A joint project of the Graduate School, Peabody College, and the Jean & Alexander Heard Library

Title page for ETD etd-07292015-123328

Type of Document Master's Thesis
Author Gross, Christopher Lee
Author's Email Address christopher.l.gross@vanderbilt.edu
URN etd-07292015-123328
Title Spirituality and Religion as a Social Determinant and Social Mediator of Health
Degree Master of Arts
Department Medicine, Health, and Society
Advisory Committee
Advisor Name Title
Dr. Jonathan Metzl Committee Member
JuLeigh Petty Committee Member
  • social determinants of health
  • narrative medicine
  • spirituality
  • religion
Date of Defense 2015-07-15
Availability unrestricted

Spirituality and Religion as a Social Determinant and Social Mediator of Health

Christopher Lee Gross

Thesis under the direction of Professors Jonathan M. Metzl and JuLeigh Petty

In recent years, the Association of American Medical Colleges (AAMC) has placed significant attention on social determinants of health (SDH) as making significant contributions to patient health and outcomes (AAMC, 2012). Although the medical community has long understood the influence of a patient’s lived environment on health, medical education has only recently incorporated SDHs into its curriculums, generally defining them as the social, political and economic influence on race, ethnicity, poverty level, socioeconomic status and education level. I contend that this definition is incomplete. Spirituality and religion (SR) informs behaviors that have health implications to at least an equal degree, and therefore should be included as a social determinant of health, and given equal weight to the aforementioned (Idler, 2014).

Currently, most relevant literature focuses on the ethicality of SR and medicine or the specific health benefits associated with various religions. Future research should go beyond these questions and address spirituality and religion as a SDH because SR can inform patient health beliefs, practices and behaviors (Idler, 2014). Not only does SR act as a social determinant of health, it acts as a social mediator of health (SMH). Although certain religious practices promote common behaviors among groups that have health specific implications (i.e. following a SR that proscribes alcohol influences health behaviors in regard to alcohol consumption), individuals in the same group might understand or respond differently to illness (health beliefs). In this way, SR can act as social mediator of health during an illness experience.

Given its ubiquity, all physicians should be educated to better understand a patient’s SR, and its relationship to medical practice and patient health. This means that providers should be open to the possibility that a patient’s SR might be influencing a patient’s health beliefs and behaviors as it relates to the lived experience, day-to-day life practices/routines, as well as their response to suggested healthcare treatment. If a clinician desires to include SR care, as a part of pastoral care, into her own practice of medicine, she should have the opportunity and resources to be well-educated and well-trained to do so. Since SR in medical education is limited, I will present a program evaluation of a community-based health clinic that incorporates SR for healthcare trainees.

Approved: Jonathan M. Metzl, M.D., Ph.D.

Approved: JuLeigh Petty, Ph.D.

  Filename       Size       Approximate Download Time (Hours:Minutes:Seconds) 
 28.8 Modem   56K Modem   ISDN (64 Kb)   ISDN (128 Kb)   Higher-speed Access 
  GrossChristopher.pdf 690.45 Kb 00:03:11 00:01:38 00:01:26 00:00:43 00:00:03

Browse All Available ETDs by ( Author | Department )

If you have more questions or technical problems, please Contact LITS.