Stress Has Hit Roseto, Pa., Once the Town Heart Disease Passed by
An exaggerated lament about the impersonality of American life today? Dr. Stewart Wolf, 66, an internist, thinks not. If his theory is right, the 1,700 people of Roseto, about 75 miles west of New York City, are increasing their risk of heart attack as they slowly break up what used to be an extraordinarily close community.
Wolf first heard of the little town in 1961, when a colleague who had practiced there for years said he had never seen anyone under 55 with heart trouble. Intrigued, Wolf, then head of the Department of Medicine at the University of Oklahoma, went to Roseto.
He and a research team surveyed 86 percent of the population, which is heavily Italian-American, studying death and hospital records, taking case histories, performing examinations and delving into the sociology of families. "We were surprised to find the usually accepted risk factors no different in Roseto than elsewhere," Wolf explains. "They probably ate more animal fat than most people. Smoking was about the same as elsewhere, and they were more obese. They didn't exercise more. But they had a lower death rate from heart attacks. It was lower than among Italian-Americans at large, and close to that in rural Italy."
There was less than one death per 1,000 population—more than 50 percent lower than the U.S. rate at the time. The nearby towns of Nazareth and Bangor had rates much higher.
The explanation for the town's healthy hearts, Wolf decided, was an amazingly low stress level. "The community," Wolf says, "was very cohesive. There was no keeping up with the Joneses. Houses were very close together, and everyone lived more or less alike." Families were run by strong father figures; housewives were highly respected, grandparents revered.
In 1978 Wolf himself moved to Pennsylvania, where he is now vice-president for medical affairs at a hospital in Bethlehem as well as professor of medicine at Temple University. The move also put him only two miles from Roseto, which he continued to study. From the start he believed the town would inevitably change, and so would its incidence of heart disease. First-generation townspeople died, young men and women left for college or careers, church attendance dropped and the town grew more fragmented. "We predicted in 1963 that if the social values these people had began to erode, they would lose their relative immunity from heart disease," Wolf says. "That's what happened. They weren't going to the Marconi Social Club. Cars changed from Chevies and Fords to Cadillacs, Mercedeses and even one Rolls-Royce. Swimming pools and fancy houses sprouted."
Wolf's last report, based on 1975 figures, showed Roseto's heart attack rate had more than doubled since 1961 and equaled the national average.
At the time Wolf began his research, most heart studies focused on diet, exercise and smoking, so his approach met some skepticism. But University of Maryland psychologist James Lynch, in his book The Broken Heart, said Wolf's work and similar studies showed social and psychological stresses "may be the most important of all risk factors" in heart disease.
Roseto is not Wolf's only research on the problem. In 1975 he went to Borneo to observe the effects of developing oil and lumber industries on the primitive Iban tribe.
A native of Baltimore, Wolf has been married since 1942 to Virginia Danforth, a descendant of the founders of Framingham, Mass., itself the focus of a pioneer study of heart disease. They have three grown children. "We're a very close-knit family," says Wolf. "That doesn't eliminate stress but it does help counterbalance it."