The Bahá'í Community and Health Promotion:
The Message and the Metaphor

by Robert Phillips

published in dialogue, 1:2, pages 30-33
Los Angeles: 1986

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I suggest there is a strong connection between spiritual development and the promotion of health. How does this view relate to modern medicine, to the technology-oriented hospital-base system that symbolizes for our society at large the meaning of health care? By and large, it doesn’t, which is precisely what I wish to talk about. Let us compare and contrast two approaches to a health care system: one based on the understanding of the purpose of human life as revealed by Bahá'u'lláh, the other the current modern health care system based primarily on the findings of biomedical science. In passing, it is important to note that modern health care is concerned primarily with treating disease not health and consequently is ill-equipped, inadequately trained, and poorly motivated to deal either with health or the major, non-medical causes of the chronic and degenerative diseases which make up the majority of the morbidity and premature mortality in our society.

Modern Health Care

The basic assumptions of biomedical science about man’s physical being are crucial to an understanding of the priorities and programs of our health care system. First and foremost of these is that the physical body can be treated as an entity separate from its spiritual existence and the ecosystem. Under the prevailing standard of medical treatment, the human organism is analyzed through a division of the body into its component organs and functional systems. Disability or disease is treated primarily through mechanical interventions, chemotherapy or surgery, at the narrowest possible level. Such reductionism is reflected in a system of medical education that prepares practitioners for increasingly specialized disciplines until there exists the frequent phenomenon of the highest paid and most powerful medical practitioners often being those individuals who are least knowledgeable concerning the major issues of health and healing that have a daily impact on the lives of most people. As Fritjof Capra observes in The Turning Point, American medical education was established in the early 1900s with “its primary purpose...the education of students and the study of disease, not the care of the sick. Accordingly, the M.D. degree it granted was to certify the successful mastery of medical science, not the ability to care for patients. The science to be taught and the research to be pursued, were firmly embedded in the reductionist biomedical framework; in particular, they were to be dissociated from social concerns, which were considered outside the boundaries of medicine.”

Yet, is it not true that scientific medicine has been productive of the highest standard of health care achieved in history? Let is examine the record.

“...surprisingly, the precipitous decline in mortality over the past century came less as a result of better medical care than from improvements in the general standard of living and specific public health measures.... Those factors which had the greatest impact on the frequency and severity of these diseases [tuberculosis, scarlet fever, influenza, whooping cough, typhus, typhoid], in addition to improved nutrition, were water and food purification, refrigeration, improved waste disposal systems, and better housing conditions.” (Jonathan Fielding, M.D., Corporate Health Management, p. 2)

The following table makes the above point by showing the relatively minor impact of medical interventions on the fall of death rates for the ten most common infectious diseases in the U.S., 1900-1973.

The contribution of medical measures (both chemotherapeutic and Prophylactic) to the fall in the age and sex–adjusted death rates (S.D.R.) of ten common infectious diseases, and to the overall decline in the S.D.R., for the United States, 1900-1973
Disease	Medical intervention and year became available	Fall in S.D.R. per 1,000 population, 1900-1973	Fall in S.D.R. after intervention as % total fall for the disease
Tuberculosis	Izoniazid/Streptomycin, 1950	2.00	8.36
Scarlet fever	Penicillin, 1946	0.10	1.75
Influenza	Vaccine, 1943	0.22	25.33
Pneumonia	Suplphonamide, 1935	1.42	17.19
Diphtheria	Toxoid, 1930	0.43	13.49
Whooping cough	Vaccine, 1930	0.12	51.06
Measles	Vaccine, 1963	0.12	1.38
Smallpox	Vaccine, 1800	0.02	100.00
Typhoid	Chloramipluemicol, 1948	0.36	0.29
Poliomyelitis	Vaccine, Salk/Sabin, 1955	0/03	25.87

What has made an impact on health, as shown dramatically in the following table, are personal and community lifestyles, environment, and human biology.

Modern medicine itself is not recognized as a risk factor. Dr. Jonathan Fielding, a professor of medicine at UCLA, notes: “Many hospital admissions are due to an undesirable secondary effect of medical care. For example, a 1979 study of 815 new admissions to a medical service of a university hospital found that 290 patients (36 percent) had one or more iatrogenic (medicine-caused) illnesses, with 76 (9 percent of all admissions) sufferings from major complications. A significant portion of iatrogenic illness is due to drug reactions, but complications of medical and surgical procedures also make important contributions to this largely avoidable problem.”

