Thesis (Ph. D.)--University of Missouri, Columbia, 2001. / Includes abstract, bibliographical references (leaves 145-152) and vita. Also available on the Internet.

Thesis (M.S.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains vi, 124 p. : ill. Includes abstract. Includes bibliographical references (p. 102-118).

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, <i>Family Life</i>, 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 <i>Family Life</i> 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 (<i>Gelassenheit</i>) and appreciation for a set of rules guiding behaviour (<i>Ordnung</i>), 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.

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, <i>Family Life</i>, 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 <i>Family Life</i> 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 (<i>Gelassenheit</i>) and appreciation for a set of rules guiding behaviour (<i>Ordnung</i>), 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.

<p>This thesis presents the results of a study exploring the health status and health determinants in two farming groups in Waterloo, Ontario, Canada: Old Order Mennonites (OOMs) and non-OOM farmers. Physical health and mental health are examined, and Canada’s 12 health determinants (excluding genetics) are included in the analysis. A survey was distributed to both groups in 2010 to obtain information on health status and determinants. Comparing the two groups reduces the likely impact of contextual features impacting both, such as local economic conditions. The mental component summary (MCS) and physical component summary (PCS) of the SF-12 were used to measure mental and physical health. The study compares health in the two populations, and uses ordinary least squares (multiple) regression to determine the relative importance of the determinants in shaping health. The study found that mental health is better in OOMs, mainly due to OOM women’s strong mental health. Physical health was worse in OOMs, and while true for both genders, OOM women appear to be particularly disadvantaged. There is overlap between the groups in the determinants shaping physical and mental health. In both groups, mental health is shaped by social interaction, stress and coping; and physical health by age, childhood disease history, coping and body mass index. This suggests these factors may be important across many populations facing different life circumstances, thus representing priorities for policy action. Interestingly, the key determinants shaping physical health in both groups do not include social factors such as social capital, although social factors do shape mental health (especially in OOMs). This may be due to the rural or farming status of the two groups, or differences between physical and mental health. Determining which is more likely requires reconciling the results of this study with others, an effort hampered by differences in models, methods and health outcomes employed.</p> / Doctor of Philosophy (PhD)