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*!/? CARTER CENTER OF EMORY UNIVERSITY
Occasional Paf>a :\!!rtes \:blwne 1, Nwnha 2
St)omored h)· The Career Center of Emory Universit)' and The Wheat Hidge Foundation Striving for Fullness of Life: The Church's Challenge in Health
The Carter Center of Emory University Atlanta, Georgia October 25,27, 1989 STRIVING FOR FULLNESS OF LIFE: THE CHURCH'S CHALLENGE IN HEALTH
Co~Sponsors
The Carter Center of Emory University Wheat Ridge Foundation
Contributing Organizations
American Medical Association Centers for Disease Control Emory University Department of Community Health The Episcopal Church Evangelical Lutheran Church in America W.K. Kellogg Foundation Lutheran Brotherhood Foundation Presbyterian Church (USA) Robert Wood Johnson Foundation United Methodist Church
Symposium Staff Dr. Constance Conrad, Symposium Coordinator Karen Weaver, Conference Planner James Cogswell, Program Consultant
Beverley Booth Shannon McCormick Cindy Hill Thomas Medlock Carolyn Humphrey Angie Miller Lenora ] ohnson Mackie Norris Kathy Kinlaw Mark Scott Linda Lehman Susan Sheridan Lutheran Theological Center in Atlanta Phyllis Gibson-Sullivan Students and Staff
Parts of this publication were originally edited from transcribed copy and published in Second Opinion (Vol. 13, March 1990), the journal of the Chicago-based Park Ridge Center for the Study of Health, Faith, and Ethics. Table of Contents
Introduction by Jimmy Carter ...... 4
Preface by William H. Foege ...... 5
Overview of the Foundations of the Conference ...... 6
Closing the Gap ...... 7
Section I: Primary Health Care Issues in the United States Today ...... 9 The Science Issues: James Mason ...... 10 The Social Issues: C. Everett Koop ...... 14 Accepting Our Responsibility: Jimmy Carter ...... 18
Section II: The Role of the Faith Community in Health and Healing...... 22 The Theology and Tradition of the Church and Healing: Mart1n Marty ...... 23 The Vision of the Poss1ble: What Churches Can Do: William Foege .... 27 A Voice for the Voiceless: The Church and the Mentally Ill: Rosa lynn Carter ...... 3 1
Section Ill: Mobilizing the Faith Community to Respond to Health Needs ...... 33 Models: Whar ChurLhes are Domg ...... 34 Action Groups Appendices Conference Presenters ...... 41 Conference Participants ...... 42 National Health Policy Meeting ...... 45 I The Church's Challenge in Health poor people between the amount of those in need. Introduction suffering that health indicators We must put our shared beliefs ]immy Carter suggest and the actual amount of into action. l think that the adage 39th President of the United suffering that occurs. The difference "charity begins at home" is particu is due to a factor that might be larly appropriate here. For unless States characterized as despair or hopeless each of us begins to take responsibil Chairman, The Carter Center ness. The fact that pa rticular people ity for our own health, we wLII be ill do not believe that anything they do equipped to go about the important wi.ll be successful or will help them business of helping those who little more than five years live a better or longer Life makes a cannot always choose for themselves ago, The Carter Center of difference. When people are offered the path to a full and productive life. Emory University held a drugs or cigarettes, or when they get A conference entitled "Clos sick, they do not have enough energy ing the Gap," which focused on what co resist or to recover. There is a Americans can do to improve their quiescent acceptance of a dismal, health. The most disturbing revela tragic !tfe. tion of that conference was that we These are sociological problems as individuals deliberately forego th.e that cannot be solved even by the opportunity to live healthier and most cnligh.tened government. l t more productive lives. We ourselves takes a multitude of efforts to make decide the status of our health, possible educational opportunities, through either a failure to learn th.e improved housing, adequate medical facts or a failure to apply the facts to care, and other programs that build our own lives. self- respect and let a person know Consider, for example, those of us that his or h.er ambitions can be who live in comfortable h.omes, dine reali zed. in nice restaurants, and when we are Churches, synagogues, and reU ill, consult the physician of our gious organizations have an impor choice. We are aware of the guide tant role to play in building self lines that can potentially h.elp all of respect and in teaching people to us live longer, h.ealthier lives. If we take an active role in leading a exercise (wh.ich sh.ould be enjoy healthier life. There is no ch.urch in able); if we eat the proper diet the United States th.at could not (which should not be a sacrifice); if coordinate and carry out an immuni we don't smoke (which saves us zation program ::~ga ins r measl.es in money); if we have regular physical their congregation. But to cross the examinations, and if we even do chasm that exists between rich and simple things like fasten our scat deprived or suffering people some belts, we could live longer. But the times three blocks away takes initia answers arc so simple that we say, rive and a great deal of h.umility. "Well, anybody can do that, so I'm The challenge of our conference, not going to do it." "Th.e Church's Challenge in Health.: But living among us are people Striving for Fullness of Life," th.is who are not able to choose a healthy past October, was to derive from the life. The poor of our inner cities different faith.s common premises on face many obstacles they feel they which to build an acceptable, cannot control, such as the polluted effective health. program. Our hope conditions in which they live, the is that each person wh.o attended the lack of access to proper medical care, conference carried away some ideas President Carter and Carter Center and an inadequate diet. There is a and examples of ways in which his or Executive Director William Foege. tremendous difference among many her congregation can reach out to THE CARTER CENTER OF EMORY UNIVERSITY I effective use of the prevention tools care crisis that burdens us all. The that we already possess. If the key to religious community must serve as Preface equity and success in our health an advocate for social justice in Dr. William H. Foege future is prevention, then the health. It is our responsibility to Executive Director, informed have a responsibility to help patch the wheel. teach such prevention. If we do not The Carter Center apply our knowledge then we do nor of Emory University progress. We end up with another broken cog in the wheel. Two hundred religious leaders from the ne way to measun:: a largest faith groups in the United civilized society is by the States answered our call in October quality and extent of it!; 1989 because they feel the economic 0 concern and care for repercussions of 3 7 million unin the health of its people. How does sured Americans; they are disturbed our society measure up? by the moral and ethical impact of The health crisis we face today in the need for preventive services and this country places an enormous affordable health care; they are economic and moral burden on us moved by the personal and spiritual all. The United States' infant implications of the lack of action; mortality rate lags way behind that and they are challenged by their of most industrialized nations. The mission. health status gap between white and Let's gather our resources in the minority Americans is ever widen religious community, teach health ing. The tobacco industry in this education, support screenings and country spends billions of dollars clinics, and provide compassion to each year to promote and glamorize help raise ourselves out of the health the addiction of a substance that takes 1,000 lives each day. And scientific findings tell us that the majority of people in the United States die premature deaths from preventable causes. Our nation's understanding of health care should be based on an holistic perspective rather than a solely medical one. The health care wheel has physical, psychological, social, and spiritual cogs which must all be in place for the system to function smoothly and efficiently. We must strive for this comprehen sive approach to health services in our homes, churches, and communi ties. The 1984 "Closing the Gap" con ference studied the scientific dimen sion of health care and concluded that the majority of death and disease in the United States is President and Mrs. Carter, C. Everett Koop, Reed Tuckson, William Foege, and premature because we don't make )ames Mason meec in President Carter's office prior tO che conference. I The Church's Challenge in Health among denominations as well as Overview of the Foundations other faith groups. ln addition, par ticipation was secured from repre of the Conference sentatives of funding agencies, theo logical seminaries, religious publica tions, religious medical organiza he church has a history of National Baptist Convention, the tions, and related agencies. ministry to persons and Evangelical Lutheran Church in Thirty-two Christian denomina communities in relation to America, the Lutheran Church tions, along with members of the T spiritual, physical, and Missouri Synod, the Episcopal Jewish, Islamic, and Native Ameri mental illnesses. However, with ap Church, the Roman Catholic can faith groups, were represented at propriate motivation, support, and Church, and the Presbyterian the symposium in October 1989. resources, churches and other faith Church (USA). groups could be doing much more in President and Mrs. Carter and Symposium Process the realms of health promotion, Surgeon General C. Everett Koop During the planning of the con disease prevention, and various agreed to serve as Honorary Co ference, the desired outcome was needed ministries in caring and Chairs for the conference. Dr. Foege one of action-oriented resolution. healing. and Reverend Zimmer served as Co The project strove for a renewed In 1984, The Carter Center spon Chairs, and Dr. Constance Conrad commitment at every level of the sored "Closing the Gap," a major of Emory University accepted the religious community to work toward consultation on health that focused duties of Symposium Coordinator. solutions to health problems and the on prevention. The study concluded Funding for the National Chu rch promotion of full, healthy lives. To that current technology and scien Leaders Symposium on Health was this end, the program goals were set tific information was not being effi secured from the following agencies as follows: to provide information ciently applied to prevent premature and foundations: The Centers for about primary health issues in death and disease. The Carter Disease Control, Henry J. Kaiser America today, to address the role of Center pointed to clergy as one of Family Foundation, Robert Wood the faith community in health and four essential groups to receive and Johnson Foundation, Lutheran healing, and to mobilize the faith use the findings of the report. The Brotherhood Foundation, W. K. community to respond to health potential for impact within the Kellogg Foundation, American needs and to commit to the promo religious community seemed great. Medical Association, Emory Univer tion of full and healthy Lives. In summer 1988, the Wheat sity Department of Community Striving for Fullness of Ufe: The Ridge Foundation, a Lutheran chari Health, Episcopal Church, United Church's Challenge in Health was held table organization that provides seed Methodist Church, Evangelical at The Carter Center on October money for healing ministries, agreed Lutheran Church in America, and 25-27, 1989. The symposium to co-sponsor with The Carter Presbyterian Church (USA). offered plenary sessions, discussion Center of Emory University an groups, resource material, a litera ecumenical conference designed to Methods ture display area, a book display, a promote the church as a mechanism The initial plans called for the health risk assessment, workshops for disseminating health informa participation of church leaders on church-based health-related tion. A Steering Committee met in (clergy and Lay}, church publications models, and a field trip to local September 1988 to plan a national editors and policy board members, church health programs. But most ecumenical conference on health. directors of health missions and important, it offered a unique oppor Dr. William Foege, Executive local health projects, and grassroots tunity for members of different faith Director of The Carter Center, and ministry leaders. groups and denominations to the Reverend Robert]. L. Zimmer, A concern for inclusiveness interact, share information, and President of Wheat Ridge, headed spurred the Steering Committee's inspire each other. ln this paper, the Steering Committee, which also efforts to ba lance ethnic, racial, each conference goal is addressed in included representatives from the gender, and geographic diversity in a separate section and supported by American Baptist Churches, the participants. They also endeavored speeches, feedback, and reactions of Southern Baptist Convention, the to obtain appropriate representation conference participants. United Methodist Church, the f6-. ~------~. ·.------_J THE CARTER CENTER OF EMORY UNIVERSITY I The study concluded that we can improve our nation's health status Closing the Gap simply by applying the knowledge and skills of prevention that we already possess. To bridge the gap, we must make more effective use of n November 1984, The ized nations· ·deaths that are pre medical science in our communities Carter Center sponsored a ventable with proper prenatal care. and churches and promote healthier major consultation on health The consultation brought to light lifestyles. The nation is not as I which involved national the burdens imposed on society by dependent on research and technol health leaders from the public and premature disease, disability and ogy to achieve an enormous im private sectors, academic, voluntary, death, measurable in humanitarian provement in health as it is on and professional organizations. as well as economic terms. Prema individual will and ability to make Entitled "Closing the Gap" and sup ture, preventable disease consumes informed choices and adopt health ported by grants from the Robert resources, exhausts health budgets, ier habits. Lifestyles are shown to be Wood Johnson Foundatton and the and presents an ethical challenge to the major determinant of health and Culpepper Foundation, the consul the cou mry. well-being [chart B]. Since we are tation focused on the "gap" repre sented by health problems that are unnecessary in light of our current scientific knowledge. The health leaders examined current interven Chart A: tion and prevention efforts and sought to develop new strategies to address precursors to premature death and disease. The study examined the primary causes of illness and death in the United States and identified attrib utable risk factors. The six generic Tobacco risk factors-tobacco, alcohol, inju ries, mental health issues, preventive Nutntton Orher services, and unintended pregnan Prev cies-were found to contribute to more than half of the deaths and illnesses in this country [chart A]. Untnt The clear conclusion was that two Pregnoocy out of every three deaths in the Deotns United States are premature or un Years of L1fe Lost Before Age 65 necessary given our technology. To bacco was identified as the leading single cause of premature death in the United States. The study noted that a pro nounced disparity between the Printed m: Closing the Gap: The Burden of Unnecessary Illness, Robert health status of minority Americans W. Amler, H. Bruce Dull, eds. Oxford University Press, 1987. and white Americans persists, dis playing the socioeconomic factor in the widening health gap. A lack of preventive services accounts also for the United States' infant mortality rate ranking 22nd among industrial- I The Church's Challenge in Health responsible for our own lifestyles, "Closing the Gap" informed us that Chart B: we are largely in charge of our own health destinies. About 1,000 premature deaths CONTRIBUTIONS TO HEALTH occur in the United States each day due to tobacco alone. Religious or~ ganizations were identified by the consultation as one vehicle for dis Medical Care seminating the current disease llo/o prevention and scientific informa tion that might help alter that statistic. The goal was to enlist the Human Biology clergy in exploring the ethical rela 26o/o tionships among society, community, industry and health of the individ ual. The religious community was cited as a resource to explore in Environment future studies. Following the consul 16% tation, the proceedings were pub Life Style lished in Closing the Gap: The Burden 49% of Unnecessary Illness, a special supplement to the September/ October 1987 issues of American Journal of Preventive Medicine (through a grant from the Henry J. Kaiser Family Foundation). In addition, Jimmy and Rosalynn Source: Jonathan Fielding. Corporate Health Management (Reading: Carter co-authored Everything to Addison-Wesley, 1984), p. 4. Gain: Making the Most of the Rest of Your Life (Random House, 1987), Printed in: Health Care and Its Costs: A Challenge for the Church, which emphasized the impact of per Walter Wiest, editor. University Press of America, 1988. sonal decisions and behavior on one's health at every age. Several conferences and work shops were inspired by "Closing the appraisal system. This system alerts Gap," including a forum on tobacco, individuals to their personal health a global consultation on health risks risks, especially those that can be in the developing world, and the altered to protect their health. The National Church Leaders Sympo HRA is now being modified to target sium on Health. specific populations such as the Following "Closing the Gap," The elderly and minorities. You can read Carter Center collaborated with the more about using the HRA in Centers for Disease Control to churches on page 19. update the public domain health risk THE CARTER CENTER OF EMORY UNIVERSITY I Section I Primary Health Care Issues in the United States Today Introduction The first section of the conference foc used on the major health tssues 111 the United States, first from a sc ientific and then from a social perspective. These issues laid the foundations for further disCitSsion of health concerns and provided current scientific information on rhc health status of Americans today. Assistant Secretary for Heal I h James Mason began the scs~ion with a review of "Closing the Gap," a 1984 Carter Center consultation [see page 7], and pinpointed the major causes of unnecessary illness and death in the United Staws. Surgeon General C. Everett Koop discussed the social issues invnlved in the health care dilemm non-smoker has in fact gained three Health Care in the U.S. · days per week, while the average smoking American is stuck with the The Science Issues life expectancy of the 1960s.) Most of this increase is due to disease prevention rather than treatment. Improved sanitation has provided safer milk and water su pplies, and nutrition for most Americans is better. Immunizations and improve ments in maternal and child health ]ames Mason have made the most difference. Assistant Secretary for Health, Over the past quarter-century, mass Department of Health and vaccination programs have reduced the incidence of measles, mumps, Human Services rubella, tetanus, diphtheria, pertus sis, and polio by more than 98 percent. In 1985 The Carter Center of mong the major health is needs of those who are disadvan Emory University and the U.S. sues in the United States taged by currenr policies and pro today, the weaknesses of grams. The current Medicaid pro A the nation's medical care gram must be made more equitable system figure prominently. Our and more attractive to potential If our churches and country's health care system is frag providers, with continued efforts to mented and costly. In addition, improve quality and control costs. families do not nurture nearly 32 million Americans are In addition, we will need to explore uninsured or significantly underin the creation of parmerships among positive moral charac~ sured. Most of these people are the federal, state, and local govern ter-including integrity, working poor and their dependents. ments, the private sector, and They earn too much to qualify for churches to strengthen the health responsible self-reliance, Medicaid and too little to buy care delivery system and make it private insurance or to pay directly more responsive to the needs of the self-discipline, for medical care. Too many find it poor. preferable economically to join or Although the gaps in health care self-esteem, and charity rejoin d1.e ranks of the Medicaid delivery in the U.S. are prominent, eligible unemployed, and few incen this century's successes in public toward others-our tives exist for sustained independ healtl1. should not be minimized. children will increas~ ence. Furthermore, the dramatic progress We need a health care system made in lengthening the lives of ingly give in to high~risk that guarantees high-quality care, most Americans and improving the access to all, affordability, and an quality of their lives offers lessons for behaviors. orientation toward prevention. At our present course of action. the direction of the Secretary for the In this century alone, life expec U.S. Department of Health and tancy has increased by over 25 Centers for Disease Control (CDC) Human Services, the undersecretary years-a 50 percent gain. In other listed 14 primary causes of Lllness of the department will be making words, every week since January 1, and death in the United States, recommendations to reform our 1990, the average American has including infectious disease, sub financing of health and long-term gained two days of life. (The average stance abuse, cardiovascular disease, care. Successful reform, we realize, cancer, dental disease, alcoholism, will hinge on our attention to the unintentional injury, and homicide/ THE CARTER CENTER OF EMORY UNIVERSITY suicide. Together, these causes are responsible for 85 percent of all health care costs, and 80 percent of Today there is a need for the non-medical lay person, those who make up the deaths in the United States. our religious communities, to