Does this mean that our system of medical care is without value? Hardly. Modern scientific medicine has made enormous advances in understanding, treating and often controlling a great number of diseases from which millions of people have or would have suffered. Yet, in the divorce of soul from body, a crippling imbalance has occurred. This imbalance has led to the inability to recognize the nonmedical factors that determine health, an inattention to the cultural, familial and emotional sources of disease and an absorption with the increasingly expensive technology of medicine which threatens to make care unaffordable to all but a few. Change must begin with a fundamental reappraisal of the system’s basic assumptions about out physical being.

Health Care and the Bahá'í Faith

Does the Bahá'í Faith begin its approach to Health Care with other or divergent assumptions? I believe it does and, further, that these assumptions suggest and mandate a fundamentally different health care system. Speaking of the purpose of health, ‘Abdu’l-Bahá says:

“If the health and well-being of the body be expended in the path of the Kingdom, this is very acceptable and praiseworthy; if it is expended for the benefit of the human world in general—even though it be for their material benefit and be a means of doing good—that is also acceptable. But if the health and welfare of man be spent in sensual desires, in a life on the animal plane and in devilish pursuits—then disease is better than such health; nay, death itself is preferable to such a life. If thou art desirous of health, wish thou health for serving the Kingdom. I hope that thou mayest attain a perfect insight, an inflexible resolution, complete health and spiritual and physical strength in order that thou mayest drink from the fountain of eternal life and be assisted by the spirit of divine confirmation.” (Tablets of ‘Abdu’l-Bahá p. 207)

And in making clear the connection between body and soul, he further states:

“Between material things and spiritual things there is a connection. The more healthful his body the greater will be the power of the spirit of man; the power of the intellect, the power of the memory, the power of reflection will then be greater.” (Divine Art of Living, p. 163)

Bahá'u'lláh also gave guidelines for health:

“O people, do not eat except when you are hungry. Do not drink after you have retired to sleep....
Do not neglect medical treatment, when it is necessary, but leave it off when the body is in good condition....
Treat disease first of all through diet, and refrain from medicine. If you can find what you need for healing in a single herb do not use a compound medicine. Leave off medicine when the health is good and use it in case of necessity....
A light meal in the morning is as a light to the body.
Avoid all harmful habits: they cause unhappiness in the world.
Search for the causes of disease. This saying is the conclusion of this utterance.” (Star of the West, Vol. 13, no, 9, p 252)

Estimated percentage contribution of the four elements of the health field to premature mortality
Cause of death	Health system	Life-style	Environment	Human biology
Heart disease	12	54	9	28
Cancer	10	37	24	29
Cardiovascular disease	7	50	22	21
All other accidents	14	51	31	4
Influenza and Pneumonia	18	23	20	39
Motor vehicle accidents	12	69	18	0.6
Diabetes	6	26	0	68
Cirrhosis of the liver	3	36	9	18
Aostaeosleosis	18	49	8	26
Suicide	3	60	35	2
Average for ten causes	10.8	48.5	15.8	26.3
Source: Center for Disease Control, Public Health Service, 1979.

Thus, the Bahá'í approach to health stems from a premise that the body and soul are interdependent. The Bahá'í writings also suggest that physical health is a powerful assistant to spiritual development and that nutrition, exercise, avoidance of harmful habits and self-care are among the key variables for the creation and maintenance of human health.

The above statements clearly suggest that the promotion of health rather than the treatment of disease would be the first priority of and the foundation on which Bahá'í individuals, institutions and communities would build the health care system of a new world order. Such a foundation would support activities and programs that would make Bahá'ís leaders and agents of much needed change in a vital area of human service.

It is important to note that the recognition of the need for a fundamental change in our health care system and the assumptions about human life that underlie it is already well advanced among a growing number of practitioners outside the Bahá'í community. In 1977 the U.S. National Institute of Mental Health completed an analysis of American medicine with this paragraph:

“During the last two decades many physicians have begun to discover the limitations in the paradigms of western allopathic medicine....The focus on pathology rather than prevention, the destructiveness of so many pharmaceutical and surgical remedies, the too rigid separation of physical and emotional problems, the assumption of an asymmetrical relationship between an all-powerful physician and a submissive patient have promoted clinicians to look for answers in other traditions and techniques.

