Immune & Brain Disorders
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Health Lessons from the Amish, Mennonites and Other Plain People
Published July 21, 2016 | Health, Immune & Brain Disorders
Story Highlights
- The Plain People, which includes the Amish and Mennonites, may offer the best chance to evaluate the health differences between highly vaccinated and mostly unvaccinated children.
- More of the Plain People vaccinate their children today compared to several decades ago, but rates of full compliance with the federally recommended child vaccine schedule are much lower than in the general U.S. population.
- While their insular communities have made the Plain People susceptible to an increased rate of genetic disorders, their healthy lifestyle protects them from many of the more common illnesses.
A Natural, if Imperfect, Source for Comparison
The best chance for evaluating the impact of many modern practices, not only vaccination, may be to look at populations that, by nature, tend not to fully participate in those interventions: Protected religious groups like the Plain People, which includes the Amish, the Mennonites and comparable offshoots of Europe’s “Anabaptist Movement” that followed the Protestant Reformation of 1525.1 The hard part is teasing out the effects of any one particular medical practice, such as vaccine use.The various subgroups tend to eschew vaccination as a tool of the modern world, but vaccination per se is not forbidden by their religion or lifestyle tenets. Vaccination practices vary greatly among the different subdivisions (there are more than 40), and use of vaccines historically increase in the face of outbreaks of diseases promoted as preventable by vaccination.2 As an example, a massive MMR vaccination campaign was conducted in Ohio in response to an outbreak of 314 measles cases among the Ohio Amish in 2014. Within the Ohio Amish population, there was a significant increase in vaccination which public health officials assert prevented “widespread transmission of measles within the entire North American Amish population.”3
Responses to a 2007 survey of Amish parents showed that 68 percent of families had allowed at least one vaccine for all of their children, 17 percent had allowed some of their children to receive at least one vaccine, and 14 percent had not vaccinated their children at all. In most cases (86 percent), Amish parents who did not vaccinate gave the same reason as most any other parent: concern over vaccine adverse effects.4 The survey does not address which vaccines were given, at what age, or on what schedule. Since most of the children are born at home or at a birthing center, “allowing at least one vaccination” is still a far cry from “fully vaccinated according to the recommended schedule.”
A Different Chronic Disease Profile
Looking at the predominance of disease and chronic conditions in the Plain communities compared to more mainstream American populations reveals some provocative findings. Though not a clean comparison of the health of vaccinated versus unvaccinated individuals, many of the conditions potentially linked to chronic inflammation associated with vaccine toxicity are missing, or are rare, among the Amish.Cancer Rates are Low in Amish Communities
A study of Ohio Amish communities showed that cancer of all types among Amish adults was 60 percent of that of the average age-adjusted adult rate in Ohio (389.5/105 vs. 646.9/105; p < 0.0001). Looking specifically at tobacco-related cancers, the Amish rate was 37 percent of the overall rate for Ohio adults (p < 0.0001). The Amish incidence of non-tobacco-related cancers was 72 percent of the age-adjusted adult rate in Ohio (p = 0.0001). The authors of that study concluded that cancer rates among the Ohio Amish are significantly lower overall compared to the general population and that the reduced incidence can be only partially explained by differences in tobacco usage.5Autism Rates are Also Lower Among the Amish
An often-publicized report from 2005 contending that there were only three cases of autism in a Pennsylvania Amish community, and that two of the children had been vaccinated,6 has been hotly challenged by medical doctors and public health officials. One particularly vitriolic critic says, “He somehow failed to notice that there’s an entire autism clinic in Amish country, the Clinic for Special Children.”7In truth, the Clinic for Special Children in Pennsylvania is not geared toward autism but is focused on all types of disorders of genetic mutation, such as maple syrup urine disease (MSUD), glutaric acidemia (GA-1), and propionic academia, among many other types of genetic disorders overexpressed among the Amish and Mennonites as a result of the relatively small size of their gene pool.8 The Amish and Mennonites descend from small pockets of Europeans who immigrated to the United States in the 1700s to escape religious persecution and have subsequently reproduced from within that small sample, amplifying the impact of genetic mutations.9
Genetic Links to Disorders With Autism Features
That’s not to say that there are no children with autism-spectrum disorders (ASD) among the Amish, but evidence indicates that many of the disorders with autism-like symptoms noted among these communities are linked to genetic mutations, rather than to a primary diagnosis of ASD. The Clinic for Special Children treats more than “150 genetic disorders affecting Amish and Mennonites… dominated by those influencing brain growth and development and previously misdiagnosed as conditions such as cerebral palsy, autism, and epilepsy. Immune system disorders and those causing prolonged seizures, sudden infant death syndrome, lethal heart irregularities, and cerebral hemorrhages also appear.”10The clinic was originally started after the founder, pediatrician D. Holmes Morton, realized that an Amish boy diagnosed with cerebral palsy, though he had seemed healthy for his first year, actually had a genetically linked metabolic disorder called glutaric aciduria type 1, or GA1, which causes irreversible brain damage from a buildup of toxic levels of glutaric acid in the brain. Morton had seen the frustration of the Amish and Mennonite families as they traveled long distances seeking help from medical institutions that had little experience with the disorders they were bringing in for doctors to diagnose and treat.
Realizing that early intervention was critical to ensure the best possible outcome for these children, Morton was inspired to begin a clinic focused on the unusual genetic disorders found in the Amish population. Several other similar centers have arisen since then, such as the DDC Clinic in Middlefield, Ohio, all focused on screening and treatment of genetic disorders.11
The genetic link to autism is an important research topic in these clinics. “Like many tales of gene discovery, the finding that mutations in CNTNAP2 lie behind a variety of brain conditions—autism, seizures, schizophrenia, Tourette syndrome, and language disorders—began with different threads,” says Ricki Lewis, a journalist who has spent time at the Clinic for Special Children with Dr. Morton. She describes the first family she encountered at the clinic, in which four of five siblings were affected by a seizure disorder with autistic-like features, and quotes Dr. Morton as saying, “One mutation can cause different types of seizures. Four kids in one family respond differently. Some are very disabled, some not very affected.”12
Health-wise, there is an interesting paradox found in looking at the so-called Plain people. On the one hand, their insular communities have made them genetically vulnerable to genetic disorders that are much more rare in the general population, while on the other hand, their healthy, natural, and hard-working lifestyle has protected them from many of the ills of modern society. Medical science has much to learn from both facets of health differences within these populations.
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