reach out arul assist in ministering to the They also account fo r 90 percent of health needs of families and individuals who are not acutely ill, but whose the potential years of life lost lifestyles and health practices place them at high risk for becoming acutely because people die unnecessarily or chronically disabled. -Sister Mary Madonna Ashton, Commissioner before they arc 65 years old. of Health, Minnesota Department of Health Two-thirds of the total years of life lost by Americans before the age The church cannot sic around and wait for the government to solve the of 65 arc preventable. An estimated problem. The issue is for the church to quit holding macrame classes and 45 percent of cardiovascular disease trying to convince u.s that it's a viable ministry. It's time for the church to deaths, 20 percent of cancer deaths, be involved actively in caring for the poor and caring for the sick. -Dr. and more than half of disabling Scott Morris, Executive Director, Church Health Center of Memphis diabetes complications could be prevented through improved and broadened application of existing enormous. In 1988 the National now the highest cause of death in preventive measures and risk Commission to Prevent Infant New York City for males between reduction strategies. Nearly two Mortality estimated that the hospital the ages of 24 and 44. We don't yet thirds of Americans arc too fat, costs for low-birth-weight babies have ultimate answers to the treat according to a recent health survey. were in the range of $2 billion annu ment of AIDS-but we know Many of our modern plagues thus ally, while the costs of providing enough to stop the transmission of have a strong behaviornl compo early prenatal care to every woman the virus from one person ro another nent, presenting public health and not receiving it were as low as $500 and to mount educational programs other American institutions with a million. that will help people avoid putting serious challenge in communication The clear conclusion of T he themselves at risk for getting the and motivation. Carter Center-CDC consultation HJV infection and AJDS. Infant health is another area of was that we arc not dependent upon The Carter Center-CDC study concern. In 1988 in the United additional medtcal knowledge and also tdennfted a number of risk States, almost 39,000 babtes dted research breakthroughs to achieve factors associated wtth the L4 before they reached the age of one an enormous tmprovement m primary health problems, and many year. And annually, an estimated health. We can become a much of these risks can be removed by 400,000 babies who have been healthier people by making more individual choice. Most frequently subjected to less than optimal effective usc of the knowledge of cited were usc of tobacco and intrauterine or prenatal environ prevention and interventions we alcohol, uncontrolled high blood ments develop a chronic disabling already possess. pressme, 1111intcnded pregnancy, condition. America's infant mortal Parr of the challenge is to adapt injury risk, lack of preventive ity rate ranks 22nd among industri traditional public health cools like medical services, and improper alized nations-t\vtcc as high as epidemiology and surveillance for nutrition. Tobacco was idenrified a:s Japan's and those of the Scandi new applications in health-related the single leading cause of prevent navian countries. Black mfant flelds. Injuries and vtolence, fo r able death. About l ,000 prevent mortality ts double the white rate, example, are leading causes of death able deaths occur in the United and the rate for whites ranks twelfth and disability which have not, until Stares each day-or 360,000 deaths world-wide. recently, been attacked as health per year. Use of alcohol was the If we just applied what we know problems. second most important risk factor. about prenatal care, case manage Another part of the job is to be There is good news about progress ment, outreach, and home visiting, able to respond effectively when a against the diseases that kill Ameri an estimated 10,000 of the 40,000 new threat to health appears. AIDS, cans today. First, smoking is down babies who die each year could be a disease unknown eight years ago, is about 25 percent over the past 20 saved, and the benefits in human years. This is a major public health and economic terms would be gain against such diseases as lung .------u L------~11 ·.I------~ I The Church's Challenge in Health cancer, emphysema, and heart witness to our failu re in achieving Maine community noticed a high disease. T he decrease in lung cancer the health goals that are realizable, number of auto fatalities and inju ries in males parallels the decrease in given the current state of scientific associated with high school gradu smoking, while smoking is still knowledge. Bringing equal opportu ation activities and resolved to do increasing for women. (Tobacco nities in health to all U.S. citizens something. In Project Graduation, advertising targeted to women, the depends on increasing our efforts to the city, the school, churches, and poor, and minorities is still winning educate people about good health. parents joined to help their teen converts to the ranks of smokers.) Prevention is the key Lo equity in our agers develop alternative alcohol Second, from 1950-1970, the free graduation activities, along with incidence rates of invasive cervical ways to avoid drinking and driving. cancer fell by more than 50 percent, This community resolve resulted in and the rates are continuing to the elimination of teen alcohol decline. T he National Cancer Two, thirds of the total related auto fatalities during the Institute credits this success to graduation period each year thereaf earlier detection (the Pap smear) years of life lost by ter. Communities in over two dozen and treatment. T hird, in the past 25 Americans before the states have since adopted Project years, mortality rates for coronary Graduation, and it has clearly heart disease declined 40 percent age of 65 is preventable. reduced a major health risk among and mortality rates for stroke adolescents. declined 25 percent-due in large A second example is a program part to control of high blood pres sponsored by the Emory University sure, cholesterol, and smoking. School of Medicine: "Helping Young This progress is promising, but it health future, for infants, child ren, Teens Postpone Sexual Involve cannot trigger complacency. We and adults. One of my personal ment. " One-third of the school still find in this country a pro goals by the year 2000 is to help districts in Georgia use the curricu nounced and stubborn disparity assure comprehensive health educa lum, which is presented by commu between the health status of minor tion classes fro m kindergarten nity volunteers. The program has ity Americans and white Americans. through twelfth grade in every now been presented to 40,000 Commissioned by the Secretary of school in the country. teenagers between the ages of 13 and Health and Human Services, a 1985 Because modern plagues are 15, and over the last three years, report by the Task Force on Black behaviorally driven, the choices we pregnancies, abortions, and birth and Minority Health gave evidence make on a day-to-day basis largely rates have declined. A program that more than 60,000 excess deaths determine whether we will suffer evaluation shows that 5 percent of occur each year among America's from sexually transmitted diseases the participating teens became mi nority citizens. (Excess is defined including AIDS, become incapaci sexually active, while 15 percent of a as deaths that would not have tated by addictive substances, matched comparison group became occurred had mortality rates for become pregnant teenagers, die sexually active. minorities been as low as those for prematurely from cancer or heart The point should be obvious to whites.) These are preventable disease, or suffer traumatic injury or church and synagogue leaders: deaths. The report identified six death. behavior is value-laden. If people areas in which an overwhelming Action and responsibility fo r are uncomfortable talking about difference exists between the health control of behaviorally based disease moral values in the public square, if status of white Americans and that lies ultimately with the individual, society has backed away from moral of minorities: cancer, cardiovascular but communities, churches, and absolutes, if the schools are com disease, diabetes, homicide, injury, fam ilies have significant roles to pelled to maintain a mythical "value and infant mortality. AIDS has play. Let me ill ustrate with two neutrality," how will children and subsequently been added to the list examples of community-based adolescents learn to behave in because it also disproportionately behavioral change. positive ways that do not put them affects black and H ispanic Ameri ln 1978, concerned citizens in a at risk for life-threatening diseases? cans. If our churches and families do not This disparity bears the clearest nurture positive moral character- ,------ ~------~I1 12 1•· ------~ THE CARTER CENTER OF EMORY UNIVERSITY I including integrity, responsible self temple of God is holy, which temple obviously equipped to make a reliance, self-discipline, self-esteem, are ye." The body's role as a temple significan t difference in the health of and charity toward others--our or tabernacle for the spirit provides the nation if they wiU articulate the children will increasingly give in to an added incentive to promore health benefits from their various high-risk behaviors. health and prevent disease. The traditions. The participation of churches and scriptural commands to demonstrate Our nation's families must also synagogues is needed in this en concern for the sick, lame, halt, participate. They must nurture deavor, and their involvement is blind, and deaf reinforce the concept moral character in children, which historically grounded. Familiar of the body as temple, as do the com comes only through traming. The scriptural passages attest to the long mands to love others as we love church should then encourage and history of the holistic approach. ourselves. But one need not tum to fortify home, and society as a whole Moses gave directions to ancient past rehg10us experience for ex should nor make the job of the Israel on both treating and prevent amples of promoting health, compas fa mily any harder than it already is. ing disease. By avoiding pork, sion, and caring; such behavior As President Bush has observed, we trichinosis was prevented. Treat continues to characterize the work need to find "ways to preserve and ment and prevention strategies for of most contemporary churches. strengthen indispensable institutions leprosy, boils, and ulcers were Churches including Seventh-day like the fa mily in the midst of social provided, and sanitation was clearly Adventists and the Church of Jesus change. As !look on the fa bric of part of their religious life. Christ of Latter-day Saints have pro society and at the instability of T he scriptures also contain clear scribed tobacco, alcohol, and other family relationshi ps, I see a real Lnstructions regarding the expression addictive substances, encouraged threat to our future." of human sexuality . Abstinence diets rich in fruits, vegetables, and The challenge for all of us who fro m sexual activity until one enters whole grains, and either prohibited are active in churches and syna a stable marriage relationship is use of mears or recommended gogues is to articulate clearly the prescribed for spiritual and social sparing use. And studies of members relationship between right behavior reasons. The sexual prohibitions of religious organizations indicate and good health. Many keys to good promoted health and welfare by that churches with teachings on health in the Judea-Christian preventing sexually transmitted health care are capable of infl uenc Scnpturcs are as valid today as they diseases, out-of-wedlock pregnancy, ing li fe-style and behavior, thereby were two or three thousand years and the tnvialization of sexual leadmg to disease reduction. For ago. We need to help people, expression. example, studies have shown that especially young people, understand In the New Testament Paul members of the Mormon church that many diseases and Ulnesses are taught that the body is the temple of living in Alameda County, Califor direct or indirect results of behavior God. "Know ye not that ye are the nia, experienced an adjusted cancer that we've been told to avoid. But temple ofGod ...if any man [or mortality rare only 55 percent as beyond talking about it, we have to woman] defile the temple of God, great as that of the whole country. be good role models ourselves. him shall God destroy; for the Churches and synagogues are If we are trying to deal with the gap between what is known about health promotion and disease prevention and what is applied by the nation's citizens, we need to be talking about t)eople's concepcs of self-worth. If a person doesn't believe in the possibilities of the future, then what difference does health information make! A young man in the inner city may be warned abaut the dangers of casual sexual relationships, but he is likely to reply: "I'm not going to grow up and be in charge of the space around me. I'm not going to decide who gets hired and fired . I'm not going to move resources from this part of the planet to that part I'm not going to get a job; I'm not going to do anything. The only way I can control my environment is to control people. How am I going to control people? Through violence and through sex. Who ever tells me I'm valuable and worthwhile in chis country! Only the woman 1 make love co. And you tell me w stop!" The health message is absolutely irrelevant in such a contexc. That's not work for the health commissioner. That's work for the church. -Dr. Reed Tuckson, Commissioner of Health, District of Columbia ,- -'------~·I u l•.------~ I The Church's Challenge in Health rather solidly set in society. A Health Care in the U.S. · stereotype of the American family held not so Long ago-the father at work, the mother at home spending The Social Issues her life taking care of 2.2 children, her husband, and her house-is now met by only 10 percent of families. Families today are smaller. We have more single-parent families, and we find a greater variety of living arrangements. Mothers are out of C. Everett Koop the home; six out of every 10 Surgeon General, USPHS, mothers with preschool-age children 1981-1989 are in the labor force, two-thirds for economic reasons. Individual members of families are older than they were a generation ago. Alcohol and drugs are abused by more family members. More teenagers are be huge gap exists between People aren't happy about being ill coming mothers. Because families the dream of ideal health or needing to go to a physician. are smaller, and because more care in the United States Having to pay a high price for a elderly people are dependent upon A and the reality of its physician's care increases people's families, the responsibility for such availability. Our aspirations far out dissatisfaction. But we need to care falls on fewer children for distance the resources available to subordinate the economic aspect of longer periods of time. pay for them. In the circles in which the relationship to the climate of Another change in the manage I travel, conversations on this trust between doctors and patients. ment of the public's health, made subject are constant. I hear them Second, the gap between our aspi before 1 came into the federal among doctors and patients, nurses rations and our resources has government, was the closing of many and therapists, social workers and opened at the worst possible time, a pharmacists, representatives of big time when demographic trends are business and small business, mem running against us. Today, fo r bers of Congress, the elderly and the example, for each person over the young. It isn't so much that things age of 65, there are five younger tax Our current system of are changing as that things have paying wage-earners to pay for that health care is not fair, changed, but many people arc trying one person's Medicare coverage. In to plan the future as though it were another 20 years, however, for each not just, and therefore indeed yesteryear. Several current person over the age of 65, only three realities need to be faced squarely if younger tax-paying wage-earners will not the morally strong our planning is to be intelligent. be contributing to Medicare. In a First, the doctor-patient relation climate of scarcity, Americans will system that our society ship has deteriorated significantly have to work out an equitable over the past two decades. This dete sharing of needed medical resources needs-and deserves. rioration began, I believe, when between one population that is professionals in the deli very of growing-that is, those over the age medical care--doctors, nurses, of 65-and the population that is therapists, and so on-starred to shrinking by comparison-that is, mental institutions with the expecta accept the nomenclature of provid those under the age of 18. tion that communities would absorb ers. Their patients in turn slipped Third, the American family has the inmates in halfway houses and several cogs when they permitted changed, and these changes are now sheltered workshops. But those themselves to be called consumers. inmates have not been sheltered and THE CARTER CENTER OF EMORY UNIVERSITY protected, and today they form a large segment of the homeless in We are a community of the whole, wooen together by our society, and America. (Americans, it may be there is no place better than our churches to help u.s understand that inter observed, are generous to a fault, but weaving of society. And there is no safer place in which to have chose they do not like AIDS hospices, drug painful, face-to-face debates about how we are to grot>e wich our own abuse treatment centers, homes for changes and our collective changes toward sustaining one another in more the retarded, or shelters for the healthful behaviors. - -Kristine Gebbie, R.N., Secretary, Washington mentally ill in their neighborhoods.) Department of Health Another change has been the closing of the great city hospitals in Churches and church leaders are urgently needed in two roles; as this country. But these are desper advocates for those with limited access to health care and as participants in ately needed now to care for the discussions about resource allocation. -Patricia Butler, J.D., Consultant, indigent, the homeless, and now the Center for Health Ethics and Policy, University of Colorado burgeoning number of AIDS pa tients, who frequently are also either indigent or homeless. The health care system in Amer vinced than ever that our whole behalf of the consumer (the patient). ica today does not respond at all to health care system needs some major In most other areas of our economy, some 12 to 15 percent of our popula corrections. Critics will say, "Wait a the marketplace docs exercise some tion. This fact constitutes a terrible minute, Dr. Koop. The system ain't control over arbitrary rises in moral burden. And because that broke, so don't fix it." charges to the consumer. But in same system satisfies its own uncon But I have to reply, "You're health care, prices have gone up re trolled needs at the expense of every wrong. The system is broken-and it gardless of the quality of care being other sector of American society, it must be fixed ." Band-Aids won't do. delivered. creates a terrible economic burden Hospital coMs are still climbing, and Try as it might, the medical for society as well. We need to no one can prove to the American profession has not achieved much change that system thoroughly, and people thar the quality of hospital success 111 self-regulation. Physicians we need to do it soon. based care is uniformly going up as can help pur the brakes on some Some critics attribute the eco well. On rhe contrary, our people general expenditures, but very few nomic crunch chiefly to the budget complain that they are paying more physicians can honestly and effec deficit. Once we get rid of the and more for medical care while tively control the delivery of serv deficit, they say, we will also close getting less and less. Worse still, as ice- much less control the costs of the gap between aspirations and the cost of hospital-based care that service-while caring for an in resources-between dreams and increases, the hospitals themselves dividual parient at the bedside. reality. Before we had a budget are trying to narrow their patient What is the effect of a health care problem, however, we had a health pool-for example, eliminating in system distingtlished hy n virru:::tl care economy whose annual infla panent medical care for poor and absence of both self-regulation on tion rate was two to three times the disadvantaged Americans. Some the part of the providers that is, inflation rate for the rest of the thing is terribly wrong with a system hospitals and phystctans-and the American economy. of health care that spends more and controls of compcnnon regarding Some will counter that things more money to serve fewer and fewer pnce, quahty, or service? really aren't that bad: they suggest people. And the same scenario could One has been the emergence of remedies like putting a reimburse be painted with respect to physician three tiers of health care, despite the ment cap on this, changing the services and fees. objecnons of many to even a two-tier eligibility regulations for that, The economics of health care are system. The available options in the cutting back a little here, or pruning peculiar. Its economy, though face of this reality are two, and both a little there. During eight years as laissez-faire, is not freely competi require major changes. Either we your Surgeon General, I thought tive, and hence it has virtually no maintain the diversity of the Ameri about the true human costs associ moderating controls working on can health care system, keep it in the ated with such a patchwork ap private sector, and demand the proach, and today I'm more con- rewarding of efficiency and quality .