OBSSR acting director Dr. Christine Bachrach opens recent retreat.

A demographer who does population research at NICHD, Bachrach has been acting OBSSR director since last April. Noting that “NIH has invested an enormous amount in genetic research,” she stressed the “need to understand how genes and the environment interact. That’s a real frontier for the behavioral and social sciences.”

And not just a frontier, but an imperative, suggested NIH acting director Dr. Raynard Kington, who closed the meeting by saying, “Behavioral and social science research must continue to define their roles in the next generation of genomics research. Mapping the human genome is the biggest scientific achievement of our lifetimes. There has to be a vision for the behavioral and social sciences in understanding gene-environment interactions.”

A member of the B/SSR community himself, Kington urged the community to “emphasize interventions for the short run, for the here and now, while continuing to expand our knowledge base for understanding fundamental causal pathways.” He also said the community “should be leaders in portfolio analysis and the management of science” and should look for imaginative ways to connect its investments with broad national issues where appropriate.

“I’m not arguing for ‘mission creep’ for this agency,” he cautioned, “but other disciplines are thinking about how their disciplines might be relevant beyond their usual applications. We’re on the verge of a deep and lengthy recession [so] more sophisticated arguments are needed in lean times. We will all be asked to do more with less.”

Participants in the recent OBSSR-sponsored retreat included (from l) NCI’s Dr. Robert Croyle, who directs the Division of Cancer Control and Population Sciences; NIDA director Dr. Nora Volkow; and NIMH director Dr. Thomas Insel.

NIH funding for B/SSR “hovers around one-tenth of the NIH budget,” said Bachrach, but the field has nonetheless contributed significantly in such areas as diabetes management, reduction of both tobacco use and the spread of HIV, addressing obesity and outlining the role of stress in cancer.

“The old models of health care are being challenged by spiraling health care costs,” warned Bachrach. “We need to help develop a sustainable approach to health and health care. What are cost-effective prevention strategies? What are the behavioral aspects of health management?”

NIMH deputy director Dr. Richard Nakamura (c) hosts one of 9 informal lunch roundtables during the retreat segment “Conversations with Senior Staff.”

A panel of representatives from the institutes that have the broadest B/SSR portfolios helped answer those questions in front of an audience that included about 350 people from intramural and extramural NIH who participated in the retreat’s plenary and breakout sessions.

NIDA director Dr. Nora Volkow acknowledged that “social symptoms are crucial in drug addiction and treatment,” then pointed out three current public health challenges with major behavioral components: smoking, obesity and the chronic ailments of an aging population.

“Smoking continues to have the number one impact on morbidity and mortality,” she said. Despite a dramatic reduction in the number of smokers (50 percent of males smoked in the 1950s, but only 20 percent smoke today, she reported), the downward curve has reached a stubborn plateau. “We can’t seem to make a dent in that last 20 percent,” she said.

She reported a “tremendous increase in the rate of type 2 diabetes in young people,” which is associated with obesity. “It used to be quite rare to have an adolescent with type 2 diabetes.”

The aging population, too, has needs that could be addressed elegantly by behavioral science. “How to implement effective interventions is the greatest area of opportunity in science,” she said.

Her prescription was threefold: Focus on epigenetics, or the study of gene-environment interactions; employ advances in imaging science to learn more about brain regions involved in behavior and decision-making; and study the role of social stressors in disease.

NIMH director Dr. Thomas Insel, whose institute has traditionally been seen as the default home of B/SSR at NIH, said NIMH currently commits some $84 million to basic behavioral and social science research and $425 million to behavioral research more generally, but added “there is a great need for continued investment.” While it is essential, he said, that NIMH plumb the underlying physiological defects in such disorders as schizophrenia, ADHD and mood disorders—at the level of what he called “genes, cells and circuits”—it is also important to learn how such interactions affect behavior and function. “We need to study both,” he argued.

He noted that HIV transmission rates “have not budged in the past 12 years—there are about 55,000 new cases each year in the U.S.” Behavioral prevention, he said, “is the best vaccine we’ve got so far.”

Dr. Richard Suzman (r), director of the Behavioral and Social Science Program at NIA, moderates the panel discussion during OBSSR’s Nov. 12 retreat.

Dr. Robert Croyle, who directs NCI’s Division of Cancer Control and Population Sciences, said that NIH, for the behavioral scientists who work here, “is like a university without a college of arts and sciences.” He said NIH needs to integrate B/SSR more effectively with basic biomedical research: “We could be a linking discipline across the institutes…a tremendous amount of collaboration could occur at NIH, but does not because many institutes lack a critical mass of behavioral and social science researchers.”

Congress is frustrated with NIH, he said, because we don’t deliver enough useful public health interventions. “We need to broaden the definition of translational research so that we’re not just talking about drug development all the time,” he said.

Croyle called for buttressing NIH contributions to health care delivery systems and for collaborating more with the National Science Foundation, which supports much basic behavioral research. “We also need tools to support methodology and measurement research,” he said, noting that recent Roadmap initiatives have helped to strengthen this area.

Many in the B/SSR field at NIH used to feel like “fourth-class citizens” but have ascended to second- class status, he said.

Former OBSSR director Kington had a remedy for that: “If you’re really smart and dedicated and believe in what you do, that will win the day in the long run.”