Improving Clergy Health

Caring for the myriad needs of a congregation can leave little time for clergy to tend to their own well-being, which ultimately can lead to burn-out or less effective ministries. In 2007, The Duke Endowment awarded a $12 million grant to Duke Divinity School to assess the overall health of United Methodist pastors in North Carolina and to develop a program that meets their needs. Through that Clergy Health Initiative, leaders wanted to give clergy the tools they needed to focus on their spiritual, mental and physical health.

Spirited Life, a two-year holistic wellness program and behavioral health study, grew from that initiative. With additional funding from the Endowment for development and implementation, the program served more than 1,100 United Methodist clergy in North Carolina with impressive results.


Studies indicate that clergy are among the nation's most overworked people, and that the long hours and constant stress of the job weigh on their health and lead to many pastors failing to take care of themselves. Another factor: The average age of clergy is rising, which brings with it more health issues.

A national survey of more than 2,500 religious leaders conducted in 2002 by the Pulpit & Pew research project on pastoral leadership based at Duke Divinity School found that 76 percent of clergy were either overweight or obese, compared with 61 percent of the general population. Only 20 percent of pastors in the Western North Carolina Conference of The United Methodist Church and about 30 percent of pastors in the North Carolina Conference had annual physicals in 2006.

Beyond the cost to the well-being of the men and women who answer God's call to serve the church, there is a rising economic cost involved: The Western North Carolina Conference spent $7.5 million in 2005 on health care benefits for some 1,000 ministers. The cost of care to the same number of clergy rose to $8.7 million in 2006.

The challenge for the church as a whole is to reverse the trends at work in the faith community, so that clergy have the space to attend to their well-being.


The Duke Endowment helped establish the Clergy Health Initiative in 2007 with a $12 million grant to Duke Divinity School, kick-starting the seven-year project. The Divinity School collaborated with the Western North Carolina Conference and the North Carolina Conference of the United Methodist Church to implement the project. 

Initial Research

In 2008, the Clergy Health Initiative conducted focus groups as well as a baseline survey of all United Methodist Clergy in North Carolina that garnered a 95% response rate among the 1,820 eligible pastors. Findings from these studies indicated that United Methodist clergy in North Carolina are more likely to suffer from obesity, chronic disease, and depression than other comparable state residents. 

The study also underscored the factors in the lives of clergy that expose them to greater risks of poor health, not all of which are under the pastors’ control.  These include pressure to live up to their call to ministry, relational stress, relationships that prioritize the giving of care over receiving it, a sedentary job, and pressure to live up to overly high and varied expectations set by others. The influence of congregations and the denominational polity is so strong that pastors’ efforts to be healthy are often enhanced – or thwarted – by the institutions in which they serve.

Moreover, clergy often perceive themselves to be healthier than they actually are.

The Clergy Health Initiative repeated this survey in 2010, 2012, and 2014, forming a longitudinal view of clergy health.

Early Interventions

In 2008, 28 district superintendents attended a Life of Leaders health immersion program in Memphis, Tenn., that included a medical examination, nutrition and financial information and a covenant in which participants established a personal accountability process they pledged to follow.

The idea was for them to bring back home the goal of personal accountability for their clergy.

In 2009, the Clergy Health Initiative launched a pilot intervention program with 81 pastors in two United Methodist districts in North Carolina, who received physical exams, lab screenings, a small monetary grant, and a series of health coaching sessions over a 12-month period.

Spirited Life

Spirited Life, designed specifically for pastors, provided resources for spiritual renewal, stress management, and mindful eating and exercise, buoyed by coaching and support from a wellness advocate.

Screenings – including height, weight, blood pressure, glucose, and cholesterol – tracked participants before, during and after the program. Small incentives helped them maintain their goals. 

Some 64% of the 1,756 eligible United Methodist clergy in North Carolina enrolled in Spirited Life in the fall of 2010.  Because of the research model, the 1,129 enrollees were divided into three groups that received services on a staggered basis: Group 1 (2011-2012), Group 2 (2012-2013), Group 3 (2013-2014).  Group 3 functioned as the control group: Those pastors began to receive services after Group 1 concluded the program.

Direct service has ended, but the initiative remains active through data collection, research and dissemination.

Participating Sites in North Carolina

  • Duke Divinity School, Durham
  • North Carolina Conference, United Methodist Church, Raleigh
  • Western North Carolina Conference, United Methodist Church, Charlotte


Area of Work

  • Clergy leadership

Program Area

  • Rural Church

Grantmaking Status

The Endowment is continuing to work through current grantees and is not accepting new applications.

Areas of Work

  • Prevention and early intervention for at-risk children

    To equip children and families with skills to ensure that children reach developmental milestones to lead successful lives.

  • Out-of-home care for youth

    To drive child welfare systems toward greater accountability for child well-being.

  • Quality and safety of health care

    Improving the quality and safety of health care delivery

  • Access to health care

    Improving health by increasing access to comprehensive care

  • Prevention

    Expanding programs to promote health and prevent disease

  • Academic excellence

    Enhancing academic excellence through program and campus development

  • Educational access and success

    Increasing educational access and supporting a learning environment that promotes achievement

  • Campus and community engagement

    Promoting a culture of service, collaboration and engagement among schools and communities

  • Rural church development

    Building the infrastructure and capacity of United Methodist churches to enhance ministry and mission

  • Clergy leadership

    Strengthening United Methodist churches by improving the quality and effectiveness of church leadership

  • Congregational outreach

    Engaging United Methodist congregations in programs that serve their communities