------ 1------~-I· 15 •.I ------~ I The Church's ChallenQe in Health with more patients rather than more country, and we must do that again. churches were part of the safety net. money; or we go to a government Let's finally say what we've failed Without even thinking, I said yes. I cost-controlled system. to say for too many years: our was raised to consider my church Experience the world over has current system of health care is not and my family as a safety net (al shown that when government fair, not just, and therefore not the though of course we didn't call it economic controls are applied to morally strong system that our that) for those less fortunate, either health, they prove in time to be society needs-and deserves. in health or in worldly goods. detrimental. Eventually, there is I will conclude with a few words Yet today many church people erosion of quality, productivity, in about the church and the churches. separate their faith from action. It novation, and creativity. The There was a time in the Christian should go without saying that replacement of physicians by non church, at least, when those propa church members should be politi medical bureaucrats as controllers of gating the gospel were afraid that cally active, understand issues, vote the system usually results in the lack concern for the welfare of one's properly, and make their representa of responsiveness to patients. And fellow human beings might be tives understand what they believe finally, rationing and waiting lines considered a distraction from the and what they want to see accom become necessary. principal concern for the sa lvation of plished. We may believe in whole Governmental cost controls the lost. In recent years, I believe, ness, in fairness, and in justice, but if cannot be the answer, but can we we were exercising all those virtues, succeed in the alternative course? I'd there would be no need for a confer like to think we can-because we ence on the topic of the church's have to--and especially because Critics will say, "Wait a challenge in health. I will, however, we've met similar challenges before. dwell on several obvious gaps in the Some 50 years ago, for example, minute, Dr. Koop. The outreach of the church-and I will we knew that it was morally wrong speak about the Christian church for our society to allow its old people system azn. ' t bro ke .... " because that's the only one in which to drift into poverty and starvation, I have had any experience. so we enacted a Social Security law But it is broken and it Three ethical issues have been to assure every American a measure very much a part of the social relief of human dignity and respect in his must be fixed. Band~ system and the political activity of or her twilight years. It was an act of Aids won't do. churches: abortion; the care and fundamental decency. We knew we feeding of handicapped children as had to do it, and we did. exemplified by Baby Doe; and the Back in the 1950s and early plight of the elderly, which leads aU 1960s, Americans became painfully too often to a discussion of euthana aware of the terrible unfairness of thinking people have been able to sia. Each of these presents a specific separate but equal education, and espouse social action as part of the challenge to churches. the courts and legislatures began the effect that the gospel is supposed to I am opposed to abortion but have process of ridding our country of the have on the lives of men and women. always admonished any church aud i crushing official, legal burden of Some of you remember the ence I've spoken to that it is not segregated schools. criticisms of social programs in the enough to oppose abortion unless Did we get rid of those burdens early years of the firs t Reagan tenn. the church is willing to extend once and for all? Well, not exactly. Although the president himself understanding, shelter, nurture, and We haven't yet solved every problem talked about a safety net, it wasn't economic aid to a woman who is associated with "growing old in quite clear to everyone what he ca rrying an unwanted pregnancy and America." And we haven't yet pro meant, what the dimensions of that seeking a way out. duced the perfect egalitarian school net were, how strong it might be, and It is not enough to oppose with system. But we have li fted from the especially how universal. In those holding fluids and nutrition from shoulders of our people a large part days I had a title and very little to do handicapped newborns unless the of the burden of shame and guilt while I was waiting for confirmation. church is equally willing to stand by that came with doing nothing. We I got a call one day asking if the the parents of the handicapped did what was morally right for this child. Many parents simply lack the - ~------~I1 16 I~------~ THE CARTER CENTER OF EMORY UNIVERSITY resources-whether material, social, AIDS is essentially 100 percent. instead pursue the traditional, non psychological, or moral-to care for And after several years of intensive judgmental American course of a disabled child, even in their own public education on the subject, the public health care. family. American people may not be in The burden of delivering this It is not enough to bemoan the clined to be forgiving and compas message unfortunately wUl fall most phght of the elderly if the church is sionate with someone who today heavUy upon the leadership of the not attentive to the needs of people engages in casual, unprotected anal black community, where the sharp who face the problems of living with intercourse or shoots Ulegal drugs est and most alarming increases in with a used needle and catches AIDS cases are being reponed AIDS. direct results of the drug epidemic in I have been preaching and teach that community. I can only hope I have been preaching ing that we must fight the disease of and pray that American blacks have and teaching that we AIDS-not the people who have it. learned from the early experience of And I still believe that has to be our the homosexual community and will must fight the disease of attitude. But I'm also a realist, and I not politicize the issue. In public don't sec Americans keeping that health. matters, political posturing AIDS-not the people distinction clear in their minds costs lives; it does not save them. much longer. The good sense and gooJ heart of who have it. The cost to the nation's treasury the American people--of all the is already beginning to mount well American people-must be appealed beyond anything we could have to and mobilized for the remaining an elderly family member. Church imagined two or three years ago. years that this aggressive nnd vicious members can provide a respite for The average annual cost for the care disease survives among us. the family or the individual almost of a single person with AIDS ranges overwhelmed with the burden of from $40,000 to over $100,000, caring for an mcapacirated elderly depending on what you include in indivtdual. the computation and whether you And fina·lly, the issue of AIDS are on the West Coast or the East must be faced by American societ) Coast. Mulriplymg the mean cost by and particularly American congrega the current annual caseload of tions. Until this point, we've been 33,000 patients yields a theoretical able to deal with AIDS within the cost of patient care this year that familiar public health model of could exceed $2 billion. compassion and restoration: the And this is terminal care for some American people feel bad when any individuals who, despite public of their number get sick, and they advice to the contrary, choose to do truly want to help. They also feel something risky. They have they are sufficiently rewarded by the gambled-and lost. So the cost of return of the ill or disabled person to compassion without restoration is his or her family, community, school, already very high, and it can only get or workplace. That's restoration. higher until we find a vaccine. AIDS draws upon the great Because we are still several years reservoir of compassion in this maybe a decade-away from the de country. Except for the final weeks velopment and release of an AIDS Church Health Center Direcwr Scott of a terminal AIDS-related Ulness, a vaccine, it is absolutely essential that Moms and Assistant Secretary of Health person with AIDS may continue we view this problem with clear eyes. ]ames Mason lrscen as Dr. Koop discusses with a normal routine of family Life, Then, with the same clear eyes, we che social1ssues of health care m the U.S. work, education, and leisure activi must put aside our natural instincts ties without endangering other to be vindictive or holier-than-thou people. But restoratiOn is far from or to say, "I told you so"; we must assured. Th.e mortality rate for I The Church's Challenge in Health ideals and practice is Habitat for Hu Health Care in the U.S. : manity, in which Rosalynn and I are involved. I belong to a very nice Accepting Our Responsibility church in Plains, a small church. Rosalynn and I teach Sunday School every Sunday that we're there. There is very little reaching out from this cozy, compatible, relatively homoge nous group of Southern Baptist Christians co those who genuinely need the ministrations of compas Jimmy Carter sion, understanding, and love. Habitat for Humanity gives me an opportunity to cross that chasm. Through Habitat, which is sup ported by individual congregations, we work side by side with some of the most destitute people in the world to build homes for them. All o talk about the church's chat we profess as paramount, and of us are volunteers, and many of the challenge in health is to what we actually do in practice. This materials are donated. Rosalynn and talk about a new responsi gap can extend through a day of 1 act as carpenters for just one week T bility, and for most of us existence, a week, a month, a year, a year, and we gee a lot of publicity accepting new responsibilities is very or an entire lifetime. It's so easy to for the program. Rosalynn has difficult. Even when we're faced with rationalize a delay. We say, "Well, learned to pour concrete, erect stud a crisis that we commonly recognize, when I am financially secure, or walls, put up sheetrock, lay flooring, we often seek to put it off on some and put on a baseboard. But the one else, on some other organization essence of the program is that we are that is either nonexistent or also joined in an equal partnership, not unwilling co assume new and vital from a position of superiority, with duties. We face gaps in our lives One--third of the biblical families who perhaps never before gaps between our personal dreams accomplished anything that would and our genuine, proven accom text of the four Gospels bring them sustained pride or even plishments, and gaps between a is devoted to healing by self-respect. We don't take any rapidly evolving science and tech government money, and we don't nology, on the one hand, and the Jesus. give away anything. The families moral and ethical understanding have to pay for their house, full that is necessary co accommodate price, no profit, no interest. The rapid change. We face, as well, an Bible says when you lend money to a apparent incompatibility at times poor person you don't charge between science and deep religious when I reach retirement age, or interest, so we don't. Just moving faith. (I should add here that I don't when I accomplish this next material into the house built through this personally experience anguish or goal, or when I'm properly recog shared labor can transform the life of pain on this score because the more I nized by my peers-then I am going chat family. Now some principles of know about the complexities of the to put into practice what my faith the Habitat for Humanity program universe-its broadest dimensions in requires." These gaps have existed, may very well be applicable to the space and its subatomic detail-the have been prominent in my own life, problem of the church's challenge in more convinced I am chat my and I don't know of an easy solution. health. religious faith is sound.) One program that serves as an ex How can we break down these We also face a gap between our ideas ample of bridging the gap between enormous, sometimes impenetrable in life, our religious ideals, the ones barriers that separate religious THE CARTER CENTER OF EMORY UNIVERSITY I leaders from the people who are prayers, my experience, my influ punished by Jesus' own associates. destitute, forlorn, neglected, inar ence, to bring about an improvement The contemporary problem of ticulate, without influence, and in the health of those for whom I AIDS, and the way religious believ actually suffering within the heart of care and for rhose with whom I'm ers have dealt with it, comes irnme communiries in the richest nation not acquainted." There is a way to tliately to mind. I have a problem on earth? We can easily answer that break down those barriers and reach with AIDS because of its connec it's not our responsibility, that one out, not as superior beings giving tions with homosexuality, with sex person can do very little, or that the blessings or benevolence but as outside marriage, with the use of government should take care of it. equals. filthy needles to inJect illicit drugs But I hope we'll instead come to I recently learned that one-third into the body. These links cause me gnps not only with the problem but of the personal teachings of Jesus in great discomfort. But the reality of also with the opportunities we have. the four Gospels are devoted to leprosy two thousand years ago was We can look around where we work healing. He treated the mental and not so different. Lepers were perhaps or live and say, "I myself am going to physical afflictions of those who even more outcast, more despised, do something about the health prob walked the same roads, lived in the more condemned, and more avoided lems in this country if no one else same communities, and suffered the than AIDS victims of today even in docs anything. I'm going to use my same political oppression but most their worst circumstances. The innate intelligence, my ability, my often were outcast, despised, ig society held a general conviction innovation, my inspiration, my nored, condemned, scorned, and almost unanimous, I believe-that Health Risk Appraisal he Health Risk Appraisal (HRA) was developed by The Carter Center in collaboration with the Centers for Disease Control in order to help individuals understand the health risks that are linked to their lifestyles. It is a preventive tool and provides concrete suggestions for reducing risk. T Health promotion programs at the community level can aid in reducing the risk factors that are known to lead to injury or life-threatening diseases. The Health Risk Appraisal can be employed in the design and implementation of such programs. Two helpful tools result from the use of the Health Risk Appraisal. One is the personal report identifying the individual's most significant factors for generating illness or prema ture death. The second product depends on the wide-scale use of the Appraisal in a congregation or commu nity. After administering the HRA to a group of people, an aggregate report c.an be compiled which details the most significant concerns for that group. From this report, priorities can be set for program development. Most people can be reached through some sort of infrastructure. Young people can be accessed through the school system; the midlife populntion can be located through business and industry. But for our elderly, the only common structure which exists is rhe religious community. The Appraisal can be a vital instrument for rhc elderly in identifying those factors that may lead to risks such as a broken hip, a highly prevalent condition. When this is done, not only can the hip fracture be prevented, but so can the move to a nursing home and thus the loss of independence thm often follows such an injury. The Carter Center is developing n risk appraisal for the elderly which will soon be available for general use. As we enter the 21st century, a quantum shift is taking place. It is the assumption of responsibility for one's own health, a shift to proactive rather than reactive thinking. Religious organizations can join this move by investing in programs that preclude the onset of injury and disease rather than treating the morbidity after it occurs. ;----- ~------1 19 ~·------~ I The Church's Challenge in Health these people suffered from the most One of the earliest health confer illness, and so on) experienced in a horrible disease on earth because of ences we had at The Carter Center certain poor neighborhood. Some of some sin known by God. And Jesus was called "Closing the Gap." In it the suffering could be attributed to embraced them, had no hesitancy we sought to analyze defmitively the environmental circumstances, about touching them or being with difference between what we know inherited traits, hazards of the them; he ministered to them. He how to do in health care-using workplace, unavailability of health did n't approve either of sin or available technology, not fu ture dis care, or poor nutrition. But about 35 leprosy, but he showed his love for coveries-and what we actually do. percent couldn't be accounted for. lepers. No matter how conservative The results startled even the experts. The researchers concluded that the a position one takes on the issue of We had over a hundred experts people's lack of hope was the homosexuality, then, it should not here: medical practitioners, public variable that accounted for the be an obstacle to dealing in a kind, heath specialists, research scientists, "extra" suffering. The people in the gentle, loving, and compassionate some Nobel laureates. Using the ac community had no faith that they spirit with those who have AIDS. cumulated information of many themselves could change their own T he task is still difficult, of course; people doing the work in many destiny, that their decisions would I'm not underestimating the diffi fields, we discovered that two-thirds make a difference in their lives. They culty. of all deaths could be delayed just by had perhaps never seen their parents In setting up the programs of The changes in our personal habits. We use strength and resolve to over Carter Center, we have to wrestle discovered that 55 percent of all come a major difficulty. If they got ill with some of these same problems. pregnancies in this country are or were tempted to have illicit sex or O ne basic guideline is that we not unplanned and many of these take drugs, or even to commit duplicate what others can do as well. unwanted. We tried to learn how crimes, they passively went along, Second, we seek to be nonpolitical devastating a blow such a pregnancy thinking nothing they could do and nonpartisan. We try to bring to can be not only to the women but would make a difference. our conferences both those who are also to the family, and how it How can we possibly separate precipitates in many cases violence these circumstances, so prevalent in within the home-child abuse, our poverty-stricken neighborhoods, spouse abuse, suicide, homicide. from the true and unavoidable It is sobering for me to We learned that the primary killer responsibility of the church? If this is of American people is cigarettes, the not our responsibility as religious know that more Colom, most addictive drug of all, last year leaders, what is? responsible for the deaths of 390,000 Following the "Closing the Gap" bians died last year Americans. Yet little is done; we are conference we constructed a health silent about this devastating afflic risk appraisal so that people could from smoking American tion on our society. We watch young do a self-analysis. Today, this health people acquire a habit that they risk appraisal is being distributed at cigarettes than did cannot break, a habit much more ad more than 1,500 local centers Americans from using dictive than heroin. They surmise around our country. About 25 from the silence of church leaders, questions are asked concerning one's Colombian cocaine. educational leaders, and parents that life history and personal habits, smoking is okay. It's sobering for me including questions on smoking, to know that more Colombians died drinking, fastening seat belts, and last year from smoking American attitude toward firearms; weight and experts on a particular subject and cigarettes than did Americans from diet; response to stress, strain, disap those who can actually implement using Colombian cocaine. pointment, or tragedy; cause of the ideas or recommendations that One study was particularly death of one's parents and grandpar are forthcoming. To bring people intriguing. An analysis was made of ents; and so on. here who can actually observe what the suffering (early deaths, addiction These risk factors are analyzed by the problem is, learn about it, and go to drugs, unwanted pregnancy, computer to determine their effect out and do something-that's one of failure to recover from moderate on one's life expectancy. For ex the elements of our center's work. ample, a 50-year-old man who - ~------~1I 20 ~I· ------~ THE CARTER CENTER OF EMORY UNIVERSITY I smokes two packs of cigarettes a day phase. We need to work together to and is 35 pounds overweight may understand what the issues are, but have the life expectancy of a 63, we also need to minimize the in, year,old. An assessment is also made grained prejudices that limit the of the consequences of a change in scope of our minds and hearts. It habits: if the same person stops would be helpful if we could set goals that are truly exciting and challeng ing and adventurous, and perhaps We need to work to~ unpredictable, that would catch the imagination of people in our gether to understand churches and denominations. I don't know what's going to happen, but I what the issues are, but want to be a part of it. I hope that we also need to mini~ we can break down the barriers that exist between ourselves and others mize the ingrained about whom we probably don't even know. That effort will require tre prejudices that limit the mendous faith-in ourselves and our capabilities, in those we'd like to scope of our minds and serve, and in the God we worship. hearts. smoking and reduces his weight by 35 pounds, he could add x number of years to his life. This appraisal, which costs just four or five dollars, would be wonderful for church members, for those entering hospi· tals, for students entering college. It allows people to look at themselves and say, "This is what I am, this is what I'm doing to myself, and this is what I can change to give me a longer, healthier, and more produc, tive life." In concluding, I want to affirm The Carter Center's interest in participating in follow,up activities of this conference. One way would be for us to provide a constant flow of information about health issues to be used in church bulletins and de, nominational periodicals. We could be a clearinghouse to let people know of successful health models that might be developed in their own churches and denominations. And we'd like for this to be a continuing process. All of us are in an exploratory .