The witnesses for the hearing were Bridget Long, Academic Dean and Professor of Education, Harvard Graduate School of Education; Kim Cook, Executive Director, National College Access Network; Judith Scott-Clayton, Professor of Economics and Education, Columbia University; and Kristin Conklin, Founding Partner, HCM Strategists.

Ranking Member Sen. Lamar Alexander (R-TN) demonstrated the necessity of reforming the federal student aid process by displaying the application in its current state -- 10 pages of application with 68 pages of instruction -- or in his words, "lots of pages of well-intentioned clutter."

Long asserted that the persistent gaps to college access by family income can be attributed to three barriers: financial needs, academic preparation, and complexity of enrollment for financial aid. She continued that empirical research has shown financial aid access has a positive impact on short-, medium- and long-term outcomes. In a small-scale test of a streamlined FAFSA application, 30 percent more high school students attended college. Cook also stressed the importance of simplifying financial aid, stating that it encompasses what she called the "three 'A's of college success": awareness, affordability, and access. She believes that financial aid information should be presented earlier in the application process, comparing the current system to buying a car or house before finding out what your financing options are.

Scott-Clayton asked the, in her opinion, too-frequently-asked question: Is college worth it? According to her, the answer is a "resounding yes," and that this is even asked at all comes from misconceptions about college access. Many students, she said, put off college as an option not because they have no desire to go, but because the decision is overwhelming. Congress can go a long way to alleviating these barriers by prorating Pell Grants based on individual course loads and by restructuring how student loans are repaid. Conklin reiterated much of what Scott-Clayton said: a more accessible federal student aid program would increase access and outcomes by helping more students see that not only is college possible, it can be affordable. They agreed that the biggest winners of a reformed system would be those who are largely marginalized currently.

In questioning, Sen. Bob Casey (D-PA) brought up the possibility of personalized help for those applying to federal financial aid as a way of increasing access. Scott-Clayton responded that studies have demonstrated a meaningful impact at small scales of a personalized guidance system, but she was concerned it would be difficult to scale up both in cost and in effectiveness. Further, she said a very effective use of one-on-one help would come from an "intervention" for students who have accepted financial aid but over the summer ultimately decide not to attend college. She finished by stating that this could be more effective and cheaper if the financial aid application itself were simplified.

Sen. Tammy Baldwin (D-WI) inquired about how this program could be better adapted to focus on the needs of non-traditional students and those who focus on a trade or occupational certificate. Long responded that she agreed with the Senator's concerns and that any changes to federal financial aid must take into account programs that are not of the traditional earned-credit type. Conklin said that simplification of the financial aid process would go a long way in responding to the needs of non-traditional students. Alexander concluded the briefing on a similar note, stating that simplifications to the system would "change the fiction that people believe they can't go to college."

On November 20, the Primary Health and Aging Subcommittee of the Senate HELP (Health, Education, Labor and Pensions) Committee held a hearing to examine the relationship between socio-economic status and health in America. This hearing focused on themes similar to those brought up in a briefing this September on "What's Ailing America: Shorter Lives, Poorer Health," sponsored by the Coalition for the Advancement of Health Through Behavioral and Social Sciences Research (CAHT-BSSR), a COSSA-organized coalition (see Update, October 7, 2013). The witnesses for the November 20 hearing were Steven Woolf (who was a panelist at the September briefing), Director, Center on Society and Health and Professor of Family Medicine and Population Health, Virginia Commonwealth University; Lisa Berkman, Director, Harvard Center for Population and Development Studies; Nicholas Eberstadt, Henry Wendt Chair in Political Economy, American Enterprise Institute; David Kindig, Professor of Population Health Sciences, University of Wisconsin; Sabrina Shrader, Masters of Social Work student; and Michael Reisch, Professor of Social Justice, University Maryland School of Social Work.

