Public health from the pulpit: First steps for clergy to help create healthier communities

On Mother’s Day 2020, I was working as a contact tracer for the Florida Department of Health. Our team labored 10 hours a day, seven days a week, reaching out to people who had been exposed to COVID-19. We explained quarantine procedures and educated people about how to protect others.

That Sunday, it was my job to interrupt Mother’s Day brunches across Fort Myers and tell folks that they had been exposed to the virus — in the days before vaccines and effective treatment. People were panicking.

It was a Groundhog Day experience as we contacted hundreds of people with bad news. It was difficult. It was depressing, especially when we’d learn about folks who had died.

I also saw the effects of superspreader events — some of them from churches that had refused to close. Florida at that time was one of the nation’s COVID hot spots and the epicenter of furious debates about masking, quarantine and religious freedom.

I already was interested in public health and theology — 2020 was the summer between finishing my master’s in public health and starting divinity school. For a young public health professional and theologian, this experience highlighted the urgency for collaboration. After all, religious communities and public health agencies seek the same outcome: healthier and more vibrant communities.

In divinity school, I tried to understand why there is such a divide between religious communities and public health practitioners. Now, as I embark on a Ph.D. in population health sciences, I continue to envision ways we can integrate theology and health education in our pews.

This ideal collaboration is far from simple. Experts in public health often lack the theological understanding and context to be culturally aware of the structures and behaviors in religious communities. And religious leaders are often overstretched in their regular clerical responsibilities; to expect them also to be skilled in health education and communication is unfair.

I have spent a large part of recent years focused on this never-ending chicken-or-egg scenario of how to build a bridge between health organizations and religious communities.

Though I think that accountability on both ends of this “bridge” is important, I want to suggest a few first steps for religious leaders.

Know your congregation.

This might sound obvious. However, knowing a bit of the backstories of the people sitting in your pews on Sundays does not mean that you understand their needs and concerns.

Consider the levels of insurance in your church. Are most people on a certain type of health insurance? Are people uninsured or in professions where their insurance level fluctuates? What about the availability of dental and vision services? Can they afford these services?

The intricacies of health insurance coverage could provide a brief peek into the health of those in your community and the gaps that may be chronically unaddressed for a significant portion of your congregation.

Though these question may not be part of the normal “getting-to-know-you” info card, being upfront about your church’s intention to work for health equity and to address potential health needs of your congregants may ease the discussion of these sensitive though vital details.

Of course, even with the most honest intentions and perfectly curated questions, there are other dynamics at play as well.

Recognize the opportunities and limitations of your role as clergy.

It is no secret that clergy are often overworked, with their expected scope of care greatly exceeding their reach. In addition, few pastors have medical or public health expertise.

However, one of the great superpowers of religious leaders is their tendency to be seen as leaders and trustworthy members of the community. Recognizing opportunities to provide guidance to members of your community on health decisions while also recognizing your own limitations may be the perfect combination of your clergy superpower.

One example of this is the way that Black and Hispanic churches served a crucial role during the worst days of the pandemic by sharing health information and offering testing and vaccination sites.

Reach out to your local health experts.

This could be the health department, a health education specialist, medical providers, or other health care workers who have experience and training to offer guidance to your congregation.

Collaborating with these folks might create opportunities for your congregation to understand more about their health concerns from reputable medical sources while you also help them contextualize their health concerns within your faith tradition. Feel free to reach out to people like myself who are deeply rooted in the intersection of health and religion.

Include these topics of concern in your sermons.

If the pandemic has taught us anything about how religion and public health interact, it’s the ways that people are influenced by information from people they trust. As a religious leader, you will likely be asked for your opinions on various health behaviors and decisions.

While honoring your educational gap on the subject matter and knowing your scope, you can still find helpful, engaging ways to include health issues in preaching. One possible place to start is by inviting your congregation to explore and be curious with you as you seek out information to make the best decisions for your own health.

