Spirituality affects both mental and physical health outcomes in the general United States population across different ethnic groups.Seybold, Kevin S., and Peter C. Hill. "The Role of Religion and Spirituality in Mental and Physical Health." Current Directions in Psychological Science 10(2001):21-24. Because of the nuanced definitions of spirituality and religiosity, the literature on spirituality is not consistent in definitions or measures, resulting in a lack of coherence. However, taken as a whole, research tends to show that the effect of spirituality is positive, associated with better health outcomes.Douglas, Amber N., Sherlyn Jimenez, Hsiu-Ju Lin, and Linda K. Frisman. "Ethnic Differences in the Effects of Spiritual Well-Being on Long-Term Psychological and Behavioral Outcomes Within a Sample of Homeless Women." Cultural Diversity and Ethnic Minority Psychology 14(2008):344-352. For those who engage in spirituality, it may serve as a buffer from negative life events, often moderating the relationship between negative life experiences and levels of anxiety or depression.Young, J. Scott, Craig S. Cashwell, and Julia Shcherbakova. "The Moderating Relationship of Spirituality on Negative Life Events and Psychological Adjustment." Counseling and Values 45(2000):49-55. The exception is when negative spiritual coping is practiced. This type of coping has negative health implications.
The homeless are a vulnerable population that experiences the moderating effect of spirituality; spirituality plays a role in their emotional and mental capacity to handle challenges they face and practice health-promoting behaviors. For the homeless who practice spirituality as a positive coping mechanism, it often improves their life and is cited as a source of strength and comfort in qualitative research.
Spirituality
Definition Spirituality does not have a clear definition, though it is generally regarded as the search for and experience of the sacred, meaning God, a higher power, or something of divine nature.Hodge, David R., Stephanie E. Moser, and Michael S. Shafer. “Spirituality and Mental Health Among Homeless Mothers.” Social Work Research 36(2012):1-12.George, Linda K., David B. Larson, Harold G. Koenig, and Michael E. Mccullough. "Spirituality and Health: What We Know, What We Need to Know." Journal of Social and Clinical Psychology 19(2000):102-116. Spirituality is characterized as something experienced personally, an individualized process that involves personal or private beliefs.Brush, Barbara L., and Eileen M. McGee. “Evaluating the Spiritual Perspectives of Homeless Men in Recovery.” Applied Nursing Research 13(2000):181-186.Hurlbut, Jene M., Leslie K. Robbins, and Mary M. Hoke. “Correlations Between Spirituality and Health-Promoting Behaviors Among Sheltered Homeless Women.” Journal of Community Health Nursing 28(2011):81-91. However, it may involve the values of community and relationship, or an emphasis on the connectedness of people. Spirituality often emphasizes the integration of mind, body and spirit, and it can provide a sense of purpose or life significance.
There is considerable overlap in the definitions of religion and spirituality and, for this reason, they are often used interchangeably in the literature. Religion, like spirituality, can provide people a sense of purpose or meaning through personal beliefs. The main distinguishing factor between religion and spirituality is that religion is generally practiced collectively with some type of structural or institutional reinforcement. Both terms are multi-faceted and are typically measured along similar dimensions. Common dimensions of spirituality/religion as defined by the National Institute of Healthcare Research and NIA/Fetzer Institute are as follows:
Preference or affiliation: membership in a specific religious or spiritual group Public practices: involvement in formal activities such as attendance at services Private practices: private behaviors such as prayer, meditation, or reading sacred texts Spiritual experiences: interaction or experience with the divine manifested in feelings and sensations Spiritual coping: how an individual uses beliefs to cope with stressful events; can be positive or negative Beliefs and values: specific beliefs and values Forgiveness: experience of reconciliation with others and with the divine, can be a form of spiritual coping Social support: intangible and tangible support offered by other members of the spiritual/religious community Intensity/commitment: importance of spirituality relative to other areas of life and its effect on behavior Spiritual meaning: sense of purpose and meaning of one's life as a result of spirituality
These dimensions are simply two examples of measures used in the literature on spirituality. Because of the nebulous definition of spirituality in the literature, measures are not consistent across different studies, resulting in a lack of coherence in the literature. However, there is a consensus in research done on spirituality that it influences health. This effect is generally positive with the exception of negative spiritual coping.
Effect on physical health Spiritual wellbeing has been associated with positive physical health outcomes in research. Spirituality reduces the likelihood of illness and is strongly related to increased longevity. For example, it lowers the rate of heart disease, cirrhosis, emphysema, stroke, kidney failure, cancer mortality, overall mortality. Spirituality also decreases blood pressure and cholesterol levels. If someone does become ill or must endure surgery, they are likely to have a better recovery. These effects may vary depending on the strictness of behavioral codes associated with a religion, the intensity of the person's practice of spirituality, and whether or not their spiritual experience is a positive one. If someone uses negative spiritual coping, the positive health benefits will not happen and the individual's health may be influenced negatively (see religious/spiritual coping section).