In his opening statement, Subcommittee Chairman Sen. Bernie Sanders (I-VT) laid out the importance of this hearing: "I think people would be shocked" when they learn of the disparity in quality of life from one part of the country to another, he said. As a nation, America is far behind many, if not most, developed countries in the world in terms of life expectancy, and some American counties have life expectancies lower than many Sub-Saharan African nations. The purpose of this hearing, Sanders concluded, is to examine why some people today are living shorter, sicker lives than their parents and what can be done to ameliorate the problem.

Woolf began his statement by detailing some troubling facts about health quality in America. American children are less likely to reach the age of five than children in other developed nations; our infant mortality rate is most similar to many countries in central Africa; regional disparities in health quality are stark -- one out of four Virginia deaths, for example, would be prevented if all Virginians had the same quality of health as those in wealthy Fairfax County; Azerbaijan has a higher life expectancy than some areas of Chicago. These striking facts, he said, demonstrate that "economic policy is not just economic policy -- it's health policy." In other words, "the lower people's income, the earlier they die and the sicker they live," he declared.

Berkman discussed some of the challenges United States labor policies and practices present for creating positive health outcomes for employees. For instance, studies have shown that when managers are more attentive to work-family issues, employees are half as likely to develop cardiovascular diseases and are much less likely to be diagnosed with diabetes. In her view, the primary problem in policymaking is the tendency to only address "short-term economic turnaround or employment or labor when in fact the spillover to health may be enormous."

Eberstadt pointed out how complex this issue is. For instance, whites, who are much more likely to have visited a doctor, have, on average, lower life expectancy than Latinos or Asians. "If the US only had Latino and Asian Americans, we would be the healthiest country on earth." These questions demonstrate the complexity of the issue. Similarly, Kindig discussed the importance of a multi-faceted approach to improving across-the-board health outcomes in the U.S. While health care access is important, studies show other factors, such as access to early childhood education, can have an equally important role in an individual's long-term health.

Shrader, a Masters student from McDowell County WV -- the county with the lowest life expectancy for men and second lowest for women in the country -- discussed her life coming out of such an impoverished region. She said that throughout her life, due to her and her family's poverty, any illness or accident was a virtual "death sentence." With the stress this level of poverty places on the daily lives of the people she grew up around, there is no surprise as to the low quality of health and resulting shorter life expectancy of those from the poorest parts of the country. When asked by Sanders specifically what it was about the quality of life in McDowell County that makes health so much worse, Shrader responded that alcohol and drug abuse is widespread, and that everybody consistently fights to pay their bills, heat their homes, and feed their families.

Sen. Elizabeth Warren (D-MA) delved deeper into this problem of low income affecting health and the citizenry more generally. Woolf pointed out that with more low-income families working, due to increased income inequality, the nation's overall workforce will continue to be sicker and less-educated, leading to an inability to compete with workers from other countries with better health outcomes. Reisch raised other issues, such as decreasing mobility among the working class. Working-class families will not attend college and they will be locked into low-income, less-healthy communities, he added. Furthermore, three-fourths of low-income children will remain in their neighborhoods throughout their lives, exacerbating the problems.

Warren and Sanders concluded the hearing by asking the witnesses to give their opinions on how to disrupt this vicious cycle of low income and poor health outcomes. Woolf stated that education reform beginning at the pre-K level is an important first step. He also said that other countries have adopted policies such as extended maternal leave and job and workforce support that have been highly successful. Reisch said that he believes a lot of progress is possible at the community level through developing community health centers and food cooperatives, for example. The consensus among the witnesses, though, was that improved access to quality education at all levels is imperative in making lasting changes to across the board health outcomes in the United States.

In closing, Sanders summarized the importance of the hearing: "You have shed light on issues that we just don't talk about enough. If we invest in our people and create a healthier, more loving society we create not only a happier society, but we end up saving the taxpayers' money as well."

