Covered by the Blood; Spiritual Determinants of Health vs The Social Detriment to Health

The Prince of Third Ward

Holman Street Baptist Church (HSBC) is located in the Historic Third Ward of Houston Texas. It is the church where I experienced a spiritual awakening and received my call to the Ministry over 40 years ago.  However, I had not attended since I left Houston to pursue my M.Div. degree at Perkins School of Theology. After retiring from Houston Graduate School of Theology, my father in the ministry and mentor Dr. Manson B. Johnson recruited me to help him build a state-of-the-art Medical Wellness Center in the heart of Third Ward which is a largely poor African American Community.  Rev Manson Johnson known as the Shepherd Teacher had pastored Holman Street for 42 years and was known by many as the Prince of Third Ward.  He had led Holman Street Baptist Church during his time to address the so-called social determinant of health. Over the 42 years, HSBC had acquired nearly 9 acres of land in the Third Ward. On this land, HSBC build quality low-income housing and created an Eastside University which offers computer training, GED, literacy classes, ESL, daycare, early childhood education, and mentoring. His crowning legacy would be to address the rampant health disparities by building a Medical Wellness Center. The Medical Wellness Center would bring medical skills of the world-famous Texas Medical Center to Ward via telemedicine, nutrient training, workout facilities, dental services, swimming pool, indoor track, and so on. It was to be his final gift to Third Ward.

Third Ward is located adjacent to downtown Houston and only several miles from the largest medical center in the world Texas Medical Center. Also located in the Third Ward in one of the nation’s largest historically black colleges, Texas Southern University. Which was created to prevent black students from attending the University of Houston only three or four blocks away.  The University of Houston launched a new Medical College in 2019.

The Shepherd’s Blood-Holman Street Baptist Church

In February 2020, Shepherd Teacher and I presented the plan and justification to an influential group of bankers, architects, community leaders, press, University of Houston Medical School, hospital doctors, and administrators. We were about to launch the first phase of planning in March 2020 when the news of COVID19 became a national concern.  This is when I first heard the Shepherd of HSBC begin to proclaim that he and HSBC would be Covered by the Blood. He began to plead the Blood over the congregation. The Shepherd’s first concern was over the panic and fear that began to grip the church and the community. He refused to close down the church or interrupt any of his plans. I have worked in the nexus between Public Health and the faith community my whole career.  This turn of events disturbed me and expressed my concern to the Shepherd privately while wearing a mask and social distancing as best as I could. However, the most intelligent and caring man I have ever known continued to proclaim the Blood until the city of Houston closed everything down. Streaming his message now, as Easter approached the Shepherd began a series on the Passover where he preached on the quarantine and the blood of the lamb. As we began to explore the Last Supper of Christ, the Cup of Blood took on new metaphorical significance in the midst of the pandemic.  The Book of Revelation and great tribulation began to be equated to the year 2020, with wildfires in California, the killer hornets, the hurricanes, and President Trump as the anti-Christ those who survived had their robes washed in the Blood. 

Early Sunday morning May 19 2020 I received a call from one of the young ministers that Shepherd Rev Dr. Manson B. Johnson died of COVID-19 complications

Homan Street Baptist Church closed its buildings and started streaming all its services. HSBC formed a COVID19 task force that seeks to encourage the congregation and community to wear masks, social distance, and wash hands frequently. It joined with several other neighboring churches to distribute masks and food. It supported the local elementary school and high school in it back to school efforts.

The Social Detriments to Black Health

For Third Ward, the social conditions for a majority of its residents, have been a detriment to black health. The root causes of poverty and racism are the primary causes of social stress which undermines Black Health in the Third Ward.  These detriments are manifested in poor housing, poverty, miseducation, medical exploitation, public health neglect, and mass incarceration.


The total population of the Greater Third Ward Super Neighborhood was 14,040 in 2012.  Its demographics are comprised of non-Hispanic Blacks (65%), Hispanics (14%), and non-Hispanic whites (14%).  The median income was $38,936; 54% of annual household income was less than $25,000.  Educational attainment 27% of those 25 years and older did not have a high school diploma.  Of the 6,683 housing units, 30% were vacant

From 2013 to 2014, the Greater Third Ward area had a higher percentage of adults without insurance (34.3%) than Houston (33.2%), Texas (29.1%), and the United States (14.9%), but lower than Harris County (36.9%). The percentages within the Greater Third Ward census tracts ranged from 28.4% to 41.9%. Asthma, diabetes, chronic kidney disease, COPD, stroke, and lack of physical activity were higher than for populations in Houston, Harris County, Texas, and the US.

