Dust and Breath: Faith, Health—And Why the Church Should Care About Both
Reviewed by Max A. Hunter, Biology, Seattle Pacific University
In Dust and Breath: Faith, Health—And Why the Church Should Care About Both, Kendra G. Hotz and Matthew T. Mathews offer a provocative analysis of the relationship between church life, theology, health, and social structure. Through insightful arguments and engaging accounts, the authors elucidate the relationship between physical (dust) and spiritual (breath) health, which has implications for both the innate dignity of the individual and broader social issues impacting health and social inequalities. In the preface, the authors tell the story of Scott Morris, who inspired the book. With a holistic vision for ministry, he pursued degrees in medicine and divinity, and then accepted an associate pastor position in Memphis, Tennessee. Recognizing the profound health and spiritual needs of the community, he established the Church Health Center, a ministry that serves over 40,000 patients a year. This book goes beyond explaining Morris’ holistic approach to ministry to analyzing what Harvard professor and physician Paul Farmer has written on the implications of structural violence and human rights for evangelism.
Dust and Breath consists of three brief chapters interpolated with excerpts from Morris’ journal and the stories of those benefitting from his ministry. The first chapter, “Dust and Breath,” draws on the first two chapters of Genesis to make a biblical argument for the healing care of human bodies and spirits. According to Hotz and Mathews, “Health refers to the presence of a comprehensive set of conditions that promote human flourishing and are anchored in our environmental, social, and vocational lives” (30). The second chapter, “Finitude and Sin: Returning to Dust and Coming Undone,” delves deeper into personal stories as a means to depict the individual in holistic terms: as embedded in human relationships and broader social structures. The final chapter, “Redemption: Our Bodies and Our World Remade,” sets out the solution to narrow-minded thinking about faith. Hotz and Mathews argue that “faith and health, salvation and healing belong together” (72). The ability to perceive a more holistic gospel has implications for rethinking both church outreach and issues affecting personal piety and health.
One of the core arguments of Dust and Breath is that
neither dust alone nor breath alone makes us who we are. Our bodily identity and spiritual identity are integrated and inseparably united. … We are ensouled flesh and enfleshed souls—whole selves whose spiritual identity and bodily identity are inextricably interwoven to form the singular fabric of who we are. (3)
Hence, Hotz and Mathews contend that “rather than thinking of health as the absence of disease, the Bible encourages us to think of health as the presence of the conditions necessary for us to flourish, to become what God intends for us” (12). These conditions include an environment suited to biological and psychological health to promote flourishing, recreation throughout the different areas in our lives, companionship and acceptance, pursuing a vocation as an image bearer of God, and finally, diverse forms of sabbath rest to “reground us in the grace-filled, life-giving rhythm established by God and by so doing contribute to health in body, mind, and spirit” (24). By examining the dietary and health needs, vocations, and recreation of poor children, the elderly, and an undocumented worker, Dust and Breath offers an account of an embodied life that is responsive to the broader sociopolitical reality.
Although the opening chapter of the book focuses on the Bible and its implications for humans as embodied and social creatures, the following two chapters are more interested in structural implications for well-being and social justice. Chapter 2 tackles the relationship between finitude and sin. In brief, human beings are limited and sinful creatures. This means that God’s divine wisdom, our natural environment, and our social realities constrain human agency. Hotz and Mathews are interested in the role that sin and sinfulness, broadly written, have in compromising our health. In the Christian tradition, these terms remind us that there are “individual choices and behaviors that are displeasing to God and for which we should be judged” (41). Acknowledging that risky behaviors often lead to poor health outcomes, the authors tie sin to “deeper patterns of brokenness and distortion in which we all participate” (41). In this context, we recognize that our fleshly nature distorts our lives. Yet, reducing poor health to a number of sinful choices obstructs our ability to recognize the complexity of the human condition.
Dust and Breath suggests that clergy, church members, and clinicians must embrace their finitude and propensity to sin in order to develop the humility needed to refrain from judging those who have compromised their health due to risky behavior and in order to spread the gospel of grace. Grace opens the door for health education and the recognition of personal patterns that lead to poor health. Through reflection on these patterns, those with compromised health can begin to change their behavior. In this spirit, Hotz and Mathews call churches to encourage exercise and good nutrition, as well as open their doors to health campaigns.
In order to develop a deeper understanding of the relationship between health, finitude, and sinfulness, on both individual and social levels, the text probes the deeper structures of human sinfulness and social structure of our sinfulness. On an individual level, idolatry and excessive self-reliance are characteristic of human sinfulness. Self-reliance is equated with attempting to “overcome our dependence on God and become utterly self-reliant” (50). In pursuing the good life and self-rule, we neglect to care for our bodies and our communities and fail to recognize God’s life-giving presence. Despair is another sinful response to the human condition, revealing fatalism and a resignation that our situation is beyond our agency and the power of a sovereign God. For example, acquiescing to circumstances leads marginalized youth to accept self-fulfilling prophecies of low expectations, leading to consequences such as teen pregnancy and gang activity. As in the case with excessive self-reliance, the answer is to uncover the deep structures of sin, and turn toward God. Hotz and Mathews admonish pastors, congregations, and healthcare providers to use information and accountability to empower patients to change their health and life conditions.
