Health risk factors among the Amish: results of a survey.

The Amish are a unique societal subgroup deliberately setting themselves apart from the modern world through religious beliefs and practices. Few reports and no systematic studies have been conducted on Amish health behaviors. A representative sample of 400 Amish adults residing in Holmes County, Ohio, were interviewed using the Behavioral Risk Factor Survey (BRFS). For comparison, a representative sample of 773 non-Amish adults responded to the same survey through telephone interviews. Prevalence of self-reported hypertension was lower among Amish than non-Amish, obesity was greater among Amish than non-Amish women but similar among men, and stress responses were more prevalent among Amish than non-Amish. While some differences between groups could be influenced by response biases, many are supported by less systematic observations of Old Order Amish societies. Patterns of health behavior reflect characteristics of Amish culture and may be responsible for certain favorable mortality rates among the Amish population. Need for cultural sensitivity is evident in health promotion program design and implementation.