--- 1 zt I L------1 ..------~ I The Church's Challenge in Health Section II The Role of the Faith Community in Health and Healing Introduction much of the unnecessary sufferLng by The second section of the confer organizing specific actions to aid the ence focused on the potential of the mental illness programs and those religious community for improving who have mental Ulness. the health of Americans. Professor Martin Marty of the University of Chicago Divinity School led the session with "The Tradition of the Church in Health and Healing." At the center of Dr. Marty's message were six key words: God, fullness, some, faith, liberal, and tradition. A panel discussion ensued including representatives from Jewish, Islamic, Native Ameri can, and Catholic groups elaborating on their group-traditional views on health and religion. Following this session Dr. William Foege, Executive Director of The Carter Center, spoke on "The Vision of the Possible: What Churches Can Do." Dr. Foege concentrated on the philosophical concepts con necting religion and health. Dr. Foege, who has three decades of public health experience, explored ways in which churches could Atlanta Mayor Andrew Young. impact the health of Americans. The church, he said, can and must em power individuals to improve the health of themselves and their com The church must continue tO serve as a11 avenue of hope for those without munities. adequate health care. It can work tOgether with government, private busi Rosalynn Carter, in tum, in ness, and other outreach organizations to improve the overaU health care formed the conference about the situation. The role of the church, regardless of denomination, is to provide potencial role of faith groups in comfort and hope to the least of these God's children. - Atlanta Mayor caring for the mentally il l. Mrs. Andrew Young Carter pointed out obstacles to the mentally Ul such as stigma, insuffi cient resources, burdens on famil y members, etc. The church, she said, has a great potentinl to alleviate THE CARTER CENTER OF EMORY UNIVERSITY I partiality. Not only are we chopped The Theology and Tradition up in yellow pages of religions, we are chopped up into specialties. of the Church and Healing Some at this conference specialize in child care and aged care and AIDS care. Each of these develops a language that doesn't seem always to contribute to wholeness. For each of us to fulfill our vocation, our profes sion, we have to get very good at specialized language that sometimes Martin Marty distances us from others. Fairfax M. Cone Distinguished When we use the word "fullness" Service Professor, or "wholeness" or "holism" we are working to overcome mere profes Divinity School, sionalization, specialization, and University of Chicago separate languages. We who are part of the Christian community must realize char in this broken world, was assigned to speak about universal love. while the fullness and wholeness the theology and tradition of Yet, we muse remember chat ours toward which we strive is the final the church in health and is only one listing in the "yellow secret of life, it is offensive and I healing. Therefore, God is the pages" of religions. Therefore, this imperial and encroaching for us to first word I muse speak. Yet, as we conference has been set up so that pretend that we have all the secrets. seek fullness and wholeness in chis we may also hear insights from a Why should we who are Christian pluralistic culture, the very words Muslim, a Jewish, and a Native stress that we are only pamal, like from which we draw strength and American perspective. This week we everyone else? At this moment in meaning are also words which may have gathered to ask ourselves about hisrory we have a chance co bring confuse and separate us. Those of us cheos and rradtrion as they mform religion to bear on health and who arc Christian may believe chat our parr of the human commumty. medtcal ethics and human care after our heritage and calling give us We also seck to understand how our having been exiled for some time by access to a nchness of faith in a parr relate~ to all the others. It's a modern secularization, the power of powerful God that can be genuinely way uf rcmtnding ourselves chat the the meJia, and academics separated helpful. fullness to which we aspire is at any from theology. People want to know the whither particular moment in history some Yet we Christians are not the only and whence of our lives. Consciously how also marked by brokenness. people who use the language of or unconsciously we long for a Agmn, the first word is God. The fullness and wholeness. The secular plumb line in relation to which first fact is that God is fullness and world has it; the new age religions things in our lives can be righted and we aren't. The first decision is to have it. But they speak in terms of ordered. In the uncertainties and recogntze that periodically we have wholeness as a striving which anxieties of our complex and to clanfy our own language and seek humans themselves fulfill, drawing dangerous world, people long for again the power behind the words. on an energy that connects every eyes to see and hearts to respond to The second word to explore lS thmg. In contrast, the believers' the moving shape of One who is our fullness, or scnving for fullness. We word ts that energy enters our world author and destiny. In our concern can only strive. Having said "God," through a dtvine creator, and for a common language and for a we know rhat we are not God. We connections happen between the rational foundation for our theolo know that we ourselves apprehend people based on response to that gies, let us not underestimate the only part of the whole. divine creator. archetypal and historical power of And a striving for fullness brings Most holistic promises are not cross and resurrection, the universal us into a second dimension of our fulfilled-particularly when they longing for messiah and the deep create the illusion that death can be rationality of our response in kind to overcome. Lewis Thomas reminds us I The Church's Challenge in Health that there are 6 billion of us now. tempted to say "We have the thing aged, technically perfected society is Stick around for 90 years, and none that the others don't have. We in disarray. Medical professionals, of us will be here. All the words said transcend the professions." I think academicians, politicians, and the about holism and fulfUlment and this denies the Christian concept of mass media have behaved as though fullness have not overcome the word vocation. We must learn to honor healing, caring, finding meaning, of death. The believing community those people of good will who know and determining ethics could be ac- exists because there is suffering: to the name of no God, but whose complished by secular rationality provide meaning and lessen that dedication, long hours, and loving alone. The patients and the parish- suffering. Our word is partial. care must surely serve God. loners knew it all along; we are And so the third word for us to The fourth word is faith. I write catching up with them and listening consider today is some. Some is an history, and having lived six decades before we speak. Ours is not an era important word for a believing of it I am struck by the way people of increasing secularization but of community to remember when it sets talk today about how secular hu- growing understanding of the up its strategies and its understand- manism is gaining. Twenty years ago, importance of the faith dimension. ing. Some is also a biblical word as in 30 or 40 years ago, science and The fifth word I'm going to accent Corinthians 13: "The knowledge we is liberal: we live in a liberal rather have is piece work." Or, to use than a secular culture. If by "secular" another translation, as Oliver Th l · h Ch · we mean that the world manages to Cromwell once said to Christians e goa zn t e rzs.... get by without reference to the who were sure God was on their tian faith is to retrieve sacred or the divine or words about side: "By the bowels of Christ have God, then there is plenty of secular- you ever considered that you could tradition from the past ity going around. And yet the way be mistaken?" our society is organized is not The third word carries on from and then project it into steadfastly secular. The public what I began to say about yellow h .{. k. h opinion surveyors can't even find pages. We are religiously yellow t e JUture, as zng W at secular people. Ninety-six percent of paged, and we are by professions and the world would look the American people tell the pollster care yellow paged. Often the ian- they believe in God, and well over 80 guage of fullness neglects the reality like if we began to live percent in our culture say they of these specializations. We have to believe in the divinity of Christ. If learn that people in different those stories. this were a secular culture, we would circumstances need to hear different have secular people all over the messages and have to be cared for in place. vastly different ways. When people I prefer the concept of a liberal need mercy we specialize in mercy, technology were sacred cows; culture, as articulated by Robert and when there is injustice we must medical and social service profes- Fowler, a political scientist from specialize in justice. This differenti- sionals were about to usher in a new Wisconsin. A liberal culture is ating or chopping up of life into spe- Utopia. I remember sitting on characterized by three things: cialty is the key feature of moderni- commissions in the 1950s as a skeptical rationality, religious zation. The search for wholeness is welfare society was expanding and tolerance, and intense individualism. the attempt to overcome specializa- growing, and many of us worried Skeptical rationality is the mode of tion by treating the patient as a about how the church could ever be the public sphere. Modern science, whole being. The patient is con- relevant, because all human need academics, research, and govern- fronted by the language of the was going to be taken care of. The ment have been organized with no medical specialist, the economic world would no longer need religious reference to questions about God. specialist, the legal specialist, and social work, nursing orders, or even The world in which we live today the religious specialist, and she, in the pastorate itself, since everything can be characterized by Descartes' the moment of her weakness facing was to be taken care of. famous remark, "I think therefore I suffering and death, must integrate Today we find that this public am." That is a significant break from them. philosophy of a scientifically man- the world view of our ancestors: "I Any therapist or care giver, believe in order that I may under- ~-~-p_e_c_ia_ll_y_in__ th_e __ re_ l_i~_·o_u_s_a_r_e_a_, _is______.l ~ .~------s-ta_n_d_-'_' ______~ I I THE CARTER CENTER OF EMORY UNIVERSITY I In the public polity, Thomas it is unsatisfying. We know that we find that it's everywhere but no Jefferson is an analog to Descartes. don't only move by secular rational where. The people who were as The separation of church and state, ity. Our decisions about care and signed by our Park Ridge Center to or better in Madison's terms, the cure and interpretation and ethics write on faith, health, and medicine drawing of a line of distinction are made with the help of intuition, in their various faith traditions between religious and civil authority, of memory, of story, of community. found, one after another, that there is cherished by the vast majority of Physicians remind us that when were no books on this. Jacob us as an achievement, a gift, a grace. people make life and death deci Burckhardt says that most things Yet it means that ways in which we sions, they don't call in the philoso that are really important to people find meaning in life, that which pher who will tell them what Aris don't get written down because they draws us together, has no official, totle says about non-maleficence. are so taken for granted. public standing. They ask "What does my pastor say? Consider Sunday school. I think That carries over into our private What does my family say? What the history of the U.S. Sunday lives as well: the third feature of our does my physician say? What does school has made the from page of liberal culture is an intense individu my God say?" We do live in a liberal the newspapers once-in the alism. I suppose Adam Smith culture, but one in which faith Birmingham bombing of years ago. matches Descartes and Thomas concerns are now taken seriously Yet think of the power that institu Jefferson here. Most Americans who even within "secular" professions. tion has had in the lives of people. say they are individualists mean The sixth word is tradition. After We don't write it down because it's they're economic individualists using God and fullness and some and faith so obvious. So the acts of prayer and the great gift of freedom that moves and liberal: tradition. Tradition is counsel and nurture, the activities the laboratory and the clinic and from the Latin traditum, handing listed in the Sunday church bulletin governmental talk. Most of us have over. God handed over to israel a haven't made it into official public no desire to change that. A few may covenant and a promise which it discourse, so we have to recover yearn for what Leszek Kolakowski grasps, so there is a Jewish tradition. these meanings now. How do we calls a hierocratic culture-an God hands over a new covenant recover tradition? Iranian-style society ruled by a with the incarnation, death, and The essential problem I think is clergy. But most do not. resurrection of Christ. Here we get a that we are forward-looking beings. We must critique this liberal vision of what the bearing of God is Politicians must plan for the future. culture, therefore, understanding toward us. God hands over every Science looks forward out of neces that we are in it but are not of it. We word I use, every conversational sity, since it eats up its own past in are in it but go beyond it. We are in element. We live by wh::~t is handed many respects. A child in the second it but provide alternatives to it. to us. If I invented the words, you or third grade today can repeat what Are we, you and I, living in thiS wouldn't understand them. We it took Euclid or Pythagoras a liberal culture? Here's a little test. continue to make new combinations lifetime to discover. But when we Most religious people in this society and concoctions and creations out of deal with tradition, memory, text, have problems with the Christian traditional stories. Pope John used to we're dealing with something from Science approach to the care of their tell the religious orders: I want you the past, and we have to look in a children. The vast majority of us arc to reform yourselves in the light of direction that people don't usually relieved when a judge intervenes to the intention of your founders to look. save the life of a Jehovah Wimess, whom you cannot go back. That's The goal in the Christian faith, in saying that society's norrrlS about what it is to live in a tradition and to the biblical tradition which Islam health care take precedence over the use it. and Judaism share, is to retrieve parents' practice of their religion. If If tradition is embodied in the tradition from the past and then we were always instinctively on the Lives of people, why was it not heard project it into the future, asking parents' side, saying "let the kids during the decades when religion what the world would look like if we die," then we would be outside that was systematically discounted? Why began to live those stories. Last night liberal culture. is it so hard today to recover these President Carter said computer data We are far enough into the liberal traditions? Those of us who work on revealed that one~third of the New culture we can't imagine alternatives this task of recovery are surprised to Testament gospel stories are about to it, except perhaps in the desert or healing. Or three~thirds are, depend in a lonely, isolated monastery. But r------ing upon what part of healing you're _1 25 • ~------. ·.------~ I The Church's Challen9e in Health talking about. wins out over death, hope over are facing tough questions about the The wholeness and fullness to despair, love over hate, healing over allocation of health resources, gov which we strive, the concepts of neglect, justice over injustice. This is ernmental policies, the way universi salvation and healing are at the not something that requires a Ph.D. ties teach medicine, and the way or heart of our faith traditions. That in history. Perhaps it happens best in dinary people come to terms with may come as a surprise to people in a Sunday school, or in the act of care. their suffering. lot of churches where such ideas are We need more than simply infor The world will not stop being seldom spoken or heard. And yet, mation gleaned from the past and scientific, secular, liberal, mindless of the churches quietly have been applied to the future. You have to theology or church traditions, or building institutions of care and know in a special, discerning way. neglectful of or often hostile to the providing people to staff them. Our Let me illustrate with the story of dimension of faith. It is one in which task is to make visible what had been the disciples on the way to Emmaus alternatives to, refuges from, assaults obscured; to refine what had been with the stranger who expounded upon the hegemonies of, and critical forgotten. Therefore, it has to be an the scriptures to them (Lu ke 24). corrections to these prevailing act of memory. They knew the old plot, then, in the tendencies by thoughtful believers There is power in the narratives performance of an act, there came have a better chance of getting a of Isaiah and in the Good Samaritan recognition, when "he was known to hearing than had been the case for story and in the story of the healing them in the breakirrg of the bread." many decades. Whether there is a of the leper. There is a power that A revelation of the resurrected Lord hearing depends upon how the the world hasn't yet heard. To our grasped arrd changed their whole Church meets the challenge study of our own stories, we must being arrd brought them toward whether it has something to say and then add the Native American fullness of life. some visible thirrgs to do to promote vision of health, to see what is to be Like the disciples, we today must the recognition that something reve learned from their tradition. So we gain new understandings out of the la tory is going on. This prospect must examine other traditions as old stories. For us, as for them, would mean that healing and health well as our own, so that we may re understandings come in the midst of are part of the story, the charter, and discover those elements which serve acts of giving and sharing arrd the promise of a faith born in the healing. Through the ages, many healing. We go forward understand context of suffering and death-the teachings and traditions of the ing that they krrew some things back suffering and death that do not have church have left people carrying then that we do not know as yet. the last word. around unnecessary guUt, being re That's how you use the tradition. pressed, not feeling free to be We do not know as yet, not adventurous, saying things about the because they were smarter than we, body that limits the necessary but because our world circumstances research that gives life. We must have changed. The stories from the retrieve those elements in which life past live among people today who Healing must begin in the souL One of the greatest diseases described in the Qu'ran is despair; therefore, God says, "Oh my servants who have been too harsh with your souls, with yourselves, despair not of the mercy of God for God forgives all sins. "- Dr. Mahmoud Ayoub, Professor of Islamic Studies, Temple University The cedar tree represents the Indian world, the Native American world; the satellite dish represents our scientific and highly technological world. Native Americans live within both worlds. They must in order to have health and welL-being. But sometimes these worlds are in conflict. Alexander Solzhenitsyn has said, "To destroy a people, you first sever their roots." I think chat's what's been happening to Native Americans. They have the highest morbidity and mortality rates of any group of citizens in our nation. Their roots are and have been severed. -Lawrence Hart, Indian Ministries Task Force, ]oint Strategy and Action Committee ,.-- ..______~ • 26 . I •.