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In his masterful book Better, surgeon Atul Gawande writes that in the 1950s, newborn babies in the United States faced great danger: "One in thirty still died at birth—odds that were scarcely better than they were a century before—and it wasn't clear how that could be changed."

An anesthesiologist named Virginia Apgar was appalled: "Babies who were malformed or too small or just blue and not breathing well were listed as stillborn, placed out of sight, and left to die." Apgar believed these infants could be saved, "but she had no authority to challenge the conventions. She was not an obstetrician, and she was a female in a male world. So she took a less direct but ultimately more powerful approach: she devised a score."

Apgar gave nurses a way to rate the health of babies at delivery: "Ten points meant a child born in perfect condition. Four points or less meant a blue, limp baby."

This simple score, devised by an unlikely person—she had never delivered a baby, as a doctor or even as a mother—"turned an intangible and impressionistic clinical concept—the condition of new babies—into numbers that people could collect and compare."

And doctors, being both compassionate and competitive, wanted to boost Apgar scores for their newborns. So they began giving babies oxygen or warming them. They switched from giving mothers general anesthesia to spinals or epidurals. They began using prenatal ultrasounds and fetal heart monitors. And what a change: instead of one in every thirty babies dying at birth, today it's one in every five hundred. Virginia Apgar's score is saving the lives of over 100,000 American babies every year.

We need an Apgar score for the church.

As pastors, we care deeply about the health and vitality of our congregations. But how can we grasp congregational health? To use Gawande's words, it's "an intangible and impressionistic" concept. We need a measure that's simple, clear, and life-giving.

Problems with the prevailing metric

Through most of the twentieth century, the prevailing statistic for churches was the number of members. But as younger generations no longer formed their identity in relation to institutions—political party, labor union, fraternal organization, church—membership gradually told less about a congregation's real state. A long-established downtown congregation, for example, might have hundreds on the membership rolls but only a handful in worship.

So beginning in the early 1960s, some denominations began to report on worship attendance, and by about 1975, attendance had become the most widely accepted way to measure a congregation's vitality. Go to any pastors' convention and you'll soon be asked, "How big is your church?" or more crudely, "How many are you running?"

Attendance has hung on now, for almost 50 years, with only minor tweaks. In the 1980s, as well-known congregations added Saturday night services, people began counting "weekend worship attendance." In the 1990s, as ...

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Kevin A. Miller is associate rector of Church of the Resurrection in Wheaton, Illinois.

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Displaying 1–1 of 1 comments

Steve G

March 14, 2012  12:39pm

This is a fine article in that it points out that relying simply on the physical presence of individuals in a church pew on Sunday morning has no relationship to the health of the congregation or the vitality of the congregation's ministry. However, simply picking out some points out of Scripture, without recognizing the context of the situation presented there, or the true message of the text, in order to develop an alternate "Scoring" mechanism for today's church is rediculous. A tried and true, highly effective means of evaluating one's congregation is found in Christian Schwartz' Natural Church Development. Its 8 key factors give a holistic evaluation of a congregation, as well as a 'score' that one can use to evaluate the congregation over time. Cost, about $150 per year. My own congregation has a four year track on each of the 8 factors, and we have found it insightful and effective in developing our ministry holistically.

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