Patterns of cancer in geographic and endogamous subdivisions of the Hutterite Brethren of Canada

Is religion therapeutically significant for hypertension?

Epidemiologic studies of the effects of religion on blood pressure suggest that religious commitment is inversely associated with blood pressure and that several religious denominations or groups have relatively low rates of hypertension-related morbidity and mortality. In this review, we examine the implication that certain characteristics and functions of religion account for this association, and we posit 12 possible explanations for this finding. We propose that a salutary effect of religion on blood pressure can be explained by some combination of the following correlates or sequelae of religion: the promotion of health-related behavior; hereditary predispositions in particular groups; the healthful psychosocial effects of religious practice; and, the beneficial psychodynamics of belief systems, religious rites, and faith. Since past epidemiologic studies may have been methodologically limited or flawed, possible explanations for the findings of these studies also include epistemological confusion, measurement problems, and analytical errors. Finally, for the sake of completeness, two more speculative hypotheses are identified: superempirical and supernatural influences or pathways.

Review of cancer among 4 religious sects: evidence that life-styles are distinctive sets of risk factors

The occurrence of various types of cancer have been reviewed and evaluated in 4 religious groups. These patterns have been critically assessed in light of the distinctive life-style features of these groups. All 4 religious groups considered in this paper have reduced overall rates of cancer, suggesting that the life-styles of all 4 groups have merit in terms of reducing the overall risk of cancer. The rate of smoking among these groups is nearly nil, and the lung cancer rate in all 4 of these religious groups is strikingly low. Cancer of the oral structures, pharynx, larynx, and esophagus is also generally quite low. Amish and Hutterites have unusually high rates of breast cancer and juvenile leukemia. Reproductive factors frequently mentioned as risk factors for breast cancer cannot explain the excess breast cancer in the Amish and Hutterite women because they should have had the effect of reducing the rate. None of the numerous risk factors, normally suggested for leukemia, are consistent with this observation. The observations on ovarian cancer tend to confirm low parity and late age at first birth as risk factors, although the evidence is not entirely consistent. Also, contrary to common observations, the pattern of ovarian cancer contrasts greatly with the breast cancer pattern, suggesting dissimilar risk factors. Their low rate of cervical cancer is consistent with promiscuity being a strong risk factor, but other frequently suggested risk factors were generally inconsistent with the observations. Cancers of the stomach, colon, rectum, urinary bladder and prostate, in these 4 religious groups, are not readily explained by the risk factors commonly implicated in cancer of these sites. The patterns of a few types of cancers were consistent with the prevailing opinions of risk factors, but some cancers were poorly explained and, in some cases, the cancer patterns contradicted commonly held opinions concerning risk factors. Religions that provide strong directives for the personal lives of adherents result in distinctive life-style, reflecting multiple disease related factors (risk factors and protective factors). Disease related factors are related to each other in simple or more complex ways (e.g. additive, multiplicative or even more complex). Therefore, when dealing with distinctive life-styles, it may be unwarranted to attempt to isolate individual risk factors.

Is there a religious factor in health?

This paper reviews epidemiologic studies employing religion as an independent construct, and finds that most epidemiologists have an extremely limited appreciation of religion. After a historical overview of empirical religion and health research, some theoretical considerations are offered, followed by clarification of several operational and methodological issues. Next, well over 200 studies are reviewed from nine health-related areas: cardiovascular disease, hypertension and stroke, colitis and enteritis, general health status, general mortality, cancer of the uterine corpus and cervix, all other non-uterine cancers, morbidity and mortality in the clergy, and cancer in India. Finally, an agenda for further research is proposed.

Congenital anomalies in the Hutterite population: a preliminary survey and hypothesis

The Alberta Provincial Congenital Anomaly (CA) Surveillance reporting forms were scanned for infants whose surnames and addresses identified them as belonging to the Hutterite Brethren. Death registrations (of infants up to 1 year) and stillbirth registrations were similarly scanned. While the overall percentage of total malformations (5%) and major malformations (2%) was no different from that of the total population of Alberta, closer examination of the actual entities showed a large number of monogenic disorders among the Hutterites. The frequency of multifactorial congenital anomalies was approximately 1%. The inbreeding coefficients, using a genealogic data base, were computed for each "case baby" and two Hutterite "control babies," the latter being births preceding and succeeding the case baby. There was no statistical difference in the distribution of inbreeding coefficients between the case and control groups. While the data are based on small numbers and therefore are preliminary, they suggest that the Hutterite lifestyle, of good nutrition (using largely home prepared foods), absence of tobacco and minimal alcohol consumption, may be one factor responsible for fewer multifactorial CAs whose occurrence is environmentally susceptible to such influences. Studies of populations with a low incidence of disorders are just as important as those with a high incidence.