The task of congregational care is a daunting one, especially when pastors venture beyond the spiritual needs of those they’re in community with. However, the ability to improve health behaviors as well as faith practices is a beautiful dynamic.

It is my hope that no one else ever receives a call on Mother’s Day to tell them that they and their families are in danger from a deadly virus. Through the intentional considerations of congregational needs and local resources, clergy can and should collaborate with health partners to help make sure the Groundhog Day summer of 2020 never happens again.

I came to rest through exhaustion.

I went to the doctor thinking I had some serious medical condition, but all the tests came back negative. It turned out I was just totally exhausted.

Around this time, I was given a book called “The Rest of God,” by Mark Buchanan, which reintroduces the virtue of stillness. Reading the book started me on a journey of rediscovering rest.

I first learned that there are different sorts of rest: physical, emotional, mental, social and spiritual. We can all feel exhausted and may recognize our need for rest, but do we know the sort of rest that we need? How good are we at recognizing the areas in which we are drained, where we need to be refreshed, restored and re-energized?

Physical exhaustion is perhaps the area that we are most familiar with, and it may be that we have only ever thought about rest in terms of our physical needs.

However, for many today, work is primarily emotional and mental rather than physical, and we are just as likely to be emotionally or mentally exhausted as we are to be physically tired.

During a year of living with a pandemic, we have all been doing a lot of extra emotional, mental and spiritual work and are probably more drained in these areas than we would be normally, even if our jobs are physically taxing.

When we are physically drained, we know that we might need to eat or drink, sit down for a while, have an early night, or even take a nap. Do we have the same awareness about what we are supposed to do when we are emotionally, mentally, socially or spiritually drained? What can restore us in these areas?

When I was suffering from exhaustion, I thought I needed to stop and just do very little, to physically rest. But in fact, I found that even though I was doing very little, I didn’t feel any more rested at the end of the day.

Eventually, I discovered that my primary exhaustion was emotional, not physical. Physical rest wasn’t what I needed. Actually, in some ways, it made things worse, because “doing nothing” just gave me more time to focus on my anxiety and worry.

I gradually learned my personal ways of emotional rest. I discovered that being in nature buoyed me emotionally — in particular, spending time with trees.

There was something about their solidity, their rootedness, their age. They had been here before I was and would still be standing long after I was not. I was comforted thinking about how they went through seasons and weathered the effects of those seasons.

The different and bigger perspective on my circumstances brought me back down to earth and out of my own head. I found it peaceful and regenerative. In fact, I found that being in nature refilled me in other ways as well, giving me mental, social and spiritual rest.

Rest need not be inactive. For me, doing physical activity that requires focus can be emotionally restful. I garden, cook or create something. If I occupy my hands, I find that my mind wanders away from my concerns.

Active rest may sound counterintuitive, but resting can simply be stopping ordinary work. Doing something that might be work to someone else may be restful for you.

If you’re feeling exhausted, noticing the areas in which you are weary is a good place to start. Is your exhaustion physical? Or is it actually emotional, mental, social or spiritual? Or is your tiredness a result of a combination of these types of exhaustion? Discovering what sort of rest you need is key.

However, it is one thing to know what sort of rest you need and quite another to actually find that rest.

Today, perhaps more than ever, rest is contested. Eliza Cortés Bast illustrates this beautifully in her essay “Rest can be hard work.” There are many factors that can keep us from resting, even when we know what we need.

But Jesus has given us an invitation to come to rest (Matthew 11:28). Rest was even listed among the Ten Commandments (Exodus 20:8) — yet when was the last time we asked for forgiveness for not resting?

People in every walk of life are exhausted, but we have a God who gives permission to rest, who invites anyone who is weary to come to rest.

Rest need not be inactive.

When doing the research for her new book, “The Soul of the Helper,” Holly Oxhandler found that the lessons emerging from her study of mental health care providers would also apply to all caregivers, even those outside health care.

Looking at the degree to which mental health care providers were integrating their clients’ spirituality or religion into their mental health treatments, Oxhandler found a positive relationship with the quality of care — and a personal mission to help people acknowledge their own spirituality when caring for others.

