into place once weight loss is achieved. Weight management programs should consist of the following:
1. Regular exercise program 2. Long-term modification to avoid potentially destructive eating behavior 3. Education in stress reduction techniques 4. Social support
137 25 Nutrition
Eating right (along with getting exercise) is the best preventive medicine known to man. Almost every chronic disease that African Americans struggle with has a risk factor that’s connected to the way many of us eat. The human body is a machine, and just like a sleek, finely tuned car, it needs the right grade and quality of fuel to ensure that it keeps running in topnotch condition. The basics are simple: Carbohydrate, protein, and fat are the three nutrients that provide the energy you need for everything from breathing to running a marathon. Along with these energy-providing nutrients, vitamins, minerals, and water play a role in every bodily function and process. The problem is an overabundance of high-fat, high-sugar, and high-salt goodies. The National Cancer Institute encourages all Americans to strive for five, which means eating a minimum of five half-cup servings of fruits and vegetables daily. The five-a-day strategy is also part of the Food Guide Pyramid, established by the U.S. Department of Agriculture (USDA). The USDA bases its recommendations on what it calls the leader nutrients in fruits and vegetables, such as vitamins C and A. Here's how it works.
25Crute, Health and Healing for African Americans, 311-13.
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The basics. The base of the pyramid is plant-based and includes the foods that should be the foundation of your diet. These are minimally processed breads, cereals, rice, and pasta. The USDA recommends eating 6 to 11 servings of these foods each day, with the smallest number of servings for people who consume about 1,600 calories day, such as sedentary women, and the highest number for people who consume about 2,800 calories a day, such as active men. A serving is 1 slice of bread, 1 ounce of ready-to-eat cereal, or 1/2 cup of cooked cereal, rice, or pasta. Level two. Vegetables and fruits are at the next level of the pyramid. Eating a variety of them helps you get your daily quota of vitamin C, beta-carotene, and folate and other B vitamins. Aim for three to five servings of vegetables and two to four servings of fruits a day. This way, you'll easily meet your five-a-day goal, and you'll get extra protection against both minor illnesses and chronic diseases. A serving is 1 cup of raw, leafy vegetables; 1/2 cup of other vegetables (cooked or chopped raw); 1 medium apple, banana, or orange; 1;2 cup of chopped cooked or canned fruit; % cup of vegetable or fruit juice; or 1;4 cup of dried fruit. Level three. The milk group and the meat and bean group are at level three, which means you should eat them in much smaller amounts than the grains, vegetables, and fruits. From the milk group, you need only two servings of milk, yogurt, or cheese a day unless you're pregnant or a young person between the ages of 13 and 25, in which case you need three servings. A serving is a cup of milk or yogurt, 11;2 ounces of natural cheese, or 2 ounces of processed cheese. You only need two or three servings a day from the meat and bean group, which is the section of the pyramid that includes protein. This food group also includes dry beans or legumes and nuts, which are non-animal sources of protein, as well as eggs. African
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Americans need to increase their consumption of these nonanimal protein sources and reduce their consumption of meat. Selections from the milk and meat groups should be lean and low-fat, since, excess dietary fat is linked to a host of health problems. Eat lean beef or poultry and low-fat yogurt and drink skim or low-fat (1 percent) milk, for example. And remember, a serving of meat is 3 ounces, which is about the size of a deck of cards. At the top. Finally, there is the group of foods comprised of fats, oils, and sweets. As you probably already know, fats are seldom lacking in American diets, especially African American diets. Since keeping fat to a minimum is essential if you want to avoid being overweight and developing high cholesterol, which leads to heart disease, high blood pressure, and loads of other problems, and the amount of fat you need is easily supplied by meat and dairy foods, there's no need to seek out fats• and oils. (The Daily Value for total fat for someone eating 2,000 calories a day is no more than 65 grams. Of that, 20 grams or less should be saturated fat.)
140 Questions
Now let’s see what you know about hypertension, obesity, and nutrition. The statements are multiple choice. Circle the correct answers.
