Tuesday, January 6, 2015

Rosetto Effect: Application in Integrative Medicine

In the early 1960s, a small town in eastern Pennsylvania came to the attention of two researchers. Roseto, founded by Italian immigrants, is a town of fewer than 2,000 residents located in the foothills of the Appalachian Mountains. Stewart Wolf, a medical doctor, and sociologist John G. Bruhn became interested in Roseto when they discovered that the male death rate from heart attack was less than half that of neighboring towns. Intrigued, the researchers set out to discover why.
At first, it was thought that perhaps their Mediterranean diet played a role. Did they exercise more? Smoke less? Inherit great genes? Residents underwent physical exams. They completed family surveys. Dietitians observed their food shopping and eating habits. Surprisingly, the results showed that people in Roseto ate the same animal fats as other Americans, smoked as much, exercised as little, and suffered from hypertension and diabetes at the same rate as their counterparts in the region. The researchers were stumped, until they began to notice that the town possessed certain characteristics that were not in evidence elsewhere. The population was very homogenous and tightly knit. Most families lived in multi-generational households. People supported and looked out for one another with a sense of community and solidarity. Their sense of identity and cohesion was reinforced by shared religion, culture, history, and traditions.
As Wolf and Bruhn noted in their retrospective, The Power of Clan, “What seems to have been learned is an old but often forgotten conviction that mutual respect and cooperation contribute to the health and welfare of a community and its inhabitants, and that self-indulgence and lack of concern for others exert opposite influences.”
Over time, as the town grew more heterogeneous, younger residents became more integrated into the world outside Roseto and began to move away from the ways of their parents and grandparents, living independently and abandoning old-world traditions. Deaths by heart attack started to climb correspondingly until they reached the same levels as in surrounding towns. The “Roseto effect” disappeared.
As Americans, we value diversity, so we are not looking to replicate a physical Roseto, with its notable homogeneity. Americans also move around more than any other people in the world, so our neighborhoods are often in flux. How then, do we create the kind of community the people of Roseto enjoyed for generations? That is what we are attempting at Georgia Integrative Medicine. We want to create an atmosphere that provides the kind of support, encouragement, and nurturing that can have a Roseto-like effect on people’s physical and emotional well-being. We want Rosetto effect for our patients as well as for ourselves.
One of the reasons why I created Georgia Integrative Medicine was to create a community of healers.  After a decade, we have dedicated team members, volunteers, and patients that creates an extraordinary healing environment.  This effect was partly inspired by my reading about Rosetto effect while studying with Dr. Andrew Weil at University of Arizona.
Yoon Hang "John" Kim, M.D., M.P.H.


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