In New Book, RWJF Scholar Explores Effects of Genetics on Environmental Science
Nov 4, 2014, 9:00 AM
Sara Shostak, PhD, MPH, is an associate professor of sociology at Brandeis University and author of Exposed Science: Genes, the Environment, and the Politics of Population Health. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2004-2006).
Human Capital Blog: Your book, Exposed Science, won two awards from the American Sociological Association: the Eliot Freidson Outstanding Publication Award from the Medical Sociology Section and the Robert K. Merton Book Award from the section on Science, Knowledge, and Technology (SKAT). Congratulations! What do these awards mean for you and your work?
Sara Shostak: Thank you! I am deeply honored that Exposed Science won those awards. This kind of recognition from one’s colleagues is tremendously meaningful on a personal level, especially as there are many scholars in these sections whose work has inspired me for years.
More broadly, the dual awards signal something important about the connection between these two domains of inquiry—medical sociology and the sociology of science. That is, science and the politics of science are important foci of analysis for sociologists concerned with population health. The conditions under which scientists do their research—the political economy of knowledge production—is a critical context for what we do and do not know about human health and illness.
Population health researchers often observe that in the United States, health disparities research tends to focus on differences between racial and ethnic groups, while in the United Kingdom the focus tends to be on variations by social class (or what U.S. researchers more often call socioeconomic status). Scholars of science, knowledge, and technology can help us understand how and why these differences emerged, and with what consequences. My book raises questions also about how any of these determinants get operationalized in laboratory-based research. All of these aspects of how science is done have direct implications for public policy, as well.
HCB: The book addresses the health impact of gene-environment interaction. Please explain what you mean by that term.
Shostak: Exposed Science examines the rise of gene-environment interaction as a way of understanding human health and illness, especially in the environmental health sciences (by which I refer primarily to toxicology and to environmental epidemiology). As I describe in detail in the book, “gene-environment interaction” is used to describe a wide variety of research agendas.
At the time that I was doing my research, it had two primary meanings. First, scientists seek to identify genetic susceptibilities that make some people more vulnerable to being harmed by environmental exposures. In this framing of gene-environment interaction, scientists acknowledge the harmful effects of environmental contaminants, but genetic variations in individuals’ responses to them are the crucial problem to be explained.
Second, scientists examine how environmental chemicals affect human genetic material, whether by causing DNA damage (e.g., mutations) or altering gene expression (e.g., epigenetics). In this framing of gene-environment interaction, scientists acknowledge human genetic variability, but the effects of environmental exposures are the crucial problem to be explained.
HCB: What are the health impacts of gene-environment interaction?
Shostak: I don’t—and can’t—assess health impacts in the book. Rather, I take the ascendance of gene-environment interaction within the environmental health science as an analytic lever that reveals important dimensions of the structure of the field of environmental health science, its central institutions, the commitments, practices, and strategies of those working within it, and how this shapes what we know about—and how we seek to govern—the relationships between the environment and human health.
My central argument is that scientists’ perceptions of and responses to the structural vulnerabilities of the field of environmental health science have both intended and unintended consequences for what we know about the somatic vulnerabilities of our bodies to environmental exposures.
HCB: Can you elaborate on that?
Shostak: Specifically, I am concerned that various sources of pressure on scientists to explain how environmental exposures have effects at the molecular level may distract us, however inadvertently, from well-documented social factors that make certain populations more likely to be exposed to environmental contaminants in the first place.
The book opens with the example of lead poisoning in children. Less than a century ago, severe lead poisoning of infants and children was a major public health challenge. Lead poisoning in children became a preventable disease as a result of decades of research and advocacy by environmental health scientists, progressive social reformers, and policymakers. Public policy—in the form of the regulation of lead in gasoline, in most paints, and in food containers, children’s toys, and municipal water systems—has played an especially prominent role. Together, these regulations resulted in a 78 percent reduction in human exposure to lead between 1976 and 1991 in the United States, as measured in blood lead levels. This was one of the major public health success stories of the last century.
