Forging Healthy Chains: Social Support and the Roseto Effect

Posted on Wed, Jul 27, 2016 @ 03:14 PM

Chances are, you already know that love is better for your health than hate or indifference. It's a no-brainer that physical health and mental health are interdependent, although the nature of the bidirectional link is only just beginning to be understood by researchers. Studies testing the direction of the link seem to indicate that depression is more likely to lead to inflammation in the body rather than occur as a consequence of inflammation in the body—but in any case, the evidence has been stacking up for some time that social support has a profound effect on mental health, which in turn pays dividends to our physical health. The story of a little town in Pennsylvania illustrates this well.

During the 1950s, a Pennsylvania physician named Benjamin Falcone had been treating patients near the small towns of Bangor and Nazareth for 17 years when he noticed that older residents from a third nearby town, called Roseto, hardly ever needed to be seen for heart problems, even though the rate of heart attacks within the other two towns and across the United States in general was on the rise.

Roseto was a close-knit community consisting of about 1,200 inhabitants who had emigrated almost en masse in the 1890s from an Italian village called Roseto Valfortore. After arriving in America, the immigrants built a relatively isolated hillside community—separate from nearby English, Welsh or German communities. By 1912, Roseto’s population had exceeded 2,000 and it incorporated to become the first American municipality governed by Italians. By the time Dr. Falcone began to notice the extraordinary heart health of its residents, Roseto was a thriving town, accepted—and even admired—by neighboring Bangor and Nazareth, and served by the same doctors and hospitals.

One day, Dr. Falcone attended a local medical society talk given by a visiting physician from the University of Oklahoma, Dr. Stewart Wolf, who frequently spent summers at a nearby farm. Dr. Falcone invited Dr. Wolf out to a local pub for a beer and in the course of their conversation, mentioned the strange phenomenon he had noticed in the Roseto residents.

It was now 1961, and Wolf was intrigued enough to engage some of his colleagues from the University of Oklahoma in taking a deeper look at the Roseto effect. Along with sociologist John G. Bruhn, the research team began to compare medical histories, physical exams, and lab tests in a large sample of Rosetans—as well as the inhabitants of Bangor and Nazareth—hoping to find the key to the apparent health and happiness of this unusual community.

What they found stymied them. Yes, the evidence confirmed it was true that coronary heart disease and death from myocardial infarction (heart attack) was strikingly lower in Roseto than in its neighboring towns. Importantly, mental illness (including senile dementia) was also much lower: half the rate of Bangor, and only a third the rate of Nazareth. But at first, no one could understand why.

“The findings were surprising because of a greater prevalence of obesity among the Rosetans,” wrote Wolf and Bruhn in their report, published in 1979 under the title, The Roseto Story: An Anatomy of Health. “A meticulous study of dietary habits established that Rosetans ate at least as much animal fat as did the inhabitants of Bangor and Nazareth.” This was reflected, not only in the high obesity rates of Roseto, but also in the fact that the town’s rates of hypertension, diabetes, and measures of serum cholesterol concentration closely matched those of the other communities. Smoking and exercise habits were also similar, and the researchers were able to eliminate ethnic and genetic factors from the mix. After all, inhabitants who left Roseto to live in other communities soon became subject to the higher death rates that plagued the rest of the nation.

What, then, could explain Roseto’s strange effect? (And no, people weren’t drinking from a special communal well or making mysterious concoctions from South American miracle plants). Having already ruled out diet, exercise, genetics, and other factors that the medical community has long believed to be “risk factors” for heart disease, the researchers turned to studying the way Rosetans lived.

What they discovered was that their initial rejection by outlying communities had forced Rosetans to turn to one another for support and mutual help. Ultimately, the researchers found, the only real differences between Roseto and its neighboring communities were social ones. Roseto’s citizens enthusiastically took on the responsibility of being their neighbors’ keepers.