“This search has led many to seek out traditions in which body and mind are regarded as one, in which therapeutics are directed at aiding the natural healing processes. Turning to acupuncture, homeopathy, herbalism, meditation, psychic healing, guided imagery, biofeedback....”

Implications for Bahá'í Involvement in Health Promotion

Such stirrings in the larger society along with the statements in the Bahá'í Writings have important implications for Bahá'ís. Let us briefly explore some of these implications.

Given the focus on behavior change in successful health promotion programs, and with the knowledge of the organic interrelatedness of soul and body, large scale health promotion programs offer either directly or by analogy useful models for Bahá'í mass teaching and development projects.

A useful example would be the work of the Stanford Heart Disease Prevention Program in Monterey County, California. This is a long term field trial of the effects of community-directed health education on cardiovascular disease. The core behavior change programs are nutrition, smoking cessation, exercise, blood pressure, stress education and weight loss—these having been determined to be the critical risk factors for cardiovascular disease. The program uses a variety of theoretical frameworks, interestingly enough all from the social and behavioral sciences and none from medicine, to guide its educational interventions. The results of the Stanford project have been encouraging. The program directors state: “Much of the success of the community education program can be attributed to the quality of the media campaign, to the synergistic interaction of multiple educational inputs, and to the interpersonal communication stimulated by application of these inputs in a community setting. A media-based program can be successful if it integrates goals, social support, and social controls and uses existing interpersonal networks as channels for the diffusion of health information. Such a strategy does not use mass communication exclusively; however, media are central to the plan. Although it is possible that in the future the entire effort might be accomplished by way of media, the current prudent choice of the “best” strategy for optimum efficiency of community-based risk reduction is a plan that blends a minimal focused amount of face-to-face instruction with an extensive media campaign that is strong enough to create the desired outcomes, in part, by itself.”

The metaphor here, in my opinion, is that with the considerable media exposure already afforded the Bahá'í Faith in many localities, Bahá'í communities can look to successful health promotion projects for ideas on how to effectively follow-up and exploit this coverage. Such projects would enable Bahá'ís to translate public awareness into knowledge of the Faith, motivation to join its ranks and the learning of the skills and characteristics necessary to adopt and maintain its beliefs. These stages of 1) awareness; 2) information; 3) motivation; 4) adoption and; 5) maintenance are the project planning stages utilized by the Stanford program. Such a systematic approach, field proven in projects designed to improve and enhance human health may well be useful to accomplish the large scale behavior change necessary to have mass conversion.

If health promotion community education projects provide a metaphor for mass teaching, then the message of enhanced health is a valuable ally for the Message of Bahá'u'lláh. The reasoning goes like this. Those people who are most effective in adopting new behaviors or beliefs are those who judge that they are capable of dealing successfully with different realities. This concept of self-efficacy is most prominently identified with the work of Stanford psychologist Albert Bandura. Individuals willing and able to change their health behaviors are those whose sense of self-efficacy makes them open to the further dimensions of spiritual health offered by the Bahá'í Faith. In addition, the Bahá'í Writings show that positive steps taken to improve physical health stimulate one’s spiritual being and open the individual to spiritual influences. This suggests that:

1. Bahá'í communities might want to become actively involved in health promotion as a social development project—realizing both its intrinsic impact on spiritual as well as physical development and the teaching potential of the contacts made through the project.
2. Bahá'í youth, given their levels of energy and enthusiasm, offer natural leadership for health promotion. Given that behavior change is more readily adopted during adolescence and youth, it is crucial that health promotion be made an integral part of Bahá'í training and community life.
3. Bahá'í health professionals, guided by the Bahá'í Writings and the growing body of literature on health promotion, may choose to consider involvement on health promotion projects and research so as to infuse the spiritual dimension into health promotion and assist in the implementation of health promotion activities within the Bahá'í community.

Such suggestions are operable only to the extent that the Bahá'ís involved are themselves models of the behaviors they seek to encourage in others. Proper nutrition at Bahá'í Feasts and other functions, non-smoking at all Bahá'í events along with encouragement and referral to existing resources to those who seek to quit, aerobic exercise as a regular feature at all Bahá'í schools and conferences, these are only a few of the manifestations of a commitment to health promotion that would make the Bahá'í community a stronger channel for the spirit of the oneness of mankind and a true representative of the Divine Physician.

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Robert Phillips is founder and co-owner of Consultant Services of Santa Cruz, California, which provides health care project management and research, organization development, education and training to hospitals and health care groups.

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