The American Amish

The American Amish defines culture as: “the sum total of ways of living built up by a group of human beings and transmitted from one generation to another” (Dictionary, 2010).  The Amish people fit this description perfectly.  They have a very concrete set of beliefs and values that guide their way of life and these values have been passed down through generations.

“Come out from among them and be ye separate, saith the Lord.”

(II Corinthians 6:17)


In order to truly understand the Amish culture, it is first important to understand the history of the Amish. The Amish are an offshoot of Christianity originating in Switzerland.  These new believers did not believe in the government involvement of religion or infant baptism as baptism should be saved for consenting adults. The formal separation of this new group occurred on January 21, 1525 when believers re-baptized themselves and the group took on a new name of Anabaptist, meaning to be re-baptized. The Anabaptist group later separated again and led to the formation of the Mennonites.

In 1693 Jacob Ammann led yet another separation from the Mennonites of a more conservative group to be known as the Amish. The Amish did not settle in America until 1737. Today, the greatest numbers of Amish settlements are in Pennsylvania, but Ohio has the largest Amish population in the United States.  Today, the Amish are separated into two major groups, the Old Order and the New Order Amish.  The Old Order Amish are more conservative than New Order when it comes to lifestyle, but both share religious beliefs.

Values, Beliefs & Traditions

Amish lifestyle is vastly different from a typical American lifestyle.   The Amish live according to a set of guidelines known as the Ordnung and follow a system of beliefs that includes: adult baptism; separation of church and state; ex-communication from the church for those who break moral law; living life in accordance to the teachings of Christ; and refusal to bear arms, take oaths, or hold political office (Andreoli & Miller, 1998).  The Amish demonstrate behaviors of humility, and modesty. They also avoid personal praise, manifestations of individualism, or attention seeking activities because of their belief that these behaviors lead to pride and self sufficiency that does not come from the Lord. Their only traces of pride can be seen in their home exteriors, yards, and fancy buggy trimmings and harnesses (Peaceful Societies, 2006).

The Ordnung dictates what is appropriate within Amish culture and what is not. For example, you will not find electricity or telephones in Amish households. In order to avoid electricity, the Amish can use kerosene, gasoline, and batteries to power lights and generators. These generators can power washing machines, water pumps, and agricultural equipment. Windmills are also sometimes used to power machinery. Most Amish, especially Old Order Amish rely on horse drawn buggies for transportation. They also rely on horses to pull farm machinery. Some technologies that Amish do use that are not prohibited by the Ordnung include inline skates, disposable diapers, cell phones, and gas grills. The technologies that Amish use greatly depend on the order that they are a part of. The Swarzentruber order is very conservative and does not allow battery powered lights to be used. The Old Order Amish don’t use modern technology, but they are allowed to ride in motorized vehicles, as long as they do not own them. New Order Amish are more lenient, and allow ownership of automobiles, modern farming machines, and the use of electricity.

The Amish believe in living separate in non-conformity. They also believe in living a simple life with a large emphasis on humility. Their education avoids subjects associated with self exaltation, pride, and enjoyment of power. The Amish believe that God is pleased when people work in harmony with nature, and therefore, they put great value into manual labor and hard work. This is another reason why the Amish always live in rural communities. They view the city as a place of evil and wickedness. Community is of utmost importance to the Amish. They often socialize through helping each other, whether it be through building projects or helping on each other’s farms. Because the Amish do not have life or property insurance, the church will assist in any case of significant loss. The elderly are cared for by the community, and often retire to the dawdyhaus, which is a smaller house that is built next to the main farm house.

In order to become a member of the Amish church, members of the community receive instruction on beliefs and are baptized between the ages of 16 and 24. Once someone becomes a member of the church, they are completely committed to the community and the Amish doctrine and practices. Marriage does not occur until both members have been baptized. Amish traditions are centered around church services, baptisms, weddings, communion, and funerals. Every other Sunday, church services are held in the home of a family within the church district. On the “off” Sundays, members will sometimes visit neighboring services in another church district (Rollins, A.).

Language & Communication

The Amish desire to remain separate from mainstream America has led to the preservation of their ancestral language, which is an old form of High German called Pennsylvania Dutch. Many American Amish do speak English, but most are not native English speakers, so health educators may want to be prepared to use a translator.

Because the Amish believe that new forms of technology draw people away from God and complicate their lives, education and communication should not include the use of telephones, computers or electrical equipment.  Nor should it require driving or other technological methods. Health promotion should present information visually or face to face due to generally low literacy rates among the Amish community.