The researchers described the character of the townsfolk as buoyant, fun-loving, enterprising, optimistic, cohesive, and mutually supportive. “Our first sociological study of Roseto revealed that crises and problems were coped with jointly by family members with support from relatives and friends,” wrote Bruhn and Wolf. “Following a death in the family, interfamilial differences were forgotten, and the bereaved received food and money from relatives and friends, who at times temporarily assumed responsibility for the care of the children of the bereaved. When financial problems arose, relatives and friends rallied to the aid of the family, and in instances of abrupt, extreme financial loss the community itself assumed responsibility for helping the family.”

In addition, families weren’t secretive. Their problems were shared—and then worked out with the help of the local priest or family “pillars.” Pillars were often older single women in the community who had taken on the responsibility of aging parents and who were highly respected and valued for their role in maintaining cohesive family and community ties.

In Roseto, nearly everyone had a vital role to fulfill—whatever their age or gender. At the end of the day, they gathered together in each other’s homes, social clubs or the local diner. But the cornerstone of life in Roseto was the family. “Family traditions provide a buffer in times of crisis and a source of stability for the community,” wrote the researchers in their 1979 report.

Of course, even in Roseto life wasn’t always rosy, and a good study wouldn’t be complete without taking a look at the “outliers,” or those whose circumstances were remarkably different from the main sample. There were some who were marginalized in Roseto, either because they had no ethnic or social ties within the community or because, for whatever reason, they had been excluded or had excluded themselves from the community’s social culture. Like their neighbors in Bangor and Nazareth, these marginalized Rosetans showed a higher incidence of illness and myocardial infarction than the general population. Indeed, in one case history, a seemingly healthy “Mr. F.” commented to the researchers (five years before he died of a heart attack) that “I don’t fit in the town—I don’t live like they do—I’m not like the Rosetans.”

He was not the only marginalized inhabitant who missed out on the health benefits of living in Roseto. “Hard work and family and personal problems were common to most of them,” wrote Bruhn and Wolf. “In addition they emphasized self-reliance and responsibility for their own actions and hence enjoyed little or no family or community support in times of crisis.”

With these observations in hand after two years of study, it wasn’t difficult for the researchers to predict in 1963 that, “If and when Roseto’s traditional close-knit, mutually supportive social structure began to crumble . . . the town’s relative immunity to death from myocardial infarction would gradually come to an end.”

In fact, that is exactly what happened. As Roseto gradually became Americanized, adopting what the researchers called “materialistic and individualistic values,” mortality from heart attacks shot up, reaching the prevailing rate in Bangor by 1975. 

Today, self-reliant attitudes are still pervasive in Western society: we don't like to accept help, nor do we like to offer it to others if we judge that they have brought their problems on themselves. Sitting in our emotional silos we watch distressing news stories that add burdensome weights to our everyday worries, and these leave us vulnerable to the accompanying advertisements that offer magic pills or dietary regimens to counteract the damage these stresses have inflicted on our health. 

Fixing broken relationships may be more difficult than taking a pill or latching on to a fad diet, but it's impossible to manufacture the joy, resilience, optimism and general well-being that is a natural byproduct when we are surrounded by love and support rather than criticism and mistrust. And it isn't only the receiver of love and support who benefits: research tells us the health of the giver benefits as well.

True, it can be difficult to maintain an atmosphere of love and support when we are constantly bombarded by the voices of those who assert their power by stirring up hate and controversy. But we don't have to allow self-righteousness, anger, fear, suspicion, and competition to rule our thoughts and actions. We don't have to be reactive, we can be proactive: purposefully and mutually accepting the role of my neighbor's keeper. We can show love toward the enemies that we are being asked to hate. When we fail to do this, we fall prey to precisely the “materialistic and individualistic values that brought Roseto into the myocardial mainstream.

A well-known quote from Martin Luther King Jr. points out that “Hate does not conquer hate. But there is much more in the context of that statement and it is just as relevant now as when it was written—if not more so:

“Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that. Hate multiplies hate, violence multiplies violence, and toughness multiplies toughness in a descending spiral of destruction. So when Jesus says ‘Love your enemies,’ he is setting forth a profound and ultimately inescapable admonition. Have we not come to such an impasse in the modern world that we must love our enemies—or else? The chain reaction of evil—hate begetting hate, wars producing more wars—must be broken, or we shall be plunged into the dark abyss of annihilation"(Strength to Love, p. 47).

