Outliers

Outliers

In 1961, a physician named Stewart Wolf was visiting a small town in eastern Pennsylvania called Roseto. Wolf was not there for the scenery. He had heard something strange from a local doctor: the people of Roseto almost never died of heart attacks. This was peculiar, because heart disease was the leading killer of Americans under sixty-five at the time. Wolf dug in. He collected death certificates going back decades and had every resident over twenty-one examined. The results were extraordinary. Men over sixty-five in Roseto were dying of heart disease at roughly half the national rate. Below sixty-five, the death rate was virtually zero. There was no heart disease. Almost none at all.

Wolf spent years trying to explain it. He checked the local water. He looked at the region's geography. He examined the diets of Roseto residents. They ate meatballs fried in lard. They put salami and hard and soft cheeses on their bread. Forty-one percent of their calories came from fat. They were not especially active. Many of them smoked. Their cholesterol levels were no better than anyone else's. Yet they were not dying of heart attacks.

Wolf eventually concluded that the explanation had nothing to do with genes, diet, or geography. It was the community itself. Roseto had been founded by immigrants from a village in southern Italy who had arrived in the 1880s and rebuilt their old-world social structures on Pennsylvania soil. Three generations often lived under one roof. The town had twenty-two separate civic organizations for a population of just two thousand. People stopped to talk to each other on the street. They cooked for their neighbors. The elderly were venerated, not marginalized. Wealth did not create obvious class divisions. The community was the medicine.