X hits on this document

PDF document

A View from the NIH Office of Behavioral and Social Sciences Research - page 5 / 14





5 / 14

determined, and multilevel in nature. Patterns of be- havior, exposures to pathogens, and the social and physical built environments are rapidly changing as a result of human agency. For example, tobacco use, diet, physical activity, obesity, and HIV/AIDS have all changed dramatically within the relatively short period of 1 or 2 decades during the 20th Century. Many changes in lifestyle and living conditions have had large impacts on subgroups of the population and on the absolute rates of disease burden within the whole population. On the positive side, from 1900 to 2004, the U.S. population witnessed a dramatic increase in life expectancy, from 47.3 years to 77.8 years, due primarily to changes in life circumstances and, more recently, due to improvements in health care.32 On the negative side, between 1976 and 1980 and in 2003– 2004, the prevalence of obesity—a risk factor for type 2 diabetes, heart disease, cancer, and other serious health problems—more than doubled in adults (from 13% to 34%) and in children aged 6–11 (from 7% to 19%), and more than tripled in adolescents (from 5% to 17%).32 Moreover, persistent problems like tobacco use and disparities in health remain as leading causes of preventable disease burden, disability, and death.

An enormous scientific challenge now presents itself: What are the best ways to understand, prevent, and treat common, chronic diseases like heart disease, cancer, addiction, and mental illness when it is appar- ent that they are the result of interactions between individuals—in all their biological complexity—and their ever-changing physical, behavioral, and social environments? To maximally improve population health, the individual’s genome and biology must be viewed in its much broader environment. Human ge- netic sequences are static, but the functional expression of that DNA sequence is influenced by the environ- ment. To begin unraveling this complexity, NIH launched its Genes, Environment and Health initia- tive33 and the Genetic Association Information Net- work.34 These trans-NIH efforts seek to identify how gene–environment interactions contribute to common diseases by supporting genomewide association studies to link particular genetic variants to specific diseases and the development of environmental and biomarker- sensor technologies to measure behavioral and chemi- cal exposures.

These activities are an excellent start, but significant challenges remain. The massive amounts of genetic and exposure data that will be collected will make sense only with improved basic behavioral and social sciences research, which can address questions such as these: How should statistical power calculations and the interpreta- tion of significant versus spurious associations be handled when so many variables can now be explored simultaneously? What is the best way to measure human phenotypes and the intermediate phenotypes that underlie complex clinical disease categories? What are the health-relevant physical, behavioral,

August 2008

and social environments, and how should these environmental exposures be measured over an entire lifespan? How can true gene–environment interactions be captured, and what are the mechanisms underlying these interactions?35 How might en- vironments be changed so that they foster, instead of assail, health?

The above considerations, as well as others, have led OBSSR to the following research priority areas in next-generation basic behavioral and social sciences research:

Gene–environment interactions. How do genetic en- dowment and early-life experiences interact to deter- mine physical and mental health later in life? How do behavioral, social, chemical, and physical environments cause epigenomic changes that, in turn, influence gene expression?

Environmental effects on physiology. How is psychoso- cial stress transduced into a biological signal that influ- ences physiology? Can these findings be used to under- stand group behavior in the context of trauma such as natural or man-made disasters? Or can they be used to elucidate mechanisms underlying the deleterious effects of impoverished environments on health? How do large- scale societal structures (e.g., racial segregation, immigra- tion and acculturation patterns, economic discrimina- tion) affect physiology and, ultimately, health?

Technology, measurement, and methodology. How can the rapid establishment of cyber-infrastructure, grid computing, and recent advancements in computer sciences, informatics, imaging, networking, and knowl- edge management be harnessed to improve data col- lection and analysis? How can the development of new tools and methodologies be improved so that they measure more precisely and directly behavior and social environments in real time (e.g., ecologic momen- tary assessment, personal sensors, geospatial coding methods) and decipher multilevel pathways linking biology, behavior, environment, and societal trends?

Social integration and social capital. How do advances in technology and mobility affect neighborhood social networks and mechanisms such as resilience and con- nectedness? What is the impact of these advances on health behaviors?

Complex adaptive systems. How can the growing un- derstanding of complex adaptive systems be used to better understand the process of decision making in health at the personal and systems levels?

Social movements and policy change. How do social movements related to health take shape and permit things like tobacco taxes, smoke-free workplace poli- cies, and school lunch program changes to occur? How and why must public opinion change before legislative, regulatory, or other legal action is possible? What science will enable researchers to frame messages in

Am J Prev Med 2008;35(2S)


Document info
Document views40
Page views40
Page last viewedMon Jan 16 13:17:22 UTC 2017