Physical health conditions of the Amish and intervening social mechanisms: an exhaustive narrative review

ABSTRACT

As an ethnic religion, the Amish are of interest to population health researchers due to a distinctive health profile arising from ethnic attributes, including a closed genetic pool and shared culture that shapes lifestyle practices. Amish-focused health research both furthers our knowledge of health conditions by comparing Amish with non-Amish and assists health practitioners in serving this rapidly growing population. Amish health research, now representing approximately a quarter of all Amish-focused publications, is in need of review, to the end of strengthening this knowledge body’s coherence, clarifying research directions, and identifying knowledge gaps, lapses, and stagnations. Herein, we synthesize and discuss Amish physical health conditions research, both the population’s distinctive health profile and mechanisms shaping this profile. Specifically, we summarize research addressing BMI, physical activity, and body image; diet and supplements; cancer; cardiovascular conditions; communicable diseases; immunity; sleep; genetic disorders; tobacco and alcohol use; periodontal conditions; traumatic injuries; natural treatments for burns; fertility; and sexually transmitted diseases. In reflection, we raise questions about the nature of intervening mechanisms shaping the Amish health profile, the strange omission of several common independent variables commonly used when studying other ethnic groups’ health, several recurring methodological complications, and public health policy considerations.

KEYWORDS:

• Synthesis
• rural health
• population health
• Anabaptist
• religion and health

Acknowledgements

The authors completed substantial work on this manuscript while affiliated with Truman State University. Potts acknowledges a Truman State University GIASR grant for support of her summer 2018 work. We further acknowledge Rosanna Hess, Karlin High Alyssa LaFever, Molly Thal, and Alicia Wodika for comments on drafts.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 This study’s sample was 52% Amish and 48% Old Order Mennonite.

2 Non-response rates for the Arthur and Holmes studies were 40% and 63%, respectively; Wenger et al. (63) expects that households with greater objections to vaccinations were probably less likely to reply.

3 According to the CDC, as of 2016, 15.5% of all adults in the United States were current smokers, with 17.5% of men being smokers and 13.5% of women; see https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

4 Whether the non-Amish comparison group was one with similar educational attainment or all levels is unclear.

Additional information

Funding

Anderson acknowledges recent assistance from the Population Research Institute at The Pennsylvania State University, which is supported by an infrastructure grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD041025) and a training grant on Social Environments and Population Health (T32HD007514).