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Behavioral Medicine is Under Attack! SBM Responds

Maybe you've heard them, the none-too-subtle threats to social and behavioral science. Congressional representatives and even a few scientists are making them.

  • In a September 30, 2013, opinion piece for USA Today, "Rethinking science funding," House Majority Leader Eric Cantor, (R-VA) and Chairman of the House Committee on Science, Space and Technology and Representative Lamar Smith, (R-TX) wrote they "have recently seen far too many questionable grants, especially in the social, behavioral and economic sciences" funded by NSF. 
  • Sen. Tom Coburn, (R-OK) repeatedly calls for the elimination of NSF's Social, Behavioral and Economic Sciences Directorate, and has questioned whether "these social sciences represent obvious national priorities that deserve a cut of the same pie" as other sciences.
  • In a Forbes opinion piece (October 7, 2013), scientist Henry I. Miller wrote that "projects carried out by its [NIH's] National Center for Complementary and Alternative Medicine (NCCAM) — which was in the first place the brainchild not of scientists but of politicians — are clearly a weak link."

The question is: What is SBM doing to stem these attacks. The answer? A lot!

Many of SBM's core activities (such as Annals of Behavioral Medicine and Translational Behavioral Medicine: Practice, Policy, Research, and our Annual Meeting) not only advance the science, they draw favorable attention to behavioral medicine from the scientific community; such focus serves as one form of effective rebuttal. To augment these activities, a core group of SBM members focuses on strategies that draw attention from the health policy community. SBM's President Dawn K. Wilson, PhD; Health Policy Committee led by Marian L. Fitzgibbon, PhD; and the Public Policy Leadership Group (PPLG) led by Sherry L. Pagoto, PhD, work hard to showcase our evidence-based research and the breadth and depth of our understanding of health and disease prevention, all of which serve the public good. They strive to:

  • Shine the national spotlight on the contributions of SBM and behavioral medicine
  • Inform and educate policy makers
  • Respond rapidly to the need for action
Shining the national spotlight on behavioral medicine contributions and solutions

Society presidents often serve as spokespersons, addressing audiences from a highly respected "pulpit."  SBM President Dawn K. Wilson, PhD, has used her pulpit more than once to influence high-level federal officials. At the invitation of Trust for America's Health Executive Director Jeffrey Levi, PhD, Dr. Wilson delivered a September 2013 presentation to the national Advisory Group on Prevention, Health Promotion and Integrative and Public Health in Washington, DC. She clearly delineated the science and contributions of behavioral medicine that help prevent costly chronic diseases. Established by President Obama as part of the Affordable Care Act (ACA), the Group advises the National Prevention Council, which is responsible for developing public, private, and nonprofit partnerships that leverage opportunities to improve our nation's health. The Council comprises cabinet secretaries, chairs, directors, or administrators of federal departments.

Dr. Levi's invitation reflects the fruit of many months of Dr. Wilson's targeted outreach to strategic policy partners. During more than a dozen face-to-face visits, other societies' and organizations' leaders shared their high regard for SBM and welcomed Dr. Wilson's central message: working together to influence health policies amplifies our voices and heightens our impact. Plans are now underway for a policy summit at the 2014 SBM Annual Meeting, where leaders can continue this exciting conversation.

Positioning behavioral medicine practitioners within the primary care and clinic setting can produce favorable outcomes as patients adopt healthy habits, lose weight, and increase their exercise. To help accomplish this, members of the Public Policy Leadership Group (PPLG) recently published editorials on behalf of SBM in high-impact journals making the case for Centers for Medicare and Medicaid Services (CMS) reimbursement of behavioral weight loss interventions. One piece, by Drs. Sherry L Pagoto, Stephenie Lemon, and Jessica Whiteley appeared in the New England Journal of Medicine; another, by Drs. Sherry L Pagoto, Stephenie Lemon, Lori Pbert, Brent Van Dorsten, and Jessica Whiteley appeared in the American Journal of Preventive Medicine.

"Ban Indoor Tanning for Minors," an SBM Position Statement by SBM members Drs. Sherry Pagoto, Joel L Hillhouse, Carolyn J. Heckman, Elliot J. Coups, Jerod L. Stapleton, David B. Buller, Rob Turrisi, June K. Robinson, and Alan Geller, MPH, RN, puts us in league with leading societies such as the American Academy of Pediatrics that has also advocated for this ban. The Statement also conveys our concern for the public's health.

Recognizing the crucial role that physical activity plays in reducing obesity, Health Policy Committee members Sandy J. Slater, PhD, and Natalie Colabianchi, PhD, authored an SBM position statement supporting robust, well-designed, safe and accessible community parks. The position aligns with federal legislation introduced by Sen. Kay Hagan (D-NC), which seeks federal funding for park revitalization, demonstrating to the Senator and her like-minded colleagues that SBM welcomes opportunities to inform policy with scientific evidence.

Informing and educating policy makers

Direct contact with federal legislators and their health aides affords a prime opportunity for impacting policy. Since 2011 SBM Board members have been visiting federal legislators' offices, where, among other aims, they encourage legislators to protect NIH funding for the social and behavioral sciences and funding for the Prevention and Public Health Fund. Board visitors share concrete, vivid examples of NIH-funded SBM research and interventions that improve the health of legislators' constituents.

When Sen. Tammy Baldwin, (D-WI), recently introduced the "Next Generation Research Act," designed to increase opportunities for early-career scientists, PPLG members saw this as a chance to review the bill and provide feedback to strengthen it.

Increasingly, policy makers focus on "return on investment," asking investigators to show how interventions reduce healthcare costs. Health Policy Committee members Edwin Fisher, PhD; Ben Gerber, PhD and Lisa Sharpe, PhD, are drafting a policy brief showing how certain diabetes interventions  reduce costly hospital and emergency department admissions. The Health Policy Committee will continue to develop briefs that promote behavioral medicine interventions within an economic context.

Dr. Wilson has also used the power of the SBM pen, adding SBM's signature to a letter to President Obama protesting use of Prevention Funds for setting up health exchanges as well as to a letter to NIH Director Francis Collins reinforcing that a key component of the agency's mission is to support behavioral and social science and economics research.

Collaborating with like-minded partners is another hallmark of effective policy work and SBM was pleased to join the Consortium of Social Science Associations (COSSA) in sponsoring a September 25, 2013, congressional briefing, "What's Ailing America: Shorter Lives, Poorer Health." The briefing highlighted recent Institute of Medicine report findings.

Responding Rapidly

PPLG and Health Policy Committee members stay on the alert for opportunities that warrant member action. With increasing frequency, electronic alerts reach SBM members' in-boxes, urging them to contact their legislators by using our easy online tool. In the past few months, SBM members have encouraged their representatives to:

  • Expand the Medicare definition of "physician" to include clinical psychologists
  • Oppose cuts to nutrition programs
  • Support legislation that would increase the quantity and quality of local outdoor recreational areas

If you want to play a part in our policy efforts, respond to these alerts! The online tool makes it easy to quickly support legislation that pushes our collective agenda forward or express concern about legislation that threatens to impede our progress. By emailing dwilson@sbm.org you can volunteer to help; new energy is always welcome.

The aforementioned attacks notwithstanding, this is an exciting time for SBM and the field of behavioral medicine. A great deal of media and other public attention emphasizes the value of behavior change and the science that supports it. Champions of health prevention reside within Congress, the current administration, and state legislatures. Engaging in public policy work is a choice – one that SBM's leaders are making, not only to thwart attacks but more importantly to convey rightful pride in members' accomplishments and serious scientific work.