Spiritual Health Is Community Health: A Theological and Environmental Exploration of the Role of Community in Spiritual Health and Spiritual Care 
Quinlan Morrow,  Loma Linda University School of Medicine, Loma Linda, CA, Loma Linda University School of Religion, Loma Linda, CA

Some of the strongest evidence for incorporating spirituality into clinical practice comes from data on health outcomes for people who regularly attend religious/spiritual services. Religious/spiritual service attendance has long been known to have preventative health effects. Regular service attendance has been shown to decrease risk for mortality in numerous conditions and increase overall longevity. Having a faith system is not sufficient for changing health outcomes, but when faith is practiced in a community context, better health is an emergent property. This requirement of community-based spirituality for health outcomes questions an individualistic understanding of spiritual health and spiritual care. Can spiritual health be understood as existing in an isolated individual, or is spiritual health synonymous with community health? Drawing on concepts from agrarian philosopher Wendell Berry, ecological principles, theologians such as Catherine of Siena, and research on religion/spirituality and health, the crucial role of community in spiritual health and spiritual care emerges, revealing that all forms of health, including spiritual health, are inextricably linked to the health of others. An understanding of spiritual health as community health challenges the inherent divisions of modern medical practice, emphasizing the connection between physical and spiritual health as well as altering approach to spiritual care. This community-oriented understanding of health reveals that spiritual care enhances health by drawing patients and providers back into community with the transcendent, creating a micro-community in which spiritual health, and therefore overall health, can improve. This approach of communities within therapeutic relationships and in the larger scope of patients’ lives suggests that the spiritual health not only of patients’ communities but also of healthcare practitioners should be addressed and can positively or negatively impact patient health. Additionally, this perspective highlights the importance of recognizing connection as a spiritual care intervention, the need for interprofessional involvement in spiritual care, importance of spiritual history and assessment questions on the current role of community in a patient’s spiritual life, and the powerful role of community involvement in patient well-being.