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New Horizons in Health: An Integrative Approach
shows that those who are more socially integrated have lower profiles of disease and tend to live longer (see Chapter 5). What is poorly understood, however, is how the life-enhancing benefits of quality relationships come about. Significant others may encourage the practice of healthy behaviors, but additional influence may follow from the emotional dynamics of key relationships and how they affect underlying physiological processes. The latter mechanisms are the focus of a multidisciplinary project currently in progress at the Wisconsin GCRC. The purpose of the work, broadly defined, is to probe linkages between psychological, social, and emotional well-being and multiple aspects of biology, including allostatic load, affective neuroscience, and immune function. It is part of the larger program of characterizing predisease pathways (see Chapter 2) and pathways to positive health outcomes (see Chapter 3).
From the perspective of this report, strong bridges between community studies focusing on predisease pathways or resilience, for example, and biomedical assessments on the same population could be carried out effectively through collaborative studies with GCRCs. Ambulatory blood pressure studies with simultaneous assessment of environmental influences (Schnall et al., 1998; Pickering et al., 1996; James et al., 1991) are important prototypes for more expansive investigations linking psychosocial and biological processes. This provides a major avenue to integrate social and behavioral sciences with biology and clinical medicine, thereby fostering symbiotic relationships and greatly enriched research programs between GCRCs and the social sciences.
COMMUNITIES AND INTERVENTIONS
Health promotion and primary disease prevention intervention programs are frequently centered around communities. Thus, the selection of communities for the core population infrastructure should partially be guided by the nature of the opportunities to assess the impact of currently operative interventions as well as for implementing new ones. We also view intervention programs as opportunities to advance understanding of more basic scientific questions. For example, a program designed to enhance a sense of purpose in life among the elderly in a retirement community—with consequential downstream positive health consequences (see Chapter 3)—could be accompanied by biomarker assessments on a subset of the community with the objective of understanding the physiological substrates that underlie an improved sense of purpose in life. This kind of activity would directly improve our understanding of the biological mechanisms associated with positive health at the psychosocial level. It also points to the major opportunity to integrate intervention studies with what are typically viewed as basic research projects.