Is God the Ultimate Healer: African American Pastors’ Perceptions of the Role of Humanity and God in Determining Health
Elijah Kindred, MDiv, Loyola University Chicago Stritch School of Medicine, Maywood, IL; Yolanda O'Neal, MBA, University of Chicago, Section of General Internal Medicine, Chicago, IL; Lena Hatchett, PhD, Loyola University Chicago Stritch School of Medicine, Maywood, IL; and Monica Peek, MD, MPH, MS, University of Chicago, Section of General Internal Medicine, Chicago, IL Chicago Center for Diabetes Translation Research, Chicago, IL, MacLean Center for Clinical Medical Ethics, Chicago, IL, Center for the Study of Race, Politics and Culture, Chicago, IL
INTRODUCTION
African American pastors are very influential in the African American community. Specifically, research has shown African American pastors have the ability to impact health outcomes of the African American community by influencing the congregation’s health beliefs, narrative, and locus of control (Harmon et al, 2018). Because African American pastors, through their theology, have the ability to influence their congregation’s interpretation of health, and how they respond to health-promoting life choices (Emmon & Paloutzian, 2003), we sought to investigate their health-related knowledge, attitudes, and beliefs. While studies have investigated pastors’ perceptions of health education, their influence in the church, and their ability to promote health from the pulpit, we are unaware of any studies that explore how African American pastors understand the factors that impact their own health. This study seeks to fill this gap.
METHODS
This mixed-methods study incorporates qualitative data and survey data gathered from a convenience sample of 15 clergy members from the South Side of Chicago. We conducted semi-structured interviews among African American pastors from the Black Church tradition, defined as including: (1) independent Black, Methodist, and Holiness-Pentecostal denominations; (2) Black congregations and fellowship in predominantly White denominations such as the Roman Catholics, Presbyterians, and Episcopalians; (3) non-denominational Christian churches that have multicultural, multiracial, and multiethnic membership but the ministerial leadership and cultural identity is African American in nature (Floyd-Thomas & Stacy, 2007). A topic guide, based on the PEN3-Cultural Model (Iwelunmor et al, 2014), was utilized to delve into participants' understanding of health in general and their own personal health. This study focused on two key questions: (1) "To what extent do you perceive control over your health outcomes versus factors beyond your influence?", and (2) "What role does God play in determining your health outcomes?"
The final themes and concepts derived from the coded interviews were collectively reviewed by the research team.
RESULTS
The majority of the sample were male (93%), averaging 51 years of age. All participants had some level of post-secondary education, with pastoral experience ranging from 4 to 33 years. About half of the pastors (48%) led medium-sized congregations (51-300 members); no mega-churches were represented.
Two prominent themes emerged: internal and external locus of control. Under internal locus of control, subthemes included the degree of control (which varied, but a sense of total control was prevalent) (“I’m in the shape I’m in because of me.”), personal responsibility (“If I’m overweight, it’s because I’m overweight. And to be honest with you, I think everybody needs to take responsibility for that.”), choice (wrong choices can “cost your life” and bring “tears and sorrows”), and the impact of external forces (i.e., aging, genetics, systemic injustices, racism, unpredictability of pastoring; God was not mentioned).
Regarding external locus of control, subthemes encompassed divine providence (“I was able to rest in the fact that whatever was going on, [God] was going to control it.”, “I had nothing to fear because [God] was still in control.”), collaborative agency (“[God] gave me this body to take care of. It’s up to me to take care of that which God gave me to take care of.”), God as healer (“I do believe that [God] can [heal], I just don’t believe we should live our life depending on miraculous healings…”), and the power of prayer (“…we should not pray for healing and not follow the science.”).
African American pastors recognize their pivotal role in their health, viewing it as their duty to care for the body bestowed by God. They take proactive steps towards fostering positive health outcomes, mindful of choices regarding diet, sleep, exercise, and following healthcare guidance. Concurrently, they recognize the influence of Divine Providence on their health. God may collaborate with humanity to bring about positive health outcomes, but ultimately, God is in control.
