The tradition of the scientific handbook as a concise, accessible source of validated information emerged in the late nineteenth century when the factual burden of scientific and medical subjects began to overwhelm students. The Handbook of Religion and Health draws on that tradition and raises the presumption that useful information linking religion to health has grown to a degree calling for summation and evaluation.

The book is thorough, encompassing in the term “health” both mental and physical well-being, and in the term “religion” all that can be construed as an aspect of spirituality, both traditional, organized creeds and nontraditional, individualistic practices. It reviews the American periodical literature of the twentieth century for any scientific correlation”either positive or negative”between religion and health.

The book consists of eight parts that cover issues relating health to religion. A section briefly summarizing the history of religion, science, and medicine is followed by one discussing the debate as to religion’s possible effects on health. These sections are then followed by three more that review contemporary research on mental health, physical disorders, and the use of health services in relation to religion. The book closes with three sections on recommendations for practice, future research, and references.

Among the references to contemporary scientific literature the authors note common failures of research design and provide “grades” to direct the interested reader towards published works that provide the best evidence linking health to religion. This book thus offers an up-to-date”through 2000”review of the periodical literature on this topic. The Handbook concludes with a chapter on needs and priorities for further research.

The authors report the consistent but not overpowering evidence that modest health benefits follow from religious commitment. While they are careful in their claims and note the need for more studies to confirm and extend these modest findings, the sheer bulk of the book (712 double-columned pages) leads one to expect somewhat more.

The authors, professors of psychiatry, psychology, and medicine at Duke and Southern Methodist University, readily admit that little rigorous scientific research has been done to demonstrate the effects of religious practice on health. Indeed, most of the beneficial findings they report are anecdotal or serendipitous. But even these discoveries are so modest that they hardly warrant further elaboration in methodical studies.

Above all, the authors wish to refute the suggestion that religious convictions may injure one’s physical or mental health, a claim that has been made since Nietzsche referred to the religious European as “a herd animal . . . sickly and mediocre.” The Handbook documents the views of several celebrated psychologists, including Sigmund Freud, who have seen religion as a kind of mental illness and thus harmful by definition. Most often it has been described as a form of obsessive compulsion or morbid anxiety. Anyone with knowledge of psychiatry and familiar with either obsessive compulsive disorder or morbid anxiety has to marvel at the glibness and lack of intellectual rigor that such claims displayed.

The authors of the Handbook diligently review these reports and rightly conclude that the evidence for the negative claims is scant and that the claims usually reflect the investigators’ preconceptions and closed-mindedness. Actual injuries from religious conviction”aside from the deleterious consequences of avoiding essential medical treatment among followers of Christian Science and similar groups”are extremely rare. These negative claims and isolated reports, like most of the purported positive correlations, have not been demonstrated by hypothesis-generated research but by anecdotes needing more empirical confirmation.

Epidemiological research can easily refute the claim that religion produces ill health, but strong positive evidence is needed to conclude that religious practice directly causes good health. We might all agree that religious beliefs can lead a person to avoid excesses of wine, women, and song, and therefore exposure to many pathogens. But this is far from proving that good health”for example, the correlations reported in the Handbook between tiny reductions of diastolic blood pressure and religious practice”is a direct result of attending Sunday worship.

And yet, the authors are highly ambitious. They are riding a wave of interest in exploring how physical conditions, such as vulnerability to infection and persistence of chronic immunologic illness, may be tied to emotional states and environmental stressors. The disciplines of psycho-neuroendocrinology and psycho-immunology have emerged from those studies. The authors of the Handbook attempt to press this research further, into the domain of religious life and observance. They claim that they have evidence to propose a “new way of practicing medicine that considers the body, mind, and spirit ” (emphasis added). Indeed the book’s Foreword promises a “new paradigm” for which this text will serve as a “definitive sourcebook.” These grand claims and promises are, alas, not met and thus are clearly overstated given that the authors find such meager evidence of health benefits of religion in the more than 1,200 studies and 400 research reviews they examine. Even the most sympathetic reader of this book will be let down in the wake of these introductory claims.

Even more disappointing is the authors’ posture towards religion itself. The Handbook simply does not take into account why people seek out a religion and what kind of effects religions and their advocates hope to promote in human life. After adolescence, when one might pray for clearer skin and curlier hair, most religious people do not expect their lives will be longer or freer of physical vicissitudes because they meditate on the teachings of the prophets or follow the way of the cross. Authentic religious piety rests on an apprehension of life’s meaning and seeks a path to a less selfish, more generative maturity tied to that apprehension. Health, like wealth, may accompany religious devotion, but neither can be its aim. Not to put too fine a point on it: one doesn’t go to church for the same reasons one goes to the gym.

The most disagreeable aspect of the book is its scientism and medical materialism. The authors write in the desiccated tone of the social scientist who divorces his thought from the human encounter with the transcendent”which is, of course, an encoun­ ter on which their entire project depends. Nowhere in this tome does one find a statement of (let alone any enthusiastic support for) the authentic place of religion in our being”where it fits, what it claims, and what it adds. It is as though the authors believe that religion can best be accommodated within our materialist and consumerist culture by hinting that, like Vitamin C, it may protect us from the common cold.

Paul R. McHugh is Psychiatrist-in-Chief at Johns Hopkins Hospital.