When communicating with the Amish, appropriate body space should be maintained, and physical contact should be kept to a minimum. In the Amish culture, it is inappropriate for contact between members of the opposite sex. As a result, all nursing care should be performed by members of the same sex if at all possible. Health educators who venture into the Amish community should adhere to modesty practices depending on their gender in order to facilitate the best quality of communication.

Relationships & Social Organization

The organization of Amish society includes the extended family, church districts, settlements, and subgroup affiliations. Family is at the core of the Amish culture, and large extended families provide for a strong support system within the community. The groups of extended families are organized into church districts for governing and fellowship purposes which consist of between 25 and 40 households. As the population grows the districts divide further. Affiliations are formed between church districts who share similar practices and lifestyle regulations. The leaders of districts that are affiliated collaborate in fellowship, and members of the districts are permitted to intermarry. The church districts in a particular region are arranged into settlements. They vary in size, but the largest known Amish settlement in the United States is in Holmes County, Ohio and consists of about 200 hundred districts. Settlements are the highest level social organization because there is no national authority, however the most significant authority remains within the church districts as the Amish are people of strong faith.

Amish society is subject to the rules and regulations of the United States government, but their loyalty lies within the leadership of the Church. They live by the verse “Obey God rather than men” (Acts 5:29). Each district is governed by ordained officials known as servants who have varying levels of authority. Each district has one bishop, a servant with full powers; two to three ministers, “servants of the book;” and one bishop, the “servant to the poor.”  The Amish utilize a method of divine selection known as “the lot” in selecting their leaders. The chosen people who receive a select number of votes from the church members enter the lot. A bible verse is placed inside the cover a hymnbook, and the members of the lot each select from a collection of hymnbooks. The candidate who chooses the hymnbook that contains the bible verse is the chosen leader. These church leaders are always men, but women are involved in the selection process.

Although the Amish are permitted to vote in state and federal elections, most of the Amish community refrains from involvement in politics unless it directly involves their community. They do, however, cooperate with local elected officials. There have been numerous conflicts between the Amish community and the Federal government in recent history due to the unique practices of the Amish. Conflicts have centered around social security, child labor, education, and military service.  The most well known conflict involved the decision of whether Amish people were to be permitted to remove their children from formal schooling before high school. The Amish separate themselves from the Federal government, but they are required to pay state and federal income taxes, sales tax, real estate tax, and public school tax. The only tax that they are exempt from is social security if they are self-employed since they do not receive its benefit. The close knit Amish communities ensure that each member is taken care of throughout their life, so federal assistance is unnecessary.

Amish families usually adhere to traditional gender roles, but this varies from family to family. The man maintains the role of the head of household and is responsible for ensuring that the family is supported financially. Women are responsible for maintaining the house and the children. These roles, however, are not concrete as men offer support in the home and women may assist with physical labor. This is consistent with the general trend in modernization of the Amish culture. In the Amish household the man is the primary spiritual leader, but men and women share the decision making within the household. Just as gender roles have become less defined, we have seen changes in the traditional Amish courtship. The old order Amish adhered to the custom of bedroom courtship, but in modern times Amish youth spend more time engaging in social activities that may be associated with courtship. Church ministers often meet with youth to sing hymns and hold discussions.

The defining aspect of the Amish social structure is each person’s commitment to their family and the other members of the community. This is evident when the people come together to support those in need regardless of the situation. The Amish hold “Frolics” when a neighbor requires help raising a house or barn. A Frolic is a work party of men from several neighboring families. Large extended families remain contact by sending letters through the mail or sending them to The Budget which is an Amish publication.

Education & Learning

Amish education is unique to their lifestyle, so it is based on homemaking vocational skills. Amish children receive traditional education through the eighth grade and are then sent out into the workforce. The education includes instruction in reading, writing, spelling, history, and arithmetic, but the primary goal of these parochial schools is to obtain real life skills they can apply to contribute to Amish society. These skills include homemaking, farming, and carpentry which are necessary to thrive in the Amish community. The curriculum focuses on the important Amish values of cooperation, respect, and the natural world instead of independent thinking and critical analysis which are emphasized more in public education. The teachers themselves have only an eighth grade education, but they receive further training from other experienced educators. There is a local board of fathers who are responsible for hiring teachers and approving the curriculum. Despite their seemingly substandard level of education, Amish students have proved to achieve high scores on standardized tests given by the U.S office of Education. In some cases the average scores surpassed those of the public school students in the region.

