In the 1960s, Len Syme, the first sociologist to land a job in the U. S. Department of Health, suspected that social factors had a bearing on certain diseases believed only to have dietary or environmental causes, such as heart disease, cancer or arthritis.
In one of his early attempts to tease out why rates of cardiovascular disease varied in numerous U. S. states, Syme found that the ‘culturally mobile’, as he began to call them — those who’d moved geographically from one societal culture to something quite different, particularly those who’d moved from farms to white collar city jobs – went on to get heart disease. This connection prevailed even when he’d eliminated other factors, such as smoking, blood pressure and all the other supposed major risk factors of cardiovascular disease. Social mobility – moving outside society as you knew it – made you ill.
At the School of Public Health at Berkeley, Syme teamed up with Reuell Stallones, another of Berkeley’s professors, to test his migration hypothesis with the perfect population: the Japanese who’d migrated to Hawaii and California.
The Japanese paradox
As a race, the Japanese fascinate any student of epidemiology because they are such an apparent paradox: they have the lowest heart disease in the world, despite the fact that smoking — one of the biggest risk factors of heart disease — is virtually universal.
Japan’s longevity statistics confound all our expectations about what is required to live a long and healthy life. In fact, Japan produces the world’s largest number of centenarians: almost 18,000 people live to 100 — many of them smokers.
Epidemiologists find transplanted societies particularly instructive, as they afford an opportunity to examine just how a particular community fares when confronted with profound social, cultural or dietary upheaval.
Syme and Stallones examined heart disease risk, plus dietary factors and any social change in a pool of 12,000 men, divided up among those who lived in Japan and two groups that had emigrated to Hawaii or northern California.
Stallones was interested in whether the Japanese had low rates of heart disease because of their low-fat diet, and whether heart disease went up when the Japanese, who maintain an excellent low-fat diet in their home country adopt a typical burger-and-fries American diet, but Syme was interested in the social factor: whether moving countries and cultures was so destabilizing that it caused heart disease.
The results confounded both their expectations. The Japanese men migrating to California had five times the heart disease of those in Japan, while the heart-disease levels in Hawaii were midway between the two, so simply migrating somewhere else didn’t automatically cause disease.
Nevertheless, the results appeared to be completely independent of any of the usual supposed risk factors of heart disease, like smoking, high blood pressure, diet or cholesterol count; in fact, the Japanese population studied contained the highest number of smokers, but the lowest levels of heart disease.
Amazingly enough, their results also appeared independent of any dietary changes. Whatever the Japanese ate — whether tofu or a Big Mac — had no bearing whatever on their propensity to heart disease.
Although changes in the dietary habits made no difference in terms of heart disease, the kind of society the transplants created for themselves did. Those Japanese men who’d adopted American cultural ways suffered the increase in heart disease, while those who’d retained their traditional culture had the lowest levels of heart disease — comparable to Japanese men back home.
The most traditional group of the Japanese Americans had a heart attack rate as low as their fellow Japanese living in Japan, while those who’d adopted the Western go-ahead lifestyle increased their heart attack incidence by three to five times. These differences could not be accounted for by any of the usual risk factors. Those with social networks and social support were protect against heart disease — regardless of whether they smoked or suffer from high blood pressure.
In search of the x-factor
Syme was intrigued enough by these results to travel to Japan in search of the missing x-factor of impregnable health. He interviewed scores of the Japanese to find out the single factor that most distinguished the social fabric of America from that of Japan.
What most marked their culture from that of America, his interviewees repeated in interview after interview, was that Americans were lonely. Anyone could see that. Americans even walked on the street alone.
The Japanese, particularly in southern Japan, maintained tight-knit social groups that were mutually supportive, as was the work environment. Joining a business is not unlike marrying into a family; it is, in most instances, a relationship for life.
In southern Japan, the Japanese even create ‘moai’, a kind of life-long social and financial safety net made up by the contributions of your friends and loved ones.
The heart attack rates of the Californian Japanese-Americans had nothing to do with moving from Japan, but everything to do with losing the close social ties that proved to be Japan’s secret weapon in staying healthy.