Every day there is something in the news that begs us to respond with hate, mistrust and suspicion, and invites us to contribute to the chain of hate and violence that arises all too naturally in human relationships. But we can't break that chain by controlling our opponents, we can only do it by controlling ourselves. 

If, as Charles Dickens suggested, "we forge the chains we wear in life," we have a clear decision to make. We can wear the chains of hate and reactivity . . . or we can forge chains of love and social support, like the Rosetans did by taking on the responsibility to be their neighbors' keepers. The choice we make could mean all the difference to our health.



Beyond the Nuclear Family
Biography: Martin Luther King Jr.: A Man With a Dream
Words of Hope



Tags: relationships, family, health, social psychology, social relationships, social support

Thoughts for Thanksgiving: Greed, Generosity, and Gratitude

Posted on Wed, Nov 27, 2013 @ 12:27 PM

Thanksgiving2013It's that time of year again, when gratitude becomes a topic of conversation all around us. Canada and the United States are not the only nations to pause in gratitude at some point during the fall season, and as it turns out, this is such a healthy activity that we might want to engage in it far more often than many of us do.

Studies highlighting the importance of gratitude and giving to personal well-being are piling up like autumn leaves, and they're hinting at some interesting connections.

When we express gratitude, say researchers, we experience fewer symptoms of physical illness; we exercise more; we sleep longer and better and report higher levels of positive emotion, greater optimism and a greater sense of connection to others. This sets off more than one beneficial cycle. For instance, improved sleep quality is not only a result of gratitude, but also a predecessor: as we sleep better we actually increase our capacity for gratitude. As our capacity for gratitude increases, we begin to focus more on our positive experiences than on our hassles and complaints. We're also more likely to help others with their personal problems and offer emotional support, thereby evoking feelings of gratitude in those we touch. 

Gratitude spreads, and so does generosity. People who receive benefits in "pay-it-forward" situations give to others more generously than in situations where they can just give whatever they want, say some studies. On the flip side, of course, greed is also paid forward. Unfortunately, the research tells us, the pay-it-forward effect of greed is even stronger than the pay-it-forward effect of gratitude and giving.

If only greed and competition could offer the same benefits to mental and physical health. Something that spreads its seeds as far and fast as greed should at least have something worthwhile to offer.

Those who think primarily in economic terms often suggest it does, of course. Remember Gordon Gekko's speech in the 1987 film Wall Street? His point of view would coincide with some economists and anthropologists who have long assumed that people make decisions in far more "cost-effective" ways than they may do in actual fact. Whole economic theories are based on the belief that people choose their behaviors through a sort of situational cost-benefit analysis. Yet psychologist Daniel Kahneman won the 2002 Nobel Prize in Economics as a result of his research in judgment and decision making. What he found is that human beings (and that includes you and me) are not the rational agents economists and decision theorists have traditionally assumed. We are ruled by emotion at least as often as we are ruled by logical economy. Most often, we decide using a mixture of emotion and logic.

This opens the door to the idea that sometimes we make decisions, not on a cost-benefit basis, but on the basis of altruism, empathy, gratitude, generosity. Admittedly, we reap mental and physical health benefits when we decide to give rather than receive, or be thankful rather than judgmental and critical. But these benefits don't always look great on paper. Good health, happiness, rich relationships and a good night's sleep are hard to quantify. They are, however, some of the things that make life worth living. 

With this in mind, I decided to have a little fun with Gekko's Wall Street speech. Just a few minor edits that mostly entail substituting the word "gratitude" for "greed." The changes might not be all that relevant to the movie, but as a life creed I find I like it this way much better:

"The point is, ladies and gentlemen, that gratitude, for lack of a better word, is good. Gratitude is right, gratitude works. Gratitude clarifies, cuts through, and captures the essence of the most fundamental spirit. Gratitude, in all of its forms; gratitude for life, for money, for love, knowledgehas marked the upward surge of mankind. And gratitude, you mark my words, will not only contribute to the health of each one of us individually, but to our malfunctioning institutions and society in general. Thank you very much."

