AN EPIDEMIOLOGICAL STUDY OF MYOCARDIAL INFARCTIONS IN AN ITALIAN-AMERICAN COMMUNITY; A PRELIMINARY SOCIOLOGICAL STUDY.

Abstract This paper reported some sociological findings of a preliminary study of myocardial infarctions in Roseto, an ItaliandashAmerican community in Pennsylvania. A medical clime was established in Roseto in December 1962 and the summers of 1963 and 1964 for Rosetans and their relatives living in nearby Bangor or elsewhere in the U.S. to undergo extensive medical examinations for evidence of heart disease. Of the 1071 Italian volunteers, 30 showed electrocardiographic evidence of a myocardial infarction. Comparisons of the prevalence rates of myocardial infarctions for Rosetan Bangorian and out of-town males showed that as one moved away from the community of Roseto the prevalence rates tended to increase. Also older Rosetan males had a lower prevalence of myocardial infarctions than Bangor and out-of-town males 65 years and over. Females had lower rates of myocardial infarctions than males in all three groups. There were too few cases of Italian females with infarctions to make valid comparisons between Rosetan, Bangorian and out-of-town prevalence rates. Of the clinic volunteers, 207 persons, including 18 of the persons with diagnosed myocardial infarctions, were seen for sociological interviews. Comparisons of the Roseto, Bangor and out-of-town Italians by sex, age, education and social class showed that more of the out-of-towners were younger, were from the middle or upper social classes and had achieved more education than the Rosetans and Bangorians. The persons with recognized myocardial infarctions were significantly older, mean age 61.7, compared to the mean age of persons without recognized myocardial infarctions, 46.5 years. The Rosetans, Bangorians, out-of-towners and patients did not differ significantly from each other in their mean marital adjustment scores. The Rosetans and patients had significantly lower (more conservative) religiosity scores compared to the Bangorians and out-of-towners. The out-of-towners, Bangorians and patients were more occupationally upwardly mobile from their parents than were the Rosetans. The groups did not differ greatly on educational mobility, but the out-of-towners tended to be the most educationally upwardly mobile followed by the Bangorians, Rosetans and patients. All groups tended to have similar family incomes. This is attributable to the fact that both Rosetan husbands and wives work, thus doubling their family incomes and matching the incomes of the out-of-towners. A brief history and description of the Roseto social structure was outlined, especially with respect to the pervasiveness of mutual support among Rosetans in virtually all activities. The role of mutual support in coping with various types of life crises was discussed. This paper presented only preliminary steps of an investigation of myocardial infarctions in an ItaliandashAmerican community. Several further areas of research are being developed in this continuing study. First a more intensive study and follow-up of currently known people with myocardial infarctions and their families is being undertaken as well as continued research with the entire original 1963 sociological sample. This should enable us to document medical and sociological changes among persons identified as having had a myocardial infarction, and in addition, among those who subsequently develop the disease. This latter possibility can be invaluable in its possibilities for uncovering predictive factors in the epidemiology of myocardial infarctions. Second, a comparison of the results of a study of Bangor, Pennsylvania, undertaken in the summer of 1964, will be made with the findings obtained in Roseto. This second area of research should shed more light on the relevance of social and cultural factors by comparing two adjacent, ethnically different communities with differing death rates from myocardial infarctions.