In the 1960s, Len Syme, the first sociologist to land a job in the U. S. Department of Health, suspected that social factors had a bearing on certain diseases believed only to have dietary or environmental causes, such as heart disease, cancer or arthritis.
In one of his early attempts to tease out why rates of cardiovascular disease varied in numerous U. S. states, Syme found that the ‘culturally mobile’, as he began to call them — those who’d moved geographically from one societal culture to something quite different, particularly those who’d moved from farms to white collar city jobs – went on to get heart disease. This connection prevailed even when he’d eliminated other factors, such as smoking, blood pressure and all the other supposed major risk factors of cardiovascular disease. Social mobility – moving outside society as you knew it – made you ill.
At the School of Public Health at Berkeley, Syme teamed up with Reuell Stallones, another of Berkeley’s professors, to test his migration hypothesis with the perfect population: the Japanese who’d migrated to Hawaii and California.
The Japanese paradox
As a race, the Japanese fascinate any student of epidemiology because they are such an apparent paradox: they have the lowest heart disease in the world, despite the fact that smoking — one of the biggest risk factors of heart disease — is virtually universal.
Japan’s longevity statistics confound all our expectations about what is required to live a long and healthy life. In fact, Japan produces the world’s largest number of centenarians: almost 18,000 people live to 100 — many of them smokers.
Epidemiologists find transplanted societies particularly instructive, as they afford an opportunity to examine just how a particular community fares when confronted with profound social, cultural or dietary upheaval.
Syme and Stallones examined heart disease risk, plus dietary factors and any social change in a pool of 12,000 men, divided up among those who lived in Japan and two groups that had emigrated to Hawaii or northern California.
Stallones was interested in whether the Japanese had low rates of heart disease because of their low-fat diet, and whether heart disease went up when the Japanese, who maintain an excellent low-fat diet in their home country adopt a typical burger-and-fries American diet, but Syme was interested in the social factor: whether moving countries and cultures was so destabilizing that it caused heart disease.
The results confounded both their expectations. The Japanese men migrating to California had five times the heart disease of those in Japan, while the heart-disease levels in Hawaii were midway between the two, so simply migrating somewhere else didn’t automatically cause disease.
Nevertheless, the results appeared to be completely independent of any of the usual supposed risk factors of heart disease, like smoking, high blood pressure, diet or cholesterol count; in fact, the Japanese population studied contained the highest number of smokers, but the lowest levels of heart disease.
Amazingly enough, their results also appeared independent of any dietary changes. Whatever the Japanese ate — whether tofu or a Big Mac — had no bearing whatever on their propensity to heart disease.
Although changes in the dietary habits made no difference in terms of heart disease, the kind of society the transplants created for themselves did. Those Japanese men who’d adopted American cultural ways suffered the increase in heart disease, while those who’d retained their traditional culture had the lowest levels of heart disease — comparable to Japanese men back home.
The most traditional group of the Japanese Americans had a heart attack rate as low as their fellow Japanese living in Japan, while those who’d adopted the Western go-ahead lifestyle increased their heart attack incidence by three to five times. These differences could not be accounted for by any of the usual risk factors. Those with social networks and social support were protect against heart disease — regardless of whether they smoked or suffer from high blood pressure.
In search of the x-factor
Syme was intrigued enough by these results to travel to Japan in search of the missing x-factor of impregnable health. He interviewed scores of the Japanese to find out the single factor that most distinguished the social fabric of America from that of Japan.
What most marked their culture from that of America, his interviewees repeated in interview after interview, was that Americans were lonely. Anyone could see that. Americans even walked on the street alone.
The Japanese, particularly in southern Japan, maintained tight-knit social groups that were mutually supportive, as was the work environment. Joining a business is not unlike marrying into a family; it is, in most instances, a relationship for life.
In southern Japan, the Japanese even create ‘moai’, a kind of life-long social and financial safety net made up by the contributions of your friends and loved ones.
The heart attack rates of the Californian Japanese-Americans had nothing to do with moving from Japan, but everything to do with losing the close social ties that proved to be Japan’s secret weapon in staying healthy.