Health Disparities

The percentages of obesity and high blood pressure were significantly higher among Greater Third Ward residents.  There are higher percentages of poor mental and physical health among adults in Houston, Harris County, Texas, and the Us.  High blood pressure was greater (40.2%) than that for Houston (32.3%), Harris County (29.4%), Texas (31.3%), and the United States (30.2%). The percentages of high blood pressure ranged from 12.6% to 51.4% across the Greater Third Ward census tracts. Diabetes was higher for Greater Third Ward (15.2%) compared to Houston (11.8%), Harris County (11.3%), Texas (10.9%), and the United States (9.4%). The percentages ranged from 14.3% to 20.3% for the Greater Third Ward neighborhood census tracks. Asthma was higher (10.8%) in Houston (8.5%), Harris County (4.6%), Texas (6.6%), and the United States (8.8%). The percentages ranged from 9.9% to 11.5% in the Greater Third Ward census tracts.

The Role of the Black Church in COVI-19

 The Black Church such as HSBC has the opportunity to play a critical role in the midst of a pandemic that threatens Black Health at historic portions. The Black Church has always been the primary source of Black Health in the context of white supremacy, medical and public health malfeasants.  Culture, context, and worldview are powerful shapers of health. Therefore, there is a need for strategic, effective message carriers, between faith communities and government/public health.  The power of the Black Church to shape worldview root metaphor such as being Covered by the Blood of the Lamb who is also the Shepherd. The role of the Black Church is to form the faith of the people who have no greater resource than their faith. In the face of a pandemic where fear grips us, it is our Faith that will make us whole. The spiritual capacities of faith as “expectant trust” are ultimately the determinant of Black Health. This is especially true in the context of the COVID-19 pandemic which has laid bare scars of centuries of social detriments to black health.  Blood is a primary root metaphor in Black Religion symbolic of Faith in covenant with God. Blood is a religious root metaphor in the African American community for the creative life-giving sacred power of God. The power of God to deliver, redeem, and overcome. Let’s examine the concept of religious root metaphor and the health of the black community

Root Metaphor Analysis:

Root metaphors are, according to James Fowler “comprehensive images derived from shared experience, that can be made to serve as generative models by which to orient and ground ourselves in the vastness and complexity of our corporate and personal human lives.”[1]  Thus, root metaphors underlie our philosophies of life, how we make sense of the world, and how we instinctively respond to our environment.

 “Covered by the Blood” is the penultimate metaphorical proclamation of faith by the Black Church.  It Proclaims:

  1. The hope of Deliverance –Passover- Quarantine – Until the plague passes over Exodus 11:12-14

This essay will explore these spiritual themes hope, faith, and love as the determinants of health for a black community under the stress of economic deprivation, social injustice, and medical neglect.

 Faith is the specific form that spirituality takes in a particular individual or group. Faith denotes both the structure and content of a person’s spirituality, both the experience of the person or group (e.g., Trust) and what the person trusts in a physician and vaccines’ or Christ and his Blood. Fear (stress) negatively impacts the immune system according to psychoneuroimmunology.

 Root causes of poverty and social stress are as important to deal with as is the distrust of providers and public health. The need is for medicine and public health to bend and accommodate the community’s culture and needs which are symbolized in its root metaphors.   Culture and worldview are powerful, so the need for strategic, effective message carriers is critical to address systemic distrust and fear.

Metaphor is pervasive in everyday life, not just in language but in thought and action. Our conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature.[2] (Lakoff and Johnson 1980:3).  A metaphor helps us to understand a thing in terms of something with which we are already familiar.  Metaphors provide a cultural worldview that offers meaning, comprehensibility, and manageability in the world for African Americans in normal times that are hard to find. In the midst of a global pandemic, a healthy worldview is even more difficult.  Fear and panic in an already distressed community are as dangerous as the virus itself. When Rev Manson Johnson pleaded the Blood of the Lamb of God Jesus Christ over himself and his people, he was seeking to make the world cohere with a sense of transcendence for people under unbearable stress.

     [1]Fowler, 52.

[2] Lakoff and Johnson, Metaphors We Live By, (University of Chicago Press, 1980) page 3

A Sense of Transcendence: The Spiritual Determinant of Health

Aaron Antonovsky, (Holocaust survivor) understood this stress was the primary source of disease. With this insight, he became one of the principal figures of the mind-body movement.  His research focus was on the survivors of the Nazi death camp. His central understanding that the ability to find meaning in suffering; comprehend the reasoning and context of suffering and; find the resources to manage or endure, reducing the stress on the body. This is what is called “sense of coherence” which was Antonovsky’s central construct that helped to launch the mind-body movement. It was first introduced in 1987 in his groundbreaking book Unraveling the Mystery of Health.[1] 

The sense of coherence is the technical phrase used by Antonovsky.  It encompasses the concept that the world is comprehensible, manageable, and meaningful.  The sense of coherence is the primary point of intersection between spirituality, religion, and health.  Health as well-being is dependent, according to Antonovsky, on a sense of coherence.  It is my hypothesis that a sense of coherence is dependent on a “sense of transcendence,” especially, but not exclusively, for the African American community.  A sense of transcendence refers to the notion that a person exists within and is connected to a context larger than the individual’s experience of the immediate world and physical senses.  The metaphor of the “Blood of the Lamb which is Christ Jesus points, out beyond the self and others is an important source of meaning, comprehensibility, and manageability in a hostile immediate world.  In addition to a sense of coherence, The Blood provides a sense of transcendence: Hope, Faith, and Love.

