Principles & Practice of Health Evangelism
Chapter 20
As Solid as Science
Textbook pages 233-242
In the minds of some people, science and religion are mutually exclusive disciplines. Science increasingly recognizes that an intelligent designer is required to explain the complexity found in the natural world. As one author said, “Science drives us conclusively and compellingly toward the existence of God. The Scriptures and science proclaim the same truth. They support each other because God’s revelation of himself in nature is just as true as his revelation of himself in Scripture. The Scriptures and science are united. - not without their distinctions, of course.-- but united. To separate them is to do exactly what the world does.”
The role of science in health evangelism is an important one. Science has done much to advance our standard of living and has provided us with wonderful technological advances. The scientific method is an invaluable tool that can validate or discredit the effectiveness of a drug, nutritional supplement, or health practice.
Traditional religious evangelism deals primarily with a person’s spiritual condition. Health evangelism deals with both spiritual and physical restoration. The tools of science are essential to measure the effectiveness of health evangelism.
In the area of healthful living, science and religion are both important. Science provides the proof that certain health practices preserve health and promote long life. Health evangelism introduces us to God who provides us with the power to change. God gives us the strength to continue good health practices once they are established.
The role of science in health evangelism is an important one. Science has done much to advance our standard of living and has provided us with wonderful technological advances. The scientific method is an invaluable tool that can validate or discredit the effectiveness of a drug, nutritional supplement, or health practice.
Traditional religious evangelism deals primarily with a person’s spiritual condition. Health evangelism deals with both spiritual and physical restoration. The tools of science are essential to measure the effectiveness of health evangelism.
In the area of healthful living, science and religion are both important. Science provides the proof that certain health practices preserve health and promote long life. Health evangelism introduces us to God who provides us with the power to change. God gives us the strength to continue good health practices once they are established.
The Scientific Method
The scientific method is the tool that science uses to prove or discredit a theory. Science proved that cigarette smoking causes lung cancer and science put robots on Mars. As you conduct health evangelism activities, it is important to use health concepts based on data that are scientifically sound. Selecting accurate information will be easy for someone with a scientific background but will be a challenge for those not trained in understanding the scientific literature.
I have been distressed to find church members who have little scientific background, proclaiming as truth, popular but erroneous health advice that has no basis in fact. These church members often pose as health experts and teach what is contradictory to what has already been established by careful study.
Every recommendation for healthful living you make needs have been tested and proved effective in a human population. You need to be able to look for published studies that support what you are telling people. You should be able to analyze a study to see if it was designed and conducted in such a way as to be able to really prove a point.
I have been distressed to find church members who have little scientific background, proclaiming as truth, popular but erroneous health advice that has no basis in fact. These church members often pose as health experts and teach what is contradictory to what has already been established by careful study.
Every recommendation for healthful living you make needs have been tested and proved effective in a human population. You need to be able to look for published studies that support what you are telling people. You should be able to analyze a study to see if it was designed and conducted in such a way as to be able to really prove a point.
Anecdotal Reports and Endorsements
The most useless and unscientific recommendation for a product, diet, nutritional supplement or proposed lifestyle change is the anecdotal recommendation. Anecdotal endorsements are provided by individuals who are famous or who have respected degrees. When there is no credible science to back up a claim of effectiveness for a product, the most a company can do is to get some recognizable person to recommend it. Scientific articles sharing anecdotal findings are called case reports and are simply for forming hypotheses to test, they do not constitute evidence of effectiveness of whatever is reported.
Population Studies
The effectiveness of medications can be studied in fairly small populations. Much larger studies are needed to document the benefits or harm from specific lifestyle behaviors. If someone promotes a certain behavior as important to health, it is important for you to learn what you can about the population in which that behavior was studied. Often, studies are just surveys of opinions. Perhaps a few dozen people were polled. Such studies do not establish the benefit of any treatment.
Retrospective Studies
The simplest type of a population study is the retrospective study. A retrospective study starts with a population that has a certain disease. The researcher then collects data from a second population of people (the control group) who do not have that disease. The more alike the two populations are in every respect, except for the presence of disease, the more valid the conclusions that can be drawn.
In a retrospective study the two populations should be matched for age, sex, geographic area, and many comorbid conditions. Establishing the similarity of the two populations is very important to suggest reliable conclusions. Yet retrospective studies cannot establish cause and effect relationships.
Careful matching of case and control populations is the most important part of a retrospective study. In the 1950's several retrospective studies of men with lung cancer that showed that cigarette smoking was much more common in men with lung cancer than in a matched control group of men who did not have lung cancer. Retrospective studies are most useful in studying rare diseases. Retrospective studies are relatively inexpensive to conduct. Many retrospective studies are conducted with as few as a hundred cases and a hundred controls.
