In 1882, eleven residents of Roseto Valfortore — a small village in the Foggia province of southern Italy — boarded a steamship headed for New York. Eight of them crossed the Atlantic with big dreams and settled near Bangor, Pennsylvania. But the welcome they expected didn't materialize. Earlier Welsh and German immigrants had staked their claims and weren't eager to share. Facing that collective hostility, four of the eight eventually moved elsewhere in America. One got back on a ship and returned to Italy.
The one who came back was greeted warmly. His stories of life on the other side of the world must have been gripping, because they spread from household to household until they took on the quality of legend. Those stories planted the seed of the American dream in the hearts of the villagers. Before long, people started leaving in earnest. By 1894, the number of Roseto Valfortore residents who had obtained American passports — excluding women and children — reached 1,200. The entire village was essentially picking up and moving to America.
When these immigrants arrived, they settled next to Bangor and built their own community, away from the hostility of earlier arrivals. They named it Roseto, after the hometown they wanted to remember. It became the first officially recognized Italian-immigrant municipality in the United States.
A Heart Doctor Takes Notice
This otherwise unremarkable immigration story made worldwide headlines in 1960. Documentaries were produced in at least four countries. Doctors, sociologists, and psychologists poured into the village. Every resident was given blood tests, electrocardiograms, questionnaires, and in-depth interviews. The term Roseto Effect was coined. This tiny immigrant village had the world's attention.
What happened?
It started with a chance meeting between two doctors: Benjamin Falcone and Stewart Wolf. Wolf, an internist at an Oklahoma hospital, was on vacation in eastern Pennsylvania when he met Falcone, who had been serving as the local doctor for both Roseto and Bangor for seventeen years. Falcone shared something curious: "The people of Roseto die of heart disease before sixty-five at a far lower rate than the people of Bangor. Isn't that odd? The two towns are right next to each other, but their life expectancies are very different."
For most people, this would have been an interesting anecdote and nothing more. Wolf took it further. He secured research funding and started a formal investigation.
First, he checked whether Falcone's observation held up. He collected local death records and analyzed every death in Roseto between 1955 and 1961, comparing them with deaths in Bangor — a town that shared the same water supply and healthcare system. The cardiovascular death rate in Roseto was less than half that of Bangor, and less than half the national average for the entire United States. Even more striking, almost no one in Roseto had died of heart disease before age sixty-five. Psychiatric hospital visits among Roseto residents were also less than half the American average.1
Some readers might be thinking, "Well, they were Italian immigrants. They probably ate a Mediterranean diet with lots of olive oil and stayed thin." If the answer were that simple, Roseto would never have become famous. Wolf's findings told the opposite story. Roseto's residents had all the classic risk factors for heart disease. They ate plenty of meat, didn't exercise much, and enjoyed drinking and smoking. Their blood pressure was no different from the national average. Far from drizzling olive oil on their food, they cooked in lard. Their blood cholesterol was the same as Americans everywhere else.
The genetic explanation was an obvious one to consider. Roseto's residents had all come from the same Italian village, and most had married within the community, so they might have shared a gene pool that happened to protect against heart disease. To test this, Wolf tracked down people who had been born in Roseto but moved away as children. Their cardiovascular disease and death rates were identical to the American average. Their diet, exercise habits, fat intake, smoking, and cholesterol were the same as those of people who had stayed in Roseto. Genetics couldn't explain it. So why were Roseto's residents so healthy?
Wolf found the answer before long. "The most striking thing," he later said, "was that the people of Roseto were enjoying their lives." The residents lived simply, modestly, without pretension. There was almost no crime. Wealthier residents gave generously; those who were less well-off accepted help without embarrassment. In a village of just two thousand people, there were twenty-two community organizations — fishing clubs, hunting groups, book circles, sports teams. Many households had three generations living under one roof, and communal celebrations were constant. They lived, in effect, like one large extended family. Wolf's conclusion: it was this tight-knit social fabric that lowered the residents' cardiovascular risk and helped them live longer.
Why the Roseto Effect Vanished
Are the people of Roseto still living long, healthy lives today? Unfortunately, no. Wolf followed the community for another twenty-five years and published his updated findings in 1989. The opening of his conclusion section reads: "The most remarkable social change was the emergence of ostentation among the residents — something that had long been taboo in Roseto. These people had believed that showing off attracted the devil's attention. But the younger generation abandoned that belief and began competing to display their wealth. They drove expensive cars through town, and a culture of petty comparison and rivalry took hold."
Young people left Roseto for jobs elsewhere. Newcomers replaced them. The once close-knit community dissolved. Roseto became just like the town next door, and the gap in cardiovascular death rates disappeared with it. The Roseto Effect was gone.2
In the decades since, as obesity has risen worldwide, diabetes, cardiovascular disease, and especially cancer have increased at an alarming rate. Deaths from infectious diseases like pneumonia have declined, but deaths from metabolic and lifestyle diseases now account for more than 67 percent of all deaths. Given this, what should we focus on to live longer and healthier? Not just exercise and diet. Maybe we also need to see family and friends more often, stay socially active, and take care of our relationships.3
Reading about Roseto, I thought, "Wait — this is just like the village I grew up in." Everyone was poor, life was hard, but through traditions like dure and pumasi — communal labor-sharing customs, Korea's own version of neighbor helping neighbor — people shared whatever they had, even if it was just half a soybean. Neighbors went in and out of each other's homes so freely that everyone knew how many spoons and chopsticks each kitchen had. When something bad happened to a neighbor, the whole village grieved together. When something good happened, everyone celebrated as if it were their own. Weddings and funerals brought the entire community out. The fathers would fuss over the fruit and sweets for a neighbor's ancestral rite as carefully as for their own family's. The mothers would set up a big pot in the yard and boil an enormous batch of noodles for everyone.
Then at some point, it all started to change. Three generations gathering for holidays became rare. The winding village paths were cut through by straight paved roads, and homes were walled off behind high fences. People locked their doors, stopped coming out, stopped participating in community events. Grown children all left for Seoul as if by unspoken agreement, and only the elderly remained, sitting alone on empty verandas. The same thing happened at work — communal culture eroded, most meetings went online, and there were fewer and fewer reasons to actually see other people in person. Forget company dinners — even sharing a table with one other person started to feel like a burden. Honbap (eating alone), honsul (drinking alone), "I'm fine on my own" — solo living became the new normal. Turn on the TV, and variety shows present living alone as the standard modern lifestyle.
Is it any wonder, then, that schizophrenia, depression, bipolar disorder, and other mental illnesses have increased? Suicide rates have reached levels that can't be ignored. South Korea has the grim distinction of the highest suicide rate among OECD countries. In 2022, it was 26 per 100,000 — 2.4 times the OECD average of 11. The trend is telling: Korea's suicide rate began climbing steadily in the early 1990s, peaking at 31.7 per 100,000 in 2011. As Korea rode its economic miracle through rapid industrialization, everyone was pushed into an unrelenting race. Social inequality widened, relationships fractured, and the pressure of college entrance exams and job hunting became suffocating. Is there no way forward?
This is where I began to wonder whether the "social hormone" oxytocin might hold part of the answer. Some readers may be thinking, "Oxytocin? The hormone that surges during childbirth and sex? How could that have anything to do with our health or our future?" I thought the same thing. But perhaps what Stewart Wolf glimpsed in the 1960s — when he compared old Roseto with new Roseto and with mainstream America, framing the difference as "competition versus cooperation" in his book The Power of Clan: The Influence of Human Relationships on Heart Disease — was only the tip of the iceberg.
Let's step into the world of oxytocin.