The surprising longevity lesson of a small Pennsylvania town

Roseto’s residents once suffered remarkably few fatal heart attacks. Researchers eventually concluded that the town’s close families and strong community life may have helped protect their health.

For years, Americans hoping to live longer have been urged to search for the right diet, workout, supplement or medical treatment. But the experience of one small Pennsylvania town suggests that another influence may belong on the list: the strength of our relationships.

As recently reported by Men’s Journal, Roseto, a community founded by Italian immigrants about 75 miles north of Philadelphia, attracted researchers’ attention because its residents appeared unusually resistant to fatal heart attacks. The phenomenon became known as the “Roseto effect.”

Researchers initially looked for the usual explanations. Perhaps residents ate a healthier Mediterranean diet, exercised more or benefited from favorable genetics. But Rosetans did not always follow the habits now associated with cardiovascular health. Smoking was common, and their diets included plenty of fat. Many residents worked in physically demanding but stressful jobs.

What distinguished Roseto was its social structure and the connections it fostered.

Multiple generations often lived under one roof. Extended families remained closely involved in one another’s lives. Neighbors visited frequently, community organizations were active and residents had a strong sense of shared identity. Social status was reportedly less conspicuous than in many surrounding communities.

In other words, people knew one another—and believed they could count on one another.

When the advantage disappeared

A 1992 study published in the American Journal of Public Health examined 3,859 death certificates from Roseto and nearby Bangor, Pennsylvania, covering the years 1935 through 1985.

Researchers Brenda Egolf, Judith Lasker, Stewart Wolf and Louise Potvin found that Roseto initially experienced a lower death rate from heart attacks. But the advantage did not last. As younger generations moved away from the town’s traditional Italian-American culture, Roseto became more like other American communities. Multigenerational households declined, lifestyles became more individualistic, and the town’s tightly woven social relationships weakened.

Eventually, Roseto’s heart-attack mortality rose to approximately the level found in Bangor.

That does not prove that friendship prevents heart attacks. The research was observational, meaning it could identify an association but not demonstrate that community cohesion directly caused Roseto’s better health. Medical care, income, occupation, migration and other factors may also have played roles.

Still, Roseto raised an important question that scientists continue to explore: Can strong relationships help people live longer and healthier lives? Increasingly, the evidence suggests they may.

Connection as a health issue

The Centers for Disease Control and Prevention says loneliness and social isolation are associated with increased risks of heart disease, stroke, Type 2 diabetes, dementia, depression, anxiety and earlier death.

Social isolation and loneliness are related but not identical. Isolation describes an objective lack of relationships or contact. Loneliness is the subjective feeling that the relationships you have do not provide the connection you need. A person can live alone without feeling lonely—or feel painfully lonely in a crowded room or an unsatisfying marriage.

A 2022 American Heart Association scientific statement concluded that isolation and loneliness are associated with about a 30% higher risk of heart attack, stroke or death from either. The association may reflect several pathways, including chronic stress, inflammation and the effect relationships have on health behaviors.

The U.S. Surgeon General’s advisory on social connection reported that isolation is associated with a 29% greater risk of premature death. It compared the mortality consequences of inadequate connection with the risk from smoking as many as 15 cigarettes a day.

These statistics should not be interpreted as guarantees. Having a large social circle will not cancel out smoking, high blood pressure, inactivity or poor nutrition. But they suggest that relationships deserve to be treated as part of health maintenance—not simply as entertainment.

Building your own Roseto in Atlanta

The lesson is especially relevant after 50, when retirement, divorce, caregiving, health problems and the deaths of friends or family members can quietly shrink a person’s social world.

The CDC recommends doing enjoyable activities with others, maintaining regular contact with family and friends, and visiting parks, places of worship, senior centers and other community spaces. Group exercise, gardening, volunteering, book clubs, arts programs and recreational sports can all create repeated contact—the raw material from which relationships grow.

Atlanta-area residents have several places to start. The City of Atlanta’s PrimeTime Seniors program offers fitness, social, educational and arts activities for adults 55 and older. DeKalb County’s senior centers provide classes, meals, wellness programs, field trips and caregiver support for residents 60 and older.

The Atlanta Regional Commission’s Empowerline can also connect older adults and caregivers with local services and opportunities at 404-463-3333.

The most useful step may also be the simplest: put connection on the calendar. Call the friend. Share a meal. Join something that meets regularly. Learn your neighbor’s name.

Roseto’s history does not offer a miracle cure. It offers something more demanding—and possibly more valuable: a reminder that staying connected may be one of the ways we help keep one another alive.