1. Which of the following should be a part of a weight management program? a. Social support b. Education in stress reduction techniques c. Regular exercise program d. All of the Above e. Only a and c
2. The Daily Value for total fat for someone eating 2,000 calories a day is no more than 65 grams. a. True b. False
3. Weight reduction can improve cardiovascular risk in the following ways:, , and results in. a. It helps to reduce blood pressure b. It improves blood sugars for those who are diabetic c. It reduces cholesterol and triglyceride levels d. All of the Above e. None of the Above
4. Obesity and becoming overweight has become an American healthcare epidemic. a. True b. False
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5. The first components of high blood pressure management are lifestyle modifications which include increasing your potassium intake and avoiding licorice. a. True b. False
6. The top of the Food Guide Pyramid is comprised of fats, oils, and sweets.. a. True b. False
7. High blood pressure usually has no warning symptoms. Your first symptom of high blood pressure is which of the following? a. Kidney failure b. Heart attack c. Sudden death d. All of the Above e. Only b and c
8. The prevalence of being overweight and obese is much higher in African American women compared to the rest of the population, a. True b. False
9. The milk group and the meat and bean group are at level three. a. True b. False
10. Hypertension (high blood pressure) is called “the silent killer”. a. True b. False
APPENDIX 5
Definitions
The following terms are defined for the purpose of clarity in exposition of this project:
Early detection: this term refers to the perception that something has occurred or some state exists. Early detection can often lead to a cure.
Health: the biblical definitions of health refer to health as wholeness and sickness as brokenness reflecting health as an integration of body, mind, and spirit—inner and outer harmony, shalom.1
Health disparities: this term refers to the significant differences between one population and another--the differences in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates.2
Maintenance: this term refers to the activity involved in keeping an illness or disorder at a satisfactory level.
Target area: this term refers to the church’s congregation and the California and Old Louisville neighborhood communities.
Wellness: this term refers to the condition of good physical and mental health, especially when maintained by proper diet, exercise, and habits.
Wholistic: this term is rooted in a Christian perspective of integrated health care of mind, body, and spirit with God as the source of all healing.3
1Abigail Rian Evans, The Healing Church: Practical Programs for Health Ministries (Cleveland: United Church Press, 1999), 141.
2U.S. Department of Health & Human Services, The Office of Minority Health, “What are Health Disparities?” [on-line]; accessed 4 February 2010; available from http://minorityhealth.hhs.gov/ templates/content.aspx?ID=3559; Internet.
3Evans, The Healing Church, 33.
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ABSTRACT
THE DEVELOPMENT AND IMPLEMENTATION OF A HEALTH AND WELLNESS MINISTRY AT THE OPEN DOOR CHURCH OF LOUISVILLE IN LOUISVILLE, KENTUCKY
Dalton Eugene Holt, Sr. The Southern Baptist Theological Seminary, 2011 Faculty Supervisor: Dr. T. Vaughn Walker
Chapter 1 gives an introduction to The Open Door Church of Louisville and its
surrounding community. The demographics of the community and church reveal that the
congregation of Open Door is receptive to the implementation of a health and wellness
ministry.
Chapter 2 addresses the biblical and theological issues surrounding a health
and wellness ministry. It seeks to provide a foundation for the understanding of the value of a wholistic approach in ministering to people. Biblical texts are presented to explain what the Bible says about the importance of our stewardship toward our bodies.
Chapter 3 describes and discusses the African American picture of health giving the past and current health status of black women and black men. In addition, this chapter seeks to discuss health disparities and the most common diseases plaguing the
African American community.
Chapter 4 explains the process used in the implementation of the project. Chapter 5 focuses on analysis and evaluation of the project initiatives. This includes both successful and unsuccessful results of those initiatives taken. This chapter also examines the strong and weak points of the project through reflection upon the project. Additionally, an assessment is be made of the impetus for future activities evolving out of this project.
VITA
Dalton Eugene Holt, Sr.
PERSONAL Born: November 22, 1954, Dickson, Tennessee Parents: Dalton Louis and Augusta Bell Holt Married: Arie L. Singleton, October 21, 1976
EDUCATIONAL Diploma, Hume Fogg High School, Nashville, Tennessee B.A., University of Louisville, 1981 M.Div., Southern Baptist Theological Seminary, 1995
MINISTERIAL Pastor, The Open Door Church of Louisville, Louisville, Kentucky, 2008-present Pastor, Emmanuel Baptist Church, Louisville, Kentucky, 2000-04