Covered by the Blood

Hope of Deliverance-Quarantine

The Exodus Story is one of the most important Biblical narratives besides the crucifixion of Christ.  It is a story of the deliverance from slavery. Slavery was the African American holocaust that lasted over two hundred years and whose effects are still being felt today. COVID-19 pandemic primarily impacts minorities and specifically African Americans with an underlying condition. These underlying conditions are the health disparities caused by the social detriments of health which are a result of the legacy of slavery.  The instrument of deliverance was the seven plagues visited on Egypt by God. The Passover story told Exodus 12:1-14, is the story of the blood of the lamb held in quarantine fourteen-day which protected a people with stay-at-home orders. The Blood of Lamb is a root metaphor for Christian African Americans for the critical act of deliverance and protection. This narrative metaphor of The Blood helps provide meaning or purpose for many during trying times. It provides hope for those who seek deliverance from bondage. It provides a story to comprehend God’s activity on behave toward the oppressed during these most troubling times. Finally, offers divine resources of hope and healing that no vaccine could ever provide to manage the devastation caused by COVID-19.  

Faith to Overcome–Personal Protection Equipment

The revelation of the multitude who were able to overcome through the great tribulation in Revelations 6:13-17 reveals the metaphorical power of The Blood of the Lamb. Those whose robes are washed in The Blood have faith to withstand the most severe hard shift. They survived lynching, beating, mass incarceration, poverty, and all-in indecency of Jim Crow segregation with robes white as snow. The Blood is personal protective equipment.

Love for Redemption–Vaccine

 The Last Supper Matthew 28 and transubstantiation of The Blood of Christ is the most powerful metaphor for Love. The Blood represents internalizing antibodies against sin and guilt. It is a vaccine against internalized oppression.  It provides the spiritual vaccine to resist and manage notions that somehow the oppressed victims are not worthy. It assures them that they are Loved.

The role of the Black Church was to create what Aaron Antonovsky would a Salutogenic framework.  During COVID, to be covered by The Blood is to provide a sense of coherence to reduce stress and a sense of transcendence to provide hope. That makes faith possible as expectant trust. Provides the greatest purpose in life Love.

[1]Aaron Antonovsky, Unraveling the Mystery of Health: How People Manage Stress and Stay Well, (San Francisco: Jossey Bass, 1987).

Social Detriments vs Spiritual Determinants

 This pandemic has exposed the impact of centuries of racial discrimination that created the underlying conditions that have resulted in devastating results. The distrust in the vaccine is only evidence of deep-seated internalized oppression that compounds the suffering of our most vulnerable communities. However, there is great strength and resilience within these communities. The question is not why the African American people are so sick?  But how is it that they are so healthy given the last 400 years of public health neglect and medical malfeasants?  If asked, most African Americans will exclaim, “it is their faith?” Trust in the Blood of the Lamb. “Covered by the Blood” is a root metaphor for physical and spiritual deliverance and well-being.  Our conversation is about the merging of Faith and Health. The African American church (as flawed as it is) and despite its present decline in influence, is still the most trusted and influential institution in the African American community. We want to assist in the mobilization of the Black Church to fulfill the role it has always played.  That is to plead the Blood over its people.

 What is a determinant of health is ultimately spiritual not social.  Health is defined by the World Health Association as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This definition of health under the racist conditions in which many African Americans find themselves requires more than the improvement of social conditions. It requires spiritual determinants of Hope, Faith, and Love. Hope provides positive mental and physical outcomes such as greater happiness even in tough times. It lowers stress that is according, to Aaron Antonovsky’s “Unraveling the Mystery of Health” which is the primary cause of disease. Hope is the basis of Faith or expectant trust, according to Thomas Droege’s “The Faith Factor I Healing”, which has a powerful placebo effect on physical healing. However, it is Love the most powerful spiritual determinant of health. Love gives meaning to our lives and makes them worth living. These provide a Sense of Transcendence (Hope, Faith, and Love) necessary for a Sense of Coherence (Comprehensibility, Manageability, and Meaningfulness).  Under conditions of degradation of centuries of racial oppression to be Covered by the Blood provides a spiritual determinant of health in the form of a sacred metaphor of health and healing.

Fred D. Smith Jr Ph.D.

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