------~ THE CARTER CENTER OF EMORY UNIVERSITY I of medicine and religion, of science The Vision of the Possible: and religion. Lily T amlin once remarked that when we talk to God the church says we are praying, but What Churches Can Do when God talks to us the doctor says we arc schizophrenic. The bounda ries are artificial; they are defined too narrowly by both sides. Medicine describes, defines, and measures tllness. It provides a diagnosis, and it attempts an intervention. Yet the William H. Foege church provides a sense of continu Executive Director, ity, a flow of history, a way of explaining health and illness. The Career Center of Emory Thcolog1an Thomas Droege has University pointed out thar both scientists and theologians have an incomplete view of the world. H is new book on the faith factor in healing makes the avid Hilton, a physician just life after death. For some people point that a disease cannot be and director of the these are new ideas, and we know described outside the story of a Christian Medical that the mind approaches new ideas person's life, beliefs, family history, D Commission, World the way the body approaches foreign and faith tradition. Einstein said Council of Churches, has observed proteins it tends to reject them. that though it mtghr be possible to that health is primarily dependent Nonetheless, churches need to be describe everything scientifically, the not on medicine but on educanon. teachmg these ideas. dcscnptton would make absolutely I believe that churches have specml SeLOnd, the chun.. h needs to do a no sense. This admission should not opportuniues to educate their better job of teaching the unit) of be an opcnmg for medicine-bashing, parishioners about health. Most people: that we have a responstbdity however. Each of us owes a great important, they can provide a larger for others and that the idea of loving deal to medicine, and many of the and more complete viSion of health. our nc1ghbor is not just a religious Churches can make a difference m idea bur ulrimarely the measure of at least five areas of education. civilization. The measure of civiliza First, the church can teach us tion 1~ not tound in knowledge or The power of interde, about the unity of body and soul and technology or even happiness. A about the damage caused by our civilized society is defined by how ir nominational efforts to inability to sec people as whole. treats other people, and a civtlized promote a health There is a unity to the idea of person, a uvilized Institution, or a brokenness, whether we are talkmg CIVIhzcd churLh 1s ddmed 111 the agenda would be tre, about sin or disease or depletion of same way. It 1s easy to respond to our the ozone layer or homelessness. ne1ghbor during an earthquake or a mendous. There is also a unity to the idea of famine, but it is harder to respond to redemption, whether we are talking the miseries and chronic problems of about forgiveness or healing or everyday life. The unexpected may seats at this conference would be environmental improvement. I have open our hearts momentarily, but for empty tf we didn't have the gift of learned that there is redemption in a most of us most of the time, avarice medicine. syringe of pemcillin, in a syringe of is the sphmcter of the heart and a But the church goes beyond that. measles vaccine: they make whole challenge to the church. lr brings order, meaning, and what is broken or keep whole what is Third, the church could provide purpose into the lives of people, into nor broken. I have learned that more education on the overlapping the lives of communities. It facili salvation means wholeness and not tates healing and the maintenance of I The Church's Challenge in Health wholeness. I walked into my first Fourth, the church should be agers that it's not the last pack of test in medical school to be con teaching parishioners about preven cigarettes that kills you; it's the fronted by a single question: What is tion. Too often we place prevention first." Things are broken with that Life? Over the past 30 years I have and treatment in opposition, when first cigarette. understood that the boundary they are actually on a continuum. So the question is one of perspec between medicine and religion Hippocrates believed that the obliga tive. Everything can be seen as disappeared with that question. I tion of protecting and developing healing from one perspective. learned in medical school that when health ranked even above that of re Everything we do is healing, but the you do a study of an unknown drug, storing health when it is impaired, brokenness isn't evident to everyone. you compare it with a placebo that and this is true. Nevertheless, we On the other hand, all efforts are has no action in order to know what don't live that way, and we don't part of prevention-as we attempt the tested drug will do. What I did spend our money that way. In the to prevent illness, to prevent the not learn in medical school is that New Testament, lllness was healed progression of illness, to prevent the placebo is in fact a measure of disability or suffering or pain or faith. The person taking it has faith death. So there is a continuum that that it will do something positive. can be appropriately viewed as dif So we are testing a drug plus faith Hippocrates believed ferent levels of prevention or differ against faith alone. The church can that the obligation of ent levels of healing even when we enlist that faith; doctors do. As are speaking of the same thing. And Droege points out, physicians are protecting and develop, as we all realize, some things can't be faith healers but they don't like to fixed. Even here, though, the church say that. They give a positive ing health ranked above can give meaning to the partial. expectant attitude to patients; they Fifth, the church should teach encourage the placebo effect. restoring health when it perspective. Health is not an end in The church also brings other re itself. It is not the purpose of life, but sources to bear on healing, and some is impaired. But we it helps serve life's purpose. And we of these resources are words. Kipling don't live that way, and often realize that only when we lose once said, "Words are the most it. Furthermore, the sentence of powerful drug used by man." Words we don't spend our illness that we allow for others helps can be used to enlist people in their to detract from their purpose of life. own destinies rather than allowing money that way. This week, 30 years after the polio them to be passive observers. The vaccine has been widely distributed philosopher Primo Levy, a Holocaust in this country and is available on survivor, attempts in his book, The because sickness was not the desired the world market for two cents a Sacred and the Drowned, to under state, and it would appear implicit dose, 5,000 children around the stand what he had learned at that health was the desired state. world are paralyzed with polio. It de Auschwitz. He makes the point that Therefore, prevention should be the tracts from their purpose of life. believers in any faith better resisted priority. But as Reverend Walter Be ye doers of the Word and not the seduction of power and had the Warrnock has said: Ministers feel hearers only. What can congrega best defense against death. more comfortable with repair tions do? Every church can review Thomas Droege has observed that because prevention feels as though its community's needs in the areas of a person with close ties to a faith you are fixing something that isn't health, education, primary preven tradition that has met the test of broken. Quite the contrary. The tion, secondary prevention, care, tini.e is likely to have a strong sense continuum of Lllness starts early and counseling, and support and then of coherence. Coherence is related only later breaks the surface of con decide where to begin. For example, to wellness, and fatalism, lacking co sciousness. The fo otball coach Hugh the health risk appraisal mentioned herence, lacks wellness. Churches McCabe died at age 47 oflung by President Carter can be used by a must give parishioners the power to cancer. Before he died he said, "It's congregation to help individuals fight fatalism, to be involved in their hard to get across the idea to teen- learn what they can do for their own own destiny, and to be involved in health and also to help decide what the destiny of the world. priority should be given to providing ,---- ~------~I1 28 ·I ------~ THE CARTER CENTER OF EMORY UNIVERSITY I certain services to the congregation. world hunger. Congregations need pediatrician, treated a child who had We'll need to learn, of course, to know what the state of the world been injured in an automobile how to give people information is and receive basic training for how accident while traveling unre without blaming them for their they fit into the world. One guide is strained. Sanders decided to try to problems. On the other hand, we State of the World, published each get child-restraint laws in his county. can't withhold information because year by the Worldwatch Institute in This led to involving the pediatric we interpret this as blaming the Washington, D.C. It helps individu society in Tennessee, and Tennessee victim. One of the greatest of als see what they could be doing for eventually passed the Hrst child earthly blessings is independence, the world environment. UNICEF's restraint laws, without any federal but we don't have it if we are denied annual State of the World's Children is action. One person's effort affected the information we need to be another helpful guide. Contact the security of an entire nation of independent. We must present magazine from the World Council of children, and an interdenomina information as a way of improving Churches and Seeds magazine on tional coalition of the church could free will. world hunger are also helpful. improve the system in similar ways. Life expectancy at birth has Much can be done at the commu A few words on the global situ increased by 25 years during this nity level. So far the church has ation. All the domestic inequities century. That doesn't mean that at responded only randomly to AIDS we know about have to be multiplied my age I can expect 25 years more certain congregations, certain by 10, 100, 1,000 if we are to com than my grandfather had at this age; people. The school health cu rricu prehend the inequities in the by this time we have passed the high lum is another area. We know that developing world. Today, tens of infant and childhood mortality school health curricula can reduce thousands of children are being born levels. At my age, I can expect only smoking rates by the seventh grade into the sixteenth century. T hey six more years than my grandfather and reduce teenage pregnancy rates. will be born and live short lives with had left at the same age. In one That is no longer a mystery, and no benefit from all the medical sense, then, all of twentieth-century churches have a role to play in schools in the world, no benefit science and medicine can give me getting school districts to implement because penicillin was discovered, no only six additional years of life at good school health cuiTicula. benefit because we have computers, this age. Yet, a researcher (Lester Churches could become more or even an alphabet. They will Breslow) in Alameda County, actively involved in solving problems receive no benefit because we have California, has shown that a person of drunken driving, child abuse, and an American Medical Association or my age doing some simple things can spouse abuse. because we have organized churche:;. live 11 years longer than a person my At the national level we must deal The basis of public health is tO age not doing those things. So in with the problem of 37 million make our science available to all. another sense, I am twice as power uninsured people 10 a land of Yet the U.S. support for health ful as all of twentieth century medical plenty. To come up with a around the world doesn't make up science and medicine in determining reasonable and equitable national for the disease burden the U.S. my own health destiny. health plan will take the best imposes through our economic That is real power, and the thought and action of churches. A decisions or our tobacco and weap church has a role in showing indi church, worrying about illiteracy and ons exports. The U.S. is a net viduals that power. This role leads teenage pregnancy, can become the exporter of disease. We need to immediately into smokers' clinics, conscience of a community, and a support the United Nations agencies Alcoholics Anonymous groups, good school health curriculum is (WHO and UNICEF), and we need weight-watching groups, counseling, needed at the national level, not just to influence our government. Our aerobics, flu vaccinations, and so on. at the local level. The power of government, on the one hand, asks It leads to church suppers that interdenominational efforts to WHO to develop a global plan for emphasize health foods. It leads into promote a health agenda would be AIDS, and on the other hand, health maintenance and injury pre tremendous. doesn't pay its dues. Before Presi vention for older people. It leads to One example should spur us to dent Reagan went to speak at the Sunday school materials that teach action. Bob Sanders, a Tennessee U.N., our government publicized the about healthy living and to collec payment of its 1987 dues to WHO tive action for food kitchens and to avert criticism. But it did not pay ,---- - I •.------~ ~------~· 29 ( I The Church's Challenge in Health promising young people, educate them in political science, engineer We the church could ing, medicine, and teaching, and allow them to be missionaries for the become the dominant church where they could do the most good. agent working for the I flnd the history of the Jesuits inspiring. Ignatius of Loyola was a health of our parishes, contemporary of Luther, and he was health equity within the caught up in the proud tradition of the individualist dedicated to a United States, and larger cause and supported by a community of believers. Those early health equity for devel~ Jesuits fused action with contempla tion; they accepted the world with oping countries. obedience and with discipline. In India they became Brahmans; in China they became Mandarins; and 130 years ago in the Pacifi c North west they became Indians. They the arrears. took rhe problems of each culture We can't do everything, of course, unto themselves. T hey believed that but we have to start somewhere. We body and soul were not distinct have to diminish our acts of ornis entities but interlocking principles of sion. We have to know what is an entity and that the improvement possible and then select a place to of the economic or social order was start. relevant to and necessary for optimal What could our communities of spiritual progress. believers become? Henry Ford said We have been given dominance that there are two kinds of people: of the world, and health is a gift those who believe they can and intended for everyone. The domin those who believe they can't-and ion is not a dictatorship; as Droege both are right. The churches have says, we are in the priestly role of to become communi ties of people caretaker beginning with the care of who believe they can. T hey must ourselves and ending with the care plan for a long future and sometimes of others and the whole creative for a very late harvest. But we the order. We as the church must have church could become the dominant a vision of being responsible for the agent working fo r the health of our entire creative order and at the same parishes, health equity within the time understand what needs to be United States, and health equity for done today at this hour in this small developing countries. corner of the creative order, believ In the past churches have identi ing that God is truly in the details. fied promising young people, put them through medical school, and sent them out to do important work as medical missionaries. What if we could break out of that mold and identify other important concerns in the world that we have to do some thing about? We could identify r---- ~------~I1 Jo Jt. ------__j THE CARTER CENTER OF EMORY UNIVERSITY I quately reach out to families of A Voice for the Voiceless: mentally ill people? A father of a son who suffered from schizophrenia put The Church and the Mentally Ill it this way: "Caught between the needs of the mentally ill person and the bewildermg, elusive services available through public agencies, the family eventually acts as its own doctor, nurse, and social worker." Summing up the situation, he said, "brokenness is the word." Yes, our churches have a problem Rosalynn Carter reaching out to people who are Former First Lady broken by mental illnesses. Yet if we of the United States look carefully, we realize that churches and religious communities themselves may be the victims of this brokenness. Many professional care givers, including ministers and ne of the major causes of on the streets. We accept it; we walk church workers, discover that after unnecessary suffering and around them. But these people many years of giving all they have, death is mental illness. 1 often ragged, dirty, wrapped in old they have nothing left to give. 0 have worked on mental blankers, huddling together to keep They're burned out. As a result, health issues for almost 20 years. I warm- are real people; they have congregations are left in the uncom have seen the suffering and devasta fortable position of depending on a tion that can come to an individual healer whose spirit is so wounded and a family when mental illness We need churches to that it seems beyond repair. Those in occurs. With trearment, however, a position to make a decision about most people can be spared the take on the task of not these caregivers sometimes respond suffering. Some can overcome the by pretendmg that a crisis doesn't illness completely; others can lead only caring for the men, extst. Other times they believe that more normal lives with the help of the caregiver's move to another medication; nearly all can be helped. tally ill, but proclaiming locale will resolve all the problems. This is not known by the population their cause, and loudly. Too often churches have sought to at large, mainly because of the ignore a simple reality: that mental stigma associated with these ill illness can come even to those who nesst:s. feelings, but little hope. And 20-30 are providing care. Mental illness of all kinds presents percent of the homeless are mentally Perhaps one of the most pressing a tremendous challenge to religious ill. Their stories are of being in and challenges for the church today organizations today. In a recent out of mental institutions, with no regarding mental health is to keep its national survey in which 20 religious one to care for them. That reality LS leaders emotionally and spiritually bodies responded, only two denomi part of our everyday life now, along healthy. The mental health of nations had ministries directed to with the addictive disorders which church leaders is more than just a the needs of mentally ill people. How we hear about daily and which are personal issue; it is a means by which can religious organizations better affecting people all over our country. the church can begirt to overcome minister to the mental health needs Ministering to the families of the the stigma that surrounds mental of the congregations and the com mentally ill is also critically impor illness. If it becomes visible that a munities they serve? tant. How can we the church shed congregation recogruzes and reaches First, they will need to face the the fear and ignorance that have out to one of its own who is suffering issue of homelessness. Homelessness plagued us for centuries and ade- from a mental problem, then it be is everywhere. We see people living comes possible for a member of that I The Church's ChalZenQe in Health church to say, "I have a mental the Atlanta area. This small congre important to a person who is suffer problem, too." When these illnesses gation was approached by an adja ing from mental illness. are talked about openly, and when cent mental health faci li ty about Finally, churches need to think people learn that mental illness, like using church space for an outpatient about their roles as advocates. physical illness, can be helped or activity. Since the church was facing Mentally ill people are one of our overcome with treatment-that is the challenge of just surviving, they truly powerless constituencies. They when the stigma will begin to decided to rent space to the center. don't write letters to their state disappear, so that we can really Through this cooperation, the representatives or their newspapers; church was able to overcome its they don't picket and demonstrate in fears and prejudices and now has a front of state capitols; there are not fuller ministry to all people. This enough advocates on their behalf. How can we the church happens so often. People resist It's easy for us to forget about them having a group home established in and their needs. If we see as part of shed the fear and their community, yet once it's estab our mission the advocacy of those lished, fear and prejud ice disappear who are poor and powerless, then ignorance that have because people realize that mentally advocacy for mentally ill people will HI people are good neighbors. become a major concern for plagued us for centuries Druid Hills Presbyterian Church churches and religious organizations. and adequately reach and St. John's Lutheran Church, Churches and congregations need to both in Atlanta, are other examples. take on the task not only of caring out to families of These churches have held worship for these people in need but of services for homeless people, many proclaiming their cause. mentally ill people? of whom have been mentally Ul for People with mental problems are years. And both churches try to our neighbors. They are members of bring healing to people's lives in our congregations, members of our minister to those who need our help. other ways. ln a program at St. families. They are everywhere in Another issue for the church is John's called Joshua Ministries, a this country. If we ignore their cries that of preventive mental health. woman offers her home. She pro for help, we wUI be continuing to We assume that being a member of a vides a loving and caring family en participate in the anguish from religious community is restorative vironment for anyone who comes, which those cries for help come. A for mental health and preventive of and they pay what they can. Druid problem of this magnitude will not mental illness. Yet mental illness HUls has art classes and other go away. Because it will not go away, does afflict members of congrega activities that help people with and because of our spiritual commit tions, and pastors and church mental illnesses feel some self-worth ment, we are compelled to take leaders often have little training for and creativity. Nothing is more action. ministering to those who suffer. Many churches in this community are doing wonderful work for the The church can reduce the stigma attached to mental iUness; address the homeless-providing shelters, soup theme of codependence, defined as any maneuver that fails to recognize the kitchens, and so forth. But when seriousness and the impact of the substance abuse problem; and take care of those who come into a shelter are the people who are in the position of giving the care. both homeless and mentally ill, - Dr. Donald Manning, Professor and Vice Chairman, Department of they're different. Church leaders Psychiatry, Emory University dmi't know what to do with them. We need to look to the examples 1 think of advocacy at three levels. First is one-on-one advocacy for a in this country of leaders and con mentally ill person. Then there's congregation-wide advocacy. Third is gregations who have become sensi political advocacy-taking on the powers that be. Finally, research is a tized to the needs, have overcome very pressing need. In this time of budget deficits, churches need to stand up the prejudices, and have good minis for funding of the mental health fight. -Dr. Thomas Bryant, President, tries for the mentally ill. One is the Nonprofit Management Associates Panthersville Presbyterian Church in - '------~~I 32 1•.