DOCTORS ' LOUNGE
( continued from page 33 )
Physicians may not agree on what is essential for the health of patients : exercise , sleep , colonoscopies , ablation , meditation , pharmaceuticals . What alleviates back pain more effectively : a rich , French dinner with loved ones or 20 minutes of acupuncture ? Is it healthier to bike 30 miles or kneel in a pew ? Is church more cost-effective than statins ? 7 The answers depend on the values of each patient and the thousands of factors that affect their lives . “ Be kind , for everyone you meet is fighting a battle you know nothing about .” 8
The health benefits of religion are robust . In adolescents , spiritual connectedness predicts less substance abuse , depression , anxiety and suicide across ethnic / racial groups . 9 Adults who attend regular religious services have lower all-cause mortality , less heavy drinking and smoking , and less depression and anxiety . 10 Religious observance correlates with positive affect , life satisfaction , social integration and purpose . 10 Religious attendance might prevent diabetes , hypertension , cardiovascular disease and even telomere shortening . 11 A meta-analysis of 42 independent samples declared higher overall mortality in nonreligious subjects ( odds ratio 1.29 ). 12 Spirituality / religious participation correlated positively with resilience in a 2021 systematic review . 13 Lest one accuse me of cherry-picking , several studies of religion and spirituality show no benefit , but rarely do they show harm . One review found that lower levels of religious participation correlated with a 32 % higher mortality , but the meta-regression results suggest that the “ positive health effects of religious participation may largely be attributed to the social participation component , rather than to the religious component .” 14 Then again , a recent large study that controlled for confounders found a clear independent mortality benefit for religious observance . 15
Despite spirited discussion 16 , 17 acupuncture clearly has health benefits for an impressive array of medical conditions . A systematic review of randomized control trials showed acupuncture benefits “ for various acute pain conditions … more effective than intravenous morphine , comparable to conventional ED ( emergency department ) treatment , and superior to standard ED care alone when used on an adjuvant basis .” 18 Perhaps most importantly “ No major adverse events were reported in the included studies .” 18 It is even safe in pediatric migraine , thank you fellow Louisville doctors ! 19 Church and Chinese medicine for the win on safety ! The evidence is not as favorable for alcohol , as new analyses disrupt the J-shaped curve : “ Epidemiological data has shown that the apparent health benefits associated with low – moderate alcohol intake are due to other factors and the optimal level of alcohol intake for health and longevity is zero . This conclusion is supported by Mendelian randomization studies .” 20 , 21 Moderate alcohol intake might only decrease ischemic heart disease in middle aged men with less than three comorbidities , 22 and that is balanced by an increased risk of cancer even at the lowest consumption . 21 Now that ’ s a tradeoff .
Alcohol also might not be the best method of coping with the pandemic . Problem and binge drinking have worsened across the board , with up to 60 % of Americans increasing alcohol intake . 23-25 During lockdown , up to 20 % of alcoholics increased use , and 17 % relapsed from sobriety ( some did decrease their use ). 26 Drug overdose deaths increased in 2020 , as those deprived of social connection also have trouble obtaining medications for opioid use disorder . 27 In contrast , religion might be more important during COVID-19 . One study from Brazil found that religious individuals had lower levels of worrying , fear and sadness . 28 In people with substance abuse , religious coping predicted significantly fewer days of drug use and lower drug craving . 29
Back to the Roman Catholic Diocese of Brooklyn , NY v . Cuomo . The New England Journal of Medicine published an insightful editorial by Wendy Parmet , JD . 30 She recounted an earlier decision in South Bay United Pentecostal Church vs . Newsom ( 2020 ) wherein Justice Kavanaugh argued that California discriminated against religious services by treating them differently from secular activities . In Calvary Chapel Dayton Valley vs . Sisolak ( 2020 ), casinos were treated more favorably than churches ( the house always wins ). Parmet argues that the New York decision could jeopardize the ability of states to intervene during pandemics , but admitted that the “ majority [ of justices ] appeared open to restrictions that treat religious services identically to comparable secular activities .” 30 Finally , Parmet predicts that “ state orders that impose tighter measures on worship than on some secular activities will face the strictest of scrutiny .” 30 Sounds like fair scrutiny based on CDC guidelines : “ In accordance with the First Amendment , no faith community should be asked to adopt any mitigation strategies that are more stringent than the mitigation strategies asked of similarly situated entities or activities .” 6
In the book “ Humankind , A Hopeful History ,” Rutger Bregman uses ample evidence to argue against the Veneer Theory of Civilization ( that humans have a polite veneer but just below the surface we could erupt into chaos and malice ). 31 On Christmas Eve 1914 , the World War I soldiers stopped fighting in multiple locations . This was not an isolated incident – it happened in the Spanish Civil War , Boer Wars , American Civil War , Crimean War and Napoleonic Wars . It turns out that people on the frontline have a very hard time killing each other . They aim too high , freeze up , or in the days of muskets , load their guns over and over rather than fire them . Research repeatedly shows that “ the greater the distance from the front lines , the greater the hate .” Estranged South African twin brothers Constand and Abraham Viljoen sat on opposing sides of the Apartheid conflict in South Africa . Abraham contacted his brother and set up secret meetings between Constand and Nelson Mandela ; their conversations led to the fall of Apartheid . In World War II , white sailors who had more voyages with Black sailors had less racial prejudice . Black and white neighbors largely didn ’ t fight each other in the 1943 Detroit race riots . Studying people in 38 countries , Thomas Pettigrew found that close contact with “ the other side ” leads to more trust , solidarity and kindness .
34 LOUISVILLE MEDICINE