New BSR Director Shares Plans
On June 7, NIA Director Dr. Richard Hodes announced that Dr. John Haaga had been appointed director of the Division of Behavioral and Social Research. Dr. Haaga was the acting director for the previous 15 months and the deputy director since 2004. "Inside NIA" sat down with Dr. Haaga to talk about his research plans for the division.
What do you see as the key research areas for BSR in the next few years?
We're going to encourage research in some areas where there are recent important findings that need to be followed up. For example, we're seeing widening disparities in health at older ages along several dimensions, including income; older people in the lower half of the income distribution in the U.S. are having significantly more health problems than people on the upper end and the gap is growing. There's also a steep educational gradient in mortality rates that's unusual, both in our own history and compared with other aging populations. The Baby Boomer cohorts are reaching old age with more chronic disease diagnoses, higher rates of disability, and even higher midlife mortality rates than previous cohorts.
On the bright side, we have some good results with behavioral approaches, community interventions, and health service changes that show promise for reversing some of the disturbing trends and persistent disparities. I hate to lapse into clichés but the phrase "We have our work cut out for us" keeps popping into my mind and my conversation.
Partly through the work of BSR staff members with the NIH program on the Science of Behavior Change, we and our grantees are trying to base interventions more closely on existing research on behavioral mechanisms. That program sponsored a conference which referred to "Pasteur's Quadrant," the idea that progress will come from reciprocal influence of basic and translational research. We expect to encourage research at multiple levels—helping individuals to adopt healthy behaviors, and helping create environments conducive to healthy behavior.
From demographers, social epidemiologists, and other researchers with life course perspectives, we're learning about other population-level changes in determinants of health at older ages. Cohorts now reaching older ages experienced very different family lives than did previous generations. We also realize now, for example, the long-term impact of investments in education made decades ago. We'd like to encourage research that uncovers lifelong influences on health at older ages and identifies opportunities at any stage of life to improve outcomes.
What is BSR's role in Alzheimer's research?
Much of NIA's work in this area is rightly focused on finding effective new treatments and prevention measures for Alzheimer's disease. There's an important role for behavioral and social science in this effort, in research on services and caregiving, population-level research and prevention. Even if the basic and translational research is rapid and successful, we will still have millions of families affected by Alzheimer's for years to come.
We need to look at how we can make life better for people with dementia and for their families, both with formal services like adult day care, home health services, and institutional care, and with support for the informal caregivers who are bearing the brunt of care. We've made progress with research on effective interventions for caregivers, but more is needed and the results we do have need wider implementation. We've also learned a lot about how to improve nursing home care in recent years, but much less is known about nonresidential services, and we plan to contribute in those areas.
Your division supports the development of the data infrastructure for behavioral and social research, funding large longitudinal studies like the Health and Retirement Study, Midlife in the United States, the National Health and Aging Trends Study and others. What's happening with those projects?
When I first started as a research assistant years ago at the RAND Corporation, I worked on surveys in the U.S. and in developing countries. We were then at the cutting edge, but population sciences still relied almost exclusively on data generated by asking people questions out loud and writing down their answers. I've seen a revolution during my career. What people say is still essential data, but we can do so much better now in understanding causes and consequences of health trajectories. Data sets with cognitive and physical performance measures, key biomarkers, genomic and epigenomic data, linkages to electronic health records or medical claims, work and earnings histories, objective measures of physical activity, the physical environment or social network interactions – these are going to be essential for cutting edge research in behavioral and social sciences in the next decades.
We will continue the BSR tradition of looking ahead, with help from the research community, when we make investments in data infrastructure. At the same time, we have to live within a budget on which there are many claims, so we'll need to be highly selective in what we support.
One particular avenue we'll explore concerns ways to get more scientific mileage out of studies no longer in an active data-collection phase. If participants consent, we could learn a lot from long-term follow-up through linkages to Medicare and Medicaid claims data, all-payer data bases, and ultimately death records.
What's the most important thing for current and prospective BSR grantees to know right now?
Both inside and outside NIH, we all talk about scarcity of resources and we rightly worry about the competitive pressures that grant-funded researchers face. It can be quite discouraging, especially for young scientists. But it's important for those thinking about pursuing aging research to know that we're making as many grants as we did in the past, even in areas not directly connected to Alzheimer's. The problems that we study aren't going away, and behavioral and social scientists can make an essential contribution.
I'm lucky to work with talented and energetic colleagues. We try to be helpful to applicants and grantees, especially young scientists who may need help navigating the NIH system and getting a research program established. For everything that behavioral and social scientists study, aging provides both intellectual challenge and an unrivalled opportunity to be useful. The slogan is true on several levels: "Aging beats the alternatives."Alzheimer's Disease Funding Opportunities