On February 28th, the Institute of Behavioral Science hosted the inaugural Richard Jessor Distinguished Lecture on Health and Society featuring renowned social scientist, Sir Michael Marmot.  

About the lecture:

"Social justice, social determinants, and health equity"

Taking action to reduce health inequalities is a matter of social justice. In developing strategies for tackling health inequalities we need to confront the social gradient in health not just the difference between the worst off and everybody else.  There is clear evidence when we look across countries that national policies make a difference and that much can be done in cities, towns and local areas. But policies and interventions must not be confined to the health care system; they need to address the conditions in which people are born, grow, live, work and age.  The evidence shows that economic circumstances are important but are not the only drivers of health inequalities. Tackling the health gap will take action, based on sound evidence, across the whole of society.

About Sir Michael:

Sir Michael Marmot is Professor of Epidemiology at University College London, and Immediate Past President of the World Medical Association.  He is the author of The Health Gap: the challenge of an unequal world (Bloomsbury: 2015) and Status Syndrome: how your place on the social gradient directly affects your health (Bloomsbury: 2004).  Professor Marmot holds the Harvard Lown Professorship for 2014-2017 and is the recipient of the Prince Mahidol Award for Public Health 2015. He has been awarded honorary doctorates from 18 universities. Marmot has led research groups on health inequalities for 40 years.  He chairs the Commission on Equity and Health Inequalities in the Americas, set up in 2015 by the World Health Organizations’ Pan-American Health Organization (PAHO/ WHO).  He was Chair of the Commission on Social Determinants of Health (CSDH), which was set up by the World Health Organization in 2005, and produced the report entitled: ‘Closing the Gap in a Generation’ in August 2008.  At the request of the British Government, he conducted the Strategic Review of Health Inequalities in England post 2010, which published its report 'Fair Society, Healthy Lives' in February 2010. This was followed by the European Review of Social Determinants of Health and the Health Divide, for WHO Euro in 2014.  He chaired the Breast Screening Review for the NHS National Cancer Action Team and was a member of The Lancet-University of Oslo Commission on Global Governance for Health.  He set up and led a number of longitudinal cohort studies on the social gradient in health in the UCL Department of Epidemiology & Public Health (where he was head of department for 25 years): the Whitehall II Studies of British Civil Servants, investigating explanations for the striking inverse social gradient in morbidity and mortality; the English Longitudinal Study of Ageing (ELSA), and several international research efforts on the social determinants of health.  He served as President of the British Medical Association (BMA) in 2010-2011, and is President of the British Lung Foundation.  He is an Honorary Fellow of the American College of Epidemiology; a Fellow of the Academy of Medical Sciences; an Honorary Fellow of the British Academy, and an Honorary Fellow of the Faculty of Public Health of the Royal College of Physicians.  He was a member of the Royal Commission on Environmental Pollution for six years and in 2000 he was knighted by Her Majesty The Queen, for services to epidemiology and the understanding of health inequalities.  Professor Marmot is a Member of the National Academy of Medicine.

http://www.instituteofhealthequity.org/

@MichaelMarmot ; @TheMarmotReview

Lori Peek was named by the Ottawa University Alumni Association as the 2017 recipient of the Ottawa University Outstanding Achievement Award. The award “recognizes individuals who have made an impact in their chosen field of endeavor, whether over a span of many years or in a relatively short time frame.” To be considered for the award, candidates must “have made accomplishments in the context of their paid career, or for a civic personal interest which they have pursued, with or without pay and achieved accomplishments that have had an impact on the world, nation, state, or community.” The full announcement is available here:

http://www.ottawaherald.com/news/20171027/ou-alumni-association-honors-two-for-service

Dr. Tom Cook presented two guest lectures at the Institute of Behavioral Science at CU Boulder, October 13, 2017: 1) The evidence about evidence-based policy: How consistent are different clearinghouses on the standards for what warrants acceptable evidence? and 2) When quasi-experimental designs reliably reproduce estimates from randomized experiments on the same topics.

