Tag: interdisciplinary health

Breaking out of the Ivory Tower

For social scientists, the drive to enter academia is often fueled by a desire to better understand people and the contexts in which they work, love, learn, play, triumph, and struggle. As researchers’ academic foci narrow, however, the ivory tower can feel like a lonely place, far-removed from the social reality we initially sought to study.  Jane Brown, James L. Knight Professor in UNC’s School of Journalism and Mass Communication, serves a reminder to us all that a career in research doesn’t have to come at the expense of connection to the community.

Over the last 35 years, Dr. Brown has defined her career by researching sex, drugs, and rock and roll, focusing on the way media affect adolescents’ sexual behavior. She has co-edited or co-authored 5 books on adolescents’ sexuality, written over 60 book chapters and articles, and is currently working on studies in rural North Carolina, Vietnam, and China. Her CV is so thick that it could be confused for a phone book, yet one of the most impressive things about Dr. Brown is only partially gleaned from a list of her accomplishments. She doesn’t just study people – she truly engages with them, critically examining the implications her research has for their lives and using her findings to inform recommendations for changes in social policy. Additionally, through mentorship and dedication to teaching, Dr. Brown has inspired many to become leaders in health communication. She has forged a strong network that extends across professionals, students, academics, and others.

Dr. Brown’s career in health communication exemplifies the significant contribution a scholar’s research program can make to her field over the course of 35 years, but it doesn’t stop there. It is also living proof that academics don’t have to relegate themselves to isolation in an ivory tower. Instead, by studying culturally relevant phenomena and maintaining a focus on building community, a career in academia can resemble a potluck dinner at which all contributions are welcome and where all guests can eat, drink, and be merry.

Complementary medicine: What is “enough evidence”?

What is the tipping point for doctors to start recommending proactive steps for health and wellness to their patients — particularly when they give a tough diagnosis of chronic or life-threatening illness, like cancer, heart disease, or diabetes? Much research has been done on the genetic ties of chronic illness. Genes increase our “risk” for certain health problems, but we need not develop a fatalistic attitude — genes show us what to pay attention to, they do not simply “determine” what diseases we will develop without question of our interacting with diagnosis

I have recently done a lot of research on what complementary medicine steps can be taken to reduce, for example, a woman’s chance of developing breast or ovarian cancer, when she is diagnosed with BRCA (a gene mutation leading to increased risk for ovarian and breast cancer). There are very promising findings about “complementary medicine” steps, like increasing the quality of your social support  relationships, reducing animal-protein intake (and increasing vegetable fruits, and fiber intake), increasing exercise, and reducing stress, as viable ways to stop breast and ovarian cancer tumor growth, specifically. However, for “medicine” (as a scientific establishment) to accept the “evidence” about these steps, many more, and many larger research studies need to be done — in other words, Randomized Controlled Trials (ex. thousands of participants at risk for cancer who do and do not exercise 3x a week, measured across several years with a “treated” and a “placebo” group), versus case control (ex. a certain group of women diagnosed with ovarian cancer, measuring tumor growth alongside low social support and high distress/depression levels) or cross-sectional studies (ex. country-by-country analysis of dietary fat and animal-protein intake and incidence of breast cancer). Meta-analytic studies (reviewing the research findings to date across a large grouping of studies) are often the best route for showing a large body of relevant research. It is fascinating to learn about the difference in research quality and what is “accepted” in the annals of medicine — but a certain amount of frustration emerges from my commitment to “public health.”

When do our ethics kick in — the hippocratic oath to “do no harm,” as the will to share important information that can help patients prevent, for example, cancer growth?

Is it a bad idea to tell patients that their cancer risk can be decreased by also decreasing animal-protein intake (to less than 1/5 of calories), or by increasing vegetable intake, or by avoiding or treating not just symptoms but root causes of stress, or by increasing the quality and quantity of positive relationships with family and friends? These do not just improve quality of life, but also have improved health outcomes, to the cellular level in cancer tumors, lesions leading to heart disease, and a host of other diseases affected by blood hormone levels (tied to food), stress hormone levels (tied to stress, social support, exercise), and inflammation (stress, social support, exercise).

Much of the data shows what increases cancer risk (i.e. high stress levels, low social support, high-fat and high meat/dairy-based diets, little exercise). Should we let patients know what does increase cancer growth, and put it in their hands to take steps to “avoid” these activities? This seems circular, but perhaps the best step to appease multiple perspectives on how much evidence is “enough evidence” to substantiate public health recommendations in a clinical environment…

Many of these complementary medicine recommendations — about stress, diet, social support, and exercise —  are already happening for people diagnosed with heart disease and diabetes, but I am very hopeful these recommendations will translate to cancer –related health recommendations as well.

When a physician gives a patient diagnosis of a life-threatening or chronic illness, at what point is it okay to recommend action steps for health?