Prevalence of obesity in religious clergy in the United States: A systematic review and meta-analysis.

OBJECTIVE: This systematic review aims to summarize the current body of evidence concerning the prevalence of obesity among clergy (i.e., the officially designated leaders of a religious group) in the United States. METHOD: From November 2022 to February 2023, five databases, one data repository, and gray matter were searched for articles and data sources. The search was restricted to articles published or raw data collected from 2001 to 2021. Study quality was assessed with a template, and heterogeneity was assessed using the I 2 $$ {I}^2 $$ statistic. The protocol for this review was registered with PROSPERO (CRD42022376592). RESULTS: Forty-seven studies of clergy obesity involving 35,064 individuals were eligible. The pooled prevalence estimate of obesity across studies was 34.8% (95% confidence interval [CI]: 32.5-37.2). Obesity prevalence was found to be increasing over time and to vary considerably between clergy from different religious traditions. Compared to national estimates, from 2005 onwards, obesity prevalence was higher than in the US adult population.

Stability and shifts in the combined positive and negative mental health of clergy: A longitudinal latent class and latent transition analysis study of united methodist pastors before and after the onset of COVID-19.

COVID-19 and its associated restrictions presented unprecedented challenges for those in the helping professions. In this study, we seek to understand how the mental health of those who belong to one specific helping profession - clergy - changed in the context of COVID-19. Using longitudinal data of a sample of United Methodist pastors from the North Carolina Clergy Health Initiative, we conduct both cross-sectional and person-centered analyses to investigate how the overall mental health of this occupational group changed, as well as how different subgroups of clergy fared within the context of the pandemic, depending on their well-being prior to the onset of COVID-19. We found that the mental health of pastors suffered within the context of the pandemic, but that individual changes in mental health differed based on what the combined positive and negative mental health patterns of clergy were prior to the pandemic, for which we used latent class analysis to identify as Flourishing, Distressed, Languishing, or Burdened but Fulfilled. Of these subgroups, having Flourishing pre-pandemic status was protective of mental health following the onset of COVID-19, whereas the other three subgroups' mental health statuses worsened. This study is the one of the first longitudinal studies of helping professionals which has tracked changes in mental health before and after the onset of COVID-19. Our findings demonstrate the utility of considering positive and negative mental health indicators together, and they point to certain groups that can be targeted with well-being resources during future periods of acute or abnormal stress.

Programming Provided by Religious Congregations in the United States to Address Mental Illness and Substance Use Disorder.

Mental health conditions, including substance use disorders, are one of the most commonly occurring yet least commonly treated health ailments in the United States. Religious congregations serve as important providers of mental health services, as they can fill this gap with accessible care. This study provides an up-to-date accounting of mental health service provision by religious congregations, using a nationally representative survey of U.S. congregations collected in 2012 and 2018-19. Half of all congregations in the U.S. provided a program or service targeting mental illness or substance use disorder in 2018-19, and rates of provision increased among Christian congregations between 2012 and 2018-19.

US Religious Leaders' Views on the Etiology and Treatment of Depression.

Importance: Religious leaders commonly provide assistance to people with mental illness, but little is known about clergy views regarding mental health etiology and appropriate treatment. Objective: To assess the views of religious leaders regarding the etiology and treatment of depression. Design, Setting, and Participants: This cross-sectional study used the National Survey of Religious Leaders, which is a nationally representative survey of leaders of religious congregations in the United States, with data collected from February 2019 to June 2020. Data were analyzed in September and October 2022. Main Outcomes and Measures: Views about causes of depression (chemical imbalance, genetic problem, traumatic experience, demon possession, lack of social support, lack of faith, and stressful circumstances) and appropriate treatments (seeing a mental health professional, taking prescribed medication, and addressing the situation through religious activity). Results: The analytic sample was limited to congregations' primary leaders (N = 890), with a 70% cooperation rate. Clergy primarily endorsed situational etiologies of depression, with 93% (95% CI, 90%-96%) endorsing stressful circumstances, 82% (95% CI, 77%-87%) endorsing traumatic experiences, and 66% (95% CI, 59%-73%) endorsing lack of social support. Most clergy also endorsed a medical etiology, with 79% (95% CI, 74%-85%) endorsing chemical imbalance and 59% (95% CI, 52%-65%) endorsing genetics. A minority of clergy endorsed religious causes: lack of faith (29%; 95% CI, 22%-35%) or demon possession (16%; 95% CI, 10%-21%). Almost all of the religious leaders who responded to the survey would encourage someone with depressive symptoms to see a mental health professional (90%; 95% CI, 85%-94%), take prescribed medication (87%; 95% CI, 83%-91%), and address symptoms with religious activity (84%; 95% CI, 78%-89%). A small but nontrivial proportion endorsed a religious cause of depression without also endorsing chemical imbalance (8%; 95% CI, 5%-12%) or genetics (20%; 95% CI, 13%-27%) as a likely cause. A similar proportion would encourage someone exhibiting depressive symptoms to engage in religious treatment without also seeing a mental health professional (10%; 95% CI, 5%-14%) or taking prescribed medication (11%; 95% CI, 8%-15%). Conclusions and Relevance: In this cross-sectional survey, the vast majority of clergy embrace a medical understanding of depression's etiology and treatment. When clergy employ a religious understanding, it most commonly supplements rather than replaces a medical view, although a nontrivial minority endorse only religious interpretations. This should encourage greater collaboration between medical professionals and clergy in addressing mental health needs.