Tom Cook is a Joan and Serepta Harrison Emeritus Professor of Ethics and Justice, and Professor Emeritus of Sociology, Psychology, Education, and Social Policy at Northwestern University (on leave). Dr. Cook is an internationally known scholar in the design and analysis of evaluation research, whole school reform, and contextual factors that influence adolescent development, particularly for urban minorities. At CU Boulder, Dr. Cook serves on the Advisory Board of Blueprints for Healthy Youth Development which is housed in the Institute of Behavioral Science. Blueprints is a web-based registry of programs proven to promote positive youth outcomes using guidelines that follow rigorous scientific standards.  This talk was co-sponsored by Blueprints, IBS, and the School of Education at the University of Colorado Boulder

Lori Hunter, Director of the CU Population Center and the Population Program at IBS, has received an appointment to serve on the National Academy of Sciences Board on Environmental Change and Society (BECS).  The BECS helps guide research in the United States on the interactions between human activity and global environmental change. It is the mission of the BECS to increase problem-focused understanding of coupled human-environment systems, and to inform transition to improved human well-being in the face of environmental change. Some of the recent reports produced by the BECS include Valuing Climate Damages: Updating Estimation of the Social Cost of Carbon Dioxide (BECS 2017) and Accomplishments of the U.S. Global Change Research Program (BASC, BECS 2017). Dr. Hunter’s expertise on human-environment interactions and the energy she brings to all of her projects will surely prove to be assets to the current and future projects of the Board.  Her areas of expertise combined with her history of leadership and service prompted her nomination to the BECS by IBS Director Myron Gutmann, who served on the precursor to the BECS, the former Committee on the Human Dimensions of Global Change. This is one of the many ways IBS researchers give service to the public. 

An article entitled "Life after the Storm: Children Who Survived Katrina Offer Lessons" was published on September 8th by the New York Times.  Dr. Lori Peek, the director of the Natural Hazards Center at IBS, did extensive research on the ground in New Orleans in the years that followed Katrina and published a book on her findings entitled "Children of Katrina", which she co-authored with Dr. Alice Fothergill of the University of Vermont.

Here is a brief excerpt from the article:

"In the years after Katrina, a pair of sociologists, Alice Fothergill and Lori Peek, made regular trips to New Orleans, interviewing hundreds of people who had been hit hard and tracking their lives over time, checking in repeatedly. After seven years, the pair identified a rough pattern among displaced children: some had not regained their footing, losing years of schooling and later sinking into unemployment; others adapted, even thrived; and there was a third group, of young people in an uncertain holding pattern, keeping themselves upright but unsteadily, managing lingering effects, like depression or anxiety.

Those in the first group tended to have few resources to start with, and lost them all. “It’s a cumulative vulnerability, in which for instance the family struggled before the storm, then could not get out, and the child lost the fragile supports he or she had,” said Dr. Fothergill, a professor at the University of Vermont.

Dr. Peek, a professor at the University of Colorado, said that those children who adapted fastest typically had family and networks with resources that held together through Katrina, or acquired strong allies along the way: teachers, pastors, shelter workers who fought for help on the child’s behalf.

The third group – “fluctuating equilibrium,” the sociologists called it – usually had lost virtually everything but had one solid anchor: a mother, a father, a teacher, an older sibling.

The rest of the article can be reach here: https://www.nytimes.com/2017/09/08/health/katrina-harvey-children.html?_r=0

Postdoctoral researchers and doctoral students to increase their knowledge of demography and genetics in one of the first programs of its kind

Article by Jeff Thomas

Jason Boardman has made headlines studying the interactions between people’s genes and their environment, finding, for instance, that social factors trump genetic forces in forging friendships. Now, the University of Colorado Boulder sociologist is helping to launch an advanced training program, one of the first of its kind in the nation, to train young scholars in this cross-disciplinary field.