Before 1950, most Amish children attended public schools. These were small rural public schools that parents were organized by parents. As the public schools began to grow, Amish parents were slowly losing control over the education of their children. The Amish community began to favor private Amish Schools. These schools allowed the Amish a method of passing down their traditions to younger generations in order to preserve their way of life, and the separate schooling limited their exposure to the non-Amish world. It prevented the children from being exposed to the technology used in public schools, and they children were no longer exposed to the influences of peer pressure. Another benefit of private Amish schools is the ability to incorporate Bible study and worship. There is a larger population of Amish students in public schools in areas dominated by traditional Mennonites. Some parents choose to place their children in the public school system to better prepare them for contact with the “English.” They are required to pay taxes that go towards public education, so there are no further costs for entering the public school system. A third option that some parents choose is homeschooling, but this is much less common.

The lack of certification of the teachers and the decision of the Amish to remove their children from school at a young age became controversial, but in 1972 the Supreme Court ruled in the case Wisconsin vs. Yoder that it was lawful for Amish families to discontinue their children’s formal education at fourteen. This decision was made based on the issues of Parental rights and Religious freedom. It is not Amish practice to defend themselves in a court of law, so the National Committee for Amish Religious Freedom took action and defended the issue in court. Throughout history the Amish have managed well in the court system despite their lack of involvement in the law since the United States upholds religious freedom.

Work Habits & Practices

The traditional Amish lifestyle relied on agriculture to make a living. Before 1960 the Amish people lived on small farms that served a variety of purposes. In recent years there has been a growing trend in specialization of the farms. Specialized farms have become more mechanized in recent times with the addition of technology such as use of mechanical “milkers” and bulk cooling tanks on dairy farms, but it still does not match the technology of non-Amish farms. The amount of technology utilized varies from farm to farm, but Amish farmers generally still rely on horses to plow their land instead of tractors.

In modern times we have also seen a shift away from agriculture as the primary income for Amish families. This is partially due to the growing cost and scarcity of land. There have been increasing numbers of Amish owned small businesses popping up around the country and perhaps the most well known being Amish furniture stores. Other successful business ventures include quilt shops, greenhouses, and bakeries. Amish men also work in construction. They form construction crews within a settlement and travel between rural towns contracting work from non-Amish people. In some settlements the majority of the people work at non-Amish owned factories or restaurants. Those who choose to make their primary income away from agriculture still often continue farming as a hobby. Despite the new diversity in the Amish work habits, the primary goal remains to find work in a way that supports an individual family but also serves the Amish community as a whole.

The women of the community are primarily responsible for maintaining the home, but women can also be responsible for earning the primary income for the household. Women may choose to operate small businesses such as quilt shops. When older family members leave the workforce they move into what is known as the Grandpa house that is adjacent to the primary residence and contribute to the household by assisting with chores.

Dress & Appearance

Amish clothing and dress/ appearance is based solely on the Amish basic beliefs and their faith. They feel that their appearance and their clothing is a very simple way to express their faith to the world. They choose fabrics that represent humility and being separate from the rest of the world. They make all of their own clothing and they make the clothing out of mainly dark simple fabrics. On occasion some groups of the Amish will use light fabrics for children’s clothing or for summer apparel. The Amish women wear dresses without any patterns, usually with long sleeves and a large skirt. Amish women and girls are not allowed to wear any jewelry as that might take away from the simplicity and humility that they are trying to present to the world. Amish women don’t cut their hair so they will wear it in a bun or a braid of some kind. They cover this braid or bun with a covering, which is just a small white cap.

On specific holidays or in church the Amish might wear a black covering instead of their traditional white covering. Amish men wear mutza suits which are very straight and simple suits. Mutza suits don’t have a collar, pockets, or lapels. In the summer some Amish men will wear a vest instead of the coat. They always wear suspenders with trousers that are neatly pressed with no wrinkles. Amish men’s everyday trousers are made of a special fabric known as Triblend Denim that is intended to be very durable. Their shirts are made of a 50/50 polyester/cotton blend fabric.  Belts, sweaters, and neckties are forbidden in Amish clothing. Amish clothing is fastened with either hooks and eyes or homemade buttons. Young Amish men are required to be clean shaven prior to being married, however once an Amish man is married he is then required to have a beard. Amish men are not allowed to have mustaches as this is also seen as detracting from the humility and simplicity of life. All of the clothing and appearance of the Amish is intended to not be something to make the person stand out, it is just about living for something else other than this world.

Food & Eating Habits

The Amish only eat foods that they have grown in their own personal garden or they have grown on their farms. They hold farmers markets for each other and they will give other members of their community food and buy food grown on other member’s farms. They don’t buy food that is in stores or has been processed and packaged. They will grow their own fruits and vegetables , which they can or freeze for later. Some of the most common vegetables that are seen and grown in the Amish community include beans, zucchini, rhubarb, peas, corn, and others. The most important vegetable for the Amish community is cabbage. They usually will pickle the cabbage and make sauerkraut. The Amish usually have sauerkraut for every meal. They will incorporate it into main dishes and even into desserts. Grains are another important part of Amish food. A staple of the Amish culture is Scrapple, which is a breakfast food that is made of fried cornmeal mush that they serve with sausage and liverwurst. The Amish are also known for their cheese which they sell in markets. They usually all have a few chickens at all times so that they can have fresh eggs. They also are known for some of their dessert pastries such as shoofy pie, sugar cookies and shnitz pie.

