The Village Effect: How Face-to-Face Contact Can Make Us Healthier and Happier (9 page)

Sardinian centenarian Teresa Cabiddu demonstrating how to make culorgiones
. (Image and Figure Credits
2.2
)

None of that sounded like a lot of fun to me, least of all consecrating one’s oldest daughter to a life of domestic slavery at the age of eight. At twenty-four, my daughter was planning for a future that revolved less around the confection of homemade pasta pockets than on a decade more of schooling, probably far from home. My husband and I wanted our children to make independent decisions, even if that meant moving thousands of miles away from us—an idea we didn’t exactly relish.
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And in North America we are not unusual; fostering independence is the goal of most parents. But generational separation is not universal. In Sardinian villages, children tend to build their adult lives near their extended families. Zia Teresa had spent her morning with two of her daughters, Gabriella and Bruna, and with her neighbor Marietta. The three women had come by to keep her company while Angela was out of the house, working her morning shift at the local bakery.

During our visit, we learned that Zia Teresa had been a headstrong child and that she’d loved to sing as a young woman. We learned the name of the man who played the accordion several decades earlier so everyone else could dance, and how he repaired it with flour and water when it broke. We learned about her favorite dish (minestrone) and her least favorite (pizza), and her nickname for another centenarian in town (Crabittu). We learned that her short- and long-term memory worked fluidly: she could recount the names and dates of birth and death of her parents and the seven siblings who’d predeceased her, all in their late eighties and nineties. She knew my interpreter’s complex family history once she’d greeted Delia with “
Figlia di chi sei
?” Zia Teresa at one
hundred was what she had been her entire life: a gregarious woman with many friends, relations, and neighbors, all of whom popped in regularly to visit and chat, all the while bolstering her importance in their lives, and her place in the community.

To properly “age in place” as Teresa has, you don’t need to live in a literal village but near a group of like-minded people who create the intimacy of one. Research by Harvard professors Subu Subramanian, Felix Elwert, and Nicholas Christakis shows that widows (and widowers) live longer if they choose to live in neighborhoods filled with other widows. Never mind how well off the community is or how healthy its residents are to begin with; when it comes to living longer, the age and marital status of one’s neighbors holds more sway. The global phenomenon of widowed people dying soon after they’ve lost a spouse—called
the widowhood effect—is
attenuated when someone who is grieving is surrounded by lots of other widowed people, especially if they’re women.

Yet another example of the female effect, it probably works this way: if you feel unbearably lonely because your spouse has died, nearby female friends with the same life experience are more likely to know how it feels and to step in to fill the companionship gap, as Marietta did with Zia Teresa. To weather the inevitable indignities of advancing age, geographic proximity to close friends and confidantes is what really matters, according to research by Teresa Seeman and Lisa Berkman.
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Indeed, what the data tell us is that the elderly, and especially widowed people, live longer in places such as Villagrande or Boca Raton—where there are lots of residents of the same age with the same concerns—than they would if they lived among Brooklynites pushing baby strollers and riding fixed-gear bikes.
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Zia Teresa reminded me of my grandmother, who at eighty, as we bent our heads over my Russian homework, told me that she might look like an old woman to other people, but she continued to see the world through the eyes of her younger self. Teresa was
able to tap into her younger persona by virtue of living so close to relatives and friends who had known her for decades, in the place where she had raised her six children. Those children lived there too, or in towns nearby. Instead of communicating electronically, they came by in person to gossip, bring food, or press her into service for the weekly baking. There were no strangers in Zia Teresa’s social network, no nurse’s aides paid to visit or support groups with others who shared the same ailments.

Remarkably, our bodies know the difference between real social support offered by people we know and the contrived version. “The source of support matters,” Brigham Young health psychologist Julianne Holt-Lunstad told me. “Not all relationships are equal. When you introduce social support, there may not be any real relationship there.” As anyone in a failing or hostile relationship knows, interaction with the wrong person can make matters worse. In one well-designed study, led by McGill nursing professor Nancy Frasure-Smith, cardiac nurses repeatedly called and visited about a thousand psychologically vulnerable men who’d recently had heart attacks. Unfortunately, these calls and visits from strangers had no impact at all on the men’s survival. And in a subsequent study, the nurses’ visits actually doubled the likelihood that high-risk women with heart disease would die within the year.
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How could this be? The study’s authors speculate that cardiac care had improved men’s survival rates so dramatically in the 1980s that it would have been hard for the nurses’ support visits to boost them further. But the higher number of women’s deaths after the nurses’ so-called supportive phone calls and visits could mean only one thing: with friends like these, who needs enemies? Shallow bonds may be good for many things, but improving one’s chances of surviving after a heart attack doesn’t seem to be one of them.

When I asked Zia Teresa how it was that she has lived so long, her neighbor Marietta answered for her. “Because it’s God’s will!”

But Zia Teresa lightly slapped Marietta’s knee to shut her up. “No, it’s because they love me,” she said softly.

“Well, I am going to the church to thank God for that,” said Marietta.

“Okay. Pray for us all, then,” retorted Teresa with a smirk, “and don’t let the priest kiss you while you’re there.”