In a retrospective study the two populations should be matched for age, sex, geographic area, and many comorbid conditions. Establishing the similarity of the two populations is very important to suggest reliable conclusions. Yet retrospective studies cannot establish cause and effect relationships.
Careful matching of case and control populations is the most important part of a retrospective study. In the 1950's several retrospective studies of men with lung cancer that showed that cigarette smoking was much more common in men with lung cancer than in a matched control group of men who did not have lung cancer. Retrospective studies are most useful in studying rare diseases. Retrospective studies are relatively inexpensive to conduct. Many retrospective studies are conducted with as few as a hundred cases and a hundred controls.
Prospective/Cohort Studies
A study of an entire cohort of a population is an even better scientific tool. Prospective population studies are conducted on large populations of people and are continued for several years. Prospective studies may enroll thousands to even millions of people.
A cohort study is begun by enrolling people by administering a questionnaire that determines a wide variety of data points such as age, sex, race, and occupation, daily or weekly use of various food items, alcohol, tobacco and drug use, levels of exercise at work and at home.
Certain physical measurements such as height, weight, blood pressure, cholesterol levels or other physical parameters may be included. Usually, people with known diseases that might affect the validity of the results are excluded so that you can measure the effect of certain behaviors in healthy people.
Cohort studies take a long time to conduct. They must run for enough years for diseases to develop and deaths to occur. You periodically monitor the health of the population and document the development of disease over time.
The American Cancer Society has conducted large prospective studies that have enrolled over one million people and has followed the subjects for several years. A large Japanese study followed 250,000 people for some 17 years. A single large prospective study can be used to study the development of many different diseases that may be associated with many different behaviors. The Framingham heart study enrolled only 4000 people but followed them for more than 30 years.
Two of the highly valuable cohort studies are the NIH-AARP study of a half million people and the Health Professionals study of physicians and nurses which also has hundreds of thousands of participants.
The most valid data regarding the relationship of various behaviors to health come from prospective studies. Many claims are made for many different health behaviors, but if there are no data from prospective studies to back up the claims, do not put a lot of stock in what is being claimed.
Retrospective studies showed a link between cigarette smoking and lung cancer, but it took large prospective studies to show that cigarette smoking was not only a cause of lung cancer but was also a major cause of cancers at other sites as well. Smoking causes cancer of the oral cavity, larynx, esophagus, pancreas, kidney, bladder, and cervix. Smoking causes emphysema and chronic bronchitis. Smoking is a major cause of heart attacks, strokes, and hardening of the arteries in general. All these facts were discovered in large prospective studies. One large prospective study can prove several things.
Other cohort studies have shown that you can prevent heart attacks by eating nuts frequently, drinking four or more glasses of water a day and by decreasing the amount of meat and dairy products in the diet. Do not believe a health claim unless there is some objective data from a large prospective study or a well conducted retrospective study to back them up.
A cohort study is begun by enrolling people by administering a questionnaire that determines a wide variety of data points such as age, sex, race, and occupation, daily or weekly use of various food items, alcohol, tobacco and drug use, levels of exercise at work and at home.
Certain physical measurements such as height, weight, blood pressure, cholesterol levels or other physical parameters may be included. Usually, people with known diseases that might affect the validity of the results are excluded so that you can measure the effect of certain behaviors in healthy people.
Cohort studies take a long time to conduct. They must run for enough years for diseases to develop and deaths to occur. You periodically monitor the health of the population and document the development of disease over time.
The American Cancer Society has conducted large prospective studies that have enrolled over one million people and has followed the subjects for several years. A large Japanese study followed 250,000 people for some 17 years. A single large prospective study can be used to study the development of many different diseases that may be associated with many different behaviors. The Framingham heart study enrolled only 4000 people but followed them for more than 30 years.
Two of the highly valuable cohort studies are the NIH-AARP study of a half million people and the Health Professionals study of physicians and nurses which also has hundreds of thousands of participants.
The most valid data regarding the relationship of various behaviors to health come from prospective studies. Many claims are made for many different health behaviors, but if there are no data from prospective studies to back up the claims, do not put a lot of stock in what is being claimed.
Retrospective studies showed a link between cigarette smoking and lung cancer, but it took large prospective studies to show that cigarette smoking was not only a cause of lung cancer but was also a major cause of cancers at other sites as well. Smoking causes cancer of the oral cavity, larynx, esophagus, pancreas, kidney, bladder, and cervix. Smoking causes emphysema and chronic bronchitis. Smoking is a major cause of heart attacks, strokes, and hardening of the arteries in general. All these facts were discovered in large prospective studies. One large prospective study can prove several things.
