Like many pastors, Dalma Cribb was so focused on the needs of others, she often forgot to pay attention to herself. She knew healthy habits were important, but she had trouble making them a priority. Every time she thought of taking a much-needed walk, her to-do list loomed like a hurdle.
Today, Pastor Cribb has found balance between a job she loves and her personal life. She’s 41 pounds lighter, down from a size 14 to 4. Exercising is part of her schedule, along with time for herself away from church obligations.
She credits Spirited Life, a two-year holistic wellness program and behavioral health study, for helping her feel the “healthiest in years.” With funding from The Duke Endowment for development and implementation, the program served more than 1,100 United Methodist clergy in North Carolina, providing resources for improving mental, spiritual and physical health through evidence-based programs, coaching and support.
Though direct service to pastors has ended, the initiative remains active through research and publishing, and could have a lasting impact in North Carolina and beyond.
Challenge for the Church
Clergy put in long hours, feeling the demand to be available whenever there’s a congregational need. They play many roles, changing quickly between being administrators, counselors, spiritual guides, fund-raisers and supervisors. Factors in their lives – including pressure to live up to their call to ministry – expose them to greater risks of poor health.
Research indicates that clergy experience higher than average rates of obesity, type 2 diabetes and hypertension, and they report high rates of depression. In 2002, a national survey of more than 2,500 religious leaders found that 76 percent were overweight or obese, compared with 61 percent of the general population.
The economic price of poor clergy health is also high, and small churches especially feel the impact of increasing costs associated with health and disability claims.
The challenge for the church as a whole is to reverse the trends, so that clergy have the resources – and permission – to attend to their well-being.
In 2007, The Duke Endowment awarded a $12 million grant to Duke Divinity School to kick-start a seven-year effort to assess the overall health of United Methodist pastors in North Carolina and to develop a program that meets their needs. The Divinity School collaborated with North Carolina’s two United Methodist conferences to implement the project.
Leaders wanted the Clergy Health Initiative to begin to foster a culture of well-being among pastors. By supporting the development and delivery of effective interventions, they wanted to give clergy the tools they needed to focus on their spiritual, mental and physical health.
Spirited Life grew from that initiative. Designed specifically for pastors, the program provided resources for spiritual renewal, stress management and mindful eating and exercise, buoyed by coaching and support from a wellness advocate. Many pastors perceived care of the body as taking time away from serving parishioners; Spirited Life reframed the issue, establishing the act of caring for the body as consistent with the intent to honor God.
Screenings - including height, weight, blood pressure, glucose, and cholesterol - tracked participants before, during and after the program. Small incentives helped them maintain their goals.
Some 64 percent of the 1,756 eligible United Methodist clergy in North Carolina enrolled in Spirited Life in the fall of 2010. Participants were randomly divided into three groups that received two years of wellness services on a staggered basis. This permitted the researchers to compare groups of participating clergy with a control group of waitlisted clergy.
The main goal was to determine the program’s effect on metabolic syndrome, a condition that raises a person’s risk of heart disease, diabetes and stroke. The study also measured stress and depression.
The Duke Endowment supported Spirited Life with another $6 million in funding in 2013.
Making a Difference
At the end of the two years of Spirited Life services, the percentage of clergy with metabolic syndrome dropped from 33 to 27 percent. This drop was even steeper at six months into the program – a time when many interventions are successful. The most impressive finding for Spirited Life was sustaining improvements for many clergy as long as two years.
Without any intervention, researchers would have expected rates to increase, says Rae Jean Proeschold-Bell, research director for the Clergy Health Initiative. “And in fact, among those clergy waiting for services during that time – our waitlist control group – we did see an increase in metabolic syndrome (from 33 to 36 percent).”
In absolute numbers, this means that out of the first Spirited Life group to receive services, 92 pastors started the program with metabolic syndrome, but only 70 ended it with metabolic syndrome.
Where did Spirited Life make the most difference?
- Weight Loss
While not everyone identified weight loss as a goal, of the 850 pastors who weighed in at both the start and end of their Spirited Life experience, 524 lost or maintained weight, and the net weight loss was 4,283 pounds. More than 29 percent lost 5 percent or more of their weight. Losing 5 percent of your weight, even if you remain overweight, has been shown to correspond to lower cardiovascular disease risk and fewer new cases of type 2 diabetes.
Thirty-five percent of clergy had elevated triglycerides at the start of services, compared with 31 percent at the end of two years. Eighteen months after the end of services – by which point most interventions have ceased to be effective – rates of raised triglycerides had dropped even further, to 26 percent of clergy. Triglycerides are fat cells in the blood that form when a person consumes more calories than the body burns.
Systolic blood pressure – the pressure when your heart contracts – decreased after two years among clergy receiving services, from 42 to 33 percent. By contrast, researchers saw an increase from 34 to 39 percent among clergy who were waiting for services. Eighteen months after services concluded for the first group, most of the improvements had been maintained.
In Robeson County, N.C., Dalma Cribb says Spirited Life will always be a part of her life. These days, she walks her dog, works in the yard or rides a stationary bike at home “to get the blood pumping.” When she visits a church member in the hospital, she’ll park as far away as she can to up her step count.
“Because there’s always something you could be doing for your church or your congregation, it’s easy to put your personal life aside,” she says. “You find yourself giving so much time to other people, you neglect yourself. But when we’re more aware of our own needs, we’re better equipped to take care of others.”
Even though Spirited Life has ended, researchers will continue to mine data from the study. All along, leaders hoped the intervention would prove beneficial, enabling other United Methodist conferences and faith communities to adopt it with confidence.
“We’ve only scratched the surface of what this initiative could become in its contribution to the larger field of employee health,” says Robb Webb, director of The Duke Endowment’s Rural Church program area. “Other denominations are looking at this study. Other employee benefit programs are looking at it. An indirect benefit is how it has brought the issue to light. Where we go from here is to build broader partnerships to create a culture of health that includes not just clergy but congregations and communities.”
Find more information about Spirited Life.
Robert R. Webb III
Director of Rural Church