CASELET I

The Roseto Effect – A lesson on the true cause of

heart disease

In 1964 a study published in the Journal of the American Medical Association examined a
population of recent Italian immigrants in Roseto, a small town in the state of Pennsylvania. The
study was instigated because the town doctor was completely baffled by the Rosetans' near
immunity to heart disease. He reported his observation and an extensive statistical population
study funded by the American State and Federal governments was conducted.

The study compared health statistics of Rosetans to neighbouring towns and the initial results
were astonishing. During the seven-year period of study from 1955-1961:

1. No-one in Roseto under the age of 47 died of a heart attack; there was a complete
absence of heart disease in men under the age of 55
2. The rate of heart attacks in men over 65 was half the national average
3. The death rates from all causes were 35% lower than anywhere else

The study confirmed the town doctor’s findings and went on to examine the factors that gave
the Rosetans such improved health. It became known as the ‘The Roseto Effect’.

So what gave the Rosetans a near imperviousness to heart disease?

Well, the researchers asked the same question and first looked at the most obvious factor – diet.
Being Italian immigrants, the researchers thought that the Rosetans must be eating a healthy
‘Mediterranean’ diet of fish, olive oil and fresh vegetables. Not so – in fact the researchers
discovered that the Rosetans did not have enough money for fish and ate high fat meatballs and
sausages, with an average fat intake of up to 40% of their entire diet! And the fats weren’t your
‘healthy’ types of fat, for the Rosetans liked to fry all of their food in good old lard.

The researchers then thought that surely if diet was not the contributing factor than it must be
lifestyle, so they looked at how the Rosetans spent their leisure and work time. It turns out that
the Rosetans were very hard workers but mostly worked in slate quarries or mines, which were
renowned for having extremely harsh working conditions with high rates of on-site accidents. As
for leisure time, the Rosetans loved their wine, beers and cigars and consumed both with reckless
abandon.

So – the Rosetans had extremely low to no heart disease, yet they ate red meat deep-fried in
lard, smoked, and drank heavily, and worked in toxic slate mines? Yes, indeed.

This also had the researchers totally stumped as well and they studied all other possible factors
such as ethnicity, water supply, environment, you name it. In the end, the researchers concluded
that the unusually low incidence of heart disease in the town could not be attributed to any of
these factors.

While living in the town to conduct the study however, the researchers observed several major
differences as to how the Rosetans related to others in their community. They noticed a
remarkably close-knit social pattern that was cohesive and mutually supportive with strong
family and community ties, where the elderly was not marginalised, but revered. Put simply, the
Rosetans lived in brotherhood with one another.
So, the researchers instead suggested that “the quality of family relationships and the social
milieu may be pertinent to the occurrence of or protection against death from myocardial
infarction.” In other words, they suggested that your relationship with others affects your risk of
heart disease.
Source:

Egolf, B; Lasker, J; Wolf, S; Potvin, L (1992). "The Roseto Effect: A 50-Year Comparison of Mortality Rates" (pdf). American Journal of Public
Health 82 (8): 1089–1092. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1695733/pdf/amjph00545-0027.pdf
 Activity – Group Discussion & Homework
Instructions – In groups, discuss the questions below.

1. The findings of the case study are a true landmark in medical research. They present
irrefutable peer-reviewed statistical evidence of how our relationships in our community are
one of the most significant, if not the main contributor to our health and wellbeing, especially
in the case of heart disease.
Our lifestyles and relationships are becoming increasingly shallow, fractured, and distracted,
despite the fact that medical science has proven this to be detrimental to our health. So, the
question is, how far will we let our health suffer as a result of our increasingly ill-relationships
amongst communities? Using a Fishbone diagram or the Ishikawa Diagram, identify how we can
improve our relationships in our community?

2. The Roseto study gives us an incredibly valuable, albeit ignored, insight into the real
cause of heart disease.

Although medical research has shown that food is a contributing factor to heart disease, this
research suggests that food has a much smaller role to play in heart disease than what is currently
emphasized. Discuss in your group and make a list of some of the best preventative measures
that can be taken to curb heart disease. Then, use only ONE of the many suggestions you have
listed down and analyse its’ effectiveness using a SWOT Analysis Diagram to support your
answer.

3. Choose only ONE (Ishikawa Diagram/SWOT Analysis) to be presented face-to-face in class.

Each group will be given 8-10 mins to present their findings.