The National Institute of Arthritis and Musculoskeletal and Skin Diseases' (NIAMS) mission is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to care out this research, and the dissemination of information on research progress in these diseases. Recognizing that "research needs, opportunities, and challenges change," the Institute is in the process of updating the Plan, designed to help guide the research it supports over the next five years. Accordingly, NIAMS is seeking feedback from researchers in academia and industry, health care professionals, patient advocates and health advocacy organizations, scientific or professional organizations, federal agencies, and other interested members of the public on its Long-Range Plan for Fiscal Years (FY) 2015 -2019. Organizations are strongly encouraged to submit a single response that reflects the views of the organization and membership as a whole.

NIAMS' plan for FY 2010-2014 includes five disease or tissue-specific areas and covers the Institute's broad mission: arthritis and rheumatic diseases; skin biology and diseases; bone biology and disease; muscle biology and diseases; and musculoskeletal biology and diseases. The 2010-2014 Plan recognizes the "importance of acknowledging transdisciplinary areas and approaches." Accordingly, the Plan emphasizes that "many of the complex diseases and conditions relevant to the NIAMS mission can be seen through a new lens using genome-wide analyses, novel behavioral/biopsychosocial research methods, systems biology approaches, and new imaging modalities." It also highlights needs and opportunities that are relevant to many NIAMS research communities: health disparities, training and careers, infrastructure, and information dissemination and outreach.

According to NIAMS, "[t]he Plan is not comprehensive; It does not mention every research area or disease of interest by name. As a broad outline for the NIAMS, however, it informs the Institute's priority setting process while enabling the Institute to adapt to the rapidly changing biomedical and behavioral science landscapes.

For more information and /or to submit comments, see:

http://www.niams.nih.gov/About_Us/Mission_and_Purpose/long_range_form.asp. Comments are due by January 15, 2014. 

A newly released report, "Faces of Austerity: How Budget Cuts Have Made Us Sicker, Poorer, and Less Secure," authored by NDD United, a coalition of over 3,200 partners, including COSSA, fighting to stop the harmful effects of budget cuts, details the stories of those affected by sequestration, including the impact of devastating cuts to social and behavioral science research funding. The release of this report was aligned with a Congressional briefing that brought a mixed group of people -- scientists, a pre-K educator, nonprofit organizers, and others -- together to tell their stories to stakeholders and Congressional staffers.

American Sociology Association Executive Officer and COSSA Board Member Sally Hillsman had this to say about sequestration and the report: "the ASA is deeply concerned about the impact of sequestration and other cuts on the federal government's social and behavioral science research programs-- programs that are crucial to our nation's economic health and infrastructure. I hope Congress and the Administration take the time to read this critical report, which should inspire them to work in good faith towards a balanced budget agreement that ensures an end to the sequestration and restoration of the nondefense discretionary (NDD) programs' budgets."

Additionally, Senator Tom Harkin (D-IA), Chairman of the Senate Labor, Health and Human Services, and Education Appropriations Committee, stated his desire to find a solution to sequestration. "From the Head Start student eager to go to school to the medical researcher on the cusp of a breakthrough, this report shows the real-life impact of the budget debate -- a debate that touches the lives of so many Americans. Our economy is stronger when we invest in infrastructure, job training, and education programs. Our families are safer when we invest in public health and public safety. Our lives are better when we invest in life-saving research. I urge the budget conference to bring an end to sequestration because we cannot afford another year of these cuts," Harkin said.

The full report is available here: http://publichealthfunding.org/NDD_report/NDD-report-digital.pdf.

On November 13, the Joint Center for Political and Economic Studies hosted a Congressional briefing on the Centers for Disease Control and Prevention's (CDC) Racial and Ethnic Approaches to Community Health (REACH) Minority-serving National Organizations (MNO) grants. The REACH program is an important component of CDC's efforts to eliminate racial and ethnic health disparities in the United States. The CDC distributes grants to support community-based, participatory approaches to identify, develop, and disseminate effective strategies for addressing health disparities across a wide range of health priority areas. The program consists of 50 community grants and six to national organizations that serve minority communities, which were the focus of the briefing.

Brian Smedley, Health Policy Institute, Joint Center for Political and Economic Studies, introduced the briefing and shared a short video presentation from the Inter-Tribal Council of Michigan, which described their tobacco reduction efforts.

