Stewart Wolf and John G. Bruhn. 171 pages. New Brunswick, New Jersey: Transaction Publishers; 1993. $29.95.

The notion that the quality of our social relationships may have a profound effect on our health and longevity has a long history but a short scientific past. A much publicized study that set out to show an association between social cohesion in the community and coronary heart disease mortality was begun in 1962 by Drs. Bruhn and Wolf. Their focus was on the town of Roseto, a cohesive and relatively stable Italian-American community in Pennsylvania. There the death rate from heart attacks was substantially lower than that of nearby towns. However, Roseto has changed over the years and so have its mortality statistics.

The Power of Clan is a sequel to The Roseto Story—An Anatomy of Health (1979). It includes the results from a follow-up survey that was done in collaboration with the Center for Social Research at Lehigh University. The authors intended to document the changes in Roseto as its people have adapted to an American lifestyle that is characterized by individualism, competitiveness, and materialism. One of the authors, Stewart Wolf, virtually acted as a participant-observer, contributing to a vivid and lively account of these changes that is supported by many anecdotes and an additional 22 pages of photographs. The book includes many tables showing demographic and health characteristics of Rosetans and their controls, and discusses potential mechanisms linking social change to increased death rates from myocardial infarction. This wealth of information provides a rich source of hypotheses and should encourage the development of sound psychometric instruments to test more rigorously the link between mutually supportive attitudes, cooperation, and health outcomes.

The Power of Clan will stimulate and revive discussion on the effects of personal relationships on health. We are reminded of the work by J. J. Groen that urged us to adopt a more comprehensive approach to our understanding and, ultimately, control of coronary heart disease in both women and men.