Book titles often interest me; few arrest me. Such was the case this past fall when Baker Academic’s catalog arrived at my home and I saw this title: Faithful and Fractured: Responding to the Clergy Health Crisis (Baker Academic, 2018). It was co-authored by a medical researcher and a pastor-theologian. I knew it was a book I had to get. Having read it, I now see that it is a book that not just pastors need to read, but it is one that should be read closely by denominational leaders, deacons, church board members, members of pulpit or personnel committees, and anyone whose life intersects with clergy.
The two authors have been kind enough to let me ask them some questions about their book, and help introduce some key themes and issues to our readers. Before sharing that interview, let me introduce the reader to the authors, courtesy of Amazon.com:
Rae Jean Proeschold-Bell (PhD, Arizona State University) is associate research professor of global health at the Duke Global Health Institute and the Duke Center for Health Inequalities and Research in Durham, North Carolina. Her research focuses on the joint treatment of mental and physical health. She is coprincipal investigator of the Duke Clergy Health Initiative, which seeks to understand and improve the health of United Methodist Church clergy in North Carolina and designs interventions for clergy, including a two-year holistic health program called Spirited Life.
Jason Byassee (PhD, Duke University) is the inaugural Butler Chair in Homiletics and Biblical Hermeneutics at Vancouver School of Theology in Vancouver, British Columbia. He previously served as senior pastor of Boone United Methodist Church in the Western North Carolina Conference and taught at Duke Divinity School. He serves as a contributing editor to the Christian Century and has authored numerous books.
__________
Jackson: Jason and Rae Jean, thank you so much for taking time to answer some questions about your significant and timely book. Can each of you say a little bit about your orientation to the subject? What first got you thinking about and researching this subject?
Rae Jean: I never planned to study clergy. I was studying the health of people with HIV and substance use, when Duke Divinity School got a large grant to improve clergy health. A friend invited me to be involved and I thought, “no way – I care about health disparities – I’m working with people who earn $600 a month or less and are really sick!” But I was convinced to see the data, so we did a statewide survey, and lo and behold clergy really do have worse health.
Jason: I was a participant in The Duke Endowment’s study as a pastor. I watched my friends take Naturally Slim seriously, and our conversation changed—we started speaking in new tongues to one another. “What time do you drink your H2Orange?” or we’d watch each other box up half a sandwich as soon as it came to the table. Rae Jean later gave me language for this—clergy obesity is a sort of public health problem. It’s not just a matter of individual will power succeeding or failing. I found that hugely liberating. Later they asked me to help write theologically and pastorally about their research findings—how could I not?
__________
Jackson: You note early on that a surprising and positive aspect of your research was the remarkable rate of response among clergy in the group you surveyed—an unheard of 95%. What do you primarily attribute that high rate to? What might it suggest?
Rae Jean: I was floored by this 95% response rate, when 80% is considered excellent and many internet surveys get only 20%. I believe pastors took the first survey because they were concerned about their health. They were looking around the room at clergy meetings and thinking that they were, as a group, stressed and not exercising enough. And they wanted to change that. Our survey participants were well-aware that The Duke Endowment was going to fund a health intervention designed just for them, and they wanted input into what the intervention would look like.
Jason: I’m not sure I’m proud of this, but we Methodist ministers are followers. When we get some piece of paperwork from officialdom, we fill it out—why else did Jesus rise from the dead?! More seriously, we see our health as a real problem. It’s not just that we might personally die sooner, though there is that. It’s also the bite out of our churches’ budgets that our health insurance takes. That’s a US problem writ large, but it confronts pastors every day in the mirror, in budget committee meetings.
__________
Jackson: Even though your research focused on clergy belonging to the United Methodist clergy in North Carolina, what gives you reason to believe your findings are indicative of larger patterns and problems in other American Protestant groups?
Rae Jean: Researchers have conducted time use studies and found that clergy — across denominations — engage in similar activities. United Methodist clergy are rather unique in that they are appointed to churches rather than being called by them, but nevertheless, clergy across American Protestant groups experience similar job demands. And then there’s the state of clergy health as documented across denominations: there are dozens of studies on clergy stress that point in the same direction, and more recently, there are a few published studies on the physical health of clergy, and they also line up indicating similar problems with obesity and chronic diseases.
Jason: Rae Jean is such a thorough researcher she can show this from the research literature. My sense is there was nothing unique to Methodist pastors in this regard—there are always some pastors who stand out for facing the same sorts of pressures: lack of agency, perceived blame for the mainline’s decline, few opportunities to blow off steam except overeating, burnout, discouragement, personalizing problems that are much bigger than our person. In scripture’s language, we’re all sinners, and our sin takes a myriad of clever forms. We read these stories about split seas and fed multitudes but we end up whiling away in meetings and sermons not near as fiery as we once hoped to preach. It’s depressing. Pass the pie.
__________
Jackson: Rae Jean, as I understand it, insurers determine rates based on the risk pools they are insuring. Since you indicate in the book that reports show clergy submitting more health care claims than the general population, does this make it less possible for church bodies to provide affordable group policies to clergy in their denomination? Or is there a different way we need to be thinking about that aspect of this subject?
Rae Jean: We note in the book that an offhand remark from a bishop back in 2006: “If we don’t get insurance right for clergy, there won’t be a church left to strengthen,” was one of the early sparks that led to our work and this book. We’ve all heard about the high cost of providing health insurance, and that’s no different for clergy. In fact, the costs for clergy have been exacerbated by a couple of factors. In North Carolina, for example, the two United Methodist Annual Conferences are self-insured. That means the pools are made up of clergy and their family members. There’s a pretty small number of people in each pool, and certain diagnoses like diabetes and hypertension are ones that clergy have at higher rates and are expensive to treat. Also, the average age of clergy, 52, is an age of accumulating diagnoses, so that doesn’t help.
Congregations are responsible for providing health insurance to their clergy. In one of our NC conferences, it costs over $16,000 a year to provide health insurance for a pastor and the pastor’s family, and the church is responsible for almost $14,000 of that. Five years ago, the church portion was about $11,000, instead of $16,000. Clergy feel the pinch, too. They have born added costs through increases in their portions of the premium, their deductibles, and their copays.
__________
Jackson: The book emphasizes a key tension within clergy health. This tension is that when one is doing what he or she believes to be holy work, that our work is sacred and meaningful to God, it “makes you more likely to sacrifice (even if unconsciously) your well-being.” As a former pastor, Jason, you understand this well. Say a little bit about how this works itself out in some problematic ways in the pastor’s life. The anecdotes about pastors feeling guilty for not working hard enough (when clearly that was not the case) especially resonated with what I have observed and experienced.
Jason: Some of us pastors feeling guilty about not doing enough is exacerbated by the way our peers are talked about and rewarded. Someone grows a big church somewhere (Andy Crouch says always ask “so when did they open the new highway nearby?”). That person gets feted with speaking gigs and book deals, and big wigs trot them out at conferences and they speak as though, if we only tried hard enough, we could do the same in our churches. Parishioners hear this stuff too and think they would like us to lead them to great growth and similar fame, but then at the heart of it, they also wouldn’t—it’s their church, they’ve figured out how to love it like it is. So in a sense this is a theological problem: what is the church for? What does God need from it for God’s purposes in the world?
__________
The rest of the interview will post later this week.
Recent Comments