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Reverend Daniel McKizzie wanted to get healthier. The senior pastor at New Creation Baptist Church, a predominantly Black church in south Minneapolis, McKizzie was diagnosed with Type 2 diabetes about six years ago. Then a year ago, he started noticing his formerly perfect blood pressure numbers going up. His doctor recommended revamping his diet and exercise. But he wasn’t exactly sure where to start.
That is, until he learned about a new health initiative from an unusual source: his own church. A Mayo Clinic trial was asking Black congregations to help evaluate a new heart health app that targeted his exact needs.
“For me, it was perfect—it gave me an incentive to be better,” McKizzie said. “And I was also able to rally folks in the congregation to follow suit.”
The connection between health and religion made perfect sense to McKizzie.
“We believe God has called us to be servants and if we don’t take care of our temples, that will shorten our effectiveness at serving God,” he said.
A pair of recent studies led by Dr. LaPrincess Brewer, an assistant professor in the Department of Cardiovascular Medicine at Mayo Clinic, show that McKizzie’s experience is not unusual. Black religious or spiritual people tend to have stronger indicators of heart health than less religious Black people, the most recent study showed. And her experience developing and evaluating the heart health app—the trial that McKizzie participated in—showed that churchgoers appear eager to use digital interventions.
Brewer analyzed data from the Jackson Heart Study, which has tracked environmental and genetic factors associated with cardiovascular disease among more than 5,000 African Americans in Jackson, Mississippi, since 1998. Brewer wasn’t surprised to find a strong link between churchgoers and heart health: Churches provide a strong support network for many African Americans. But she hadn’t expected to see health benefits from religious practices, such as private prayer, that take place outside of attending services. But in her study, these religious practices also yielded benefits.
Brewer used metrics, formerly called Life’s Simple Seven, that have been developed by the American Heart Association as a measure of heart health. The seven factors point to three behaviors (diet, physical activity, and nicotine exposure) and four physiological factors (weight, cholesterol, blood pressure, and blood glucose levels) that contribute to good heart health.
RESULTS: Here’s what the data show about the benefits of Black religious practice on heart health.
- People who more frequently attended any type of religious service or activity were 16 percent more likely to be at an intermediate or ideal level of physical activity than people who attended services less often.
- The same more-religiously-active group was also 10 percent more likely to consume a heart-healthy diet, 50 percent more likely to be a non-smoker, and 12 percent more likely to maintain good blood pressure.
- People who engaged in private prayer more frequently were 12 percent more likely to be at an intermediate or ideal level for diet and 24 percent more likely to be a non-smoker.
- People who use religion to cope were 18 percent more likely to be at an intermediate or ideal level of physical activity, 10 percent more likely to eat a heart-healthy diet, and 32 percent more likely to be a non-smoker.
The findings from the study, published this August in the Journal of the American Heart Association, also validate the tools that Brewer has been developing through the Mayo Clinic’s Fostering African-American Improvement in Total Health (FAITH!). The program is a participatory research effort aimed at preventing heart disease in underserved communities. Brewer started designing the app through FAITH! in 2016.
Community-based interventions need to be culturally tailored, Brewer told Sahan Journal, because Black adults suffer from poorer heart health and die of cardiovascular disease in greater numbers than white people. It’s one reason white people tend to live longer than Black people, the American Heart Association said in a 2017 scientific statement.
And Minnesota is not exempt from that inequity. Another 2022 study by Brewer and colleagues found that Black Minnesotans display risk factors for cardiovascular disease equal to or worse than the participants in the Jackson study. In Minnesota, they found, Black adults ages 35–63 die from cardiovascular disease twice as often as their white counterparts.
In Minnesota, researchers have found that Black adults ages of 35–63 die from cardiovascular disease twice as often as their white counterparts. “Although we’ve been ranked nationally as one of the healthiest states for decades, the benefits are not always seen in underserved racial and ethnic minority groups, especially African Americans,” said Dr. LaPrincess Brewer, a cardiologist and researcher at Mayo Clinic.
Getting on a pulpit to talk about health
Brewer grew up attending a Black church in Charlotte, North Carolina. Through that experience, she observed that conversations about health rarely occurred until someone passed away or received a devastating diagnosis.
“That’s when there’s a recentering on health,” she said.