CONCLUSION
This study uncovers a perceived conflict between the influence of human agency and divine intervention in shaping health outcomes, particularly among African American pastors. This dynamic may extend its implications to the wider African American community. Despite their extensive experience as religious leaders articulating theological perspectives, our research suggests that the pastors still grapple with distinguishing their own role from that of God in determining health outcomes. Even though they are considered 'messengers of God,' these pastors acknowledge the influence of behavioral and structural factors on health outcomes. Engaging pastors directly in faith-based interventions, rather than merely incorporating faith as a component, could prove to be an effective strategy.
African American pastors are very influential in the African American community. Specifically, research has shown African American pastors have the ability to impact health outcomes of the African American community by influencing the congregation’s health beliefs, narrative, and locus of control (Harmon et al, 2018). Because African American pastors, through their theology, have the ability to influence their congregation’s interpretation of health, and how they respond to health-promoting life choices (Emmon & Paloutzian, 2003), we sought to investigate their health-related knowledge, attitudes, and beliefs. While studies have investigated pastors’ perceptions of health education, their influence in the church, and their ability to promote health from the pulpit, we are unaware of any studies that explore how African American pastors understand the factors that impact their own health. This study seeks to fill this gap.
METHODS
This mixed-methods study incorporates qualitative data and survey data gathered from a convenience sample of 15 clergy members from the South Side of Chicago. We conducted semi-structured interviews among African American pastors from the Black Church tradition, defined as including: (1) independent Black, Methodist, and Holiness-Pentecostal denominations; (2) Black congregations and fellowship in predominantly White denominations such as the Roman Catholics, Presbyterians, and Episcopalians; (3) non-denominational Christian churches that have multicultural, multiracial, and multiethnic membership but the ministerial leadership and cultural identity is African American in nature (Floyd-Thomas & Stacy, 2007). A topic guide, based on the PEN3-Cultural Model (Iwelunmor et al, 2014), was utilized to delve into participants' understanding of health in general and their own personal health. This study focused on two key questions: (1) "To what extent do you perceive control over your health outcomes versus factors beyond your influence?", and (2) "What role does God play in determining your health outcomes?"
The final themes and concepts derived from the coded interviews were collectively reviewed by the research team.
RESULTS
The majority of the sample were male (93%), averaging 51 years of age. All participants had some level of post-secondary education, with pastoral experience ranging from 4 to 33 years. About half of the pastors (48%) led medium-sized congregations (51-300 members); no mega-churches were represented.
Two prominent themes emerged: internal and external locus of control. Under internal locus of control, subthemes included the degree of control (which varied, but a sense of total control was prevalent) (“I’m in the shape I’m in because of me.”), personal responsibility (“If I’m overweight, it’s because I’m overweight. And to be honest with you, I think everybody needs to take responsibility for that.”), choice (wrong choices can “cost your life” and bring “tears and sorrows”), and the impact of external forces (i.e., aging, genetics, systemic injustices, racism, unpredictability of pastoring; God was not mentioned).
Regarding external locus of control, subthemes encompassed divine providence (“I was able to rest in the fact that whatever was going on, [God] was going to control it.”, “I had nothing to fear because [God] was still in control.”), collaborative agency (“[God] gave me this body to take care of. It’s up to me to take care of that which God gave me to take care of.”), God as healer (“I do believe that [God] can [heal], I just don’t believe we should live our life depending on miraculous healings…”), and the power of prayer (“…we should not pray for healing and not follow the science.”).
African American pastors recognize their pivotal role in their health, viewing it as their duty to care for the body bestowed by God. They take proactive steps towards fostering positive health outcomes, mindful of choices regarding diet, sleep, exercise, and following healthcare guidance. Concurrently, they recognize the influence of Divine Providence on their health. God may collaborate with humanity to bring about positive health outcomes, but ultimately, God is in control.
CONCLUSION
This study uncovers a perceived conflict between the influence of human agency and divine intervention in shaping health outcomes, particularly among African American pastors. This dynamic may extend its implications to the wider African American community. Despite their extensive experience as religious leaders articulating theological perspectives, our research suggests that the pastors still grapple with distinguishing their own role from that of God in determining health outcomes. Even though they are considered 'messengers of God,' these pastors acknowledge the influence of behavioral and structural factors on health outcomes. Engaging pastors directly in faith-based interventions, rather than merely incorporating faith as a component, could prove to be an effective strategy.