Soul of the Helper book cover

“[Recognizing one’s own spirituality] is really applicable to everyday helpers, especially given the large percentage of folks who identify as being religious or religion being important in their lives,” Oxhandler said.

Across all sorts of care professions, having a healthy spiritual life oneself can correspond quite closely with being able to provide spiritual care to others, she argues in the book.

Oxhandler is an associate professor of social work at Baylor University and has a background in spiritually integrated mental health.

She spoke with Faith & Leadership’s Chris Karnadi about the book and the hope she has for caregivers to recognize and care for their own souls before caring for others. The following is an edited transcript.

Faith & Leadership: Who are the readers you wrote the book for, and what did you hope they would learn?

Holly Oxhandler

Holly Oxhandler: The ideal readers that I had in mind with this book are the everyday helpers for whom faith is important, and perhaps they are wrestling with mental health struggles or they love someone who is wrestling with mental health struggles or they are bumping up against those edges of burnout.

They continue to go and do and help and serve in whatever ways they are uniquely equipped to care for others, but they’re realizing that in their efforts to serve, they just get exhausted. They are realizing that they need to find new ways to refill their own wells as they go out and serve others.

Especially after these last couple of years, the book is for parents, teachers, faith leaders, mental health care providers and general health care providers, but also the everyday helpers like the baristas and our engineers and our community organizers who are still serving others in their own unique ways. It’s those informal caregivers especially I was thinking of when I wrote this book.

F&L: How would you go about convincing people who don’t think they are caregivers that they are providing care?

HO: First of all, I think that each of us has the capacity to be a caregiver or to be a fellow helper in one way, shape or form.

As we go about our days, we are tending to and supporting and helping and loving those around us in a number of different ways, whether that’s through our volunteer service or in connection with our friends or family members or the people that we interact with at work. On a daily basis, we’re engaging in some form of helping or serving or just connecting with those individuals.

I really would hope that those who are serving in these myriad ways recognize that the ways that they interact and support and serve and help and care for others are profound and have a big impact on the lives of those around them, whether that’s a close loved one or a complete stranger.

As someone who identifies as Christian, I think about the idea of loving my neighbor as myself. That really does have a strong emphasis on recognizing that I am serving others in some capacity, even just as someone who identifies as a Christian or who is trying to embody and live out a life that follows what Jesus taught me. I mean, I would really push and try to encourage folks to recognize that we all have the capacity to be a helper in one way, shape or form.

F&L: Why do you think considering one’s own spirituality is so important in offering care?

HO: The heartbeat of this book is recognition that caregivers and helpers have got to wake up to the sacred, to that divine spark, that image of God within themselves as they go out and serve others.

We need to wake up to the fact that we are worth caring for and tending to — the gift of our precious and sacred life. And that this life is not promised, and that it is a gift to get to steward it.

We have to wake up to it within ourselves so that we can care for ourselves well, especially so that as we go out and serve others, we’re better positioned to discern and best meet the needs around us and to recognize and tend to the sacred, the image of God, that divine spark within our neighbors as we go out and serve.

In part, my fear is that if helpers are not taking that time to tend to their own inner landscape and all of those layers within them that make up who they are, there is a risk of them imposing the pain, the difficulty that many of us experience through our lives on those around them as they’re trying to help.

Father Thomas Keating writes about “programs for happiness” — that many of us will go through our lives aware or unaware that we are seeking power, control or affection. And my fear is that helpers are not paying attention to the sense of their own belovedness, that they are worth that love and care, and they will unintentionally go out and seek those programs for happiness as they serve others and unintentionally cause harm in that process.

F&L: What kinds of beliefs and practices do you think lead to burnout for caregivers?

HO: I want to emphasize that the contribution to burnout comes from individual but also systemic sources. Individuals may be wanting to seek the affirmation, the accolade, just the addictive dopamine bump that they get when they’re giving and serving and helping others, but also they may have been surrounded by systems that communicate that their worth is dependent upon what they do. If their value is dependent on their productivity, or the way that they help and serve, they just go without even realizing the ways that it could potentially be hurting themselves and others.