Dust and Breath, however, calls the reader to go beyond thinking of sin as a personal issue. We are social beings involved in communities, broader networks, and sociopolitical systems. Individual sin impacts the functioning of this structure. Hotz and Mathews explain,
The same sinfulness that warps the patterns of the individual human heart gets woven into society’s deep structures so that sinful patterns of action are perpetuated sometimes even without the intention of members of that society. (59)
One finds the manifestation of this sinfulness of human nature in economic, health, and immigration policies. Housing discrimination and sub-prime lending are examples of public policy and laws that have led to disparities in health outcomes. The authors note:
Even today when segregation has officially ended, we find the legacy of generations of racism in the educational, economic, and health disparities that persist between black and white Americans. … Racism is a sin that negatively affects nearly every aspect of life for African-Americans, and this is true regardless of whether individual people are themselves racist. (61)
Racism illuminates the relationship between individual sinfulness and structural sin by demonstrating that one group’s belief about another group can get encoded into institutional practices. In the end, structural systems inform the social determinants of health. For example, humans are designed to respond to adversity through the “fight-or-flight” response. The need for African-Americans to negotiate hostile social terrain elevates their body tension, which compromises their immune system and makes this group vulnerable to chronic disease and mental illness. This reality is represented in statistics indicating disparities in morbidity and mortality for African-Americans.
In chapter 3, “Redemption: Our Bodies and Our World Remade,” Hotz and Mathews deploy the Church Health Center to encourage their readers to reimagine the relationship between piety and wellness. The authors write:
When most of us think of the personnel and equipment needed for ministry of the church, we think about pastors and deacons, a pulpit and pews, a table and font. We imagine a church building designed for worship and filled with hymnals and Bibles. In Memphis, Tennessee, you can find a church like that, St. John’s United Methodist Church. … Directly across the street you will find its Wellness Center campus. Both the clinic and the Wellness Center are ministries supported by St. John’s and other local congregations. (72)
In brief, St. John’s collaborative and holistic approach is that Christian leadership must move beyond dichotomous thinking regarding church and health. The church must attend to both salvation and healing. Faith and health illuminate the relationship between dust and breath. Hotz and Mathews remind the church that “we are dust-and-breath creatures, the living image of God. We cannot care for the image and neglect the life any more than we can touch the dust and not honor the breath” (73). Marvin Stockwell, communications manager at the CHC, tells the story of Rosie. She arrived at the Wellness Campus with serious health issues related to obesity. Rosie’s weight hovered near 400 pounds. Having lost nearly 70 pounds due to a crash-course diet, she needed support to deal with her emotional needs and expand her dietary knowledge. The CHC provided a structured environment in which she could change her behavior to improve her bodily and spiritual health. The authors conclude, “Rosie’s transformation is also one of spirit. Rosie has to love herself as a beloved child of God” (79). This story reminds us that salvation, broadly speaking, involves healing, restoration, and making the individual whole in this life, not just the one to come.
In the end, Hotz and Mathews call for much more than a holistic approach to ministry. Their multifaceted ontology of the human being, based on the apocalyptic narrative in the scriptures, seeks the transformation of the present-day world order. The new order leads to shalom, or peace, a world in which “we inhabit a healthy environment with clean air and water, engage in meaningful work, and enrich other’s lives through companionship” (86). This biblical vision is provided as a blueprint to guide our work in building the kingdom of God. The apocalyptic vision outlined in the Bible requires the cessation of human conflict and a broad-based justice including humans, creatures, and the environment flourishing in harmony. Hotz and Mathews write:
In shalom, human flourishing does not come at the cost of the well-being of others. Instead, life is lived interdependently and in mutually enriching ways. We inhabit a healthy environment with clean air and water, engage in meaningful work, and enrich other’s lives through companionship. (86)
This vision for the redemption of creation appropriates in the biblical narrative hope for both humans and creation. As a member of the John Perkins Center for Reconciliation, Leadership Training, and Community Development, I have embraced Perkins’ holistic vision for ministry and human flourishing. As a global community activist, his vision resonates with the value for recognizing the sinfulness of extreme self-reliance, as described in Dust and Breath. Hotz and Mathews explain, “The body of Christ flourishes when each community contributes what it can and draws from others what it needs” (92).
Over the last four years, I have been both working on issues in the city of Seattle, and teaching on ethics and justice in SPU’s biology department. Our course on issues and values in biology involves discussing the principles of bioethics, reproductive technologies, stem cell research, and environmentalism. And for four years, I have longed for a book like Dust and Breath – that is, a book that would allow me to make the connections needed for students to apprehend a more holistic vision of Christian morality and biblical justice. Hotz and Mathews have provided the perfect tool for inculcating my students with a vision for health care as a Christian mission, founded in critical social analysis and sound biblical thought.