From Outliers: The Story of Success by Malcolm Gladwell.
People of Roseto, Pa, a town entirely made up of citizens who came from the village of Roseto Valfortore in Italy. Intrigued by the extremely low incidence of disease in Roseto, including no coronary artery disease in anyone younger than 55, medical researchers in the 1960s dedicated themselves to studying this phenomenon. Rosetans did not follow a healthy diet and obesity was prevalent; they did not exercise; smokers were everywhere. Their relatives living elsewhere had a high incidence of disease, ruling out a genetic explanation. Nearby towns with the same climate and environmental influences had an incidence of heart disease 3 times that of their Rosetan neighbours.
They described a unique sharing of experiences that defined the town’s social structure. They discovered a feeling of trust and security among Rosetans because the people of the town always had someone they knew and who knew them to turn to for support. They concluded that the extraordinary health of this unique population could only be explained in terms of “extended family” and “community.”
Flash forward 4 decades to the research findings of Dr Barbara Starfield and her colleagues, showing better health outcomes for populations with regular access to primary care settings and personal physicians. Beyond the social determinants of health, these contacts might play the most important role in determining the well-being of our population.
Why primary care and family practice have so powerful an effect on health outcomes is usually explained by the elements that define family medicine: comprehensiveness, continuity, and coordination of care. Underlying all of these is the ongoing relationship between the patient and physician—the personal family doctor who provides the trusted advice and care for any medical problem throughout the lifespan of individuals and their families.