Then the other piece, especially around those systemic issues, is when we have organizations and systems set in place that don’t allow the helpers to truly heal and rest and recover from the occupational hazards of the work that they do in serving others.

Without having systems in place to support them, burnout is inevitable in some ways, because of the ways that health care providers, faith leaders, other caregivers are exposed to secondary trauma, vicarious trauma, compassion fatigue and more. Without having systems in place to allow them to heal, I think, it just really increases their risk of burnout.

F&L: What are some things that need to be realigned to create more sustainable habits or more sustainable conditions for caregivers?

HO: What would be implemented would be unique based on the individual, the organization, the system, the region, the type of caregiving and things like that.

Some of the things that need to be put in place, though, are individuals starting to recognize their inherent worth and that they are worth a slower pace, and beginning to advocate for others to have access to this as well.

This is a big part of what social workers do, and I love that I get to be a social worker and the ways that we can advocate for more policies and systems to be in place for things like, for example, a paid maternity leave.

I do hope to see more helpers modeling the need to do this work — to slow down and to ask for help, to learn to ask for help with humility, and recognizing that the previous helpers were not able to do everything for everyone all of the time. So learning how to humbly ask for help and to receive — not just ask but receive — that help.

That’s not easy for helpers. I don’t think that’s easy for many of us, but when we have picked up that narrative that we are the helpers, we do all the service, it’s really hard to humbly allow others to care for and help us. So I think some of that modeling is important. And the advocacy piece, I think, is important.

Advocating for more mental health care would be something that I would just love to see more generally.

We know that about half of all lifetime cases of mental illness in the U.S. pop up by the time kids are 14, and about 75% by age 24. So we see this in younger individuals. And then again throughout life, over 80% of us meet criteria for a mental health struggle at some point.

Having space for mental health treatment to allow us to do some of this self-reflective work, I think, is really important too, alongside our spiritual practices and religious practices that help us connect to God, to whomever we believe in in terms of our higher power.

F&L: What is your Namaste Theory for helpers?

HO: I found that mental health care providers who were more deeply motivated to live out their belief (whatever it was that they believed in) and were more deeply connected with the divine within themselves tended to have more positive views and were more likely to actually integrate their clients’ religion or spirituality into treatment.

And it wasn’t just in my sample of social workers, psychologists, family therapists, counselors and nurses, but we saw this in other samples where the mental health care providers who had higher levels of religiosity — were more frequently engaged in their religious practices — tended to integrate the clients’ faith in more.

Namaste, which translates to mean “the sacred within me recognizes the sacred within you,” really brought order to what I was finding within my research.

As I talked with other helpers, it made sense to them too. When folks are more deeply grounded in what they believe in, they’re able to hold that space for those around them to explore and to ask questions and to wrestle with their faith in a nonjudgmental way.

Translating that to the everyday helper is really where the heartbeat within this book is. And recognizing that we as helpers — it’s really on us to pay attention to our inner landscape, including that divine spark, that image of God within ourselves, as we go out and serve others so that we can recognize it within others while recognizing that we are worth the love and care that we give to so many others.

Near the end of every December, as I consider new trajectories and intentions for the coming year, the idea of reclaiming rest is always on my list. Each year, I boldly declare that I will experience deeper rest, find better rhythms of rest, not wait to rest until I’m bent with exhaustion.

I will play more! I will unplug! I will read for fun!

Truthfully, I don’t know whether I want to pay the price for rest. Not real rest — the kind where you actually lose yourself in the stillness of mind, body and spirit.

Each layer of who I am challenges regular rhythms of rest: full-time minister, mom and wife, woman of color, student, mentor. Those bump against each other in a cacophony of competing demands. On my best days, they fall in line. On my worst, I am behind. I can’t afford long stretches of catching up, especially in seasons like this one.

Rest becomes expensive. It feels irresponsible and wrong.