Effect on mental health Spirituality tends to improve mental health. Spirituality is associated with lower rates of suicide, anxiety disorders, and depression. In regards to depression, individuals who are more spiritually involved are more likely to recover. In a review of forty-three studies, Rew and Wong (2006) found that religiosity and spirituality are important correlates of adolescent health with 84% of the literature indicating a positive correlation.Rew, Lynn, and Y. Joel Wong. "A Systematic Review of Associations Among Religiosity/Spirituality and Adolescent Health Attitudes and Behaviors." Journal of Adolescent Health 38(2006):433-442. Spirituality also reduces the likelihood of drug/alcohol dependency or abuse and is associated with a more effective recovery from abuse/dependence. While spirituality generally improves mental health, for individuals who use harmful forms of religious coping, spirituality is "correlated with impaired mental health and poorer resolution of negative life events."
Religious/spiritual coping There are two types of spiritual coping, positive and negative. Positive spiritual coping manifests itself as a strong relationship with God, seeking support from the community and a higher power, looking for meaning in life and helping others.Pargament, Kenneth I., Bruce W. Smith, Harold G. Koening, and Lisa Perez. "Patterns of Positive and Negative Religious Coping with Major Life Stressors." Journal for the Scientific Study of Religion 37(1998): 710-724.Wachholtz, Amy B., Michelle J. Pearce, Harold Koenig. "Exploring the Relationship between Spirituality, Coping, and Pain." Journal of Behavioral Medicine 30(2007):311-318. Most people who practice spirituality engage in positive spiritual coping which is associated with improved mental and physical health.
Negative spiritual coping, a pattern distinct from positive spiritual coping, has negative health implications. Negative spiritual coping involves deferring all responsibility to God, feeling abandoned by God or blaming God for difficulties. It often manifests itself as a less secure relationship with God, an ominous worldview and general spiritual discontent. For those who engage in negative spiritual coping, it is related to significantly poorer physical and mental health outcomes as well as higher mortality. In a study done by Pargament (1998), negative spiritual coping had differing negative health implications among different populations. For citizens of Oklahoma City who experienced the federal building bombing, it was associated with more post-traumatic stress disorder symptoms and higher levels of callousness. For college students, negative spiritual coping was associated with higher levels of emotional distress and poorer physical health. For hospital patients with physical ailments, negative spiritual coping was associated with higher levels of depression and lower quality of life.
Role of spirituality in the lives of homeless people A homeless person is an individual without a consistent, fixed nighttime residence or someone whose nighttime residence is a supervised shelter that provides temporary housing.Runquist, Jennifer J., and Pamela G. Reed. "Self-Transcendence and Well-Being in Homeless Adults." Journal of Holistic Nursing 25(2007):5-13. Homelessness is a chronic stressor producing reduced wellbeing.Irwin, Jay, Mark LaGory, Ferris Ritchey, and Kevin Fitzpatrick. "Social Assets and Mental Distress Among the Homeless: Exploring the Roles of Social Support and Other Forms of Social Capital on Depression." Social Science and Medicine 67(2008): 1935-1943. Homeless populations are a vulnerable population experiencing a higher prevalence of mental and physical health problems as well as victimization and increased mortality rates. Spirituality is one method some homeless individuals use to cope with their position of high vulnerability. Runquist and Reed (2007) found that spiritual perspective correlated positively with measures of wellbeing among the sample of homeless individuals surveyed and that measures of wellbeing correlated positively with self-rated health status. Social capital resulting from spirituality or religion, according to Irwin (2008), is a critical factor to wellbeing among homeless populations. It increases the resource base of the individual enabling them to cope with their situation in healthier ways.
Youth Youth, typically defined as people between the ages of twelve and twenty-four, make up a large portion of the homeless population.Bender, Kimberly, Sanna J. Thompson, Holly McManus, Janet Lantry and Patrick M. Flynn. "Capacity for Survival: Exploring Strengths of Homeless Street Youth." Child Youth Care Forum 36(2007):25-42. As they are a transient population, it is difficult to get an accurate count of homeless youth; the number is commonly thought to be somewhere between 1.3 and 2 million.Ferguson, Kristin M., Qiaobing Wu, Grace Dyrness, and Donna Spruijt-Metz. "Perceptions of Faith and Outcomes in Faith-based Programs for Homeless Youth: A Grounded Theory Approach." Journal of Social Service Research 33(2007):25-42.Kidd, Sean A. "Street Youth: Coping and Interventions." Child and Adolescent Social Work Journal 20(2003):235-260.Lindsey, Elizabeth W., David Kurtz, Sara Jarvis, Nancy R. Williams, and Lary Nackerud. "How Runaway and Homeless Youth Navigate Troubled Waters: Personal Strengths and Resources." Child and Adolescent Social Work Journal 17(2000):115-142. These youth have higher rates of mental health disorders, suicide, and drug/alcohol dependency due to the high amount of stressors in their lives.