The National Institute on Aging has awarded Professor Boardman, from CU Boulder’s Institute of Behavioral Science (IBS), and Professor Michael Stallings from CU Boulder’s Institute for Behavioral Genetics (IBG), $595,666 over three years, to create a formal training program in the area.

Boardman was a tenure-track assistant professor in sociology at the University of Colorado Boulder in 2005 when he decided to expand his research in social demography, or the statistical study of human populations, to include behavioral and statistical genetics. “Essentially, I had to take graduate level studies in these areas,” Boardman said. “I didn’t have much of a background in many of those fields, so I was raising my hand a lot.”

Boardman decided to look at the intersection and interaction between social factors — such as where one lives or works or whom one socializes with — and genetic factors as both influence complex health behaviors, such as smoking. He has published on this topic extensively, and beginning next year, like-minded post- and pre-doctoral students will be able to as well in the new training program.

Boardman’s genetic research has previously been supported by a five-year award from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the National Institutes of Health. This grant allowed Boardman to maintain his position as a faculty member but spend nearly half of his time studying genetics with researchers at IBG. 

Leaders of both IBS and IBG hailed the award: 

“This is a tangible vote of support at the national level for the successful collaboration between IBS and IBG,” John K. Hewitt, director of IBG, said. “It reaffirms the value of our efforts to develop innovative interdisciplinary graduate and postdoctoral training programs.”

"This new grant demonstrates the leadership that Jason has achieved in connecting social and behavioral science with a deep understanding of genetics, something that draws on the outstanding expertise of the two institutes and amplifies our ability to train the next generation of researchers," Myron P. Gutmann, director of IBS, added.

Demography and genetics postdoctoral researchers and doctoral students will be annually funded by the grant over three years to increase their respective knowledge of demography and genetics —demographers will study behavioral genetics, and behavioral geneticists will study demography. 

Three postdoctoral researchers, two of whom received support from NIH, have recently taken similar paths at the two research institutes, and have all been involved with innovative research projects, leading to tenure-track positions at leading universities.

Benjamin Domingue is now an assistant professor in the Graduate School of Education at Stanford University. During his time as a postdoctoral researcher with Boardman, he was supported by several funding mechanisms in an ad-hoc manner. The goal of this new program at CU Boulder is to replicate the training that Domingue received but in a more formal manner. Brooke Huibregtse, the first postdoctoral researcher appointed to the training program, said she is excited about the opportunity to integrate new approaches with her formal training in psychology.

“Investigating genetic risk factors is only one side of the coin; it is important to also consider the social context in which complex health behaviors develop,” she said. While there are now numerous research articles expanding on the study of the interaction between genes and environment, there is not a permanent training program today, according to Boardman. Reviewers noted that the strength of research from both the IBS and IBG, as well as researchers from CU Denver, was a significant factor in the decision to locate such a program at CU.

“This is an important indication that reviewers and NIH see this as the place to go to receive this very unique training,” Boardman said. “This training program will enable the next generation of scholars to tackle complex public-health issues such as increasing rates of obesity, individual differences in stress sensitivity, and complex and comorbid substance-use disorders with innovative and cutting-edge approaches.”

According to the proposal, IBS faculty members have expertise in areas that could not easily be duplicated by other research institutes, including the intersection of people’s genetics and their environment and its role in health outcomes, patterns of HIV/AIDS in Africa and healthy adolescent development.

“IBG has an incredibly strong and international reputation in research on genetic factors linked to different behaviors across the life course,” Boardman said. IBG “hosts annual workshops on twin modeling and advanced statistical genetics that are among the most popular courses on this topic in the country. Indeed, following a comprehensive external evaluation of IBG, one reviewer commented that IBG is, ‘a world leader that is unique in its extensive combination of human and animal model research studies of human behavioral variation.’”

