BOOK REVIEW                                                                                                          

 

Nov 2015. Christian Journal for Global Health, 2(2): 76-77. 

Religion as a Social Determinant of Public Health, By Ellen 

Idler, Ed, Oxford University Press, 2014 

Stephen C. Ko
a
 

 
a
 MD, MA, MPH, MDiv, Assistant Professor of Global Health, Boston University School of Public Health, 

USA. 
 

The overall assertion of this unique 

work lies squarely in its title, Religion as a 

Social Determinant of Public Health.  As the 

prevailing research and policy model utilized 

in public health, the social determinants per-

spective presupposes that primary determi-

nants of health are not necessarily clinical care 

and the provision of services, but rather the 

circumstances and conditions affecting daily 

living.  The authors contend that religion 

should not only be considered as an independ-

ent determinant of health, but also for its vari-

ous interactions with other influential determi-

nants such as politics and economics.  

 In 2005, Emory University began a stra-

tegic initiative on religion and human spirit, 

resulting in the formation of the Religion and 

Public Health Collaborative.  The origins of 

this book stem from this initial collaborative 

and subsequent interdisciplinary faculty semi-

nar from 2010-2013.  During this time, pre-

dominantly Emory faculty from a diverse set 

of scientific, scholarly, and professional back-

grounds developed the outlines, manuscripts, 

and eventual chapters of the volume.   

 Divided into five parts, the first reports 

on religious practices within major faith tradi-

tions worldwide.  Categorized by their cycles 

of repetition, scholars portray time-honored 

practices contextualized within their religious 

frames.  Daily practices of vegetarianism in 

Seventh Day Adventists and refuge meditation 

in Contemporary Buddhism are presented 

alongside weekly practices celebrating Eucha-

rist in Roman Catholicism.  Annual religious 

practices such as fasting in Islam are described 

alongside one-time religious practices of cir-

cumcision in Judaism and baptism among  

Latin American Pentecostals.  These depic-

tions provide the groundwork for analysis of 

associations between religion and public 

health. 

 The second part traces the impact of 

religion on public health in the last two centu-

ries, exclusively within the United States and 

England.  Major movements are assessed, the 

first being John Wesley’s impact on public 

health through the Methodist Church.  There, a 

fundamental burden for the poor led to in-

creased access to healthcare and enhancement 

of layman medical training through the publi-

cation Primitive Physick.  Within the United 

States, the Social Gospel movement’s positive 

impact on public health is juxtaposed to the 

deleterious effects of 19
th
 century Comstock 

Laws on reproductive health.   

 In the third part, authors investigate cur-

rent research involving religion as a social 

determinant of individual physical and mental 

health along a life course perspective.  From 

religious beliefs and their impact on maternal 

and child health to rituals and the comfort they 

provide to geriatric patients coping with end of 

life issues, empiric evidence is deconstructed 

and examined.  Meanwhile, the natural inter-

section between religious practices and mental 

health is considered, focusing on the impact of 

ethical values and moral emotions.   

 In the fourth part of the book, the effect 

of religious institutions on global health is re-

viewed in the context of low and middle in-

come countries.  Highlights include a histori-

cal narrative of the complex relationship be-

tween neighboring World Council of Churches 

and World Health Organization.  Initial col-

laborative programs between the two institu-



77   Ko 

Nov 2015. Christian Journal for Global Health 2(2): 76-77.                                     

 

 

tions are uncovered while tracing the evolu-

tion of hospital-based tertiary care to an em-

phasis on primary care reaching individual 

communities.  This Christian Medical Com-

mission focus ultimately led to WHO’s mo-

mentous Alma-Ata Declaration on Primary 

Care in 1978.  The history of several promi-

nent religious organizations are espoused, in-

cluding the African Religious Health Assets 

Programme (ARHAP) with its pioneering fo-

cus on identifying and understanding the role 

of religious assets for health.  Other highlight-

ed religious institutions include the La Leche 

League, Heifer International, Shri Kshetra 

Dharmasthala Rural Development Program, 

Khaka Ahsania Mission, and L’Arche Com-

munity.   

 Finally, the role of religion and religious 

institutions is scrutinized during three princi-

pal public health challenges in recent history.  

These include HIV/AIDS, influenza, and Alz-

heimer’s disease.  Each is unique in its epide-

miology, pathophysiology, morbidity, and 

mortality.  Yet, each possesses epidemic po-

tential beyond geopolitical borders.  In par-

ticular, the complex role of religious institu-

tions within the history of the HIV/AIDS crisis 

is conveyed.  This includes positive impacts 

such as the creation of the AIDS National In-

terfaith Network along with more nuanced 

tensions resulting from religious beliefs that 

HIV virus is a punishment from God, the con-

sequence of immoral behavior, or the result of 

karma.   

 The authors have built a compelling ar-

gument supporting the addition of religion as a 

significant determinant of public health.  They 

have done this by investigating the complex 

effects of religion and religious institutions on 

public health in various contexts throughout 

history.  The book’s unique interdisciplinary 

approach yields different perspectives into the 

complexity of this topic while affirming the 

need for broader conversation and dialogue.  

In July 2015, the Lancet published a series on 

“faith-based healthcare” arguing that the ex-

tensive experiences, strengths, and capacities 

of faith-based organizations offer a unique 

opportunity to improve health outcomes.  For 

Christians, the paradigm of holistic ministry 

encompassing physical and spiritual healing 

dates back to Levitical laws within the Penta-

teuch and the earthly ministry of Christ.  Not 

surprisingly, Christian ideology and Christian 

institutions have had a major impact on public 

health for some time.  However, these roles 

have largely been overlooked, discounted, and 

ignored.  With burgeoning awareness and 

momentum, the essays within this book lay the 

foundation for inclusion of religion, religious 

beliefs, and religious institutions as social de-

terminants of public health.  In doing so, they 

reinforce the incorporation of Christian be-

liefs, practice, and theology within the frame-

work of public health participation and re-

search.  For it is precisely these underlying 

principles of charity, compassion, and self-

sacrificial love that lie at the heart of influen-

tial Christian engagement. 

 
Competing Interests: None declared.  Dr. Ko is on the Editorial Board of CJGH   

 
Correspondence: Professor Stephen C Ko.  801 Massachusetts Avenue, 3

rd
 Floor, Boston, MA 02118.  USA.  

scko@bu.edu  
 

Cite this article as:  Ko, S. Book review: Religion as a social determinant of public health, by Ellen ldler, Ox-
ford University Press, 2014. Christian Journal for Global Health (Nov 2015), 2(2): 76-77. 
 
© Ko, S. This is an open-access article distributed under the terms of the Creative Commons Attribution Li-
cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original 
author and source are properly cited. To view a copy of the license, visit 
http://creativecommons.org/licenses/by/3.0/ 

 

www.cjgh.org 

mailto:scko@bu.edu
http://creativecommons.org/licenses/by/3.0/