Fertility, migration, and mortality in an old order Amish community.

Mortality, fertility, and migration data were used to identify population structure in a group of Old Order Amish living in New York State. Two thousand and sixteen individuals were accounted for since the community was first formed in 1948 and this is nearly total ascertainment of the population. Further, ethnography compared Amish households to neighboring non-Amish households to understand differences in health beliefs, caregiving patterns, and economic strategies. Despite evidence that suggests that the Amish have health risks comparable to U.S. population and that they under-utilize health care, this study demonstrates that Amish age standardized death rates are 19% below the U.S. death rate in 1960. Natural fertility combined with low infant mortality, migrating to form new communities when population density increased, and selective but appropriate use of western biomedicine have emerged as strong cultural patterns that facilitated reproductive success and longevity among the Amish. Am. J. Hum. Biol. 10:619-628, 1998. © 1998 Wiley-Liss, Inc.