Doctors eye expanding faith-based health initiatives

Some physicians hope federal funding will help existing faith- and community-based health programs or spur new ones.

By Gina Shaw, amednews correspondent. March 12, 2001.

Washington -- When President Bush first announced his plan to eliminate regulatory barriers to government funding of service programs that are run by religious groups, he mentioned after-school programs for at-risk youths and pre-release prison services -- not health care.

But many physicians and other health care professionals say they think faith-based health care projects are a perfect fit for any federal money that would be freed up by the White House initiative.

The new White House Office of Faith-Based and Community Initiatives will work with parallel offices within several federal agencies, including the Dept. of Health and Human Services. If the president's plans move forward, where will health and medicine fit in?

"This is potentially an opportunity for faith-based groups who are now providing free health care to people and families with chronic illness to get some financial support," said Harold G. Koenig, MD, director of the Center for the Study of Religion/Spirituality and Health at Duke University School of Medicine, Durham, N.C. "Health has not been a specific area that the president has mentioned as being covered by this effort, but it does seem to be a natural."

The program is likely to face some challenges. It has generated opposition from groups as diverse as the American Civil Liberties Union and Pat Robertson's Christian Coalition. But that hasn't dampened some health officials' enthusiasm for the new initiative.

On March 4 and 5, Duke was scheduled to host "Faith in the Future," a national conference sponsored by the Templeton Foundation. The meeting was developed to focus on the role that faith-based organizations can play in health care for the nation's growing aging population. Among the scheduled speakers was John J. DiIulio Jr., PhD, named by Bush in January to head the Office of Faith-Based and Community Initiatives.

Mulling the possibilities

One model scheduled to be discussed at the conference is parish nursing. "We're probably going to suggest that federal funds be used to help provide incentives to health care systems and religious communities to fund a parish or congregational nurse who can communicate with the health system," Dr. Koenig said.

Duke's divinity and nursing schools jointly sponsor a parish nursing program in several African-American churches in Durham's Walltown community. The project equips retired area nurses to serve as church-based nurses within their congregations. "I would hope that with a new federal office, there would be more opportunities for these kinds of initiatives to take hold," said Keith Meador, MD, MPH, Duke University professor of pastoral theology and medicine who directs the program.

But what about people who aren't members of a church, synagogue or mosque?

Dr. Meador notes that the new White House office deals with both faith-based and community programs. "For some people, religion is not where they anchor, and we need services for them, too, rooted in their neighborhoods and communities."

The Catholic Health Assn., which represents more than 2,000 Catholic health care systems, facilities and related organizations in the United States, was an early supporter of the White House initiative.

"I think the programs that will benefit most will likely be in areas where we are in collaboration with others, such as Catholic Charities, or are in ecumenical or community partnerships to provide different types of health and behavioral services," said the Rev. Michael D. Place, STD, CHA's president and CEO.

Since 1993, the Robert Wood Johnson Foundation has provided seed funding for a variety of local and regional interfaith health programs through its Faith in Action grants. "The Bush proposal has raised a lot of interest in faith-based activities," noted foundation spokesman Stuart Schear.

Although the foundation takes no position on the Bush initiative or on government funding for faith-based health care programs in general, it does encourage grantees to seek additional funding beyond the Robert Wood Johnson startup money. It's too soon to know who might be able to seek federal funds under the Bush plan, if it overcomes congressional and judicial hurdles, but some Faith in Action grantees have said they "perked up their ears" on hearing of the proposal.

Focusing on prevention

Florida already has taken a role in promoting faith-based health care. At the Duke conference, Florida Dept. of Health Secretary Robert Brooks, MD, was scheduled to report on those projects, including one that provides grants to churches for programs in preventive health.

A little more than $1 million of the state's $10 million in "Closing the Gap" grants to improve health in minority communities is going to church-based efforts, such as an education and outreach project to inform African-American women about breast and cervical cancer. The program is run by Leon County's Bethel Missionary Baptist Church.

"I think the president's willingness to make this a priority shows his understanding of the challenges facing the health care system in the coming century and the resources present in faith-based communities to meet the needs of their citizens," Dr. Brooks said.

Duke's Chancellor of Health Affairs and James B. Duke Professor of Medicine, Ralph Snyderman, MD, agrees. He sees chronic health problems, such as asthma, obesity and hypertension, as areas in which churches and other faith communities can play a particularly beneficial role.

"I see this type of initiative far less as being involved with religion than being involved with organizations in which people engage in a positive way to affect the quality of their life," Dr. Snyderman said.

Many faith-based health care programs, he noted, scrape by on limited dollars. "At Duke, we do most of them on our own nickel, or with help from foundations. With the new White House office, it's conceivable that government opportunities for funding such programs would be very positive," he said.