During the holidays, I watched as social media accounts that I follow — those of brave leaders holding high the banner of biblical justice — hinted at rest. The posts were curious. Laptops put away. Mugs of tea, glasses of wine, fireplaces. Yet no pictures of them actually resting. No pictures of them curled up, reading. Accounts where I am used to seeing faces and arms raised behind the dais became just tableware.

It is very possible that this is truly what rest looks like. But I suspect that people simply do not want to see us rest. As people of color, championing our causes, we are not afforded the liberty of public rest.

People depend on the public expression of who we are — sharing our tweets, our images, our hashtags — to help further their own public spaces. Our defiant act of rest gives them nothing to move the cause forward. Pictures of rest are incongruent and feel counterproductive.

I can hear you yelling, “This isn’t healthy!” But there are realities you need to consider.

Rest can feel like a waste of resources. As a person who grew up in poverty and now dedicates my work to ministry, I know this well: rest feels like a waste of money.

For those of us in fields that are constantly hunting for money, doubly so. We mentally convert personal plane tickets and restaurant meals into salaries for our teams and essential food for the underserved. It is a constant internal exchange rate — every dollar or minute we spend on ourselves is a self-centered currency. It could and should go to the cause.

Opportunities — like the loan of a vacation house where we can decompress  — don’t come up for us often. When they do, we find ways to host a board meeting there, a staff retreat, a volunteer gathering. We are constantly aware that the people around us are giving, too, so we most likely will not use such a gift for personal rest. For ourselves, we will find a cheap space. We will pack our own food and drive our own cars.

We don’t have generational spaces to fall back on. When I first began full-time ministry, I was amazed by the number of people who simply disappeared in the summer.

In the neighborhood where I grew up, parents had to continue working during the summer. Neighborhood summer programs and camps were a necessity while kids were out of school. No one was going anywhere. There was consistent noise and clamor until the streetlights came on.

For the current world I find myself in, that is not the case. Family cabins and lake houses are passed down for generations.

This is not a disparagement. But amid the challenges of lockdown that so many of us experienced this past summer, I was surprised by how many around me packed up and headed to the generational oasis. It was hard to hear their bitter complaints of being confined as they rounded up swimsuits and sunscreen.

Rest produces guilt. Every minute I spend away, every minute I spend with my guard down, is an invitation to return to more work and more worry.

My absence risks the people I serve, the core of who I am. What if something happens to them while I am gone?

Rest often requires money. The money I spend to fill my tank is often the money that’s truly needed somewhere else.

Once, on a work trip, I got myself ready early and sat outside the inexpensive hotel. Back home was cold, so the California sun was a warm invitation to sit and relax.

I snapped a selfie, captioning it that I was soaking up the sun waiting for my ride. When I returned home, our head of donor relations went in hard, reminding me that contributors did not pay for me to sit in the sun and that my message could jeopardize the funding for the organization. They were not paying me to relax.

We, as people of color, remind ourselves often that we cannot always carry the ball for the systems we are in. We sometimes must let the ball drop. I courageously say those things, affirm those things and repeat those things.

However, when I return to the daily reality of my work, I see places where the ball was dropped, and the inbox is twice as full the next day with more meetings, more pain, more work. Gripping the ball, at least for a little longer, keeps our souls safer.

The media and the Scriptures remind us to rest. I feel my shame creeping in as I realize that my body, mind and soul say they need rest. I am not a martyr by any means. I am, however, a pragmatist. The times feel hopeful and hard, and there’s work to be done.

This year, my personal hope is for something new. With all the baggage and blowback that may come, I plan to choose extravagant rest.

It will be the slow art of baking in the middle of my work-from-home days. It will be bold pictures of me soaking in the sun, playing cards and reading books. It will be weekend retreats that are not filled with uninterrupted work and prayerful discernment but with goofy pictures, my mouth wide with laughter, my heart wildly unburdened and unbothered.

This year, rest will be resistance so that the strongest me can be restored to take on the demands of the work.