Health promotion in local churches in Victoria: an exploratory study

Abstract

Church-based health promotion has increasingly gained attention in strategies to address health disparities. In Australia, we have limited understanding of the role of local churches in health promotion and without this, how they might be involved in meaningful partnerships to tackle public health challenges. The objective of this qualitative study was to explore how churches are involved in health promotion in the state of Victoria. The research involved in-depth interviews with ministers from 30 churches in urban and rural Victoria, and case studies with 10 of these churches to enable further exploration. These case studies, conducted in 2010, included interviews with church staff, focus groups with volunteers, participant observation and document analysis. Analysis was iterative, utilising open, axial and thematic coding. Three different expressions of church - traditional, new modern and emerging - were identified and found to differentiate the levels and types of health promotion activity. Case studies illustrate the different expressions of how church mission influences health promotion activity. The traditional churches were involved particularly in disease screening and health education activities with their own, predominantly older congregation members. The new modern churches tended to have the material and human resources to be harnessed in health promotion activities involving congregation members and others. Emerging churches, in contrast, engaged in broad health-promoting activities, including disease prevention, lifestyle activities and socio-ecological approaches at a community level. These research findings highlight the opportunities and challenges of engaging with local churches in health promotion efforts and public health programmes to address health inequities.

Barriers and challenges affecting the contemporary church's engagement in health promotion

“…15 The methods for this research have been reported elsewhere. 8 In brief, a qualitative approach was adopted to address the research aim of exploring barriers and challenges to church engagement in health promotion in Victoria. Churches and church-affiliated organisations were purposively sampled to include those involved in a range of health and welfare activities and to achieve a mix of congregation sizes and rural and urban locations.…”

“…[4][5][6][7] Ayton and colleagues have described how and why churches in Victoria, Australia, are involved in health promotion activities. 8 In the sample of churches studied, activities ranged from downstream actions, such as disease screening and health education, midstream actions, including social support programs (youth groups, mothers groups, craft groups, mentoring programs) and physical activity initiatives (walking groups, sporting groups), and upstream programs such as advocacy on issues like problem gambling, housing and employment for vulnerable communities. 8 These reflected the continuum of downstream to upstream approaches to health promotion as described by Keleher and Murphy.…”

“…8 In the sample of churches studied, activities ranged from downstream actions, such as disease screening and health education, midstream actions, including social support programs (youth groups, mothers groups, craft groups, mentoring programs) and physical activity initiatives (walking groups, sporting groups), and upstream programs such as advocacy on issues like problem gambling, housing and employment for vulnerable communities. 8 These reflected the continuum of downstream to upstream approaches to health promotion as described by Keleher and Murphy. 9 How church leaders understood and operationalised church mission influenced whether church activities were focused on church attendees or the broader community.…”

“…The work of churches as found by Ayton et al 8 demonstrated the various types of health promotion work undertaken by churches, but others have noted a range of barriers to church engagement in health promotion, including concerns about the separation of church and state and evangelism and proselytising. 10 Tensions between churches and the public health sector may stem from discordant values as reflected in the reluctance to promote condom use to prevent sexually transmissible infections such as HIV, 11 the status of women in conservative churches, 12 and abortion debates.…”

“…18 In an earlier paper we have described the health promotion work of churches, which is extensive and spans the health promotion continuum. 8 Yet limited research has been conducted into the barriers and challenges that may impact on the ability of local churches to be involved in health promotion. To better understand the potential for engaging Australian churches in health promotion programs and partnerships, in this article we investigate the range of barriers and challenges that impact the nature and scope of their health promotion activities.…”