Boardman said faculty members are still determining whether to offer an academic certificate for the program. Meanwhile, the interaction between IBS and IBG researchers continues to lead to interesting studies, including “wet lab” scientists such as IBG’s Tom Johnson, who studies molecular behavioral genetics using worms and mice.

“It’s amazing what comes up when we’re all together talking about this,” Boardman said.

This article was originally publoshed on CU's A&S Magazine. The original article can be read in it's entirety here. 

Opioids, obesity—not 'despair deaths'—raising mortality rates for whites

Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according to new CU Boulder research. The study, published online today in the International Journal of Epidemiology, also found that, contrary to widely reported research findings, suicide and alcohol-related deaths are not to blame for increasing mortality rates among middle-aged whites.

The results call into question recent reports suggesting that what have become known collectively as “despair deaths”—by suicide, alcohol and drugs—are on the rise among white Americans, particularly men, facing a lack of economic opportunity and an increase in chronic pain. “We find little empirical support for the pain-and distress-based explanations for rising mortality in the U.S. white population,” said lead author Ryan Masters, an assistant professor of sociology at CU’s Institute of Behavioral Science. “Instead, recent mortality increases have likely been shaped by the U.S. opiate epidemic.”

Masters said metabolic diseases, including heart disease, obesity and diabetes, are also playing a key role. After years of declining death rates for such diseases, thanks to new drugs and procedures, that progress has slowed for men and stalled for women, the study found. “When it comes to mortality, we are just starting to see the real health consequences of the obesity epidemic,” he said.

Masters, along with graduate students Andrea Tilstra and Daniel Simon, launched the study in spring 2016 after papers revealed, following years of decline, U.S. mortality rates had begun to inch up among middle-aged white non-Hispanic men and women. Follow-up studies suggested such increases were disproportionately driven by chronic liver disease, suicide and overdoses, which some suggested were “symptoms of the same underlying epidemic” of emotional distress, economic insecurities and chronic pain. One study published in 2015 in the Proceedings of the National Academy of Science referred to “despair deaths” among a “lost generation whose future is less bright than those who preceded them.” 

“The despair death narrative caught fire and has since begun to inform mortality research and media coverage, and shape dialogue among policymakers and politicians. Yet our research shows it is demonstrably incorrect,” Masters says. For the new study, he looked at U.S. mortality data from the National Center for Health Statistics, the Centers for Disease Control and Prevention, and U.S. Census Bureau for U.S. non-Hispanic white men and women age 25 to 34 and 35 to 54 from 1980 to 2014. While previous research had lumped men and women, 10-year age spans, and drug, alcohol and suicide deaths together, Masters and his team disentangled the datasets, looking independently at genders, individual year ages and distinct causes of death. They also distinguished between “period effects” in which shifts in mortality rates were similar among all age groups, and “cohort effects” in which the shifts were unique to individuals born in a particular time frame.

One glaring pattern emerged. Among men and women of all age cohorts studied, drug-related deaths have skyrocketed. For instance, in 1980, 1.4 per 100,000 men and 1.76 per 100,000 women died from drug overdoses. By 1998, those numbers had climbed to 9.5 for men and 3.6 for women. By 2014, they’d risen to 36.5 for men and 24.4 for women. Meanwhile, the researchers found “no substantive increases in white men’s alcohol-related mortality at any time.”  Suicide rates did rise slightly between 1999 and 2014 for men and women. But this was due largely to spikes among all age groups during times of economic downturn. “This suggests that economic insecurities are not isolated to a single ‘lost generation,’” said Tilstra. 

With drug-related mortality rates, “It took off around the time when prescription opioids became readily available, and it has kept rising steadily ever since,” Masters says. The team, in yet-to-be published research, has also looked at the numbers for black men and black women and has seen similar patterns of soaring rates of drug abuse across age cohorts since the late 1990s.

