Muslims are the fastest-growing religious minority in the United States, with over 7 million Americans declaring themselves as followers of Islam and more than 2,000 mosques nationwide. But in spite of the numbers, little data has been collected about American Muslims’ beliefs about health and disease, or their experience in the U.S. health care system. One reason for this also lies within the demographics, as American Muslims are a particularly diverse minority, containing South Asians, Arabs, and African-Americans, as well as both recent immigrants and long-term, multiple-generation natives. With such a wide variety of members from different ethnic, racial, and socioeconomic backgrounds, how does one pin down the health care experience of American Muslims?
The only way, thought Aasim Padela, was to talk to all of them – or at least representatives from each of the major groups in the American Muslim community. For his recent report, “Meeting the Healthcare Needs of American Muslims,” Padela and his colleagues at the Institute for Social Policy & Understanding went to the rich Muslim community of southeastern Michigan, one of the largest Muslim populations in the United States. Reaching out to multiple mosques and holding focus groups with over a hundred participants, the group looked for common denominators of people who share the Islamic faith, but perhaps little else.
“We looked at American Muslims as a conglomerate and asked what was common,” said Padela, assistant professor of medicine and director of the Initiative on Islam and Medicine at the University of Chicago. “We wanted to talk to each of these three large groups, which we know comprise the majority of American Muslims, and look at what’s similar in terms of health care challenges and beliefs. What we found as similar is something we can attribute to their faith.”
The final product was a fascinating piece of medical anthropology, a snapshot of how American Muslims view their own health or illness, the struggles they face in the U.S. health care system, and their solutions for establishing stronger communication between their faith and their medical caretakers. In an environment where physicians are expected to meet their patients halfway on ways to prevent and cure disease, understanding the perspective of a community that is already large, and growing larger, is an important first step toward improved care.
One primary finding of the report describes the “medical narrative” of American Muslims, their views on where disease comes from and the most effective strategy for fighting it off. Many participants in Padela’s focus groups believed that God takes an active role in health and illness, perceiving conditions from a winter flu to breast cancer as divinely ordained.
“Most participants perceived illness through a religious lens as predestined,” the authors wrote, “a trial from God by which one’s sins are removed, an opportunity for spiritual reward, a reminder to improve one’s health, and sometimes a sign of personal failure to follow Islam’s tenets.”
One might think that treating such a patient would be difficult for a physician, faced with a patient that believes they are being religiously challenged through their illness. But Padela said that a closer understanding of Islam refutes these fatalistic notions, and that most Muslims agree that health issues are best confronted with a combination of spiritual and medical healing.
“God also says to take care of your body, and that means you have to go to people in this world,” said Padela, who conducted the research as a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan. “Doctors are a part of that, but only a part. Imams play a big role in healing, in the sense that they help you understand disease and illness.”
However, this dual approach to healing also carries frustration for many Muslims. A patient might go to the hospital for procedures and a mosque for spiritual guidance, but rarely do the two worlds intersect. Hospital chaplains trained to address the spiritual issues of Muslims are a rarity, Padela said, and imams visiting patients in the hospital may not be familiar enough with medical issues to offer fully informed advice. As a medical student, Padela himself would occasionally fill in as an imam, offering guidance and leading prayers when no other Islamic scholar was available.
Along these lines, many of the recommendations suggested by focus group participants and listed in the report are focused on opening lines of communication between mosque and medicine. Imams could be invited to help create programs of cultural sensitivity for hospital employees, educating them about the unique perspectives and health care needs of American Muslims. In the other direction, medical awareness campaigns specifically tailored to American Muslims can be created for use at mosque services and other religious gatherings, educating both imams and their community. Padela suggested that physicians and imams could collaborate on a series of sermons that instruct Muslims on what their religion compels in times of illness.
“If hospitals go to the community and have that mutual learning process, it will help the community and help the patients at the bedside,” Padela said.
For more on the findings of the report, download the pdf at the Institute for Social Policy & Understanding website. You can also watch a series of videos from a recent conference on Islamic Bioethics organized by Padela earlier this year.