What We’re Learning

What we're learning

Pastors work within a complex web of relationships — peer, family, congregation, and denomination among them — with sometimes conflicting demands that have repercussions for pastors’ vocation and health. In that web, the influence of congregations and the denominational polity is so strong that pastors’ efforts to be healthy are likely to be enhanced — or thwarted — by the institutions in which they serve.

The information in the tabs below provides an overview of our initial findings.  Through our wellness intervention, Spirited Life, we are exploring ways to improve the health of United Methodist clergy.

Download our published research papers.

Read more about our findings at Faith & Leadership and Duke Today:


In 2007, The Duke Endowment funded Duke Divinity School to assess and improve the health of United Methodist clergy in North Carolina.  Since then, we have:

  1. Launched a longitudinal survey of all United Methodist clergy in North Carolina, which occurred in 2008, 2010, 2012, and 2014, and will occur again in 2016.  
  2. Conducted focus groups on holistic health with diverse subsets of pastors and clergy supervisors, and interviews with pastors on stress and positive mental health.
  3. Collected survey and biometric data at 4 to 8 time points from over 1,100 clergy participating in Spirited Life, a randomized controlled trial testing a two-year holistic health intervention.

With these data, we are able to discern a fuller picture by combining the experiences of clergy in their own words with the survey responses of large numbers of clergy. We can also compare the responses of clergy to those of the general population or people in other occupations. 

Spiritual Vitality

We found that existing measures of spiritual well-being do not work with clergy because they often are based on frequency of prayer and church attendance. We partnered with Bishop Kenneth Carder to create and publish the Clergy Spiritual Well-being Measure. We have administered this measure to over 1,700 clergy and have found that it is able to assess changes in spiritual well-being for individual clergy across time. Our findings indicate that a pastor’s spiritual well-being corresponds nearly 100% to that person’s mental health; we have not found anyone with strong spiritual well-being and poor mental health or vice versa.

Physical Health

By comparing the self-reported health diagnoses of clergy to those of a representative sample in North Carolina, we have learned that clergy have a particularly high rate of obesity – 41% - compared to just 29% of North Carolinians, even when demographic adjustments are made. Not surprisingly, then, clergy also have above-average rates of diabetes, high blood pressure, asthma, and arthritis.

We conducted health screenings with more than 1,100 clergy in 2010 and found that over 35% qualified for metabolic syndrome, which is characterized by a large waist circumference plus at least two of the following: high blood pressure, blood values indicating probable diabetes, raised triglycerides, and lowered HDL. Having metabolic syndrome puts one at risk for stroke, heart events, and even death in the next year. Fortunately, through Spirited Life, our two-year health intervention, we managed to significantly lower the rates of metabolic syndrome in UMC clergy in North Carolina.

One bright spot in the physical health of clergy is that only 5% of clergy are current smokers, compared to 18% of North Carolinians. Not smoking is particularly important in the face of metabolic syndrome risk factors.

What the physical health findings mean

We are continuing to study why pastors’ rates of chronic disease and obesity are higher than those of their non-pastor peers. This fact may be due to:

  • The challenging aspects of the pastors’ vocation
  • The way pastors view physical health. Despite the number of diagnoses these pastors reported having, overall, they also reported having better physical health functioning than their peers across the United States. Overall, they felt that their physical health was not getting in the way of their work and social activities. It could be that these pastors are so attuned to their spiritual life and enacting their strong calling that they neglect warning signs of their physical health.
Mental Health

We have found that clergy have both high rates of depression and high rates of positive mental health, also called flourishing.  How can this be?  As individuals, we each experience mental illness on one continuum, and positive mental health on a separate continuum.  It seems that pastors are high on both – they hold the emotions of funerals and weddings, of crises and joyful healing. We are currently analyzing data from in-depth interviews with 52 clergy on how they sustain positive mental health in the face of challenging clergy work.

From our longitudinal survey, we have identified several factors that affect both positive and negative mental health in clergy: financial stress, congregant demands, life unpredictability, and lack of social support. Ameliorate these conditions among clergy, and it’s likely that mental illness will decrease and positive mental health will improve.

Working to reduce clergy depression is critical. UMC clergy in NC had the following depression rates in 2008, 2010, and 2012, respectively: 11.1%, 10.5%, and 9.6% (the U.S. national average was 5.5% in 2008). Over 7% of clergy had survey scores qualifying them for both depression and anxiety. Fortunately, in their lifetime, 43% of clergy reported having sought mental health services, and in the past year, 15% of clergy reported receiving treatment for depression, anxiety, or stress.

However, this is not solving the problem. National mental health research suggests that the best way to address depression is to prevent it by promoting positive mental health. Our longitudinal survey showed that three things uniquely relate to positive mental health in clergy:

  1. Congregants showing support for their pastor as an individual (and not just as a pastor)
  2. Clergy supervisors expressing thoughtfulness over the pastor’s next church appointment
  3. Congregations that are open to new experiences and that welcome outsiders