------~ THE CARTER CENTER OF EMORY UNIVERSITY I Section III Mobilizing the Faith Community To Respond to Health Needs Introduction explore health initiatives already The overarching goal of the working in the religious community; National Church Leaders Sympo address specific questions relating to sium on Health was to seek ways in religion and health; share experi which the religious community could ences, impressions, and personal be coordinated to improve access to reflections; and foster a commitment health care and enhance the quality w working toward the solution of of life for the congregation and health problems and the promotion community. Churches could be of fu ll and healthy lives. come a major promoter of health In presenting the latchnote, Terry and health policy if the religious Hamilton, President and Co-Chair network was mobilized. W ith of the National Assembly of Reli sharing, communication, provision gious Women, intended to motivate of information, support and net the participants to action in their working, the churches can be own communities and congrega enabled to be more active in thts tions. She summed up the spirit of area. the conference with the quote: "We The goal of the last session of the are the people that we hllvc been conference was to present and waiting for." I would also like to offer some practical suggestions in the context of Matthew 25. "Then the Holy One shall say to the people on the right: 'You who are blessed by my Maker, come and receive the birthright which has been prepared for you since the creation of the world. I was deaf and you provided sign language interpret ers. I was hearing impaired and you provided assistive listening devices. I had a child with Down's Syndrome and you asked my whole family to s~::rve as greeters. I w a~ in a wheelchair and you made a way for me to approach the Communion Table. I was schizophrenic and you welcomed my sharing in your prayer group. I was vision impaired and you bought an enlarging copier mnchine. I was a recovering alcoholic and you en trusted me with responsibility. I had AIDS and you gave me a place to live. I had no voice and you gave me a funded conference task force. I tell you, indeed, whenever you did this for one of the least of these brothers and sisters, you did it for me .... -Holly Elliott, President, United Methodist Congress of the Deaf Rather than serving as an alternative to or refuge from our liberal culture, the church is in the process of assuring the integration of its healing tradition, not only among its own members and its health care and social service organizations, but also ro represent those values within the larger social context -Sister Kathleen Popko, President, Sisters of Providence r-- 1 33 • ~------. ·.------~ I The Church's Cluzllen&e in Health how they may best remain asympto, Models: matic and preserve their state of health. An example of an AIM What Churches are Doing education program is its Wednesday night sessions. At 6:30 p.m. a meal is served, followed by a presentation from an invited speaker; topics Several model health projects comfortable and wil ling to volunteer include psychological and social were presented at the symposium. in a spiritual support capacity. So issues, exercise and relaxation, These models were chosen to we engaged the local AIDS service immune system and visualization, exemplify how religious organiza, organization and their educational nutrition and AIDS, etc. From 8:30 tions can actively play a role as department in assisting us with that to 9 p.m., six to eight people form health providers in society. Four task. We set up not only AIDS 101 small support groups, and the session different areas were sought: educa, information activities, but we also closes with meditation and prayer. cion, advocacy, service, and theologi, began to do preventive education In addition to education, AIM offers cal reflection. Although 15 models most particularly with youth." spiritual support groups, pastoral were presented at the symposium, Among the educational materials care training, and meals programs. only one example of each category now put out by AIM is a brochure, AIM is unique in that it is truly will be presented in this section. "Teens and AIDS: Playing it Safe," interfaith, including Christianity, The model presentations were an which gives basic information about Zen Buddhism, Judaism, Islam, New im portant dimension of the confer, AJDS in the fo rm of illustrative Age Religion, Native American, and ence because quality examples of hypothetical cases within a high Channeling. This scope of partici, projects that actually work can serve school setting [published by Ameri, pating faith groups makes it possible as catalysts for other initiatives. By can Council of Life Insurance, for A IM to reach out to the variety learning about others's successes, Health Insurance Association of of spiritual needs of people from new initiatives arc facilitated. America]. Also distributed is a different religious perspectives. For cartoon narrative, "Rappin," ex, more information on AIM, contact Education plaining simple preventive measures, Reverend David Martin, 1000 Sir In 1986, a group of people came culturally sensitive to today's youth. Francis Drake Blvd., # 12, San together in the San Francisco Bay Part of preventive education, Anselmo, CA 94960, (415) 457- area to participate in an interfaith according to Reverend Martin, 1129. worship service for those suffering targets those already infected with from AIDS and HIV infection. HIV. Too often these people are Marin County, California has an faced with only the idea of a 100 HIV prevalence of one,in,88, and percent fatality rate for AIDS. Un, this worship service was a spiritual fortunately, this attitude breeds a response to the tragedy caused by a suicide rate fo r those with HIV frightening epidemic. Following this infection of over 50 times the worship service, several religious national average. The reality, leaders decided to instigate a more however, is that the study showed 50 ongoing effort to provide for the percent of HIV infected persons spiritual needs of those affected by were still asymptomatic after 10 HIV infection. Thus, the AIDS years. This is the radical approach Interfaith of Marin (AIM) was Reverend Martin espouses in that formed to serve such a purpose. In the root iss ue is the preservation of starting the project, Reverend David health: "how do I maintain my Martin (Executive Director) notes, wcllness given that I am HIV "We found in 1986 as we formed, positive?" that people in congregations were AIM provides preventive educa, The Reverend David Martin, asking for basic education and infor, tion for HIV infected persons on director of AIDS Interfaith of mation about AIDS before they felt Marin. THE CARTER CENTER OF EMORY UNIVERSITY I Advocacy of communication. Thus, through only how to set up clinics and Dr. Marilyn Washburn, President developing a network it is possible to develop AA networks, but also how of the Presbyterian Health Network, know in Georgia what is happening to stop dual licensure-so that es presented a model showing the in the Tennessee legislature. Addi tablishments in their communities ability of a religious structure such ns tionally, communication between can't sell gasoline and alcohol at the the Presbyterian Church to advocate church lobbyists in Washington is same ttme. Claims Washburn, for different health issues on a facilitated through such a network. "those are things that are cheap and variety of levels. In 1983, the According to Dr. Washburn, "[The make far more difference than General Assembly of the Presbyte network] is a way we get to be in rehabilitation in terms of the num rian Church (USA) funded a study touch with our lobbyists and repre- bers and preventive measures." For on the cost of health care as tt more information, contact the affects church and society. A task Presbyterian Church (USA), Presby force was put together of medical The problem was not renan Health etwork, 100 Wither persons, pastOrs, and lay people who spoon Street, Louisville, Kentucky, met over a period of several years. that there was nothing 40202. Seven presbyteries were invited to answer the question "what would it going on at the state Service look like if your presbytery took Dr. Scott Morris, a physician and seriously the issues of health and and local level, but that elder of the United Methodist healing within the church?" there was a lack of Church, recognized the potential The result was the formation of a role the church might play in the network. According to Dr. communication. health of people who are poor and Washburn, "The theory of the sick. In September 1987, he network is that those of us at a founded the Church Health Center national level of church have sentt-ltives in Wnshington to let in Memphis, Tennessee. This center neither the time nor the expertise to them know where our concerns arc. is a non-profit, ecumenical organiza resource everything that's going on We meet with our representatives in tion that works with over 100 in the church. So it's a stmple way the Washmgton office face-to-face churches and focuses on rhe 'whole that people who arc doing things are to let cad1 other know our concerns. person' approach to medtcme and put in touch with other people and We hwe regul1r c:onract now." health. The medical center provide~ can become part of a network to A third area is that of advocacy <111 health care servtces offered by a share what's gomg on and to use our wirhm the church structure ttself. famtly phystC.tan: preventive, thera resources collectively." This is acwmplished primarily peutic, hee1lth promotion, and There are four different areas of through rhc meeting of the General education. advocacy of the Presbyterian Hetllth Assembly. Health related overtures Dr. Morris believes the church N~;:twot k. The first is pensions, are presented to the General Assem has a biblical and historical commit calling for coverage and accessibility bly by scetng to tt that people are ment to care for the poor and sick for those with no access tO health there to advocate on the floor when this means an active response on the care among employees of the church. a topic comes up. This is a "crisis part of the church in the provision It was realized that the vast majority ministry" since the General Assem of basic primary health care. Thus, of Presbyterian employees were part bly meets only for five days. Dr. Morris' organizatton is a family of the 37 million uninsured. Work Finally, the last area has tO do physictan oriented health center began on this by initiatives such as with making advocacy a part of all staffed by two full-time physicians including the women's unit of the health related ministries. The best from 7 a.m. to 9 p.m. during the Presbyterian church in penston example of thts is the Presbyterian week, as well as on Saturday morn committee meetings. policy on alcohol. Twelve consult ings for those who cannot afford to A second area of advocacy is leg ants were contracted through a take time off from work. Evening islative, largely on the national level. national agency so that local presby hours are staffed by among 80 The problem was not that there was teries could invite one of these volunreers, primary care physicians nothing going on at the state and professionals ro help them learn not who donate their time to visit on site local level, but that there was a lack after normal working hours. Seventy ,--- ~------~1I Js Il• ------~ I The Church's Challen&e in Health which tend to direct the course of our action. Theological world views are disseminated to the average lay person through worship and liturgy. The objective of the "Worship and Liturgy" model presented by the Reverend Mark Scott and Dr. Char les Hackett was to show how the way we worship and the liturgy we read can be modified to emphasize the healing aspects of Christian faith. By tracing the history of the concepts of health, shalom, sin, and evil, Dr. Hackett demonstrated the origins and developments leading to the "rites of reconciliation" liturgy of today. Where do we get this modem notion of making a confession and Dr. Scott Morris exammes two sisters at hrs Church Health Center in Memphis. getting absolution? patients are seen each day by the their offices or on site. We also have Reverend Mark Scott pointed out center, which gives primary care to a full-time social worker, a parHime that connectedness within the body the maximum extent possible, in nutritionist, weight-loss classes, of Christ is the root issue when cluding lab work and the provision etc.... " people come together and worship. of medication. If necessary, one of ln addition, the Church Health "No one can ever explain the healing 150 volunteer specialists, who have Center sponsors a health education power of worship." As to specific agreed to see people in their offices program centered around "lay actions a congregation can do, Dr. and perform necessary diagnostic advisors" who are trained in an eight Scott recommends: tests at no charge, can be called in. week session to teach churches 1) Remember that illness isolates Dr. Morris feels that free clinics about hypertension, diabetes, mental people from their well selves and don't work. Patients are charged on health, etc. "Health Watch" is a from others. a sliding scale based on their income, congregational-level program that 2) Help people find a new sense of with the average visit costing 10 to helps congregations identify those connectedness in life. Pray for them, 15 dollars. Patient fees and Medi with medical problems going un etc. caid together account for 50 percent treated. For instance, a young 3) Make sure pastors include them of the $500,000 operating costs. pregnant woman can be identified in congregational prayers. The other half is covered by early and pressed to get prenatal 4) Pay attention to the healing churches, foundations, hospitals, care. scriptures. and businesses. Health education, primary care, 5) Preach on healing lessons. A 'whole person' approach is preventive care, counseling serv 6) Choose hymns and anthems advocated. As Dr. Morris states, ices-all of these serve to bring emphasizing that worship is healing. "Fifty percent of people who come to fullness of life to the needy people of 7) Make visits, telephone con the primary care M.D.s have no Memphis. For more information, tacts. medical problem; they come because contact Dr. Scott Morris, Church 8) Develop prayer groups with the their lives are falling apart. I don't Health Center, 1210 Peabody, specific responsibility of praying fo r care how good a doctor you are, you Memphis, Tennessee, 38104, (901) the needs of the world. can't put someone's life together in a 272-0003. 9) Have special healing services. 10- or 15-minute office visit. For For more information on the this reason we have a full-time Theological Reflection Worship and Liturgy model, contact pastoral counselor on our staff. We Our beliefs about God, salvation, the Reverend Mark Scott, St. John's also have volunteer pastoral coun and health reflect theological issues Lutheran Church, 1410 Ponce de selors as well who are backed up by Leon, Atlanta, Georgia, 30307, (404) psychiatrists who see patients in 378-4243. THE CARTER CENTER OF EMORY UNIVERSITY I were addressed to local congrega Action Groups and tions, religious institutions, inter faith efforts and possible follow-up Distillation Committee Report activities to this conference. Major areas for program development were: • local congregations' opportunity ach conference participant nations. to model positive health practices; was assigned to a discussion Both presenters and participants • a variety of educational sugges group to consider specific stressed the need for health to be tions targeted at children, families, E questions regarding the role viewed in an inclusive sense as both religious leaders, and people with of the religious community in health wholesome lifestyle as well as special needs; and healing. Examples of some medical care. In point of fact, those • the opportunity for ethical questions addressed by discussion whose lifestyles are limited by reflection including the intersection groups are Listed below: poverty, discrimination (including of science and religion; • What can the churches and ind ividual and collective acts of • empathy with those who suffer; other faith groups do to instill racism and sexism), and/or other • the need to model healthy individual responsibility for one's negative bu rdens will be at high risk policy and practice within the own health and for that of others? in health matters and in access to religious community as a social • How do we go about building a medical care when health fails. institution; stronger religious coalition so that This presents a challenge to • equipping individuals as care we can collaborate more effectively religious communities to reflect their givers; regarding health concerns? own capacity to be a source of health • offering support to providers of • How can churches and other and healing. Thus a variety of care; fa ith groups communicate more ef suggestions were provided for pos • embracing a global vision at the fectively at the national and local sible congregational programs and congregational level; levels regarding health issues of other programs which challenge reli • participating in the develop mutual concern and interest? gious bodies to be active catalysts in ment of community-based programs • What are some specific ways developing a more equitable na directed to a variety of health needs; that churches can reach out to tional health policy. Such a chal • building networks among pro minority communities which may be lenge must address: fessional leaders with health portfo most affected by the gaps in health • divisions within the religious lios; care provision in the United States? communities on what should • providing forums where a constitute a shared "health" agenda; variety of public and private sector Distillation Committee Report • the need for agreement on what interests can discuss and formulate A committee was formed to is quality basic health care to which health care strategies. examine the feedback from the everyone should be entitled; Participants acknowledged that discussion groups. Consisting of • a realistic assessment of issues the religious community cannot deal Father Thomas Harvey, Catholic of cost as well as access; with the full range of current health Charities; Gwen Crawley, Presbyte • the present lack of knowledge, issues without entering into the rian Church (USA); and the Rever awareness, and behavior models in public policy arena at national, state, end Charles Miller, Evangelical too many communities of the and local levels. Lutheran Church in America, the dangers of high-risk behaviors such A variety of specific policy committee drew on individual as smoking, alcohol consumption, initiatives were suggested. However, reflections from each session of the poor diet, drug usage, and casual against a backdrop of 37 million symposium as well as summaries sexual activity; uninsured citizens, participants from the discussion groups. Their • the need to keep a balance spoke with a united voice in calling report, which was presented as between activities which focus on for a national policy of universal follows on the last day of the sympo prevention rather than treatment. entitlement for access to health care sium, was intended to serve as a Participants made a variety of and encouragement of religious motivational piece and to display the programmatic suggestions which people to analyze this issue and enter common ground that existed among the public debate. the various faith groups and denomi- - L------1I 37 .-.