THE FOUNTAIN OF YOUTH

Zia Teresa’s unusually long life would be but an amiable detour in my story if it did not illustrate several powerful scientific findings. As we’ve seen in the previous chapter, social contact can help keep individuals alive when they happen to get sick. But where we live and the social life we lead there can also keep us healthy, creating pockets of longevity—or dare I use that twee word
wellness—
tied to a specific place.
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When Gianni Pes and Michel Poulain first presented their Sardinian Blue Zone data, they expected other scientists to greet their findings with skepticism, if not derision. After all, discovering a longevity hotspot is nothing new. Strange practices and obscure places where people supposedly live longer than elsewhere have surfaced at regular intervals since at least the biblical period, when Methuselah supposedly lived to the age of 969. A millennium later, people thought eating the meat of poisonous snakes would add decades to their lives. In the nineteenth century a neurologist, Charles-Édouard Brown-Séquard, injected himself with an extract from ram’s testes, declaring that it would add years to his life. Meanwhile, Serge Voronoff, a Russian physician, tried an extract of chimpanzee testes instead, and thought it a far superior product.
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Needless to say, none of those practices panned out.

More recently, in the 1970s, several longevity hotspots surfaced, including the Caucasus in the former Soviet Union (where the local Abkhasian people supposedly live longer because they drink kefir instead of water), the Hunza Valley in Pakistan, various
Japanese islands, and an Ecuadorean village called Vilcabamba. Tales of men fathering children at the age of 160 (yes, yogurt is that good for you!) were rampant. Unfortunately, when researchers delved deeper into the phenomena of 160-year-olds who swilled kefir (or was it vodka?) first thing in the morning, then swam across frigid fjords and had indefatigable libidos, they discovered that record-keeping in many of those places was unreliable, to say the least.
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Residents’ extravagant claims about themselves or their family members often couldn’t be confirmed. There is an aspirational, if not a public relations aspect to exaggerating one’s age. After all, if peasants on the Russian steppes lived to the age of 150, how bad could life really be under Soviet-style communism?

Other so-called longevity Shangri-Las reflected different, dire realities. In Japan, which ranks among the countries with the highest median age (that is, the greatest number of people who survive the longest), a significant proportion of its oldest citizens had simply gone missing. Most of them were men who’d moved to the big cities looking for work during Japan’s economic boom years. Finding industrial jobs, these men worked obsessively long hours for decades, never building any social networks in their urban locales. They died miserable deaths, anonymous and alone. With no record of what had happened to them, their previous home municipalities assumed they were still alive and crowed about their growing cadre of centenarians.

At 111, Sogen Kato was supposedly Tokyo’s oldest man. His mummified corpse was discovered by officials who arrived at his home in the summer of 2010, hoping to congratulate the gentleman on his birthday. Instead they found his skeletal remains lying on a bed, wearing underwear and pajamas and covered with a blanket. Kato had died thirty-two years earlier, at the age of seventy-nine. His family told police that Kato had confined himself in his room more than thirty years before to become a living Buddha. They had been cashing his pension checks ever since. Such grisly discoveries put
the Japanese longevity record in question and prompted some national soul-searching. The country’s social services tried to track down the rest of its so-called centenarians and could not find 234,354 of them.
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If any confirmation was needed that proximity to friends and family who care about you is essential to survival, this was it.

WHAT IS IT ABOUT PLACE?

Sardinia, however, is no mystical Shangri-La. The residents aren’t blessed with extraordinarily long lives because they drink the local red wine or eat plum tomatoes from their gardens. While the resveratrol in the regional wine matters some, ongoing face-to-face social contact with people who know and care about them matters more than any of the molecules on their plates or swirling around in their wineglasses.
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In fact, two places in the United States where people live unusually long lives are places where people don’t drink any alcohol at all. Loma Linda is a modern city of twenty-two thousand in San Bernardino County, just east of Los Angeles. Downwind from L.A.’s smog clouds and right beside a Lockheed-Martin plant that has long been leaching perchlorate—a chemical by-product of rocket fuel—into the town’s groundwater, the Loma Linda area boasts rates of perchlorate in its drinking water that are eighty-three times higher than the limits recommended by California’s Department of Health. It also has the worst ozone pollution in the nation, according to the American Lung Association. Yet Loma Linda’s residents live an average of six years longer than other Americans, in large part due to the social bonds among the Seventh-day Adventists who live there. Their support systems and diet, combined with a state-of-the-art medical center, mean that the residents live longer there than they do in neighboring towns.

And, as in the mountains of Sardinia, the culture of the place is beginning to close the mortality gap between men and women.
The average thirty-year-old Adventist man from Loma Linda lives 7.3 years longer than male citizens elsewhere in the United States; the average Adventist woman lives an average of 4.4 years longer than other American women (and women already have a six-year head start).
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David Snowdon is an epidemiologist from southern California who pioneered some of the basic research linking the lifestyle of the Loma Linda Adventists to their reduced rates of chronic disease. He realized early on that longevity is less about a place than about who lives there and how they interact.

After he’d studied the Adventists of Loma Linda, Snowdon chose to shine his statistical searchlight on Catholic nuns. He and his research team followed 678 members of the School Sisters of Notre Dame for fifteen years, from 1986 to 2001. The nuns, all between 75 and 106, were living in convents in the American heartland: Wisconsin and Minnesota. Snowdon and his colleagues mined the minutiae of their childhoods for data and tracked their cognitive abilities and eventual decline. As the environment of these nuns was fairly consistent and there were several siblings among them, Snowdon tried to tease apart the relative influence of genes and early experience on their lifespans and lucidity as they aged. Most of the nuns bequeathed their brains to his lab, and Snowdon was able to make some astonishing connections between early experience and the neural tangles of Alzheimer’s disease. For our purposes, though, one of his most important discoveries was that once these nuns reached the age of sixty-five, their risk of dying in any given year was 25 percent lower than it was for other American women their age. Why would these nuns, whose diets were high in animal fat and who exercised very little, live significantly longer than average American women?