Rod Lew, Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL) discussed APPEAL's efforts to reduce health disparities among Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI), an incredibly diverse population comprised of two racial categories and speakers of 100 different languages. APPEAL's focus has been on reducing tobacco use and combating obesity in the AANHPI population. He emphasized the importance of tailoring approaches to the community and culture they are operating in, building on existing relationships, and nurturing leadership within the communities. Lew highlighted the work of NAPNEHD, the National Asian American and Pacific Islander Network to Eliminate Health Disparities, which operates in New York City and Palau.

Nicolette Warren, Society for Public Health Education (SOPHE), shared some of the details of SOPHE's Health Equity Project, "Sustainable Solutions for Health Equity." Two SOPHE chapters, one in Jenkins County, Georgia and one in northern California were awarded grants for pilot programs aimed at addressing diabetes disparities in their communities. The Jenkins Country project is taking a community-based participatory approach to reducing disparities among African Americans in rural Georgia by integrating healthy messages into everyday activities. The northern California program focuses on the American Indian/Alaska Native population and works with community partners to change attitudes about exercise and nutrition.

Valerie Rochester, Black Women's Health Initiative, spoke about efforts to address the disparities in breast and cervical cancer rates experienced by Black women. She noted that Black women are more likely to be diagnosed at a young age, develop more aggressive forms of cancer, and die more often from cancer. The REACH-funded activities focus on building awareness of these disparities, education, and early detection in Atlanta, Chicago, and Washington, D.C. Rochester emphasized the importance of grounding the approach in the socioeconomic realities of the community (e.g., making sure that facilities are conveniently located) and of taking the unique needs of the population into account. For example, because Black women tend to have denser breast tissue, traditional mammography equipment may not detect tumors. Programs targeting Black women need to use digital mammography units to provide effective screening.

Autumn Saxton-Ross, Joint Center for Political and Economic Studies Health Policy Institute, discussed efforts to integrate social media into the Health Policy Institute's "Place Matters" work. Place Matters operates in 19 communities to "build the capacity of local leaders around the country to identify and improve social, economic, and environmental conditions that shape health." Saxton-Ross explained how two Place Matters teams were using social media, including Facebook, Twitter, and YouTube, in Bernalillo County, New Mexico and Baltimore, Maryland. The team in Bernalillo County (which contains Albuquerque) used social media to raise awareness about the effects of mining and development, and the Baltimore team focused on building engagement around housing and education.

Delia Pompa, National Council of La Raza, spoke about how REACH funding assists efforts to reduce the disparity in cervical cancer rates among Latina women. She explained that cultural barriers can prevent Hispanic women from getting cervical cancer screenings, including high poverty rates, language barriers, and knowledge gaps. Programs in Chicago and Washington, D.C. target these barriers with toolkits for community health workers. 

The National Institutes of Health (NIH) is seeking research applications that develop and test innovative theories and computational, mathematical, or engineering approaches to deepen the understanding of complex social behavior. According to the funding opportunity announcement (FOA), Modeling Social Behavior (PAR-13-374), models help explain observations, understand system dynamics, illuminate uncertainties, offer options for interventions, set boundaries of parameters and outcomes, discipline our thinking, and identify new questions. These are valuable, tangible results of applying modeling, especially mathematical and computational modeling to social behavior research.

The FOA encourages applications that build transdisciplinary teams of scientists spanning a broad range of expertise. Minimally, such teams should include investigators with expertise in the social and behavioral science as well as computational and systems modeling. Applications from cross-trained investigators with expertise in complex systems and computational thinking and approaches are also encouraged. Applications are expected to demonstrate bridge-building between disciplines, scales and levels. It further encourages both small research projects focusing on theory building and testing, development and testing of innovative methods or methodological approaches and small infrastructure projects focusing on development and testing of shared resources as well as larger more integrative research projects focusing on the modeling of complex behavior.

