Unser Satt Leit: Our Sort of People - Health Understandings in the Old Order Mennonite and Amish Community

Our cultural orientation informs our fundamental understandings of health. It has the potential to guide how we define health, how we understand the determinants of well-being, and how we respond to illness. For researchers, the recognition of this reality is central to not only how we interpret our findings, but also to the ways in which we develop the approach, questions, and methods central to our research. The Old Order Mennonites and Amish are a culturally, ethnically, and religiously distinct population existing within the North American society. This thesis sought to improve upon previous health-related research on this population by asking several basic questions: Among Old Order Mennonites and Amish, how is health perceived and 'good health' understood? What are the perceptions of the determinants of health? How is illness perceived? What is the response to illness? And how does culture relate to health in the Old Order community? A hermeneutical approach was adopted to address these questions and a qualitative textual analysis of an Old Order magazine, Family Life, completed. To allow the voices of community members to guide understandings, a broad approach to health was adopted throughout the examination of two years of the publication (2001, 2000). Findings indicate that in the Family Life writings health is primarily defined by an individual's ability to fulfill his or her role. A focus on nutrition and reproduction dominated discussions of the determinants of physical health and an individual's relationship with God was viewed by many as the central source of mental health or illness. Emotionally, analysis suggests that individuals may have a range of responses to illness including a desire to accept the experience of illness as a part of God's plan, a struggle to find this acceptance, and the incorporation of community and Divine support throughout this pursuit. Behaviourally, health information appears to be transferred through a variety of mediums including health practitioners, community members, and advertisements. Individuals expressed concern with appearing too quick to seek professional medical care and may incorporate a range of considerations into the decision of whether to begin, continue, or end medical treatments. The textual analysis indicated that a mixture of methods may be adopted for achieving health. Individuals appear to care for themselves through home remedies or non-medical measures (including alternative treatments) for as long as possible. In situations of acute physical illness, however, there appears to be comfort with seeking formal medical care. Amidst limited discussion of a physiological root of mental illness, analysis suggested that the main method of treating mental illness is refocusing concentration toward God rather than the self. In consideration of the cultural understandings guiding these submissions related to health and illness, there were two primary themes. The first is that God determines life and is an active and present force in the lives of individuals. The second theme is that the community responds to this belief in God's defining role in particular ways. More specifically, the Old Order orientation to life which includes a deferment of individual will to that of the authority of God and Community (Gelassenheit) and appreciation for a set of rules guiding behaviour (Ordnung), directs discussions and understandings of health in culturally-unique ways. Overall, this study highlighted the distinct ways in which cultural perspective guides understandings of health and illness within the Old Order community