• ------~ I The Church's Challenge in Health and men sleeping on park benches Concluding Remarks across from the lighted windows of the comfortable is a similar kind of gnawing. I wonder if it is gnawing that I experience when lam asked, as I was just this week, "what should a pregnant woman do who is HIV positive, has one child who is already seriously ill with HIV disease, and what is the likelihood of serious illness on the part of this new child?" Terry Hamilton I wonder if what we shall experience President and Co-chair, once we leave each other here is National Assembly of Religious gnawing that will not let us go until we attend to it. Or will we, as Joseph Women Roberts said, "study it to justify doing nothing." Again, in my tradition one of the great events of the twentieth century he liberal culture is a gift full Not too long ago, read ing about was Vatican II. And duri ng this of problems, but it doesn't African spirituality, I observed what process the reaffirmation of the rule out faith, as Martin l thought was a parallel. In the understanding of the Church or, Dr. T Marty said. To this, William tradition, in the way of the people a Ayoub, the faith community as the Foege added that the church must child accepts the God of the parent. people of God all called to ministry, provide a perspective. When I was a However, there are occasions when and the promise inherent in ecu child, I could never make a decision God calls to a particular person, and menical and interfaith dialogue. between the sun, a blue sky, a God like the pangs of hunger gnaws Sister Kathleen Popko said, "one country road, irises by the brook, or at the mind and heart until proper emerging trend for all of us as the dark moments between the attention to and recognition of the religious organizations and institu deepest shadow and the twilight of tions is this looking to the future and dawn. It was right to insist as a child examining our priorities for advo that I did not need to choose. cacy. We're doing this," she said, "as Likewise between medicine and We are the people we we also critically reflect and dialogue religion we have the luxury of not on the theological understandings of choosing. But we have the responsi have been waiting for. our decisions and actions." bility of using both of them well. This brings me to the theme of In the tradition that I share, we prevention and treatment. It was say in confession, "Bless me for I said here that prevention and treat have sinned." What I have learned ment are held to different standards. over these few days is the need to say call is given. One essential notion To me this is like women and men some similar kinds of words as the that underlies that kind of reality is being held to different standards. starting point of change. I believe we the notion of re lationship. In the Lorraine Hansbury, a distinguished can do that. As I read the book African tradition, supportive rela woman writing in the 1950s, said, Sisters in the Spirit, I was fascinated. tionships are what sustain health: "l "until the social/moral structure ad It tells a story of several African am because we are." When relation mitted the equality of women, all American women, and their call to ships are broken is when illness ethical questions could not be fully ministry. These women attempted occurs. explored, nor could they properly be suicide, fe ll chronically ill , fell into I wonder if what I experience resolved." This kind of thinking that great depression because they could when I go down Fifth A venue in prevention and treatment are to be not decide whether the call to minis New York and see homeless women held to different standards may be an try was real and of God or fa lse and indicator that the languages of of the Devil. health care and of wellness, need to THE CARTER CENTER OF EMORY UNIVERSITY I be expanded and a new vocabulary We also have models that are don't necessarily make good choices. put in place. working, among them, Habitat for She noted our insistence on technol Maybe the language is something Humanity, Christ House, and AIDS ogy over public health nurses. In of what Martin Marty described as Interfaith. These are just a few of other cases, as President Carter "the understanding that ordinary the many models that were pre pointed out, we even export ill people had that the acts of healing sented here. These are models where health. As a resident of New York could not be separated from provid lay people and clergy work together. City, I was struck when he said that ing care and determining meaning." But we also know that we have not more Colombians died from our I was deeply moved when Dr. optim ized what prevention can cigarettes than Americans died of Ayoub stated that in the Qu'ran it is accomplish. Colombian drugs. He said that clearly understood that healing must Public offi cials who were here many times the smaller churches in begin in the soul, and that the yearned to have some kind of part poor communities are more involved greatest disease is despair. He said nership. What we need are creative in social and humane concerns than that God breathed into us the spirit minds and hands to set ourselves to many of us who are part of larger of God which is life with dignity. the task. But we must also be very churches. He said too, though, that This established a kind of right to careful and thoughtful about what as a rna tter of policy we often wellness and is supported also by the that response is going to be. Because severely restrict the ability of MA's, Jewish tradition. Rabbi Feldman said the increasing cost of services related PA's, and RN's to provide health he experienced the Talmud and the to some illnesses creates a kind of care services that might in fact be writings of Maimonides to call for an reluctance to continue to fund cheaper and go further toward active restoration of well ness, and payment for health care. One prevention. that it was urged simply because it example is AIDS, which Dr. Koop The simple question I have is, was right, and it must be done mentioned. On the other hand, can't we do better? And of course I without prejudice and without Patricia Butler told us that those have an answer: I think we can. In conditbn. I think because of that we withour health care benefits are Proverbs, there is this scripture: can be very, very hopeful. But subsidizing health care benefits for "There is a generation, oh how lofty Kinlaw's analysis reminds me too of those that do have health care. arc their eyes. Their eyelids are the words in the Mass that I hold We m::ty have many obstacles to lifted up." But it also says this: dear. Those words say, "I am not overcome to successfully tackle this. "There is a generation whose teeth worthy, but say the words and I shall These obstacles are all the under arc swords and their jawteeth are be healed." I will be healed ns an standings that we have shared these knives ro devour the poor off the individ ual surely, but also we who few days-the differences that are earth, and the needy." It seems to gather shall be healed. Here I think present in our communities, the me that the privilege of leadership is Kinlaw picks up an important sensitivities rhar some of us lack, our ability to influence people. theme: only a healed community whether to sexism or racism or Gertrude in Hamler made our reality can be healing. Both Martin Marry language and culture or to age and very clear: "All that lives must die, and a member of our act ion group social class. Delores Williams says passing through nature to eternity." brought to our attention the impor that truth is our way of being human The only time we really have is now. tance of faith communities as the in the world. She says the gift that I think we must either be the genera facilita tors and reinforcers of sup African American women have tion with our eyes lifted or we will port for one another. We establish given to society is making a way surely be the generation of the meaning and direction in commu when there has been no way. It devourers. nity-especially community en seems to me that those two issues, Mable Thomas, one of the riched by our diversity. how we are in the world, the deci Georgia state legislators, said, "We We have said that brokenness is sions we make, and our comfortabil are the people that we have been present in our midst. We have said ity with taking the risk ro try to waiting for." If we have the concern, that our faith can and should inform make a way when there is no way, we are the people that need to begin our actions. From scripture to are the issues that are fundamental to move that concern. The way to modem systems of health care, to our grappling together. express this is, as stated in Luke's religious groups have involved them Kris Gebbie said, though, that we scripture, "our hearts must be where selves in the well being of the com- our treasure is." And our treasure must be one another. L.___m_u_n_ity_.______.J ~ l I •.------~ I The Church's Challen&e in Health "Recognizing that the health of all Quotes from Participants is a responsibility of society in general, the medically poor including the uninsured and the "The mood of the conference is "Health is a right that we all have underinsured and those with cata one of optimism, of hope, of chal and our society must take responsi strophic illness or injury-must be lenge, of excitement." bility. The way our system has supported at all levels of the church -Reverend Robert]. L Zimmer, evolved in terms of paying for community. All denominations Presiclem, Wheat Ridge Foundation medical care is not conducive to should include programs designed to equal access to health." increase access to health care "The people feel an urgency about -Dr. Christine Collins, Health services for the poor as a primary using old structures [like the Planner, University ofTennessee objective." - Archbishop Eugene church] in a new way ... That is Medical Center Marino, Archdiocese of Atlanta what I hoped would happen here. I think people wUI not be able to leave "Health is everything that has an "What challenges lie before us as here without feeling a large sense of impact on the human organism. It we sec our neighbors lying out all accountability." -Arnold Tiemeyer, involves the gift of life which is a gift around us, and what are we called to President, Lutheran Home at German from God. To utilize that gift to its do? Maybe we ought to look at the town fullest means understanding what Good Samaritan's definition of has an impact on it. So it's very mercy. Mercy is not a gush of senti "The health crisis feels so over much an issue of trust and move mentality. It is not the feeling that whelming. What can one church or ment of the process, the journey of one ought to be patronizing and gra one person do? Yet, we arc seeing at life." -Dr. Kenneth Bakken, Presi cious, but at the center of mercy is this conference that, yes, one church dent, St. Luke Health Ministries always justice. Mercy is justice in can do something. We're getting tears. Mercy is Jesus standing before some good ideas and suggestions. "We're interested in the churches Jerusalem and knowing it was When you start lumping some of because we recognize that a lot of slipping though his fingers, and these churches together, you find in systems in our society have broken saying as tears ran down his eyes, fact that you can have a real im down. Families aren't what they 'How many times I would have pact." -Thomas Peterson, G loballnk used to be; therefore, the role of the embraced you, but you would not.' churches and other community That is what we are called on to do: "We've helped one another ap groups and schools really become to see those in need and to break out preciate the great need that exists all key to figuring out how to help of the little parochial parameters of over the land to help people achieve people socialize themselves in a way ecclesiastical distinctions chat bind the kind of wholeness and well-being that will maximize their health." us so tightly, and to realize that God that God the creator had in mind for -Donna Hall, Henry]. Kaiser Family has called us to a broad concern." all of us. What we take back is a Foundation -Reverend joseph Roberts, Senior renewed sense that faith must be Pascor, Ebenezer Baptist Church, active in love." -Ralph Bohlmann, "The church is at best a commu Atlanta President, Lutheran Church-Missouri nity of the people of faith, and it Synod goes far beyond the church. A more inclusive term could be used to "Globally, the number one cause characterize the concern and the of disease is poverty. The United efforts and the work that we all must States is not an exception. If we're do together, people of the church not doing something about poverty, and people of other communities of we're not doing something about faith. My hope is that this would health." -Dr. Davicl Hilwn, Associ lead to a fellowship offaith." ace Director, Christian Medical Com -Dr. Mahmoua Ayoub, Professor of mission Islamic Studies, Temple University .--- ~------~I1 40 I~· ------~ THE CARTER CENTER OF EMORY UNIVERSITY I The Reverend Charles S. Miller Conference Presenters Executive Director Social Ministry O rganizations Evangelical Lutheran Church in America The Reverend Joanna Adams Dr. James 0. Mason Pastor Assistant Secretary for Health Dr. Scott Morris North Decatur Presbyterian Church Department of Health and Human Executive Director Services Church Health Center of Memphis Sister Mary Madonna Ashton Commissioner of Health, State of Dr. Mahmoud Ayoub The Reverend Joseph L. Roberts Minnesota Professor of Islamic Studies Senior Pastor Temple University Ebenezer Baptist Church Dr. Thomas Bryant President Ms. Patricia Butler Dr. Sylvia Talbot The Non,Profit Management Asso Consultant Vice Moderator ciates Center for Health Ethics and Policy Central Committee University of Colorado World Council of Churches The H onorable Jimmy Carter The Carter Center Mrs. Rosalynn Carter Dr. Reed Tuckson The Carter Center Commissioner of Public Health Ms. Lynda Crawford District of Columbia Assistant Professor Rabbi David M. Feldman Community Health Nursing Jewtsh Center of Teaneck, NJ The Reverend Robert J. L. Zimmer Emory University President The Reverend G. Robert Gary Wheat Ridge Foundation Dr. William H. Foege Director of Pastoral Services Executive Director Emory Un1versity Hospital Sister Kathleen Popko The Carter Center of Emory Univer, Presidenr sity Ms. T erry H amilton Sisters of Providence President Ms. Kristine Gebbie National Assembly of Reltgious Dr. M. Roy Schwarz Secretary Women Assistant Executive Vice President Washington Department of Health Medical Educanon and Science Dr. C. Everett Koop American Medical Association Mr. Lawrence H . H art Former Surgeon General Chair Mr. Dennis Tolsma Indian Ministries Task Force Or. Donald Manning Assistant Director Joint Strategy and Action Commit, Professor and Vice Chairman Public Health Practice tee Department of Psychiatry Centers for Disease Control Emory University Dr. James T. Laney The Honorable Andrew Young President Dr. Martin E. Marty Mayor Emory University Divinity School City of Atlanta University of Chicago The Most Reverend Eugene A. Marino Archbishop of Atl anta Roman Catholic Archdiocese ,.- ~------~·I 41 I~· ------~ I The Church's ChallenQe in Health Mr. Charles W . Dull Conference Participants Aid Association for Lutherans Mr. Millsaps Dye SE Jurisdiction Administrative Council Dr. David F. Adcock Father Robert J. Brooks United Methodist Church Luther Terry Preventive Medicine The Episcopal Church Fellow Ms. Holly Elliott Public Health Service Mr. David Caes United Methodist Congress of the Deaf Christian Community Health The Reverend Cameron M. Alexander Fellowship Ms. Teresa Eshbach General Missionary Baptist Convention Brethren Health and Welfare Ms. Sally Camp Association Dr. Hisham Altalib Health and Healing Ministries Institute of Islamic Thought Evangelical Lutheran Church in Dr. Joyce Essien America Centers for Disease Control Dr. llham Altalib Institute of Islamic Thought Monsignor James Cassidy Ms. Laura Loving Fauntleroy Archdiocese of New York Child Welfare Services of Newport, Rl Mr. Robert T. Banks Home Mission Board Dr. Paul Christakis Dr. Cad F.W. Ficken Southern Baptist Convention Greek Orthodox Church Lutheran Theological Center in Atlanta Very Reverend Father Khajag Mr. Purcell Church Barsamian Interdenominational Theological Mr. Ernest Fitzgerald Vicar General Center Resident Bishop Diocese of the Armenian Church The United Methodist Church Dr. Christine Collins The Reverend Harwood Bartlett University of Tennessee Medical Center The Reverend Richard Foege Episcopal Charities Foundation Emanuel Lutheran Church of Ms. Karen Collins Tacoma, WA The Reverend Robert L. Bayler Child Advocacy Office Evangelical Health Systems National Council of Churches The Reverend William Foege, Sr. Dean B. Lyn Behrens Dr. James Costen Dr. Saul Freedman School of Medicine Interdenominational Theological Lorna Linda University Center Dr. Chiquita A. Fye African Methodist Episcopal Church Mr. Michael Bento Ms. Gwen Crawley Ogilvy and Mather Health Ministries Global Mission Unit Dr. Juarlyn Gaiter Presbyterian Church (USA) Centers for Disease Control Mr. J. Thomas Bertrand Secretary of the University Dr. C. Anne Davis Dr. E. Clinton Gardner Emory University Carver School of Church Social Work Candler School of Theology Southern Baptist Theological Seminary Emory University Dr. Ralph Bohlmann President The Reverend Everett Van Debnam Ms. Connie Gates The Lutheran Church-Missouri Synod Second Baptist Church of Pottstown, Institute for Development Training PA Dr. Frederick Bonkovsky Pastor Jeanette Good Columbia Theological Seminary The Reverend Eldon DeWeertb First Congregational Church of Evangelical Lutheran Church in Amherst, MA Dr. Ronald Braithwaite America Health Promotion Resource Center The Reverend Kenneth G.Y. Grant Morehouse School of Medicine Dr. Walter R. Dowdle Presbytery of Boston Centers for Disease Control Mr. Jack E. Bresch Dr. Benjamin Greene Catholic Health Association of the U.S. Dr. Thomas A. Droege American Baptist Church in the USA Valparaiso University Major Robert Bridges The Salvation Army ,-- ~------1· 42 1I~ ------THE CARTER CENTER OF EMORY UNIVERSITY I Ms. Zelma Greene-Minthom Dr. Majd Kamalmaz Dr. Clair Martin American Indian Program International Institute of lslamtc Dean Phelps Stokes Fund Thought School of Nursmg Emory University Pastor Jonathan Greer The Reverend Jasper N. Keith Cathedral of Faith Church of God Columbta Thcologtcal Semmary Dr. Anne Russell Mayeaux of Atlanta Aquinas Center of Theology Mr. Mike Kerr Emory University Ms. Christine Helen Grumm Centers for Dtscase Comrol Evangelical Lutheran Church in Bishop Lowell H. Mays America Dr. Jan Kuzma Evangelical Lutheran Church m School of Public Health America The Reverend Christoffer Lorna Lmda Untverstty Grundmann Ms. Charlene McCullough German Institute for Medical Missions Ms. Katherine Landin Ladies Mmtsmes Department Candler School of Theology Church of God International Ms. Donna Hall Emory Umverstty Katser Family Foundation Ms. Rhonda J. McDowell Dr. Dora Ames Lee Rural Health ProJeCt Ms. Jane Hull Harvey Umted Methodist Church United Methodist Church General Board of Church and Society The United Methodist Church Mr. H. Michael Lemmons Dr. Belle Miller McMaster Congress of N;monal Black Churches Social justice and Peacemaking Unit Father Thomas Harvey Presbyterian Church (USA) Catholic Charities Dr. Larry Lewis Home Mission Board Mr. James L. Merrell Ms. Frances Haskins Southern Baptist Convention Editor Lutheran Social Services of Central "The Disciple" Ohio Dr. Eugene Linse Board for Social Mmisrry Services Ms. Betty Merriman Dr. David Hilton Lutheran Church-Missouri Synod Kaiser Permanemc Christian Medical Commission World Council of Churches Mr. Lee E. Loder Dr. Herbert Meza Nattonal Black Church AIDS Council Presbytenan Church (USA) Ms. Jamie C. Hilton American Foundation for the Blind Ms. Edith M. Lohr Ms. Melanie Minton Dakota Ho~pttal Chrisnan Church and Churches of The Reverend Wayne Holcomb Chnst Collaborative Support Programs of Ms. Lavada Loper New Jersey Home M tss1on Board Ms. Cecilia Moran Southern Baptist Convenuon Soc1al ] usttce and Peacemakmg Dr. E. Brooks Holifield Presbytenan Church (USA) Candler School of Theology Ms. Mary Lee Loving Emory University Christian Church (Disciples of Christ) Dr. Romney Mosely Tnnity College Ms. Cathy Holmberg Dr. Ngina Lythcott Lutheran Brotherhood Dartmouth Mcdtcal School Pastor Charles Mueller Trinity Lutheran Church of Roselle, IL The Reverend Glenda B. Hope The Reverend David Mahsman San Francisco Network Ministries News and Information The Reverend Howard Mueller The Lutheran Church-Missouri Synod Health and Healing Mmistries The Reverend Richard E. Ice The Lutheran Church-Missouri Synod American Baptist Homes of the \Vest The Reverend Thomas F. Mainor Presbyterian Health Network Ms. Barbara Murray The Reverend Mwalimu lmara National Association Hospitality Morehouse School of Medicine The Reverend Robert Maltzahn Houses St. Michael's Lutheran Church Dr. Thad Jackson Mr. Clinton Marsh Mr. Philip E. Jenks \Vesthtlls Presbytenan Church of American Baptist Churches in the USA Atlanta r-- ~------· 1 43 ·!------~ I The Church's Challenge in Health Ms. Sarah Payne Naylor Lt. Colonel Orville Salmon Dr. David Topazian Lutheran Office for Governmental The Salvation Army Christian Medical and Dental Society Affairs Evangelical Lutheran Church in Ms. Willease Sanders Ms. Gabriele Uhlein America Teen Pregnancy Prevention Program Wheaton Franciscan Services, lnc. Baptist Education and Missionary The Reverend Roger Neeb Ms. Karen S. Vroman Peace Lutheran Church of Hurst, TX Mr. Cayetano Santiago National Benevolent Association U.S. Public Health Service Mr. Wilfred Nolen Mr. James Wagner Church of the Brethren Benefit Trust Dr. Donald G. Schockley General Board of Discipleship University Chaplain United Methodist Church Dr. Laurence O'Connell Emory University The Park Ridge Center Ms. Loretta Walker Mr. Paul Schultz Commission for Women Mr. Phil Olson Bay Area Native American. Ministry Evangelical Lutheran Church in Center on Rural Elderly America Dr. Thomas F. Sellers Mr. Robert Parham Department of Community Health Mr. James Wall Christian Life Commission Emory University School of Medicine Christian Cemury Magazine Southern Baptist Convention The Reverend John D. Sharick Ms. Rose Wallace Ms. Carolyn Parks Presbyterian Church (USA) Metropolitan InterFaith Association Christian Community Health Fellowship Dr. Stephen ) . Sloop Major H elen Sue Warnock Emory Presbyterian Church The Salvation Army Dr. Bob Perryman Baptist Bible Fellowship International Mr. Corey B. Smith Ms. Judith Hope Wellington Evanston Hospital Bay Area Native American Ministry Ms. Mary Lou Perryman Park Crest Baptist Church Mr. J. Robert Spangler Major Charles White General Conference of Seventh-day The Salvation Army Mr. Thomas R. Peterson Adventists Global Ink Ms. June Whitlow The Reverend Thomas A. Summers Women's Missionary Union Dr. Hugh D. Pickett South Carolina Department of Mental Southern Baptist Convention American Baptist Churches in the USA Health Ms. Nancy S. W iens Ms. Savannah Potter-Miller Dr. 0 . Wytch Stubbs Candler School of Theology African Methodist Episcopal Zion Dekalb Medical Center Emory University Church Dr. Joseph E. Sutherland Dr. Donald J. Wilson Mr. Gordon E. Robbins ReSource Unlimited, Inc. Social Justice and Peacemaking Unit Centers for Disease Control Presbyterian Church (USA) Dr. E. Dawn Swaby-Ellis Dr. Mary 0. Ross Emory University School of Medicine Ms. Sylvia J. Wilson Women's Convention Johnson C. Smith Seminary National Baptist Convention, USA Ms. Myra L. Taylor Women's Convention Dr. James Wind Mr. Gardner Russell National Baptist Convention, USA T he Park Ridge Center Church of Jes us Christ of Latter-day Saints The Reverend Hubert Temme The Reverend Henry K. Wohlgemuth Wheat Ridge Foundation Lutheran Ministries of Georgia, Inc. Dr. Judith A. Ryan Congregational Health Services Dr. John A. Terry Dr. Lee V. Woodbury Lutheran General Health Care System Button Gwinnett United Church uf Professional Health Services, lnc. Christ Dr. Lorry Rytting Ms. Bemardette Woodbury Church of Jesus Christ of Latter-day Mr. Arnold Tiemeyer Professional Health Services, Inc. Saints Lutheran Home of Germantown ..