Population Health

As a spatially concentrated, rapidly growing rural ethnic religion, the Amish require particular consideration for the promotion of public health and safety.

Responding to this need, Dr. Anderson has undertaken several research projects. He has scrupulously synthesized a corpus of 246 Amish health publications, articulated major causes of buggy crashes, empirically established that Amish have lower COVID-19 vaccination rates, disaggregated cultural-religious dynamics in Amish-internal disagreements about mental health care, and critically analyzed the historic production of knowledge in Amish-focused health research. His analyses rely on a mix of qualitative and quantitative methods pulling from census data, originally collected field data, public records, and ongoing participant observation.

With many years among the Amish and in public affairs, Dr. Anderson’s studies make highly insightful recommendations for healthcare outreach, policy, and future research. As such, Dr. Anderson’s research has enabled more informed outreach efforts that respectfully account for Amish perspectives while also noting potential public health impacts. His multifaceted, interdisciplinary approach to complex issues is informing efforts to improve population health outcomes.

Project: Amish Population Health Review Series

Dr. Cory Anderson, with former research assistant Lindsey Potts, offer a milestone series of syntheses on Amish health/wellbeing, focusing on health conditions, healthcare services, religion, and ethnicity.

Five articles provide indispensable direction not only for Amish-focused
health scholars, public health officials, and service providers but for anyone broadly interested in how ethnic religiosity shapes health/care.

The series highlights many open questions about how cultural context intersects with Amish community health, where more nuanced mixed methods research is needed. But it also identifies some consistent areas of health strength and vulnerability with implications for education, policy, and service provision. Research recommendations emphasize addressing theoretical and methodological limitations, increasing interdisciplinary collaboration, and applying health research to best serve the needs of growing Amish communities through culturally appropriate interventions and resources.

  • Amish have lower rates of various cancers compared to non-Amish populations, possibly due to lifestyle factors, although Amish women have higher rates of breast cancer
  • Evidence on Amish cardiovascular health is mixed, with some studies showing lower and some higher rates of conditions like hypertension and heart disease compared to non-Amish
  • Amish have higher rates of some rare genetic disorders due to a closed genetic pool and high degree of endogamy
  • Amish lifestyles tend to promote higher levels of physical activity, which may contribute to lower obesity rates, especially among children and younger adults
  • Amish diets, while still high in fats, include more raw and homegrown foods than typical American diets
  • Mental health conditions may be underdiagnosed in Amish populations due to cultural factors and stigma
  • Amish show much interest in complementary and alternative medicine (CAM), especially for chronic conditions, and make wide use of chiropractic care, reflexology, and supplements
  • Attitudes toward preventative health services like screenings are mixed; additional education may be needed to promote utilization
  • Injuries remain very common among Amish, especially children, due to exposure to animals and farm equipment; safety recommendations receive a mixed reception
  • Cultural attitudes, focus on natural remedies, cost concerns, and transportation issues act as barriers to accessing professional healthcare
  • Amish prefer paying for healthcare through personal funds and private Amish church-based sources instead of state and commercial insurance programs
  • The center of Amish health research since around 1990 has been cultural competency-focused studies, though healthcare services would benefit by considering additional service perspectives
  •  Employ more explicit social theory when analyzing and explaining health differences, not just applying broad cultural characteristics of Amish to explain study findings
  •  Identify and test specific explanatory mechanisms linking components of Amish ethnicity to health outcomes
  •  Collect more systematic data allowing for Amish/non-Amish health measure comparisons
  •  Measure and analyze standard health determinants often omitted in Amish studies such as socioeconomic status, access to care, education
  •  Conduct more multi-site, multi-affiliation studies to disentangle settlement-specific variables from Amish population-wide mechanisms
  •  Justify and be more precise about defining the ‘Amish’ population under study; what defines ‘Amish’?
  •  Increase mixed methods designs pairing qualitative cultural analysis and quantitative health outcome data
  •  Develop Amish-specific summary measures of population health and health inequalities
  • Create more opportunities for collaboration across social sciences, public health, genetics, clinical medicine
  •  More deeply review certain topics with focused literature reviews
  •  Increase now-lagging research in injury prevention and mental health measurement
  •  Monitor healthcare financial trends and usage of public health programs
  •  Translate health findings into educational programs and policy recommendations tailored to Amish

Project: Buggy-Motor Vehicle Crash Studies

Mobilizing originally collected data, public records, and court documents, Dr. Anderson has moved buggy crash research forward by characterizing major buggy/motor vehicle crash scenarios, analyzing the combination of variables that lead to crashes, raising questions about the “quick fix” of increasing rear buggy markings, and documenting the higher risk of crash during sunrise/sunset. While much research comes from his M.A. thesis in Urban & Regional Planning, Dr. Anderson remains active in evaluating road safety legislation, working with stakeholders including Amish and safety experts, and addressing the press about buggy crashes.

Other Health Studies

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