The Social Side of Health
Tuesday, December 3, 2019
Social and behavioral research in the IRP examines a wide range of factors that influence health, including diet, tobacco use, and social interactions.
The NIH IRP is world-renowned for its high-risk, high-reward biomedical research. While the NIH may be best known for its clinical and biomedical research on topics from cancer to allergies to addiction, IRP investigators have also produced a rich body of work conducted in the area of social and behavioral research (SBR). In this post, I will describe how SBR furthers the NIH’s goals of improving human health with some examples of the excellent work done by SBR investigators in the IRP.
SBR represents the union of two domains of scientific inquiry: social science and behavioral science. Social science aims to determine how individuals and groups construct and adjust to social systems, environments, and organizations. Similarly, behavioral science is predominantly focused on how cognitive, communicative, and behavioral processes occur and adapt to change. Together, these two domains of study inform us about the many ways in which humans and other animals behave, interact, and respond to their environments. Importantly, discoveries in this area have direct and meaningful implications for human health. According to the NIH Office of Behavioral and Social Sciences Research, “This broad approach to the multilevel and multi-modal influences of behavior, from genetic to societal, provides the behavioral and social sciences with a unique perspective on the dynamic interactions that can influence health outcomes of individuals and populations.”
Currently, there are 222 investigators conducting SBR in the NIH IRP, constituting nearly a fifth of the IRP’s approximately 1200 investigators. At the NIH, SBR is divided into three broad focus areas: social and behavioral sciences, health disparities research, and epidemiology. These areas have considerable overlap and IRP investigators are often involved in work at the intersection of two or three of them.
The diversity of topics studied by SBR investigators touches upon virtually every aspect of human health, evolution, and development. For example, consider the work done by IRP Stadtman Investigator Sherine El-Toukhy, Ph.D., and Senior Investigator Tonja Nansel, Ph.D., on different aspects of health during pregnancy. Dr. El-Toukhy examines how text messaging interventions affect tobacco use among pregnant women. The NCI-developed program sends messages of encouragement to the cell phones of participants who wish to quit smoking. Her team found that pregnant black women were more likely than pregnant white women to remain in the six-to-eight-week program but were not any more likely to abstain from tobacco after the program ended. This research helps to shed light on the limits of behavioral interventions designed to reduce racial health disparities by modifying risk factors that contribute to poor health. Similarly, Dr. Nansel’s research followed a group of pregnant women six years postpartum in order to investigate how neurobehavioral factors like self-control influence parent feeding practices, as well as how early life food exposures affect dietary intake and growth during early childhood.
“Identifying critical influences on the development of eating behaviors during early childhood could impact long-term trajectories of eating behavior and weight,” Dr. Nansel explains.
“It is hard to understand, treat, and prevent any of these conditions without paying close attention to behavioral and social factors as well,” Dr. Joseph says. “It has been noted in the literature time and time again how our zip codes are as important as our DNA.” Other SBR investigators in the IRP take a bio-behavioral approach, which examines how human health is affected by the reciprocal influences of biology on behavior and behavior on biology. For example, both Lasker Clinical Research Scholar Paule V. Joseph, Ph.D., and Senior Investigator Laura Koehly, Ph.D., collect a combination of biological and social behavioral measures in their research. Dr. Joseph studies how sensory disorders affecting taste and smell, along with related behavioral factors such as diet and alcohol use, affect a host of different health outcomes, including metabolic diseases and gastrointestinal distress in cancer patients. While Dr. Joseph’s lab has a large genomics component, she is also interested in how genes interact with social and behavioral factors to influence health.
The way individuals communicate and intertact with their peers and family can profoundly influence their health.
Similarly, Dr. Koehly studies biochemical and psycho-social responses to chronic stress associated with caring for children born with rare inherited conditions. Her work is done from a social network perspective, where the social support system surrounding parents and affected children is mapped out to understand how interpersonal processes ‘get under the skin’ to affect biological responses to stress. In this way, her research reveals how social support is associated with stress hormones and how the stress response from one family member may be related to the stress levels and responses of other family members. Ultimately, these social and biological factors strongly affect how a family copes together as a collective.
While SBR is thriving at the NIH, IRP scientists working in the field do face unique challenges in an environment where most research involves cells, test tubes, and microscopes. Dr. Nansel, for example, says it can be difficult to find other SBR investigators across the IRP to collaborate with. However, these obstacles are more than balanced by the great advantages of working in the IRP. Dr. Nansel says she feels privileged to work at NIH because it allows her to pursue scientific advances to improve health while mentoring the next generation of behavioral scientists, a common theme articulated by the investigators I corresponded with for this post. For their part, postdoctoral fellow Jasmine Manalel, Ph.D., and IRP graduate student Calandra Whitted, both members of Dr. Koehly’s lab, feel that working and training at NIH gives them the chance to translate biomedical findings into feasible tools to improve health-related behaviors. In addition, they are excited by the opportunities for collaboration and interdisciplinary research facilitated by working in the IRP.
“The most challenging aspect of conducting social and behavioral research is also the most rewarding: the interdisciplinary nature of the IRP,” Dr. Manalel says. “Interdisciplinary collaborations facilitate the exchange of research ideas and the translation of findings across fields of study, which is always exciting.”