Other cohort studies have shown that you can prevent heart attacks by eating nuts frequently, drinking four or more glasses of water a day and by decreasing the amount of meat and dairy products in the diet. Do not believe a health claim unless there is some objective data from a large prospective study or a well conducted retrospective study to back them up.
The Adventist Health Study
The unusually good health of Seventh-day Adventists is of particular interest to the scientific community and the world at large. As a people, we have more good health behaviors and better health than any population in any country of the world.
The first study of Seventh-day Adventists began back in the 1950s. The current Adventist Health Study II is a large prospective epidemiological study. There are close to 100,000 participants from across the United States. The Adventist Health Study data collection and analysis is done by Loma Linda University.
The AHS-II study is confirming the validity of the health principles found in the Bible and the writings of Ellen G. White. Hundreds of new and surprising benefits of vegetarian and vegan diets have been discovered for the first time. Diet, exercise, water, avoidance of tobacco, alcohol, and coffee, and dozens of other variables are being examined.
Over the past 60 plus years over 450 articles, based on data from Adventist Health Studies, have been published in peer-reviewed scientific journals. Many more articles will appear every year from this important study.
The Adventist Health Study has discovered significant new health information. Several of these new health facts have been confirmed by other often much larger studies of secular populations conducted by secular universities.
The first study of Seventh-day Adventists began back in the 1950s. The current Adventist Health Study II is a large prospective epidemiological study. There are close to 100,000 participants from across the United States. The Adventist Health Study data collection and analysis is done by Loma Linda University.
The AHS-II study is confirming the validity of the health principles found in the Bible and the writings of Ellen G. White. Hundreds of new and surprising benefits of vegetarian and vegan diets have been discovered for the first time. Diet, exercise, water, avoidance of tobacco, alcohol, and coffee, and dozens of other variables are being examined.
Over the past 60 plus years over 450 articles, based on data from Adventist Health Studies, have been published in peer-reviewed scientific journals. Many more articles will appear every year from this important study.
The Adventist Health Study has discovered significant new health information. Several of these new health facts have been confirmed by other often much larger studies of secular populations conducted by secular universities.
Statistical Significance
Some discussion of what constitutes proof is necessary. I do not want to go into a detailed discussion of the mathematics of probability. It is sufficient to say that rigorous mathematical tools exist to exactly measure the significance or validity of data collected.
There is always a possibility that a positive association discovered in a study is due to chance and is not real. The scientific community has agreed that no claim of proof for an association will be made unless there is less than a 5% chance that the outcome was a random occurrence. Probability is expressed as p. Therefore, a finding must have a p value of 0.05 or smaller to be statistically significant.
The proof that an association is real is based on the magnitude of the association, the consistency of an association in multiple studies, and the validity of the association in various populations and demonstrating dose-response relationships. It is also helpful if there is experimental evidence in animal models that support the theory.
There is always a possibility that a positive association discovered in a study is due to chance and is not real. The scientific community has agreed that no claim of proof for an association will be made unless there is less than a 5% chance that the outcome was a random occurrence. Probability is expressed as p. Therefore, a finding must have a p value of 0.05 or smaller to be statistically significant.
The proof that an association is real is based on the magnitude of the association, the consistency of an association in multiple studies, and the validity of the association in various populations and demonstrating dose-response relationships. It is also helpful if there is experimental evidence in animal models that support the theory.
Peer Review and Publication
Research regarding the health of populations has a time-honored mechanism to keep things honest. It is the peer review process. Research at every center of scientific study is monitored by an Institutional Review Board (IRB). Any bias in study design or population selection is pretty much eliminated through the peer review process.
Peer review continues when it comes time to publish research data. Research is introduced to the world through presentation to a skeptical scientific audience at regularly held meetings where research results are first presented.
Scientists also seek to have their findings published in respected science journals. The editors of these journals distribute the articles they receive for publication to several independent (often competing) scientists who are often themselves doing research in the same area.
If the study was sound and the results accurate, the article is recommended for publication. If defects or inaccuracies are found, the article is returned to the author for clarification, revision or perhaps more research is needed to adequately prove the point.
The medical literature of the entire world is catalogued in the United States National Library of Medicine in Bethesda, Maryland. Authors, article title, journal, and a brief abstract are published online at pubmed.gov. The articles from over 5000 different medical journals are catalogued each month and are available for anyone to review. Currently there are over 36 million articles on file in the library.
Do not promote any new health concept, idea, or practice in your health evangelism program unless you can find support for it in multiple places in peer-reviewed scientific articles, preferably large prospective studies. Every health activity promoted in your health evangelism program should be supported by sound scientific evidence.
The Bible supports this type of rigorous accuracy in all we do. “Let all things be done decently and in order." 1 Corinthians 14:40.” The Old and New Testaments contain dozens of recommendations to be orderly in all that we do.