Sleep well, be grateful, and give others a reason to be grateful too on this Thanksgiving and in the year to come.

Tags: greed, social relationships, gratitude, thanksgiving, generosity

I Can't Live Without You: When Unrequited Love Turns Deadly

Posted on Thu, Apr 12, 2012 @ 12:07 PM




We can either accept romantic rejection with dignity or we can deny the loss of a dream and obsess over the love object (and I do mean "object"), becoming a thorn in their side, their stalker or even worse.

It's the "even worse" that was the focus of research by Aaron Ben-Ze'ev and Ruhama Goussinsky, both of the University of Haifa in Israel. Their findings were published in 2008 as In the Name of Love: Romantic Ideology and Its Victims. Why, the book asks, does one man react to unrequited love by murdering his wife or girlfriend, while another walks away and rebuilds his life?

After reviewing existing research and interviewing 18 men convicted of murdering their wives or girlfriends, Ben-Ze'ev and Goussinsky argue that it isn't simply a possessive personality that leads to murder, nor is it accurate to suggest these are merely "crimes of passion." Rather, they write, "what is perceived to be the ultimate expression of romantic love—'I can't live, if living is without you'—is in fact a state of mind that turns the partner, who is perceived to be the sole supplier of meaning, into a hostage." Romantic Ideology, in other words, can carry dangerous undertones for those who swallow it hook, line and sinker.

"You are all that I am living for," sang Elvis Presley in a song titled "I Want You, I Need You, I Love You." The murderers, who insist they still love their partners and always had, echo the words of the bards. "Only she was on my mind," insisted one. "People might say, there's happiness, and I'd tell them, it's her. People might say there's enjoyment, and I'd tell them, it's her. People might say there's a world, and I'd tell them it's her. My life was a black curtain. Just her."

What a heavy burden to place on a person one claims to love. A romantic ideal that paints the partner as a god, responsible for providing us with the sum total of life meaning and happiness is, in reality, an ideal that imprisons them in our selfish expectations. "Genuine romantic love," say the researchers, "should involve first of all profound reciprocity, which is indicative of the crucial caring aspect," They define "profound reciprocity" as an interest in the profound happiness and well-being of the other. "When I do something for my beloved, I do not do it because I expect to get something in return, but because I care so much for her that I want to do it."

Although the murderers in this study claimed they did love their victim and still do, the burden they placed on their beloved contradicts any such claim.

Ben-Ze'ev and Goussinsky argue that their findings pull the rug out from under legal defenses that reduce charges for crimes of passion. The murderer, they insist, considers the consequences and makes the decision to act despite what it will mean to him personally. His choice may be "colored by depression and despair and by his inability to cope with the impending separation." And perhaps it is even helped along by cultural romantic ideals. But it is still a choice.

Extreme examples like these aside, however, Ben Ze'ev and Goussinsky don't completely discount the value of ideals. Ideals are essential, they insist. "They inspire us to improve and approach a standard that we esteem." But the authors also stress the importance of boundaries, and an understanding of human limitations so we can be content with what we have. "In love, as in life," they write, "a measure of positive illusions, accompanied by some awareness of reality as well as compromises and accommodations, is of great survival value."


Social Issues: Family Violence
Who Am I: The Question of Youth Violence

Tags: social relationships, romantic love, unrequited love, love and relationships, what is love

Thanksgiving Day Musings on Family and Friends

Posted on Mon, Nov 28, 2011 @ 06:58 AM

family thanksgivingThanksgiving week brought my adult daughter home for her first visit since last August when she took a job nearly 3,000 miles away. While this circumstance alone would have been enough to make this Thanksgiving Day a joyful occasion, we also had the pleasure of being with "chosen family," those special relationships we develop that blur the lines between blood relatives and close friends. 

Unfortunately it's impossible to have every treasured family member with us on every holiday, but in these cases it makes sense to treasure those family and friends that we can have with us, while also being grateful for all of our loved ones however scattered they may be. 

