Rockefeller neuroscientist applies basic science to health care reform

A self-described "molecular sociologist" is extending his basic research to the national policy debate on health care reform. Bruce McEwen, head of the Laboratory of Neuroendocrinology, led a panel of scientific experts last month at the Institute of Medicine's Summit on Integrative Medicine and the Health of the Public. The Institute is the most prominent independent medical advisory board in the country and will release a report from the conference in November, as Congress is likely to be considering major health care legislation.

McEwen, who has been involved for about 10 years with health policy advisory groups, says his lab work on the impact of stress on the brain has led him to look beyond basic science to meaningful translational studies. "But now we're thinking beyond that even, to how the social environment that people are in will affect the structure and function of their brains," McEwen says.

The Institute of Medicine, the medical arm of the National Academies, recruited McEwen to moderate the panel on "The Science" at its Summit on Integrative Medicine and the Health of the Public, held last month. Integrative medicine includes some controversial and hard-to-study "alternative" therapies such as acupuncture, yoga and meditation - not McEwen's particular interest - but more generally gives weight to preventive care and lifestyle and environmental changes that cultivate good health.

"Our health policy is still narrowly operating on the model of infectious disease - where you have a single cause of a disease and you have an antibiotic or some thing would help cure it, like penicillin," McEwen says. "Yet most of the diseases and disorders we're dealing with are polygenic and multifactorial in terms of the social and environmental causes." Take asthma and air pollution, or obesity, for instance, he says.

McEwen was recruited in part because of his research developing the concept of allostatic load, a term he coined in 1993. The concept explains how chronic exposure to the body's stress response - a very helpful response to acute threats - takes a toll on many organs, especially the cardiovascular system but also the immune system and the brain. Drawing on two previous reports to which he contributed, "The Science of Early Childhood Development" and "Reaching for a Healthier Life: Facts on Socioeconomic Status and Health in the U.S.," McEwen emphasized that toxic stress at any point in life, but especially early on, has detrimental health effects on physical and mental disorders and that that stress can come from myriad sources, socioeconomic and otherwise. Early in life it is physical and sexual abuse that has huge and lasting effects.

The panelists McEwen moderated spoke on research into environmental epigenetics, genomic/predictive medicine and the impact of social environment on health, among other topics.

"The big task is to educate legislators, and their staffers, on what works and doesn't work and to give them an idea of the science behind this," McEwen says. "I think it's important for us to reach out and work with the people in positions to influence policy as well as our colleagues in social and biological sciences, and particularly to develop relationships with people who are coming at some of these questions from a different perspective. In my case, I've been working to bring the brain into the debate about socioeconomic status and health."

Summit on Integrative Medicine and Health of the Public