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plinary and systems science perspectives may be valu- able approaches for addressing health disparities and inequality.22 These approaches permit researchers in the field to step back and consider the ways that their science has been framed by historical, disciplinary perspectives (i.e., a focus on intra-individual, molecu- lar, genetic “causes” within biomedical frames of refer- ence versus a focus on the socioeconomic forces and the levels of socio-environmental context, such as social position and poverty, as the “causes of the causes” within ecologic frameworks). For example, a recent study used county-level geospatial and racial-group coding to categorize into clusters the population of the U.S. according to expected longevity; these clusters are called the “Eight Americas.”61 An incredible gap of 35 years of life expectancy was reported between the highest and lowest life-expectancy ranks among the eight clusters. The lowest cluster is grouped among nations of the world with the lowest life expectancy (sub-Saharan Africa and Russia) and can be viewed as excluded from the gains made in average life expect- ancy in the U.S. during the entire 20th Century. Life expectancy in the cluster at the high end of the Eight Americas exceeds that of nations whose life expectancy is the highest in the world (3 years better than Japan for females and 4 years better than Iceland for males).

Abrams22 suggests a new framework for integrating historically disparate frames of reference from individ- ual and population sciences into a new synthesis. This framework would embrace a model of genes and the social and physical environments in a complex, nonlin- ear, reciprocal interaction of risk and protective factors,

over the lifespan and across generations.2,20,39,62


disciplinary research and systems science can perhaps clarify the extent to which gene–environment interac- tions account for racial and ethnic health disparities and improve the development of effective interventions and policies to eliminate those disparities. 63

These brief examples are but a few of an increasing number of approaches that use a problem-focused, outcomes-oriented goal to strengthen the science of dissemination, implementation, and policy research. The hope is that a deeper understanding of the basic mechanisms in complex adaptive systems will help to improve the design of the next generation of interven- tions and lead to better (i.e., informed by science) health policies. Such approaches use the tools of basic and applied interdisciplinary science; systems science; and problem-focused, outcomes-oriented strategies to maximize their public health impact.

New Directions at NIH in Support of Interdisciplinary, Translational, and Systems Sciences

Although OBSSR does not have grant-making author- ity, it partners with NIH institutes and centers to

develop research initiatives, alternately playing a lead or participatory role. Since 2003, OBSSR has led the development of a number of trans-NIH initiatives un- der the auspices of the NIH Roadmap. The three themes of the NIH Roadmap are New Pathways to Discovery, Research Teams of the Future, and Re- Engineering the Clinical Research Enterprise.

Interdisciplinary research, one of the components of the Research Teams of the Future theme, has included several initiatives specifically targeting the behavioral and social sciences. The OBSSR-led initiatives Supple- ments for Methodological Innovations in the Behav- ioral and Social Sciences (RFA RM-04-013)64 and Meet- ings and Networks for Methodological Development in Interdisciplinary Research (RFA RM-04-014)65 sup- ported research on dietary intake, physical activity, child development, stress–immune interactions, envi- ronmental exposures, treatment decision making, pa- tient quality of life, gene–environment interactions, pain, and aging. Seven postdoctoral institutional-training grants were awarded under another NIH Roadmap initiative, Interdisciplinary Health Research Training: Behavior, Environment and Biology (RFA RM-05- 010).66 These programs provide formal coursework and research training in a new interdisciplinary field for individuals holding advanced degrees in a different discipline. The Exploratory Centers for Interdiscipli- nary Research (RFA RM-04-004)67 program is support- ing the centers that are investigating cognition, elder self-neglect, or youth vulnerability to sexually transmit- ted infections and unintended pregnancies. Another center focuses on the pathways through which the environment, genetic, and psychosocial domains jointly shape child health and well-being. A 2007 initiative, Facilitating Interdisciplinary Research via Methodolog- ical and Technological Innovation in the Behavioral and Social Sciences (RFA RM-07-004),68 supports the development of new and innovative measures, meth- ods, and technologies that underlie the interdiscipli- nary integration of human social science, behavioral science, or both, with other disciplines across varying levels of analysis. Links to descriptions of the projects funded under these and other interdisciplinary NIH Roadmap initiatives can be found on the NIH Road- map website (www.nihroadmap.nih.gov/interdisciplinary/ fundedresearch.asp).

Finally, one of the initiatives developed under the Re-Engineering the Clinical Research Enterprise theme is the Institutional Clinical and Translational Science Award (CTSA; RFA RM-08-002).69 CTSAs are coopera- tive agreements to provide resources and develop methodologies to overcome blocks at both the discov- ery (translation between bench and bedside) and im- plementation (translation between bedside and prac- tice and community) steps. Translational research has two components: (1) applying discoveries generated during research in the laboratory and in preclinical

S222 American Journal of Preventive Medicine, Volume 35, Number 2S


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