January 2009 Issue Volume 37 Issue 1

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IOM Meeting Focuses on Behavioral/Social Determinants
of Health

"In calculating the area of a rectangle, which contributes more to the area’s total: The base or the side?" A trick question? No, but professor Jack P. Shonkoff used the riddle to succinctly characterize the nonsensical, but often-asked, question about the relative contributions of nature/genes or environment/experience to complex phenomena such as an organism’s behavior or a person’s health, illness, or intelligence. Shonkoff, of Harvard University’s medical school, thus set the tone for the first session, "The Biological Endowment and Susceptibility to Disease," of the Institute of Medicine’s (IOM) two-day Annual Meeting in Washington, DC. The session was one of five panels and individual presentations that comprised the entire second day of the 38th IOM meeting, the public portion of the meeting, on October 13.

While there were only a handful of social scientists among the 17 speakers, the all-day focus on issues behavioral and social was intense and serious. And the several biologist speakers all discussed how their research interfaced with key social and behavior factors in modulating health and illness. The purpose of the meeting’s focus, however, was undermined somewhat when the annual roster of newly elected members to the IOM, released the previous day, included a typical roll of renowned biomedical, molecular, cellular, and genetic researchers (65 in all) but did not include any social scientists, even though there are deserving members of this latter community contributing to medical science, and there are some social scientists already among the IOM member ranks. As it does nearly every year, IOM also released a few studies this year that draw on social science expertise (e.g., Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs and Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence), thus making the absence of new members hailing from our social science disciplines, for example, more puzzling.

iom_tna logosAmong speakers at the October 13 meeting of particular interest to Footnotes readers would be: anthropologist Susan C. Scrimshaw, Interim President of The Sage Colleges, who introduced the day’s program; epidemiologist Teresa Seeman, of the Geffen School of Medicine at UCLA who introduced the first session, which included physician Jack P. Shonkoff, director of Harvard’s Center on the Developing Child, who spoke about the "The Early Childhood Roots of A Lifetime of Physical and Mental Health"; Columbia University psychologist Frances A. Champagne, who spoke about "The Interplay of Genes and the Environment in Determin-ing Plasticity Across the Life Span."

Shonkoff emphasized the inherently interactive nature of biology and environment and elaborated on the long-term effects of early adverse life experiences. The second panel, which addressed "The Health of Populations: Networks, Neighborhoods, Disparities and Health," included, among others, epidemiologist Lisa F. Berkman, director of the Center for Population and International Health at Harvard School of Public Health; and epidemiologist and physician Ana V. Diez Roux, director of the Center for Integrative Approaches to Health Disparities at the University of Michigan.

A panel of two Robert Wood Johnson Foundation Health and Society Scholars was introduced by Harvard Medical School Emeritus Professor of Social Medicine Leon Eisenberg, whose panel addressed "Interdisciplinary/Bridging Work In Health Disparities." Panelists included Elliot Friedman, from the Institute on Aging at the University of Wisconsin-Madison, and Rebecca Thurston, of the Department of Psychiatry at the University of Pittsburgh. A final panel on "Rethinking How to Achieve Individual and Population Health," chaired by Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation, included former U.S. Surgeon General David Satcher, speaking on the "Social Determinants of Health and Their Implications for Public Health"; and sociologist Mary Woolley, President and CEO of Research!America, speaking on Americans’ attitudes toward health research. Health Affairs magazine Editor-in-Chief Susan Dentzer made an engaging appeal to broaden the national health care reform public debate that had become a central component of the fall 2008 presidential campaigns.

PowerPoint slides of the presentations are accessible at the IOM website (www.iom.edu/CMS/2951/16671/16689/43074.aspx). logo_small

 

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