Spiritual determinants of health and healing: an epidemiologic perspective on salutogenic mechanisms.

This article provides an overview of both empirical research and conceptual and theoretical approaches bearing on the connection between spirituality and health. Special emphasis is placed on key epidemiologic concepts that are typically overlooked or misinterpreted in discussions of religious and spiritual factors in health and healing. These include the natural history of disease, the epidemiologic triangle, the levels of prevention, risk factors, protection, salutogenesis, and host resistance. After reviewing research evidence of both a protective factor for health and therapeutic factor in healing attributed to religiousness, faith, or spirituality, a typology is proposed which classifies potentially salutogenic mechanisms underlying such effects. This model differentiates among biological, psychosocial, bioenergy-based, nonlocal, and supernatural pathways. Finally, the clinical and scientific implications of this work is described.