Title: The Role of Sociology and Social Networks in Integrating the Health Sciences
1The Role of Sociology and Social Networks in
Integrating the Health Sciences
Bernice A. Pescosolido Indiana University Present
ation in the Networks and Complex Systems Talk
Series, Indiana University, November 28,
2005 Support is acknowledged from NIMH grant
K0242655, Indiana Consortium for Mental Health
Services Research (ICMHSR), and Indiana
University (COAS OVP)
2- The long-standing debate about the importance of
nature versus nurture, considered as independent
influences, is overly simplistic and
scientifically obsolete. - -- Neurons to Neighborhoods (20006)
- It is time to reconceptualize nature and nurture
in a way that emphasizes their inseparability and
complementarity, not their distinctiveness it is
not nature versus nurture, it is rather nature
through nurture. - -- Neurons to Neighborhoods (200041)
- In the past 25 years, the study of human health
has included a distinguished, but neglected
intellectual tradition put forth by numerous
investigators, who saw the need for broad
integrative frameworks that capture complex
pathways to illness and disease. - -- New Horizons in Health (200121)
3Series of Reports
- New Horizons in Health An Integrative Approach,
2001 - Toward Higher Levels of Analysis Progress
Promise in Research on Social and Cultural
Dimensions of Health, 2001 - Bridging Disciplines in the Brain, Behavioral and
Clinical Sciences, 2000 - From Neurons to Neighborhoods The Science of
Early Childhood Development, 2000 - Through the Kaleidoscope Viewing the
Contributions of the Behavioral and Social
Sciences to Health, 2002 - Breaking Ground, Breaking Through The Strategic
Plan for Mood Disorders Research of the NIMH,
2002 - Translating Behavioral Science into Action, 2000
4Basic Problem
- Limits of biomedical approaches in predicting who
gets sick, who seeks treatment, and who recovers
Call
- Understanding contexts
- Integrating health sciences
5Dilemma
- How to synthesize
- How to select among panorama of influences
Possible Solution
- Contexts as social structures
- Social structures as association or
interaction - Social networks
6Claim
- This convergence makes way for social networks
place in integrated health research
7Three Baseline Conditions for a Response
- All levels relevant to health and health care
must be considered, separated out and linked in
an overarching theoretical frame by a similar
mechanism, even when research targets only one
level - Room must be made to tailor such frameworks to
particular populations, whether socially (ethnic
or age groups) or medically (disease types)
defined - Find a way to work within big science to
address problems from social construction to
social causation that contribute to our
understanding of basic social processes as well
as medical phenomena
8Current Climate
- driving the disciplines toward each other
- bringing the behavioral and social sciences more
strongly and visibly into the full panorama of
health research - groundswell of support
- foster communication among scientists who have
been too long isolated behind disciplinary walls
9Looking Up From the Microscope and the Clinic
- The success of pure biomedical science that has
led to the call to look up from the microscope to
the environment. - Epigenetic modification
- 50 genetics and 50 environment
- 90 of diseases do not follow simple genetic
rules of inheritance - Effectiveness not efficiency
10The Current Landscape of Integration
11The Environment
- The Black Box of BMS
- Luck, Chance
IOM (Committee on Assessing Interaction Among
Social, Behavioral, and Genetic Factors and
Health)
- How should social environments be conceptualized
and measured? - Which aspects of the social environment should be
included and at what levels of analysis? - How do we consider present influences and those
that have accumulated over the life course?
12E. O. Wilson
De Waal
- Continued disarray of the social sciences, 1996
13Requirements for Integrating Models and Frameworks
- consider and articulate the full set of
contextual levels that have a documented role in
past empirical research - offer an underlying mechanism or engine of
action that connects levels, is dynamic, and
allows for a way to narrow down focal research
questions - employ a metaphor and analytic language familiar
to both social and natural science that can
facilitate synergy - understand the need for and use the full range of
methodological tools proven useful in the social
and natural science
14Bronfenbrenner Nested Contexts
15The Key Social Networks as Theoretical Foundation
- Puts human face on issues of access, barriers,
intervention, by conceptualizing these as actions
of individuals. - Relationships are fundamental mediators of
human adaptations. - Networks are the active ingredients of
environmental influences. Offers the underlying
engine of action. - Neurons to Neighborhoods
16NEM-Phase I Cause Consequence of
Illness/Disease Reconsidered (SOS)
- The Role of Others
- The Role of Cultural Toolboxes
- The Role of Time
- The Role of Options
- Embeddedness Social Networks
- Habit/Knowledge Content
- Dynamics
- Patterns Pathways
- Turning Points, Trajectories
17The NEM Phase I
(Pescosolido, Advances in Medical Sociology, 1991)
18The NEM Phase I
Support Choice, Coercion Muddling
Through 46 25
33 (Social Science Medicine, 1998) Patterns
of Care Social Influence (Medical Care, 1998)
Limits Role of Treatment/Organizations
19Network-Episode Model Phase II
- The Dynamics of Treatment, Organizational and
Policy Change - Networks
- Outside Networks
- Inside Networks
20 The NEM Phase II
(Pescosolido Boyer, A Handbook for the Study of
Mental Health, 1999)
21The NEM Phase II
- Support
- Power of Organizational Context
- (Wright, Psychiatric Services, 1997)
- Limits
- Role of Disease Course
- Role of Individual
- Role of Community
22The Network-Episode Model Phase III
- The Elaboration of Contexts
- Focus on Multi-disciplinary Integration and
Synergies - People as the Agents of Change
- Networks as Mechanism that Connect Different
Levels and Processes
23What Should An Integrated Health Science Model
Look Like?
24Barabási Complex Network Model
25The Network-Episode Model Phase III (Rejected)
26The NEM III Under Construction
27Nagging Questions
- Need we all embrace the Network-Episode Model or
even the network metaphor? - Does this mean that everyone must be engaged in
multi-level, multi-disciplinary endeavors? - How are integrated, multi-level studies likely to
be accomplished?
28Multi-disciplinary versus Interdisciplinary
- All too often it is insisted that there is only
one kind of data, one methodology that should be
employed, when everything we know about the major
issues in the development of the social sciences
should warn us against such imperialism. - Jane Lewis, 2003
- The Political Quarterly
29Big Science
30The Crossroads
- Shackled by tribal loyalty
- Snarled by disunity and a failure of vision ?
- OR
- Have we traveled different pathways to a similar
vision?
31Conclusion
- Biophobia (Freese et al 2003)
- Methodenstreit (Swedberg 1989)
- Imperialist intrusion (Collins, 1986)
- OR
- Mutual credibility (Modell, 2002) ?