Participating NIH institutes and centers include: Cancer (NCI); Alcohol Abuse and Alcoholism (NIAAA); Biomedical Imaging and Bioengineering (NIBIB); Child Health and Human Development (NICHD); Dental and Cranofacial Research (NIDCR); Environmental Health Sciences (NIEHS); General Medical Sciences (NIGMS); Mental Health (NIMH); Center for Complementary and Alternative Medicine (NCCAM); Division of Program Coordination, Planning and Strategic Initiatives (DPCPSI); and the Office of Disease Prevention (ODP).

NIGMS is interested in mathematical and computational systems modeling of social and behavioral and social phenomena and processes, including the emergency of new functionality from simple behaviors; the influence of interrelationships between affect and cognitive processing on collective behavior; the role of resilience in collective behavior; use of social media and internet-based communities and other dynamic social networks to understand principles of collective behavior and improve human health; use of geocoded data in modeling and role in helping understand and influence collective behavior at multiple scales; and the use of "Big Data" and new technologies for research into collective behavior and for monitoring and intervening to improve public health.

NIAAA is interested in basic and applied research on systems-based modeling approaches to advance understanding of behavior; decision-making; and interventions pertaining to alcohol consumption and alcohol-related outcomes, including: modeling the role of social interactions and social context in moderating or amplifying risking drinking behaviors and associated adverse outcomes; modeling decision-making processes in social contexts as they pertain to alcohol-related behaviors and outcomes; modeling social determinants of effectiveness in preventive or treatment interventions for alcohol-related outcomes and alcohol use disorders; and modeling interactions between social and life-cycle influences and associated risk and protective factors on drinking trajectories and alcohol-related outcomes.

NICHD encourages basic and applied research on models of behavior and social processes associated with health, disability, and developmental outcomes from the pre-conception period into adulthood. Topics of interest to NICHD include: models of the complex relationship between demographic and environmental factors and their effects on health and population processes, including fertility, family formation, population distribution and immigration; child, maternal, reproductive and population health models utilizing multi-level perspectives; models that address the complex factors affecting intellectual, behavioral and physical disability outcomes, rehabilitation outcomes, and long-term impacts of disability on individuals and families; and models that address policy resistant health problems such as the connections between sexually transmitted diseases and/or chronic disease risk factors within individuals and communities.

NIDCR is interested in projects that help develop and test causal explanation of oral health behavior across complex social systems and/or multi-level causal explanations of oral health.

NIEHS is interested in support research that: use visual analytic software to model collective behavior and group dynamics and/or to identify individuals and communities demonstrating resilient attributes in the context of environment exposures and negative social factors; develop models that situate individual behaviors within the context of community exposures - what role do culture and belief play in understanding risk and behavior change when individual beliefs differ from community values; develop models that integrate variance in the level of risk associated with multiple aggressors or the combined impact of chronic and multiple exposures across the lifespan; and develop approaches to integrate data from either wearable devices informing on personal environment and/or data bases of geospatial distributions of ambient pollutant levels into computational models of risk.

NIMH is particularly interested in applications that seek to build transdisciplinary teams that can apply appropriate modeling techniques to multidimensional social neuroscience data. Topics of interest to NIMH include: explanatory, predictive and informative models and simulations of normal and abnormal structures and functions of the nervous system relevant to social behavior and cognition; mathematical, statistical and other quantitative analyses of research related to social neuroscience; theoretical and computational approaches to delineate and understand the structures and functions of neural circuits relevant to social behavior and cognition; theoretical and computational approaches that relate nervous system processes to social learning, representations of social context, social inference, and social information and consolidation; and theory and algorithms for designing experiments and integration and analyzing data related real-time dyadic interactions, among other topics.

NCCAM encourages research designed to better understand: the drivers of use of complementary health approaches; the patterns of purchasing of complementary health products; along with research that would better understand or model complementary health practitioner utilization; and how access to medical care influences utilization of complementary health approaches, or vice versa.

Applications may be submitted on or after January 5, 2014. For more information and/or to apply, see: http://grants.nih.gov/grants/guide/pa-files/PAR-13-374.html.