Lissa Rankin: The #1 Public Health Issue Doctors Aren’t Talking About (Transcript)

Lissa Rankin

Watch and read the full transcript of Lissa Rankin’s TEDx Talk: The #1 Public Health Issue Doctors Aren’t Talking About at TEDxFargo July 2016 Conference.

Listen to the MP3 Audio here: the-1-public-health-issue-doctors-arent-talking-about-by-lissa-rankin-at-tedxfargo


Two years back, I was on a book tour for my book Mind Over Medicine and I was talking to the audience just like you all. And as a physician, I had done research on some conventional things that affect our health but also some unconventional things. And the question I would get asked over and over again is: what is the greatest risk factor for your health? And I would say loneliness and there would be dead silence in the room just like there is here.

And it took me awhile to figure out that this was a really uncomfortable answer for a lot of people. People wanted me to say diet or exercise, or maybe yoga or meditation, or something that they felt like they could do and be proactive about. And people felt helpless in the face of their loneliness. And this helped me to realize that we need to start to pay attention to this.

So I want to start by telling you a story and then I’m going to give you some data to speak to your mind in case you don’t believe me and you’re feeling a little skeptical that loneliness could be this important, that it could actually be the number one public health issue that we’re facing right now.

Roseto effect

And then I want to speak to your heart, because that’s really what this is all about. So let’s go back to 1961 to Roseto, Pennsylvania. And Roseto, Pennsylvania in 1961 was a very special place that was filled with Italian immigrants who had come from the old world in Italy and had settled in this small town. And Dr. Stewart Wolf was a cardiologist from the University of Oklahoma. And he showed up in Roseto one day because he had a vacation home in the Poconos and he was having a drink at the local bar with one of the doctors there.

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And the doctor there said, “You know, it’s so strange — the people of Roseto, they never seem to get heart attacks”. Well, he was a cardiologist, so this caught his attention. So he went and he checked out the death records, and sure enough, these people were not dying of heart disease. The people of Roseto had half the rate of heart attacks of the national average. There were no heart attacks in men under 65 and the death rate from all causes was 30% to 35% lower than average. So this was unusual.

So Dr. Wolf called in a whole team of researchers and they started researching these people to figure out what’s going on here. And John Bruhn was one of these researchers and he said, “There was no suicide, no alcoholism, no drug addiction and very little crime. They didn’t have anyone on welfare. Then we looked at peptic ulcers, they didn’t have any of those either. These people were dying of old age. That’s it”.

So they thought, “Well, it must be something in their diet. Maybe it’s the olive oil” but they found out that the people in Roseto were eating meatballs fried in lard. They were eating pizza and pasta with egg and sausage. A whopping 41% of their calories came from fat. Many of them were morbidly obese. They didn’t exercise and they smoked.

So you can imagine this cardiologist was going, “Wait a minute, what’s this?” So they thought, well, maybe it’s something in their DNA. They went back and they checked their ancestors who came from Roseto Valfortore in Italy and they found those that had settled elsewhere in the US but no, it wasn’t that. They had the same rate of heart disease as everybody else in the US. And it wasn’t their healthcare and it wasn’t their water, they ruled out everything that they could. And they finally concluded that the people of Roseto had half the rate of heart disease and significantly lower rates of all other causes of death, because the people in Roseto were never lonely.

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This doesn’t have such a happy ending, because like many people in our culture, you know, the children of Roseto grew up and they wanted the American Dream, they wanted to be modernized like everybody else. They didn’t like living in this small community village where everybody lived in multi-generational homes. Grandma and the kids all lived together. They’d all go to work, they’d come home, they’d have celebrations, they’d go to church together.

That Roseto in 1961 was evidence of the power of the tribe. But by 1971, everybody had moved to the suburbs, they’d gone into their own little boxes. They had started separating from one another. They weren’t living in multi-generational homes anymore. In 1971, the first heart attack, that’s in somebody less than 45, happened. High blood pressure tripled, strokes increased. And by the end of the 1970s, Roseto had the same risk of heart disease as everybody else in the country.

So Roseto — we learned from them that human beings nourish each other and the health of the body reflects this. Now researchers have studied a lot of Blue Zones and Roseto was one of those Blue Zones. Blue Zones are places on the globe where there’s an unusual number of people who lived to be greater than a hundred and these are places like Okinawa, Japan; Sardinia in Italy; Loma Linda, California; Ikaría in Greece; and every single one of these Blue Zones they lived like the people of Roseto did. They lived in community. They lived in tribe. They know they belong. They grow up from the time they’re little knowing that they’re part of this tribe. And this has a physical health protection on the body.

Physiology of loneliness

So how does this happen? Let’s talk a little bit about the physiology of loneliness. We are tribal beings. We are supposed to be together. We come from love and when we die we go back to love. And the whole point of being human is that we’re here to love each other, we’re here to be together. And our nervous systems are wired that way.

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So when we feel socially isolated, then the nervous system goes into threat and the limbic brain, the survival part of the brain, the really primordial brain starts to freak out. It goes into the sympathetic nervous system or what Walter Cannon at Harvard called the stress response. You may know it as the fight-or-flight response. And when the nervous system is in fight-or-flight response the body fills with cortisol and epinephrine. These hormones put us at risk of heart disease and every other kind of illness.

And we know that the body is beautifully equipped with natural self-healing mechanisms. We make cancer cells every day. We fight our own heart disease every day. We have natural longevity enhancements built into our bodies.

But here’s the kicker. Those natural self-healing mechanisms only work when the nervous system is in what Herbert Benson at Harvard called the relaxation response. This is the parasympathetic nervous system. When we know that we belong, when we can feel ourselves in love, in community, in tribe, then the nervous system relaxes.

But you think about the single mom who’s by herself trying to raise three kids and get to her job and the kids are sick and she doesn’t have any help. And what about her social life and what about her self-care? Her nervous system is in stress response all the time. And this puts her at risk of disease and decreases her longevity.

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