Nourishing Relationships Produce a Healthy Community

In 2003 the Dads4Kids Fatherhood Foundation rather prophetically stated, (See footnote 1.)“The quality of the relationships between mothers and fathers and their children will determine the destiny of Australia.”

Convinced that such a statement was true in 2003, the team at Dads4Kids are just as convinced today. Whilst preparing the submission, ‘Healthy Men, Healthy Families, Healthy Nation’ from Dads4Kids for the Senate Committee Inquiry into Men’s Health many years ago. I was stuck trying to explain the importance of the health-giving qualities of positive and strong family relationships. The reality is people are nourished by other people but how do you explain that to the broader population and especially sceptical government bureaucrats.

That’s when I first came across the so called Roseto Effect.

The Rose Garden: A History of the Roseto Effect

Malcolm Gladwell, in his bestselling book, ‘The Outliers’ tells the story of such a nourishing community, Roseto.

Dr Stewart Wolf was a physician. He studied digestion and the stomach and taught in the medical school at the University of Oklahoma. He spent his summers on a farm in Pennsylvania, not far from Roseto – although that, of course, didn’t mean much, since Roseto was so much in its own world that it was possible to live in the next town and never know much about it. “One of the times when we were up there for the summer – this would have been in the late nineteen fifties – I was invited to give a talk at the local medical society,”

Wolf said years later in an interview. “After the talk was over, one of the local doctors invited me to have a beer. And while we were having a drink, he said, ‘You know, I’ve been practicing for seventeen years. I get patients from all over, and I rarely find anyone from Roseto under the age of sixty-five with heart disease.'”

Wolf was taken aback. This was the 1950s, years before the advent of cholesterol lowering drugs and aggressive measures to prevent heart disease. Heart attacks were an epidemic in the United States. They were the leading cause of death in men under the age of sixty-five. It was impossible to be a doctor, common sense said, and not see heart disease.

Wolf decided to investigate. He enlisted the support of some of his students and colleagues from Oklahoma. They gathered together the death certificates from residents of the town, going back as many years as they could. They analysed physicians’ records, they took medical histories and constructed family genealogies. ‘We got busy,” Wolf said. “We decided to do a preliminary study. We started in 1961. The mayor said, ‘All my sisters are going to help you.’ He had four sisters.

He said, ‘You can have the town council room’ I said, ‘Where are you going to have council meetings? He said, ‘Well, we’ll postpone them for a while.’ The ladies would bring us lunch. We had little booths where we could take blood, do EKGs. We were there for four weeks. Then I talked with the authorities. They gave us the school for the summer. We invited the entire population of Roseto to be tested.”

The results were astonishing. In Roseto, virtually no one under fifty-five had died of a heart attack or showed any signs of heart disease. For men over sixty-five, the death rate from heart disease in Roseto was roughly half that of the United States as a whole. The death rate from all causes in Roseto, in fact, was 30 to 35 percent lower than expected.

Wolf brought in a friend of his, a sociologist from Oklahoma named John Bruhn, to help him. “I hired medical students and sociology grad students as interviewers, and in Roseto we went house to house and talked to every person aged twenty-one and over,” Bruhn remembers.

This happened more than fifty years ago, but Bruhn still had a sense of amazement in his voice as he described what they found. “There was no suicide, no alcoholism, no drug addiction, and very little crime. They didn’t have anyone on welfare. Then we looked at peptic ulcers. They didn’t have any of those either. These people were dying of old age. That’s it.”

Wolf’s profession had a name for a place like Roseto – a place that lay outside everyday experience, where the normal rules did not apply. Roseto was an outlier.

Wolf’s first thought was that the Rosetans must have held on to some dietary practices from the Old World that left them healthier than other Americans. But he quickly realised that wasn’t true. . .

He then looked at the region where the Rosetans lived. Was it possible that there was something about living in the foothills of eastern Pennsylvania that was good for their health? . . . Another dead end.

What Wolf began to realise was that the secret of Roseto wasn’t diet or exercise or genes or location. It had to be Roseto itself. As Bruhn and Wolf walked around the town, they figured out why. They looked at how the Rosetans visited one another, stopping to chat in Italian on the street, say, or cooking for one another in their backyards. They learned about the extended family clans that underlay the town’s social structure. They saw how many homes had three generations living under one roof, and how much respect grandparents commanded.

They went to mass at Our Lady of Mount Carmel and saw the unifying and calming effect of the church. They counted 22 separate civic organisations in a town of just under 2,000 people. They picked up on the particular egalitarian ethos of the community, which discouraged the wealthy from flaunting their success and helped the unsuccessful obscure their failures. . .

When Bruhn and Wolf first presented their findings to the medical community, you can imagine the kind of scepticism they faced. They went to conferences where their peers were presenting long rows of data arrayed in complex charts and referring to this kind of gene or that kind of physiological process, and they themselves were talking instead about the mysterious and magical benefits of people stopping to talk to one another on the street and of having three generations under one roof.

Living a long life, the conventional wisdom at the time said, depended to a great extent on who we were – that is, our genes. It depended on the decisions we made – on what we chose to eat, and how much we chose to exercise, and how effectively we were treated by the medical system. No one was used to thinking about health in terms of community.

Wolf and Bruhn had to convince the medical establishment to think about health and heart attacks in an entirely new way: they had to get them to realise that they wouldn’t be able to understand why someone was healthy if all they did was think about an individual’s personal choices or actions in isolation. They had to look beyond the individual. They had to understand the culture he or she was part of, and who their friends and families were, and what town their families came from.

They had to appreciate the idea that the values of the world we inhabit and the people we surround ourselves with have a profound effect on who we are.