“And be ye not conformed to this world, but be ye transformed by the renewing of your mind that ye may prove what is that good, and acceptable, and perfect, will of God.”
(Romans 12:2)

United States Statistics

It is difficult to find accurate statistics because of a lack of detailed record keeping among the Amish, but following are some statistics for the Amish population in the United States:

In 2009, the state with the largest Amish population was Ohio with an estimated population of 56,430 Amish citizens.  The next two most populated states were Pennsylvania and Indiana with 51,435 and 39,960, respectively.  (Young Center for Anabaptist & Pietist Studies, 2010).

*These statistics include both Old- and New-Order Amish groups, but excludes some less conservative groups including the Amish Mennonites.

The average Amish family consists of seven members and about 66% of Amish children end up leaving their religion and Amish home to join modern society (Treating the Amish, 2009).

The Amish & the Healthcare Environment

Discrimination & Exploitation

This Amish are a very vulnerable population. They are only educated to the 8th grade level and therefore, their knowledge of medical practices is limited. The Amish are targeted by modern health quacks. The Amish often fall victim to quackery medicine as the quacks will discredit medical providers by claiming conspiracies and give false testimonies of other Amish patients (Weyer et al., 2003).

Based on research by Adams and Loverland (1986), the Amish are exploited for many reasons. Those reasons include:  limited education, lack of insurance, cash payment for treatment, distrust of mainstream medicine, religious discouragement of suing, and strong belief in folk medicine.

Differences From American Culture

The lifestyle led by the Amish offers the biggest differences from the U.S. culture. The Amish are only educated to the 8th grade level, do not drive cars, and do not practice preventative medicine.  Many Americans take prescription medications on a regular basis, and the Amish frown on this practice.  Even though most Amish people do not take prescription medications, herbal medicine is encouraged in the Amish community (Sharpnack, P., Griffin, M., Benders, A., & Fitzpatrick, J., 2010).  The Amish often delay seeking medical care and are at risk for more complications secondary to the initial problem (Weyer et al., 2003).   However, when it comes to childbirth many Amish women are now utilizing hospitals and Amish Birthing Centers which are very similar to modern hospitals (Lemon, 2006).

Health Risks

The health risks for Amish are quite significant. The Amish do not practice birth control and large families are encouraged. Therefore the Amish are at risk for difficult pregnancies and complications due to pregnancies with late age. The Amish tend to marry within their community and so, the increased occurrence of incest increases the risk for genetic diseases and the prevalence of recessive genetic disorders (Weyer et al., 2003).

Cultural Medicine

Medical practitioners must acknowledge that the Amish believe in folk medicine and home remedies. Powwowing, or braucha, is a brand of faith healing still practiced by some Amish (Weyer et al., 2003). Powwowing involves audible or silent incantations, touch, or moving near a sick person, provided by a person who has inherited a power to heal (Adams & Loverland, 1986).   Braucha is a healing method with an “emphasis on the continuum of life and death” (Sharpnack, P., Griffin, M., Benders, A., & Fitzpatrick, J., 2010).

When it comes to childbirth, many Amish women take a traditional herbal “Five-week formula” late in their pregnancy.  This formula consists of several different herbs and natural medicines that aid with everything from uterine contractions to varicose veins. (Lemon, 2006).  Even though many Amish refuse modern medicine, more and more Amish women are giving birth to their children in modern hospitals so healthcare providers should be prepared to learn about Amish cultural and folk medicine.

Top Five Things a Healthcare Provider Should Know About the Amish

In no particular order:

  1. The Amish have limited education.  So, minimize medical and technical jargon and use simple communication.
  2. Limited resources (electricity, transportation, etc).  Be prepared for there to be issues with appointment making, especially when it comes to transportation.
  3. Folk medicine practice.  Be willing to consider herbal remedies and remember to ask about cultural/folk medicine when caring for these patients.
  4. Risk for genetic diseases.
  5. Family values.  The Amish place a high value on family so any Amish patient will likely have a large number of family members present.  Be prepared and remember to respect this.

“Be not yoked with unbelievers. For what do righteousness and wickedness have in common? Or what fellowship can light have with darkness?” (II Corinthians 6:14)


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