-- ~------~1I 44 ~·I ------~ THE CARTER CENTER OF EMORY UNIVERSITY I tion's policies on 13 criteria for a National Health national health policy, as deter mined by the American Public Policy Meeting Health Association. The result was the discovery of a tremendous consensus among the faith commu nity on many of the central elements of a national health policy-most ne of the immediate our of the American Public Health important, universal access to health comes of the conference Association; and Reed Tuckson, care. was the organization of a Commissioner of Health, District of Finally, the group brainstormed Ofollow-up workshop en Columbia. on strategies for reaching the goal of titled, "National Health Policy: The In the first session, "Elements of a health care for all. The following Faith Communities' Agenda." The National Health Policy," each distillation report was produced and task of this new workshop was to ex consultant elucidated key elements approved by the group: plore the role of the faith community of and options for a national health in achieving a national health policy. ln the other session, "Issues The distillation committee was policy. to Consider," each consultant spoke charged with reviewing the actions A design team came together on one of four issues which might of the group, seeking convergences, (consisting of alumni from the destroy the chances of forming a and reporting common ground. In October Striving for Fullness of Life national health policy: AIDS and addition, the committee incorpo conference), and included Dr. rated the material from Session IV, Marilyn Washburn of the Presbyte "Toward a Strategy for a National rian Health Network; Reverend Health Policy," into the report. Kenneth Grant of the Presbytery of There is a tremendous A great deal of common ground Boston; Savannah-Potter Miller, an appeared as members reported on Atlanta attorney; and Reverend consensus among the their denominational health policies. James Cogswell, consultant to The With respect to the 13 criteria de Carter Center. They helped design faith community on veloped by the APHA, all denomi and facilitate this workshop of nations either answered yes to each, January 25 and 26, 1990. Selection many of the central with some explanations about of participants proceeded with the elements of a national individual faith processes, or were objective of involving as many silent. There were no negative different faith groups as possible; health policy-most answers. Although there is much this would insure that the outcome common ground, this comparison is of the conference would represent as important, universal a complicated process. fully as possible the national health While most faith communities agenda of the faith community. access to health care. have a policy base that would en Three goals were set: 1) review courage, or at least allow participa one another's health care and social tion in, an advocacy campaign for a justice policies; 2) discover common national health care system, that ground in policies; and 3) reflect on epidemics; funding and revenue; policy base would not automatically possible strategies in light of legisla lifestyle changes; and relations with lead us tO a consensus in favor of tive proposals surfacing in state and health professionals. one national health care plan. Thus, local governments. In addition to these sessions, par we recommend that each faith group Four expert consultants joined ticipants discussed the si milarities convene discussions to apply their the group: Susan Sherry from the and differences among their denomi policy base to the current or ex National Health Care Campaign in national policies. A matrix was pected legislative options. Washington, D.C.; Dr. Kenneth created comparing each denomina- The distillation committee Frieshof of Physicians for a National recommends two strategies: fi rst, Health Policy; Katherine McCarter that we examine the recommenda- ,.---- ~------~·I 45 ··I ------~ I The Church's Challenge in Health tions for action that emerged from 10. Each faith group must deter the conference and determine those mine the priority of these health which can be acted upon in the near issues and provide the necessary future; and second, that we deal resources to implement the group's with one another with grace, ac policy. knowledging that all faith groups will move at different speeds. 11. Develop a process for demon strating models of lifestyle change. Strategies Proposed: 12. Participate with existing coali 1. Send to all national church tions: IMPACT, Interfaith Action, bodies the completed "Denomina Health Care Working Group, WISC tional Health Policies" form with NCC: Health and Welfare Working citations from their documents. Group. 2. Add 14th point: role of the 13. Develop constituencies with religious organizations as health care business, senior groups, etc. providers, with special attention to church-state concerns. 14. Educate Congress on the role and mission of the non-profit 3. Add 15th point: role of religious provider. groups in advocacy for public policy. 15. Educate provider groups on the 4. Develop communication process effects of various national proposals. with each other and Congress on issues. 5. Identify and develop constituency in our faith groups for health care reform. 6. Expand and better define ideas of health promotion and disease prevention. 7. We need to define what we mean by "comprehensive benefits." 8. Create a process to involve the congregations and the health-related institutions and agencies of the faith groups in understanding health related policy issues and involve ment within development. 9. Examine the possibilities for coalitions between the fa ith groups and other organizations that can support the policies of the faith groups. - L------~1I 46 I~· ------~ THE CARTER CENTER OF EMORY UNIVERSITY I Amler, R.W., & Dull, H.B. (1987) Bibliography Closmg the gap: The burden of unnecessary iUness. New York: Oxford University Press. Batista, R. (Ed.) (1987). Implementing Health Education Haugk, K.C. (1976). "Urban contribu preventive services. New York: Oxford tions of churches and clergy to commu University Press Bauder, E.E. (1971, July). "The clergy nity mental health." Community Mental man's contribution to community Health}oumal, 12, (1), 20-28. Halburn, T., & Pisanscschi, J. (Eds.) mental health." Hospital & Commumry (1988). AIDS information resources Psychwtry, 207-210. Kong, B.W., Miller, J.M., Smoot, R.T. directory. New York: Amfan Press. (1981). "Churches as high blood Comstock, G.W. & Parmdge, K.B. pressure control centers. " Amencan Hudson, T. et al. (1988). Clinical (1972). "Church attendance and )ourniJlofPubltc Health, 71, 1173. prevenuve medtcme: Health promotion and health." journal of Chrome Drseases, 25, diSease preventum. New York: Little 665-672. Lasater, T.M., Wells, B.L., Carleton, Brown & Co. R.A., Elder, J.P. (1986). "The role of DePue, J.D., Wells, B.L., Lasater, T.M., churches m dtsease prevention research Lierman, T. (198 7). Building a healthy & Carleton, R.A. (1987). "Training studies." Public Health Reports, 101, (2). Amenca: Facts, figures, and funding. volunteers to conduct health programs 125-131. in churches." American)oumal of Parker, S. (Ed.) (1988). Disease Preventive Medicine, 51-57. Levin, J.S. (1984). "The role of the prevention/health promouon: The facts. black church in community medicine." Palo Alto, CA: Bull Publishing. Eng, E., Hatch, J., Callan, A. (1985, Journal of the National Medical Associa Spring). "Institutionalizing social sup tion, 76,477-483. Ruffel, M. et al. ( 1989). The United pan through the church and into the States health system: Ongms and functions. community." Health Education Quar Levin, J.S. & Vanderpool, H.Y. (1987). New York: John Wiley & Sons. terly, 12, 81-92. "Is frequent rehgtous attendance really conducive ro bcner health?" Socwl Williams. C. ct al. (1988). Mother and · Forster,J.L. (1982,June). "Acommuni SctenceandMedtcme, (27), 7, 589-600. child health. Delwering the servtees. New tarian ethical model for public health York: Oxford Umversity Press. mterventions: An alternative to indi Saunders, E., Kong, B.W. (1983, May). vidual behavtor change strategies." "A role for churches m hypertension Journals )oumalofPublic Health Policy, 151-163. management." Urban I lealth, 49-54. Farruly and Commun1ty Health. Aspen Galli, N., Greenberg, J.S. & Tobm, F. Wells, B.L., DePue, J.D., Lasater, T.M. Pubhcauons. (1987, May). "Health education and & Carleton, R.A. ( 1988). "A report on sensitivity to cultural, religious, and church Site wetght control." Health Preventwe Medictne. Academtc Press, ethnic beliefs. "journal of School Health, Ed~«:utiUII /b~urdt, 305-316. 1250 Sixth Ave., San Otego, CA, 56, 5, 177-180. 92101-9923. Westberg, G.E. (1973). "Can the clergy Griffith, E. E., Young, J .L. & Smith, D.L. help overworked physictans? Experi Church and Mental Health (1984). "An analysts of the therapeutic ence wtth an experimental church elements in a black church service." clinic." Postgraduate Medtetne, 53, (7), I. History and Theology Hospital Community Psychiatry, (35), 5, 165-169. 464-469. Browning, DonS., ed. Pracucal Theol Health in America ogy, Westminster Press (Philadelphia), Hatch, J.W., Lovelace, K.A. (1980). 1983. "Involving the southern rural church Facts on File, Inc. and students of the health professions in 460 Park Avenue South Lapsley, James N., Salvatum and Health, health education." Public Health New York, NY 10016 Wesrmmster Press (Philadelphta), 1972. Reporcs, 95, (1), 23-25. A profile of health and dtscase in America, J. Helscrich (ed.) r-- L------~·I 47 •.1------~ I The Church's ChallenQe in Health Letterman, Henry L., ed., Health and Wimberley, Edward P. PastoraL Care E. Grief, Loss, and Separation Healing: Ministry of the Church, Wheat and Spiritual Values: A BLack Point of Ridge Foundation (Chicago), 1980. View, Abingdon Press (Nashville), 1982. Mitchell, K.A., and H. Anderson. AU our Losses, All our Grief: Resources for McNeill, John T. A History of the Cure ill. Problem-focused Literature PastoraL Care, Wesrmjnster Press of Souls, Harper and Row (New York), (Philadelphia), 1983. 1951. A. Alcohol and Drug Addiction Most highly regarded history fro m the Sullender, R. Scott. Grief and Growrh, period of ancient Israel to the styles of Bamette, Hen lee H. Tile Drug Crisis Paulist Press (New York), 1985. the various Christian denominations and the Church, Westminster Press during the first half of the twentieth (Philadelphia), 1971. F. Handicaps century. Johnson, Vernon. I'lL Quit Tomorrow, Hauerwas, Stanley. Suffering Presence: Neibuhr, H.R. with D.D. Williams and Harper & Row (San Francisco), 1980. Theological reflections on medicine, the J .M. Gustafson, The purpose of the mentally handicapped, and cite church, Church and its Ministry, Harper and Row Oates, Wayne E. AlcohoL In and Out of Notre Dame Press (Noae Dame). (New York), 1956. the Church, Broadman Press (Nashvtlle), 1966. G. Mental Illness Tillich, Paul, The Meaning of Health, Exploration Press (Chicago). 1984. B. Care for the Caregivers Fairchild, Roy W. Finding Hope Again: A pastor's guide to counseling depressed ll. General Works Rassieur, Charles. Stress Managemem for persons, Harper & Row (San Francisco), Ministers, Westminster Press (Philadel 1980. Fenhagcn, James C. Ministry and phia), 1982. Solitude: The Ministry of the Laity and Oates, Wayne. The Religious Care of che Clergy in Church and Society, Seabury C. Congregational Care Psychiatric Patient, Westminster Press Press (New York), 198 1. (Philadelphia), 1978. Clinebe ll, Howard J. , Jr. The MentaL Nichols, J. Randall, The RestOring Word: Health Ministry of the Local Church, Pretzel, Paul. Understanding and Preaching as Pastoral Communication, Abingdon Press (Nashville), 1972. Counseling che Suicidal Person, Abingdon Harper and Row (San Francisco), 1987. Press (Nashville). 1972. Takes into account the entire worship Johnson, Roger A. Congregauons as liturgy, not just the sermon. Nurturing Commuruties , Fortress Press H. Physical illness (Philadelphia), 1979. Nouwen, Henri J. The Wounded Healer, Studies of nine Lutheran congregations, Oates, Wayne E. and Charles E. Oates. Doubleday (New York), 1972. A call to showing the elements of their success as People in Pain, Westminster Press affirm creativity in the face of ou r caring communities. (Philadelphia), 1985. finitude . McConnell, Mary. Tile Gift of Hospital Young, Richard and Albert L. Meiberg. Patton, John. Pastoral Counseling: A ity: Opening the door of community life tO Spiritual Therapy: How the physician, Ministry of the Church, Abingdon Press people with disabilities, Publications of psychiatrist, and minister can collaborate in (Nashville), 1983. Northwestern University (Evanston, healing, Jason Aronson (New York), Provides a counseling manual with JL). 1977. many insights about dynamics from a clear Christian perspective. Schmitt, Abraham and Dorothy. Wl1en a Congregation Cares: A New Approach to Thompson, Murray S. Grace and Crisis Minisoies, Herald Press (Scottdale, Forgiveness in Ministry, Abingdon Press PA), 1984. (Nashville), 1981. D. Dying Willimon, William H. Worship as Pastoral Care, Abingdon Press Mills, Liston (ed.). Perspectives on (Nashville), 1979. Dearh, Abingdon Press (Nashville), 1969. r- ~------~I1 48 1I~ ------~ THE CARTER CENTER OF EMORY UNIVERSITY I Healthfinder CHll..DREN National Child Safety Council T oll~free Numbers for Health Information Childwatch (800) 222-1464 National Hotline for Missing Children Thts Healthfinder lists and describes ALZHEIMER'S DISEASE (800) 843-5678 toil-free numbers of orgamzattons that (202) 644-9836 in DC provide health-related information. Alzheimer's D1sease and Related Disor They do not diagnose or recommend ders Assocumon Nanonal Runaway Switchboard treatment for any disease. Some (800) 621-03 79 (800) 621-4000 numbers offer recorded information; (800) 572-6037 m IL others provtde personahzed counselmg, Brookdale Center on Aging referrals, and/or written materials. Alzheimer's Respite Lme CYSTIC FIBROSIS Unless otherwise stated, numbers can be (800) 648-COPE reached w1thm the contmental Umted Cystic Fibrosis Foundauon States and operate Monday through (800) 344-4823 Friday. CANCER (301) 951-4422 in MD ACQUIRED IMMUNODEFI AMC Cancer Information CIENCY SYNDROME (AIDS) (800) 525-3777 DIABETES Public Health Service Cancer Information Service (ClS) American Diabetes Association AIDS Informacion Hotline (800) 4-CANCER (800) ADA-DISC (800) 342-AlDS (808) 524-1234 in Oahu, HI (Neighbor (703) 549-1500 m VA and DC (800) 342-SAlD for informanon in islands caU collect) Spanish (800) 638-6070 in AK Juvenile D.abeces Foundation International Hotline Nat1onal AIDS Information Cleanng Y-Me Breast Cancer Support Group (800) 223-1138 house (800) 221-2141 (212) 889-7575 in NY (800) 458-5231 (312) 799-8228 in IL National Gay Lesb1an Cnsisline DOWN SYNDROME (800) 221-7044 CHEMICAL PRODUCTS (212) 529-1604 m NY, AK, and HI National Down Syndrome Congress Chemical Referral Center (800) 232-6372 (800) CMA-8200 m continental U.S. (312) 823-7550 in lL ALCOHOLISM and HI (202) 887 13 15 in DC and for collect National Down Syndrome Society Al-Anon Family Group Headquarters calls from AK Hotline (800) 356-9996 (800) 221-4602 (212) 245-3151 m NY and Canada National Pest1c1de Telecommumcations (212) 460-9330 m NY Network Alcoholism and Drug Addiction Treat (800) 858-7378 ment Center DRlNlGNG WATER SAFETY (800) 382-4357 CHILD ABUSE Safe Dnnkmg Water Hotline National Council on Alcoholism (800)426-4791 (800) NCA-CALL Nac1onal Ch1ld Abuse Hotlme (202) 382-5533 in DC (800) 422-4453 Parents Anonymous Hoehne (800) 421-0353 (800) 352-0386 inCA .-- ~------~I· 49 I·· ------~ I The Church's Challenge in Health DRUG ABUSE HANDICAPPING CONDITIONS Hearing Helpline (see also HEARING AND SPEECH) (800) 424-8576; Drug-Free Workplace Helpline (800) EAR· WELL (800) 843-4971 The Epilepsy Foundation of America (703) 642-0580 in YA (301) 443-6780 in MD (800) EF A-1000 (301) 459-1000 in MD National Association for Hearing and Just Say No Kids Club Speech Action Line (800) 258-2766 HEATH Resource Center (800) 638-8255 (415) 939-6666 inCA (800) 544-3284 (301) 897-0039 in HI, AK, and MD call (202) 939-9320 in DC collect National Cocaine Hotline (800) COC-AINE Job Accommodation Network National Hearing Aid Helpline (800) 526-7234 (800) 521-5247 National Federation of Parents for (800) 526-4698 in wv (313) 478-2610 in Ml Drug-Free Youth (800) 554-KlDS Library of Congress National Library (301) 585-5437 Services HOSPICE CARE for the Blind and Physically Handi National Parents' Resource Institute for capped Children's Hospice International Drug Education (PRIDE) (800) 424-8567 (800) 242-4453 (800) 241-7946 (202) 287-5100 in DC (703) 684-0330 in YA (404) 658-2548 in GA Nationallnformation System for Health Hospice Education Institute Hos NIDA Helpline Related Services (NIS) pice link (800) 662-HELP (800) 922-9234 (800) 331-1620 (800) 922- 1107 in SC (203) 767-1620 in CT Target Resource Center (800) 366-6667 National Rehabilitation Information Center HOSPITAL CARE (800) 34-NARlC EATING DISORDERS (301) 588-9284 in MD Hill-Burton Hospital Free Care (800) 638-0742 Anorexia Bulimia Treatment and (800) 492-0359 in MD Education Center HEADACHE (800) 33-ABTEC Shriners Hospital Referral Line (301) 332-9800 in MD National Headache Foundation (800) 237-5055 (800) 843-2256 (800) 282-9161 in FL Bulimia Anorexia Self-Help (800) 523-8858 in IL (800) 227-4785 HUMAN SERVICES HEARING AND SPEECH FITNESS Project Share American Cleft Palate Association (800) 537-3788 Aerobics and Fitness Foundation (800) 24-CLEFT (301) 231-9539 in MD (800) BE FIT 86 (800) 23-CLEFT in PA Dial a Hearing Test HUNTINGTON'S DISEASE GENERAL HEALTH (800) 222-EARS (800) 345-EARS in PA Huntington's Disease Society of ODPHP National Health Information America Center Grapevine (800) 345-4372 (800) 336-4 797 (800) 352-8888 Voice and TDD (212) 242-1968 in NY (301) 565-4167 in MD (800) 346-8888 inCA, Voice and TDD ,..----- ~------~~1 so ~I· ------~ THE CARTER CENTER OF EMORY UNIVERSITY I IMPOTENCE MEDICARE/MEDICAID PARKlNSON'S DISEASE Recovery of Male Potency DHHS Inspector General's Hotline (800) 835-7667 (800) 368-5779 National Parkinson Foundation (313) 966-3219 in Ml (301) 597-0724 in MD (800) 327-4545 (800) 433-7022 in FL INCOME TAX MENTAL HEALTH Parkinson's Education Program (800) 344- 7872 Federal Internal Revenue Service for American Mental Health Fund (714) 640-0218 inCA IDD Users (800) 433-5959 (800) 428-4732 TDD (800) 826-2336 in IL (800) 382-4059 in IN ; T DD PLASTIC SURGERY (800) 424-1040 Voice National Foundation for Depressive Illness American Society of Plastic and (800) 248-4344 Reconstructive Surgeons LEARNING DISORDERS (800) 635-0635 (see also HANDICAPPING CONDITIONS) MULTIPLE SCLEROSIS PRACTITIONER REPORTING The Orton Dyslexia Society National Multiple Sclerosis Society (800) ABCD-123 (800) 624-8236 Practitioner Reporting System (301) 296-0232 in MD (800) 638-6725 (301) 881-0256 in MD ORGAN DONATION LIVER DISEASES (see also RETINITIS PIGMENTOSA) PREGNANCY American Liver Foundation (800) 223-01 79 The Living Bank ASPO/Lamaze (American Society for (201) 857-2626 inN] (800) 528-2971 Psychoprophylaxts in Obsretrics) (713) 528-2971 in TX (800) 368-4404 (703) 524-7802 in VA LUNG DISEASES Organ Donor Hotline (800) 24-DONOR Bmh Control lnformauon Line Asthma Information Lme (800) 468-363 7 (800) 822-ASMA PARALYSIS AND SPINAL CORD National Pregnancy Hodme Lung Line National Asthma Center INJURY (800) 852-5683 (800) 222-5864 (see also HANDICAPPING (800) 831-5881 in CA (303) 355-LUNG in Denver CONDITIONS) Pregnancy Counsclmg Services American Paralysts Associauon (800) 368-3336 LUPUS (800) 225-0292 (804) 847-6828 m YA (201) 379-2690 m NJ Lupus Foundation of America (800) 5 58-0121 APA Spinal Cord Injury Hodme RARE DISORDERS (202) 328-4550 in DC (800) 526-3456 (800) 638-1733 in MD American Leprosy Missions (Hansen's Terri Gotthelf Lupus Research Institute Disease) (800) 82-LUPUS National Spinal Cord Injury Association (800) 543-3 131 (203) 852-0120 in CT (800) 962-9629 (20l) 794-8650 in NJ (617) 935-2722 in MA Cooley's Anemta Foundation (800) 221-3571 (2 12) 522-7222 111 NY r------ L------~1 51 .I1------~ I The Church's Challen&e in Health Cornelia de Lange Syndrome SAFETY TRAUMA Foundation (see also CHEMICAL PRODUCTS) (800) 223-8355 American Trauma Society (ATS) (203) 693-0159 in cr Consumer Product Safety Commission (800) 556-7890 (800) 638-CPSC (301) 925-8811 in MD National Information Center fo r (800) 638-8270 TDD Orphan Drugs and Rare Diseases (800) 492-8104 TDD in MD (800) 336-4 797 UROLOGICAL DISORDERS (301) 565-4167 in MD National Highway Traffic Safety Administration American Kidney Fund National Lymphedema Network (800) 424-9393 (800) 638-8299 (800) 541-3259 (202) 366-0123 in DC (800) 492-8361 in MD National Neurofibromatosis Foundation National Safety Cou ncil Peyronie's Society of America, Inc. (800) 323-7938 (800) 621-7619 for placing orders for (800) 346-4875 (212) 460-8980 in NY information on safety and accident (316) 283-2456 in KS prevention National Organization for Rare (3 12) 527-4800 in IL Simon Foundation Disorders (800) 23-SIMON (800) 447-NORD (203) 746-6518 in cr SICKLE CELL DISEASE VENEREAL DISEASES National Tuberous Sclerosis National Association for Sickle Cell Association Disease VD Hotline (Operation Venus) (800) 225-6872 (800) 421-8453 (800) 22 7-8922 (301) 459-9888 in MD (213) 936-7205 in CA Tourette Syndrome Association VISION (800) 23 7-0717 SPINA BIFIDA (718) 224-2999 in NY American Council of the Blind Spina Bifida Information and Referral (800) 424-8666 United Scleroderma Foundation (800) 621-3141 (202) 393-3666 in DC (800) 722-HOPE (301) 770-7222 in MD (408) 728-2202 in CA American Foundation for the Blind (AFB) SUDDEN INFANT DEA TII (800) 232-5463 RETINlTIS PIGMENTOSA SYNDROME (212) 620-2147 National Retinitis Pigmentosa American SIDS Institute National Eye Care Project Helpline Foundation (800) 232-SIDS (800) 222-EYES (800) 638-2300 (800) 847-7437 in GA (301) 225-9400 in MD National SIDS Foundation WOMEN (800) 221 -SIDS REYE'S SYNDROME (301) 459-3388 or 3389 in MD Endometriosis Association (800) 992-ENDO National Reye's Syndrome Foundation (414) 962-8972 in WI (800) 233-7393 SURGERY (800) 231-7393 in OH PMS Access Second Surgical Opinion Hotline (800) 222-4767 (800) 638-6833 (608) 833-4767 in WI (800) 492-6603 in MD Women's Sports Foundation (800) 227-3988 (212) 972-9170 in AK, HI, and CA ,---- ~------~1 52 I~· ------