That emphasis on health “should be the cultural norm within the African American faith community,” she said.
So when she moved to Rochester 10 years ago, Brewer started working with the FAITH! Initiative, which now has connections with about 120 Black Christian communities in Rochester and the Twin Cities. The framework proved useful during the pandemic, when many of the faith communities shared COVID-19 resources and information, encouraging members to get vaccines and boosters.
Those relationships with churches have paved the way for introducing new interventions. Brewer’s team has been able to tap participants at various stages of developing the heart health app, for example. When community members are involved from the beginning, it’s easier to get buy-in, Brewer said.
In addition to tracking diet and steps, the latest version of the app asks participants to complete an education module each week. The modules focus on health disparities affecting the Black community, such as high hypertension, and practical strategies to overcome barriers, such as heart-healthy versions of traditional recipes. The app also sends personalized messages and includes a group chat area with a moderator who encourages discussion on self-efficacy, self-regulation, social support, and obstacles to practicing a healthy lifestyle.
Carmen Robinson, 61, a member of Greater Mount Vernon Missionary Baptist Church, in North Minneapolis, said she didn’t need much persuading to join the app trial.
“I have struggles with weight and health—I want to get healthier,” said Robinson, who has been diagnosed with prediabetes. It’s also what God wants, she said.
“God doesn’t want us to overindulge,” she said. “He wants us to take care of our temple.”
During the 10-week trial and six-month follow-up, Mayo Clinic researchers measured participants’ blood pressure, glucose levels, cholesterol, and body mass index (a measure of body fat). The researchers then graded how heart-healthy their diets were.
Robinson found that the app kept her accountable. “When life happens and you don’t realize how much or what you’ve eaten, it tells you what days you’re kind of lacksadaisy,” she said. The app encouraged her to eat more whole fruit, which she had eliminated from her diet when she found out she was pre-diabetic.
By the end of the trial, her cholesterol, glucose, and blood pressure had all improved. She’d also lost weight, but regained it.
Most participants improved in both diet and physical activity level. But Brewer was also interested in how willing people were to use digital health tools.
“It’s really showing us that African Americans are open to using mHealth [mobile health] interventions,” Brewer said. “There has been a surge of digital health interventions, but often they’re not designed with these communities in mind.”
Sidestepping historical traumas to get advice from a trusted source
Getting health information from a trusted pastor offers another powerful benefit, Brewer said. Brewer and other researchers have previously described a lack of trust in medical research because of historical traumas.
“The folks are willing to be trusting of us, given the history of some abuses in the scientific field for people of color,” Reverend McKizzie said.
Brewer is also eager to share the numbers from the Jackson Heart data with church leaders. She’s hoping it will help them realize the role they can play in promoting health from the pulpit. Sermons can emphasize prevention strategies such as quitting smoking, exercising regularly, and eating a heart-healthy diet, she said.
McKizzie said that participating in the trial inspired him to preach more about health. Previously, he had shared his experience with prostate cancer, encouraging young men to get screened. And he encouraged congregants to get the COVID-19 vaccine and boosters. McKizzie explains that he takes a holistic approach to the wellbeing of his church.
“We talk not just about the spiritual being, but also the physical being,” he said.
That means fellowship dinners are starting to change at his New Creation Baptist Church. Congregants will find less macaroni and cheese and fried chicken, and more salads and baked chicken, McKizzie said.
The connection between religion and heart health appears to go beyond attending services; private prayer also appeared to improve heart-health metrics.
People should know they can “leverage their faith in guiding the need to protect their temples by practicing healthy behaviors,” Brewer said. “Christian Biblical tenets are in alignment with practicing healthy behaviors and preventive screenings.”
The Qur’an also speaks about honoring your body for God, Brewer said, and many other faiths touch on issues of health and wellness as well.
Although the app trial ended last spring, McKizzie still tracks his eating habits and steps, hitting about 15,000 steps per day. His numbers and weight had improved during the trial, but there’s one component missing now, he said: peer pressure.
The 16 churches involved in the study competed against each other to log the greatest number of steps. McKizzie himself often walked 20,000 steps a day, just to make sure his church stayed on top, and New Creation Baptist Church won. The reward? a catered dinner and a trophy, which is now displayed in the entryway to the church.
If he hears of another health initiative for his church?
“We will definitely sign up again.”