Despite these successes, thousands of U.S. children, especially low-income and minority children, are exposed to harmful levels of lead each year. As blood lead levels have fallen nationally, disparities in lead exposure and lead poisoning have increased.
Changing the social environments in which children grow up is imperative to protecting children’s health and giving them the best chances in life. I don’t think we need to know about genetic variation in lead absorption in order to take action to reduce children’s exposure to lead. However, as a consequence of the politicization of environmental regulation, and the current focus on genetics within the life sciences more broadly, environmental health scientists, who unquestionably care deeply about kids’ health, have real motivations to examine molecular processes. And, as demonstrated by the case of lead, this happens even in instances when social, political and economic factors that could be addressed via public policy are well documented.
HCB: How did you become interested in the subject?
Shostak: I became interested in research on gene-environment interaction research in the environmental health sciences when I was a graduate student; the book emerged from what was initially my doctoral dissertation. At that time, I knew that I was interested in doing work on environmental health, I was intrigued by the field of science and technology studies, and I was both compelled by and critical of some of the limitations of work being done on the ethical and social implications of the (then in-progress) Human Genome Project. As someone with a background in public health, I was more interested in the public policy than the clinical implications of genetics. So, with encouragement from my advisor, Adele Clarke, Ph.D., I began searching for a “case” that would let me investigate these issues.
I soon found the website of the National Institute of Environmental Health Sciences (NIEHS) “Environmental Genome Project” and, fascinated by what I read there, began reading widely in the environmental health sciences. As soon as I realized that genetic variation had previously been seen as “an annoyance” or “the noise” in environmental health studies, but was being redefined as the signal, as a focal concern, I was completely hooked.
I wanted to understand how this change had happened; how had the NIEHS come to define gene-environment interaction as its “mantra” and what would the consequences, both intended and unintended, of that shift be? The interlinked puzzles at the center of the book—why and how did environmental health scientists rally around research on gene-environment interaction?—motivated me throughout.
In working on putting together the pieces of these puzzles, I benefitted tremendously from the work of historians of science and of public health, as well as from the incredible generosity of individual scientists, some of whom met with me multiple times for in-depth interviews about their research and careers.
HCB: You argue that environmental scientists are under attack. How so, and why?
Shostak: At the time that I was doing my research, environmental health scientists were facing multiple challenges. These included the relative lack of autonomy of the environmental health sciences as a field; ongoing challenges to and critiques of environmental epidemiology and toxicology in controversies over risk assessment and regulation (such that a prominent environmental health scientist told me that the contentious dynamics between industry and the regulatory agencies have become the “drumbeat” to which the field works); the rising power of genetic (versus all other) explanations for human health and illness; and growing concern that specific institutions of environmental health research, including the NIEHS and the National Toxicology Program (NTP),were losing status, funding and political support.
My contention is that research on gene-environment interaction, with its focus inside the human body and at the molecular level, has been compelling to environmental health scientists precisely insofar as it offers a diverse array of strategies for meeting these challenges. To be sure, it’s also really interesting! As Paula Braveman, MD, MPH, and colleagues write in their American Journal of Public Health (2011) paper on health disparities and justice, the research we need to identify precise biological mechanisms is not always the same as the research we need to motivate effective public health policy. And, as I suggest above, I think that focusing on the molecular level runs the risk of obfuscating the social, political and economic factors that we already know shape people’s lives and life chances.
HCB: You were an RWJF Health & Society Scholar from 2004-2006. Did that experience shape your current research and, if so, how?
Shostak: Exposed Science is deeply informed by my experiences as an RWJF Health & Society Scholar at Columbia University. To be sure, my focus on the population health implications of scientific research was honed during that time. I also benefitted tremendously from the generosity of individual site faculty.
Ezra Susser, MD, DrPH, met with me repeatedly to talk about the history of epidemiology as a discipline. Peter Bearman, PhD, read drafts of the manuscript and really pushed the development of the analysis. David Rosner, PhD, MPH, who is one of my intellectual heroes, provides a model of engaged scholarship that is unflinching and critical, but always endeavors to improve and support the field of public health. I hope that I honor all of their examples, and their gifts to me, in my research and teaching.
This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.