Religious Congregations' Technological and Financial Capacities on the Eve of the COVID-19 Pandemic.

Background: The COVID-19 pandemic dramatically upended religious life and placed significant strain on religious congregations. However, the effects of the pandemic were likely not felt evenly across the religious landscape. Purpose: We used data from the fourth wave of the National Congregations Study, gathered on the eve of the coronavirus pandemic in 2018-19, to identify the kinds of congregations that may have been especially vulnerable to the challenges of the COVID-19 pandemic. Methods: Using bivariate and multiple regression analysis, we examined two aspects of congregations' preparedness for the pandemic: technological infrastructure and financial stability. Results: We found that, while many congregations were technologically and financially equipped for a time of social distancing and economic recession, there were stark inequalities in levels of preparedness among congregations on the basis of race, class, size, urban/rural location, religious tradition, and the age of congregations' parishioners. In particular, Catholic congregations and congregations with older attendees tended to lack streaming or online communication capacities, and both rural and small congregations had more limited technological infrastructure and less financial cushion. Somewhat surprisingly, predominantly Black congregations were more likely to have worship streaming systems set up prior to the pandemic, though these congregations were more likely to lack other kinds of technological and financial infrastructure. Conclusions and Implications: Though COVID-19's full impact on congregations will not be known for several years, these results highlight variations in congregations' readiness for the pandemic's challenges, and they show that COVID-19's impact likely has not been felt equally across the religious landscape.

The Financial Impacts of COVID-19 on United Methodist Churches in North Carolina: a Qualitative Study of Pastors' Perspectives and Strategies.

Background: In the wake of the COVID-19 pandemic, churches in the United States were forced to stop meeting in person and move to remote forms of worship and congregational life. This shift likely impacted congregational finances, which are primarily driven by individual donations. Initial research has suggested that there is a great deal of heterogeneity in the financial impact on congregations, but there has been scant research examining how pastors and congregations are managing finances during this period. Purpose: This research examines the impact of COVID-19 and its associated restrictions on congregational finances and the strategies pastors used to adapt their church's finances to the health restrictions. Methods: We conducted in-depth, qualitative interviews with 50 pastors in the North Carolina and Western North Carolina Conferences of the United Methodist Church appointed to 70 congregations. Using applied thematic analysis, we analyzed transcripts at both the pastor and congregation-level to identify similarities and differences in financial impact, financial strategies, and pastor experiences during the pandemic. Results: Most congregations reported small decreases in giving that were offset by federal Paycheck Protection Program (PPP) loans and other grants from the denomination. Some congregations, mostly urban and fairly large, reported significant increases in giving, while several other, predominantly small congregations, reported their church's finances had been negatively impacted by the pandemic. Even in cases where the net impact of the pandemic was small or non-existent, pastors were forced to adopt a host of new strategies to manage finances. In general, small and large congregations experienced and responded to the financial impact of the pandemic very differently.and Implications. Conclusions: This research suggests that the pandemic's impact on congregational finances were more than just on the bottom line. And while most churches weathered the economic challenges without severe impacts, questions remain as to the long-term impact of the pandemic on church finances. Supplementary Information: The online version contains supplementary material available at 10.1007/s13644-021-00474-x.

Pastoral Ministry in Unsettled Times: A Qualitative Study of the Experiences of Clergy During the COVID-19 Pandemic.

Background: COVID-19 and its associated restrictions around in-person gatherings have created unprecedented challenges for religious congregations and those who lead them. While several surveys have attempted to describe how pastors and congregations responded to COVID-19, these provide a relatively thin picture of how COVID-19 is impacting religious life. There is scant qualitative data describing the lived reality of religious leaders and communities during the pandemic. Purpose and methods: This paper provides a more detailed look at how pastors and congregations experienced and responded to COVID-19 and its associated restrictions in the early period of the pandemic. To do so, we draw from 26 in-depth interviews with church-appointed United Methodist pastors conducted between June and August 2020. Pastors were asked to describe how their ministry changed as a result of COVID-19 and interviews were analyzed using applied thematic analysis approaches to identify the most common emergent themes. Results: Pastors reported that COVID-19 fundamentally unsettled routine ways of doing ministry. This disruption generated both challenges and opportunities for clergy and their congregations. In the findings, we describe how clergy responded in key areas of ministry-worship and pastoral care-and analyze how the pandemic is (re)shaping the way that clergy understood their role as pastors and envisioned the future of the Church. We argue for the value of examining the pandemic as an "unsettled" cultural period (Swidler 1986) in which religious leaders found creative ways to (re)do ministry in the context of social distancing. Rather than starting from scratch, we found that pastors drew from and modified existing symbolic and practical tools to fit pandemic-related constraints on religious life. Notably, however, we found that "redoing" ministry was easier and more effective in some areas (worship) than others (pastoral care). Conclusions and Implications: The impact of COVID-19 on pastors and congregations is complex and not fully captured by survey research. This study provides a baseline for investigating similarities and differences in the responses of pastors within and across denominations and traditions. It also provides a baseline for assessing whether changes in ministry implemented during the early stages of the pandemic remain in place in the post-COVID world.