Public health professionals address problems in our society. This case study is an inductive, bottoms-up approach that begins with understanding how health and wellbeing are created in spiritual communities.  The public health sector has been studying health inequities – avoidable health inequalities between groups. There is a tremendous amount of evidence supporting this notion.

The American Diabetes Association reports that 13.2% of African Americans are diagnosed with diabetes compared to 7.6% of non-Hispanic whites. The complications from diabetes include blindness, lower limb amputations and increased chances of stroke, high blood pressure and kidney disease.

The Centers for Disease Control and Prevention claims that 24% of African Americans die of heart disease. These health inequities have persisted despite the evidence calling for change. Conventional thinking ultimately brings us to the cost to improve health amongst African Americans. But, in this case, there is plenty of money. California alone spent over $5 billion on preventable hospitalization costs mostly due to diabetes complications and heart disease.

Health inequities call for us to suspend our conventional professional thinking and to open ourselves to solutions that may be in place that we are not aware of.

Over an 18 month period I used social action research to study and understand how five African American led churches in Sacramento, Calif., restore and maintain the health of their congregations. I learned that the Pastors of the churches changed their own lifestyles before asking those in their congregation to do the same. This leadership led to positive behavior changes related to buying, preparing and eating food, decreasing and eliminating sugary drinks and drinking more water and juices and becoming more active.

These behavior changes also resulted in a decrease in weight and an increase in energy. While listening to church members, I also learned that some had improvements in blood pressure, hgA1c and cholesterol. The Pastors had created an effective behavior change continuum.

First, they brought awareness as to the lifestyle causes of type 2 diabetes and heart disease. This awareness led to activation in positive behavior change. Once the lifestyle behaviors changed, church led efforts focused on behavior maintenance, and finally, the self-management of health and wellbeing. The Pastor’s have created an evidenced based approach to restoring health and conserving wellbeing.