Behavioral medicine across the life course: Challenges and opportunities for interdisciplinary science

Abstract

Welcome to San Francisco and the 27th Annual Meeting of the Society of Behavioral Medicine (SBM), a celebration of ‘‘Behavioral Medicine Across the Lifespan.’’ I extend warmest appreciation to our program chair Dr. Amanda Graham and co-chair Dr. Paul Estabrooks for developing and coordinating this outstanding program. I also extend gratitude to our Bay area volunteers (Dr. Sara Knight and committee), our management company, and our board of directors for their individual and collective efforts with this meeting and throughout the past year. I also thank my family for making this journey with me. Members of SBM will recall that we recently revised and expanded our mission statement to place emphasis on the generation and application of knowledge of behavioral medicine to improve the health of individuals, families, communities, and populations. Consistent with this mission, we embraced a social–ecological model that focuses on the multiple levels of determinants of health. As Dr. Judith K. Ockene noted in her 2005 Presidential Address (1), this model also provides a framework for understanding, organizing, and connecting programs at the multiple levels of influence. Indeed, a substantial body of evidence, generated by members of SBM and others in our multidisciplinary field, demonstrates that factors operating beyond the individual are critically important and potentially modifiable influences on health behaviors and health across the life course. Clearly, the epidemic of childhood obesity, a major challenge to the health of the public, has focused attention on such environments as the family, schools, communities, the food industry, the media, and broader social and environmental contexts and conditions that influence the balance between energy intake and energy expenditure. This epidemic has also prompted collective action and partnering across the sectors and stakeholders concerned about the potential negative impact of childhood obesity on the health of future generations and systems of health care. Indeed, the theoretical and practical significance of this model for our field has been and continues to be demonstrated (2) (Figure 1). Embedded in this model is the concept of lifespan, the theme of this 27th annual meeting. Developmental lifespan science has evolved over the past two decades as an interdisciplinary field that places emphasis on the interactive influences of genetics, biology, and behavior on health across the life course of individuals and diverse populations. It also emphasizes proximal (e.g., the family) and distal (e.g., social and environmental conditions) contexts as important and potentially modifiable influences on health and developmental processes. Influenced by the insightful systems thinker, Ludwig von Bertalanffy, developmental lifespan science encourages us to ‘‘think’’ systems, nonlinear modes, and feedback mechanisms (3). From cells to societal level systems, concepts emphasized are interdependence, interrelatedness, and semiautonomy. A major component of this ecological systems perspective and consistent with SBM’s inaugural mission statement, ‘‘the whole is more than and different from the sum of its parts’’ is emphasized. Contemporary developmental science recognizes the potential for positive change in biological, behavioral, and psychological processes across the life course of individuals. Optimal health-promoting environments are recognized as conducive to positive change, whereas interindividual differences in person–environment interactions are acknowledged and celebrated. Although older developmental paradigms searched for the universals in human development and aging, current paradigms focus on individual differences that are influenced by the interaction of genetic and environmental factors. Dr. Claude Bouchard will discuss this topic in his Master Lecture tomorrow as he focuses on genetic influences on individual differences in response to behavioral interventions. Life course sciences including developmental psychology, epidemiology, and sociology have also evolved over the past two decades, offering additional insights within our ecological model and relevant to each of us in the behavioral medicine community. As articulated by Elder (4), life course developmental theory: