In bringing to a close last month's Socioeconomic Status and Health meeting at the National Institutes of Health (NIH), Norman Anderson, director of the Office of Behavioral and Social Sciences Research (OBSSR) called for a multi-level approach to biomedical research that includes the complete integration of behavioral and social studies. "The causes of illness do not arrange themselves according to university departments," Anderson told conferees.

The meeting, organized by the New York Academy of Sciences, examined the effect of social conditions, such as education, occupation, wealth, race and gender on health inequalities. It marks the increased prominence of social and behavioral science within the NIH—America's bastion of hard-core biomedical research.

Anderson, appointed as OBSSR's first director in 1995 following its congressionally mandated creation in 1993, told Nature Medicine that a review of behavioral and social research funded by NIH reveals that the organization spends around $1 billion of its $15 billion budget on such studies. "When you consider that these conditions are the largest killers, then this funding is far from sufficient," he says.

He is referring to the idea that many cancers, cardiovascular disease and some other fatal conditions have strong behavioral and social components that, if understood more fully, may provide the key to their prevention. Many attending the conference were physicians and/or researchers from mainstream biomedical research institutes, and all agreed that this concept is behind the increased standing of social research within NIH.

Their message is that while enormous sums of money have been devoted to determining the molecular and cellular basis of many diseases in recent years, this has had relatively little effect on disease incidence and prevalence. Thus, health specialists are looking for additional means of understanding and treating disease. They want all NIH institutes to absorb social science as an integral part of their studies—something that has hitherto been attempted only by the National Heart, Lung, and Blood Institute.

NIH director Harold Varmus has made health inequalities one of his eight "areas of emphasis" for research, and immediately following the conference, Anderson met with a specially appointed National Academy of Sciences committee to begin the process of priority setting for behavioral and social science research. The committee is expected to report its findings in January 2000.