Research continues to underscore the multiple benefits we reap from every one of these varied relationships. Whether or not we have spouse, children, mother, father, siblings or cousins, aunts and uncles or grandparents—we can nevertheless fill our lives with close friends and other social relationships that contribute just as much to our health and happiness.

However, doing so requires conscious effort on our part. Relationships can't be maintained, or even formed in the first place, if we are uninterested in actively reaching out to others. Thankfully, especially considering how common it is for family to be widely scattered in our mobile society, technology has provided us with tools that can help make this task just a little easier. And while there may certainly be some few who allow these technologies to crowd out their real-life relationships, an increasing body of research into the social impact of sites such as Facebook finds that most people use technology to strengthen and maintain relationships that are already important in their lives.

Researchers have long realized that silence, at least in the quest for healthy relationships is not golden—rather, relationships thrive when frequent communication is set against a healthy backdrop of gratitude for the ability to connect. It may be worth asking ourselves the question: Is my family among those who use social technology as a tool for increasing and maintaining communication?

Tags: family relationships, social relationships, thanksgiving day, family and friends

Bringing It All Back Home

Posted on Thu, Jun 04, 2009 @ 08:54 AM
UCLA study examines how outside stressors affect family relationships
stress and family relationships

A common theme of this blog is that much of who we are and what we do can be traced back to the quality of our family relationships. Positive, supportive family relationships contribute to our well-being in countless ways—while negative, abusive ones can be deadly.

Most parents would love to give their children the best possible environment in which to develop physically and emotionally: they understand that it's not only the immediate well-being of children that is at stake, but their future well-being—and that of the wider community as well.

But however ardently parents may hope to ensure that positive environment, it isn't always easy for them to do so. In Western society it is increasingly necessary for families to have two wage earners, and school, extracurricular activities and other obligations also encroach. Could there be an effect on family interaction as a result? If so, how? This was essentially the question explored by Rena Repetti and her colleagues at the University of California, Los Angeles, in a peer reviewed study published in the April 2009 issue of Current Directions in Psychological Science

"The family is popularly imagined as a stable haven, a place where individuals come together to recuperate from the ups and downs of the outside world," wrote the researchers. "But the family has ups and downs of its own; it is a dynamic system, not impermeable to outside influences but porous and continually in flux. For example, parents' job schedules and children's homework shape family time, activities, and routines. Other effects of work and school on the family are less overt." 

Certainly, as the researchers explain, we may continue to react to a particular stressor long after the event has occurred. As a result, we may continue to nurse our wounds after returning home. How does the fallout affect our family relationships?

"We have found that, following more stressful days at work, spouses and parents adjust their social behavior at home in two ways. One common pattern is an overall reduction in social engagement and expression of emotion," says the report. In a series of studies, Repetti and her colleagues found that mothers as well as fathers withdrew emotionally and disengaged socially from their children after stressful or exceptionally demanding work days, and spouses "were more distracted and less responsive" toward one another. Children also showed lingering reactions to school stress. Both elementary-school-age children and teens initiated more conflict with other family members after a day characterized by problems in academics or with peers.

"A second short-term response to job stress resembles the stereotypic image of an agitated employee kicking his dog after an argument with his boss," write the researchers. This plays out as "an increase in irritability and displays of anger with both spouse and children."  Ripetti and her colleagues note that this second pattern usually occurs in a particular subset of people: particularly those with a history of psychological distress.

How harmful is all this take-home stress in the long run? It depends. If the short-term effects are allowed to build up over time, there may be more lasting effects. Especially within families with high levels of conflict, or where one or more family members have a history of depression and anxiety.

We do know from other studies explored in this blog that family support and parental engagement are crucial to the well-being of children, so if our coping style in reaction to stress at work involves withdrawing from our families at home, it can't be good over the long haul. As difficult as it may be to push ourselves out of our comfort zone, resilience experts suggest that connecting rather than withdrawing is our best bet for handling stress. Rapetti's research is fascinating and important in several respects: but perhaps the most important thing parents can take home from this study is a new awareness of what they may be bringing home to their children at the end of their work day.

Tags: psychology children, research family, social relationships, children emotional, development children, families and children, job and family, resilience research, stress child, stress children