Integrate Your Health: Relationships for Longevity

Lola Magazine Community, Dr. Nicole Cotter

There is a small town in eastern Pennsylvania named Roseto that was settled by Italian immigrants in the 1880s. It was named after the village in southeastern Italy from where the immigrants originated. In the 1950s, it was noted that the residents of Roseto had a dramatically lower rate of heart disease compared to their neighboring towns, despite the fact that its citizens did not follow what would be considered a heart-healthy lifestyle: They smoked cigarettes, drank wine, consumed sweets, and cooked with lard. The striking difference between Roseto and more typical American towns, however, was the town itself: The community was close-knit, the citizens visited each other and celebrated together, often several generations lived under one roof, and elders were revered and included. Roseto at the time had no crime, alcoholism, drug addiction, and very few applications for public assistance.

Citizens were not lonely. They were supported and the town was protected from the modern world. In essence, they were connected and happy. Sadly, in the 1960s the traditions began to crumble, the western lifestyle was introduced, and the incidence of chronic disease rose to match that of the surrounding communities.

From the observations of this town, the term “Roseto Effect” was coined, describing the phenomenon by which a close-knit community experiences a reduced rate of heart disease. Although we talk a lot of about nutrition and exercise, there is more to health and longevity than what we eat and whether we go to the gym. The community in which we live and the relationships we have are vital to our health. In truth, relationships preserve health and loneliness is deadly. Loneliness is experienced when we are physically isolated but also when we are emotionally isolated, illustrated well in recent research into the emotional consequences of social media in our youth. Loneliness activates the sympathetic nervous system, fuels inflammation, and increases the risk of chronic disease. It makes it more difficult for us to cope with stress. Loneliness impairs memory and increases the risk of dementia. It also increases the risk of an early death. Loneliness has been shown to be as detrimental to a person’s health as smoking. Mother Theresa said it well when she said, “The greatest disease in the West today is not tuberculosis or leprosy; it is being unwanted, unloved, and uncared for. We can cure physical diseases with medicine, but the only cure for loneliness, despair, and hopelessness is love.”

In the 1930s, a group of scientists started the Harvard Study of Adult Development, which would become the longest longitudinal study of its kind. The study initially included 268 Harvard sophomores and 456 men raised in inner-city Boston, tracking them over their lifespan in the hopes of identifying the predictors of longevity. It has since incorporated the wives of many of the subjects, as well as their children. The current study director, Dr. Robert Waldinger, gave an excellent TED talk summarizing the findings of this study. He states that “the clearest message we get from this 75-year study is that good relationships keep us happier and healthier.” This research shows that the people who are the most satisfied in their relationships at the age of 50 will be the healthiest at the age of 80, and that relationship satisfaction is a better predictor of health than cholesterol. Dr. Waldinger describes three big lessons learned from the Harvard research: Social connections are really good for us, it is not the number of friends you have but the quality of the close relationships that matters, and that good relationships not only protect our body but they protect our brains. In our society, we are misled to believe that wealth and fame matter most, but the Harvard study has illustrated that the people who fare best in life are those who foster relationships with family, friends, and community.

If there is one thing we are good at in Louisiana, it is community. We celebrate big and know how to bring people together to have a good time. The good news is that fostering our community and relationships is good for our health. Let’s put down the smart phones, call a friend, organize dinner with the neighbors, and spend some quality time with our significant others and families. In the words of musician Tim O’Brien, “if there’s ever an answer, it’s more love.”

Nicole M. Cotter, MD is an integrative physician in Shreveport, Louisiana. She was the first board-certified Integrative Medicine physician in northwest Louisiana and is one of the few integrative rheumatologists in the nation.  She is the owner of Integrative Medicine of Shreveport-Bossier (, a consultative practice where she partners with patients to create personalized health plans that integrate complementary medicine with conventional to care for the whole person.