“We do not doubt that times of economic insecurity can have severe consequences for a population’s health, nor do we doubt that pain and distress can pose serious health problems,” the authors conclude. “However, taken together, our findings suggest that it is unlikely that recent trends in U.S. white men’s and women’s mortality rates have been driven by an epidemic of pain and rising distress.”

Instead, the authors point to over-prescription and misuse of opioid-based painkillers, heroin use, and an “obesogenic” environment. They hope their paper will encourage policymakers and researchers to explore those drivers and their solutions further.

This article was originally published by CU Today. The original can be found here. 

This article was originally published in CU Boulder Today. You can view the original article here.) 

By: Lisa Marshall

With record high temperatures scorching the Southwest this week, farmers were quickly reminded of the severe droughts that threatened their crops and livelihood in recent years. How will they manage increasingly scarce water when drought comes again? A new CU Boulder-led study suggests that self-imposed well-pumping fees can play an important role, incentivizing farmers to slash use by a third, plant less thirsty crops and water more efficiently.

When we talk about groundwater crises arising all over the world, the knee-jerk reaction among policymakers is often to ask, ‘What can government do?’ not ‘What can farmers do?’,” said Krister Andersson, director of the Center for the Governance of Natural Resources at CU Boulder's Institute of Behavioral Science and co-author of the paper in the Journal of the Association of Environmental and Resource Economists. “This study shows that there exists a good alternative to top-down regulations—that self-organized efforts can have a huge impact on how much water farmers use.”

The study centered around a novel initiative in Colorado’s San Luis Valley, where several hundred farmers voted to self-impose a fee on groundwater—which is typically free and largely unregulated—beginning in 2011. The move came after a historic drought in 2002 and subsequent dryer-than-average years left the region’s aquifer depleted and some farmers worried that the state might begin shutting down wells, as it had in other areas. Historically, farmers have relied primarily on surface water from streams and run-off, but as population growth and climate change have strained supplies, agriculture has grown increasingly reliant on water pumped from underground.

The new fee, now at $75 per acre foot of water, is among the first in the nation. About 700 farmers who manage 170,000 acres are subject to the fee. Proceeds are used to help local irrigators buy supplemental surface water or to pay them to let their acreage go fallow, or unused, in dry years. As part of a National Science Foundation grant aimed at assessing self-organized water conservation programs, CU Boulder researchers have spent years in the San Luis Valley Basin meeting with stakeholders and collecting data.

“With this study, we have been able to offer validation that what they are doing is working,” said co-author Kelsey Cody, a graduate research assistant in CU Boulder’s environmental studies program. The study drew upon five years of data from farmers inside and outside the fee district before and after it was implemented. It found that farmers subjected to the fee pumped 32 percent less water per year on average. Some switched to less water intensive crops. Others upgraded to more water-efficient irrigation equipment. Notably, some did not reduce their water use at all and instead opted to pay extra.

“This is because a fee does not prescribe what one can and cannot do; it just forces the irrigator to consider the cost of the water itself,” notes lead author Steven Smith, who did the research as a doctoral student at CU Boulder and who is now an assistant professor of economics at Colorado School of Mines. The authors stress that while the study confirms that irrigators are using less water and changing their farming practices, more research is necessary to determine how the fee has impacted them financially and whether the fee has caused the aquifer to recharge. Another study is in the works.

Despite wetter weather in the past year, the participating irrigators intend to keep the fee in place, and other nearby districts are moving to implement a similar one, said Cleave Simpson, general manager of the Rio Grande Water Conservation District, which helps facilitate the fee. “We are cautiously optimistic about it.” 

As lawmakers in California, Texas, and other states ponder ways to regulate groundwater use, the researchers hope what’s happening in the San Luis Valley can serve as a lesson. The authors stress that a self-imposed groundwater fee may not be appropriate for all agricultural areas, but as the state looks for ways to conserve groundwater, it could be one effective tool. “The punchline here is that irrigators are far more responsive to these price mechanisms than was previously believed,” said Smith. “Through their adoption, they may be able to induce a lot of conservation.”