Physical Health Conditions of the Amish and Intervening Social Mechanisms: An Exhaustive Narrative Review.

Ethnicity & Health

Anderson, Cory, and Lindsey Potts. 2022.

27(8):1952-78.

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Research Points
  • Comprehensive review of 126 studies on Amish physical health conditions and social mechanisms impacting health

  •  Synthesized research on 14 topics: BMI/activity, diet, cancer, cardiovascular, communicable diseases, immunity, sleep, genetic disorders, tobacco/alcohol use, periodontal conditions, injuries, burns, fertility, STDs
  1.  BMI/Activity:
    ● Amish have lower obesity rates, more physical activity but body image still predicted by BMI
    ● Physical activity linked to occupations and transportation

  2.  Diet:
    ● Amish diet high in homegrown foods but also fat; supplement use is common
    ● Emphasize nutrition but diet does not always match; changes over time need study

  3.  Cancer:
    ● Generally lower cancer rates, but higher for some types like breast cancer
    ● Lifestyle factors like low smoking rates may contribute to lower cancer risk

  4.  Cardiovascular:
    ● Mixed evidence on CVD rates compared to non-Amish
    ● Possible genetic factors but lifestyle like activity also relevant

  5.  Communicable Diseases:
    ● Vaccination rates lower than non-Amish but uptake varies
    ● Disease outbreaks disproportionality affect Amish when immunization is low

  6.   Immunity:
    ● Farm life may bolster immunity through animal exposure
    ● Specific effects seen for asthma risk and gut microbiome

  7.  Sleep:
    ● Wake early, sleep durations shorter than non-Amish, affected by season, age, and heritability

  8.  Genetic Disorders:
    ● Many rare disorders due to founder effect and endogamy
    ● Well-studied with searchable databases created 

  9.  Tobacco/Alcohol Use:
    ● Low tobacco use overall but higher among some affiliations
    ● Very low alcohol use; higher among adolescents

  10.  Periodontal Disease:
    ● Unexpectedly low rates given poor dental care
    ● Possibly diet offers some protection

  11.  Injuries:
    ● Most common injuries reflect lifestyle: animals, falls, buggies
    ● Age and gender patterns exist in injury data

  12.  Burns:
    ● Child scalds common
    ● Burdock leaf therapy used, with mixed evidence of effectiveness

  13.   Fertility:
    ● Very high birth rates, shorter birth spacing than non-Amish
    ● Some better outcomes like lower preterm births

  14.  STDs:
    ● Expected to be low due to marital fidelity norms but minimal research exists

 

  • Identifies gaps in knowledge on social mechanisms of health outcomes, overlooked variables (e.g. education, class, discrimination), methodological limitations of cross-sectional self-reported data, and best policies

  •  Improves Amish serving healthcare provider awareness of population salient genetic disorders, lifestyle practices potentially impacting health, and particular health needs such as injuries, cancer, and infectious disease

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