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How Religion and Spirituality Affect Stress and Health

An interview with Dr. Neal Krause on stress, faith, and religion.

Neal Krause, used with permission
Source: Neal Krause, used with permission

Stress is something everyone feels in different ways throughout life, especially as we age. Faith is one way many people cope with difficult events to promote mental well-being. However, faith can be a complicated part of a person's identity.

Neal Krause, Ph.D. is the Marshall H. Becker Collegiate Professor Emeritus at the University of Michigan School of Public Health. He retired in 2015. Neal has written extensively about the relationship between religion and health among older adults. He has received numerous awards for his research, including the 2017 Kleimeier Award from the Gerontological Society of America. This is the highest award the Society gives for lifetime contributions to research on aging.

JA: How did you first get interested in this topic?

NK: When I began my research career, my primary focus was on how older adults cope with the stressful events that arise in their lives, including things like the death of a loved one and financial difficulties. Throughout these studies, many participants indicated that they relied on their faith during difficult times. After hearing these spontaneous comments time and time again, I realized I could no longer ignore religious issues in understanding how older people cope with stress. This decision led to years of research on religion and health in late life, which I later expanded to adults of all ages.

JA: What was the focus of your study?

NK: We entered into two studies without any expectations of what might emerge. Our data came from a nationally-representative sample of individuals 18 years of age and older. We asked study participants whether they consider themselves to be "religious," "spiritual," "religious and spiritual," or "neither religious nor spiritual." A vast literature suggests that people who are more deeply involved in religion tend to enjoy better physical and mental health.

Based on these findings, the Part 1 paper was designed to see if the four religious/spirituality categories were associated with physical and mental health outcomes. Given my interest in stress, we wanted to focus on how members in each group coped with major stressful events.

The Part 2 paper was designed to learn about those who were more vulnerable to health-related problems in Part 1. We focused specifically on whether there were differences between groups in how they practiced their faith. We examined various measures of religion including the frequency of church attendance, social relationships with fellow church members, the use of religion to cope with stress, and the practice of virtues associated with religious life (e.g., compassion, forgiveness, and humility). Both studies are unique because they are based on data from a large sample who represent all adults in the United States, and because of our comprehensive analyses, especially in the Part 2 paper.

JA: What did you discover in your study?

NK: The findings from the Part 1 paper were striking. Those who said they were "religious" experienced more health-related problems than individuals who said they were "spiritual," "religious and spiritual," and "neither religious nor spiritual."

In contrast, no other differences emerged among the study participants in the other groups. We focused on three health outcomes: how people rate their own health (i.e., as excellent, good, fair, or poor), symptoms of depression, and levels of alcohol consumption.

The findings from the Part 2 paper were equally compelling. The data suggest that compared to people in the other three groups, people who were "religious" went to church less often, prayed less frequently, and did not read the Bible as often.

Study participants who were "religious" had less positive feelings about God and were more likely to worry about the nature of their relationship with God. Similarly, members of the "religious" group were less likely to exchange social support (i.e., give or receive support) with fellow church members. Finally, the "religious" group was less likely to rely on their faith when major stressors emerged in their lives.

JA: Is there anything that surprised you in your findings or that you weren't fully expecting?

NK: I was surprised by the consistency of the study findings. The "religious" group stood far apart from the participants in the other groups. And it didn’t seem to matter what measure we used to assess these differences.

JA: How might readers apply what you found to their lives?

NK: Rather than being antithetical to religion, spirituality seems to represent the emotional soul of religion. This means, for example, that without the core experiential aspects of spirituality, engaging in religious rituals becomes little more than a sterile and impersonal exercise.

To the extent this is true, our findings speak directly to those who elect to become involved in religion: do not overlook the deep subjective and emotional side of religious practices.

Please note: we are not advocating that people become involved in religion; instead, we are merely suggesting that if people voluntarily choose to do so, they may wish to consider what our findings indicate.

JA: How can readers use what you found to help others?

NK: Research indicates that a significant number of people turn to the clergy when they encounter stressful experiences. It is for this reason, pastoral counseling has become a major component of the mental health treatment system. Although our findings are certainly preliminary, they hint at things that pastoral counselors may find useful in their work.

Stressful times tend to try one’s faith—they can make people question their beliefs as well as the efficacy of their faith. If they feel it is appropriate, pastoral counselors may wish to encourage these individuals to cultivate the emotional and experiential side of their faith.

JA: What are you currently working on that you might like to share about?

NK: I am slowly writing a new book that summarizes what I have learned in over 25 years of research on religion and health. I want to color way outside the lines in this volume. I realized that in order to accomplish this goal, I needed formal training in religious studies.

I have enrolled in a Bachelor of General Studies degree program to take courses from a religious studies department as well as courses on religion including comparative literature on religion and the study of the supernatural from the folklore department. So far, my new studies have been great fun.


Neal Krause, Kenneth I. Pargament, Peter C. Hill, & Gail Ironson. (2019a). Exploring religious and/or spiritual identities: Part 1 - Assessing relationships with health. Mental Health, Religion, & Culture, 22 (9), 877-891.

Neal Krause, Kenneth I. Pargament, Peter C. Hill, & Gail Ironson. (2019b). Exploring religious and/or spiritual identities: Part 2 - A descriptive analysis of those who are at risk for health problems. Mental Health, Religion, & Culture, 22 (9), 892-909.