Peer review continues when it comes time to publish research data. Research is introduced to the world through presentation to a skeptical scientific audience at regularly held meetings where research results are first presented.
Scientists also seek to have their findings published in respected science journals. The editors of these journals distribute the articles they receive for publication to several independent (often competing) scientists who are often themselves doing research in the same area.
If the study was sound and the results accurate, the article is recommended for publication. If defects or inaccuracies are found, the article is returned to the author for clarification, revision or perhaps more research is needed to adequately prove the point.
The medical literature of the entire world is catalogued in the United States National Library of Medicine in Bethesda, Maryland. Authors, article title, journal, and a brief abstract are published online at pubmed.gov. The articles from over 5000 different medical journals are catalogued each month and are available for anyone to review. Currently there are over 36 million articles on file in the library.
Do not promote any new health concept, idea, or practice in your health evangelism program unless you can find support for it in multiple places in peer-reviewed scientific articles, preferably large prospective studies. Every health activity promoted in your health evangelism program should be supported by sound scientific evidence.
The Bible supports this type of rigorous accuracy in all we do. “Let all things be done decently and in order." 1 Corinthians 14:40.” The Old and New Testaments contain dozens of recommendations to be orderly in all that we do.
Spirit of Prophecy Comments on Science
Modern science has become powerful because it is discovering truth that God has authored.
Health evangelism should be brimming with high quality scientific medical knowledge. We know science and we know the God of science. Those who come to us for help will recognize we have accurate scientific knowledge and can introduce them to the God of behavior change who designed the science.
In this quotation, Mrs. White correctly recognizes that science properly conducted possesses all kinds of power. Science is useful. Accurate science should be a part of any health evangelism program.
In this next quotation, a practical knowledge of the science of human life is advocated. This knowledge has been produced through many millions of scientific research studies conducted over the past 100 years.
Understanding God and understanding true science are complementary not mutually exclusive.
Here is nice summary of how health evangelism is to be practiced.
Rational science was in its infancy in the late 1800’s and early in the 20th century. The last 100 years have brought breathtaking advances in all branches of science which continue to this day. Ellen White embraced true rational science while condemning the many harmful practices of health practitioners of her day.
- “God is the author of science. Scientific research opens to the mind vast fields of thought and information.” Counsels to Teachers, Parents and Students, 426
Health evangelism should be brimming with high quality scientific medical knowledge. We know science and we know the God of science. Those who come to us for help will recognize we have accurate scientific knowledge and can introduce them to the God of behavior change who designed the science.
- “The light that God has given in medical missionary lines will not cause His people to be regarded as inferior in scientific medical knowledge, but will fit them to stand upon the highest eminence.” Medical Ministry, 65
In this quotation, Mrs. White correctly recognizes that science properly conducted possesses all kinds of power. Science is useful. Accurate science should be a part of any health evangelism program.
- “The schools established among us are matters of grave responsibility; for important interests are involved. In a special manner our schools are a spectacle unto angels and to men. A knowledge of science of all kinds is power, and it is in the purpose of God that advanced science shall be taught in our schools as a preparation for the work that is to precede the closing scenes of earth's history.” Fundamentals of Christian Education, 186
In this next quotation, a practical knowledge of the science of human life is advocated. This knowledge has been produced through many millions of scientific research studies conducted over the past 100 years.
- A practical knowledge of the science of human life, is necessary in order to glorify God in our bodies. It is therefore of the highest importance that among the studies selected for childhood, physiology should occupy the first place. How few know anything about the structure and functions of their own bodies, and of Nature's laws. Many are drifting about without knowledge, like a ship at sea without compass or anchor; and what is more, they are not interested to learn how to keep their bodies in a healthy condition, and prevent disease.” The Health Reformer 08-01-1866
Understanding God and understanding true science are complementary not mutually exclusive.
- “The closer our connection with God, the more fully can we comprehend the value of true science; for the attributes of God, as seen in His created works, can be best appreciated by him who has a knowledge of the Creator of all things, the Author of all truth. Such can make the highest use of knowledge; for when brought under the full control of the Spirit of God, their talents are rendered useful to the fullest extent.” Counsels to Teachers, Parents and Students, 38
Here is nice summary of how health evangelism is to be practiced.
- “Whenever possible, let a room be provided where the patrons can be invited to lectures on the science of health and Christian temperance, where they can receive instruction on the preparation of wholesome food and on other important subjects.” Testimonies of the Church, Vol 7, 115
Rational science was in its infancy in the late 1800’s and early in the 20th century. The last 100 years have brought breathtaking advances in all branches of science which continue to this day. Ellen White embraced true rational science while condemning the many harmful practices of health practitioners of her day.