Linking Social, Health, and Economic Outcomes to Genetics

    • May 2, 2013

Dalton Conley, PhD, gives new meaning to the term multidisciplinary. A professor at New York University, Conley holds joint appointments to NYU's departments of sociology, medicine, and public policy. He is an adjunct professor of community medicine at Mount Sinai School of Medicine, a research associate at the National Bureau of Economic Research, a permanent member of the Council on Foreign Relations, and the father of two teenagers.

"I go from interesting research problem to interesting problem, and I borrow methodologies and theoretical lenses or policy concerns about the world from wherever they come," Conley explains.

Winning an RWJF fellowship. Just after earning his PhD in sociology from Columbia University, in 1996, Conley received a two-year fellowship with the Robert Wood Johnson Foundation Scholars in Health Policy Research program. The Scholars program provides new doctorates in economics, political science, and sociology with two-year fellowships to bring their disciplines into the field of health policy research. The program is based on the belief that engaging talented young people from these disciplines in debate about health policy will result in better health policy, and ultimately in better health. See Program Results Report for more information.

Conley spent his fellowship at the University of California's campuses at Berkeley and San Francisco, and he credits the program with launching him "on a path not away from sociology but looking beyond it to questions about methodology that economists have been grappling with more seriously."

That path led Conley to study racial inequalities, the measurement of class and social status, and how health and biology affect (and are affected by) social position.

While participating in the Scholars program, Conley wrote Being Black, Living in the Red: Racial Inequality in Wealth. Based on Conley's doctoral dissertation, the book examined the causes and consequences of the disparity in net worth between Blacks and Whites in the United States and argued that the wealth gap continues to fuel racial inequality today. Conley also wrote a memoir, Honky, that used his own experience as a White boy growing up in a low-income community of color to explore dimensions of race and class privilege.

Another award from RWJF. Next, Conley researched the connections between maternal poverty and low-birthweight babies and, with a 2000 Robert Wood Johnson Foundation Investigator Awards in Health Policy Research grant, studied differences among siblings in child development (including health) and adult outcomes.

In 2005, Conley became the first sociologist to win the National Science Foundation's Alan T. Waterman Award, given to the best young researcher in any field of science, math, or engineering. In 2011, he became a Guggenheim Fellow.

On to genetics. But it is recent advances in genomics that really excite Conley, as he looks into the social transmission of health and education outcomes while controlling for genetic factors. The genomics revolution "has been an incredible font, a geyser, of data. And many of us in social science are data hounds; we go where there are good data," Conley says.

As Conley observes, economists, sociologists, and health scholars often try to measure the social factors that affect a person's health, educational outcomes, or economic success, and they usually look for upward (or downward) mobility across generations within a family. Those factors are influenced both by the "social inheritance" that parents pass on to their children—i.e., their level of education or economic status—and by genetic inheritance.

The relationship between genes and health outcomes is well known, but the link between social inheritance and outcomes is less clear. Can we say with certainty, for instance, that raising a mother's level of education will raise her child's level of education or improve his or her health?

This is where genetic sequencing comes into play. "For the first time we're able to take something that was a lurking variable, a confounding effect, something we really had no way to measure or deal with, and measure it explicitly, put it in model, and see what it does—like adjusting someone's education and seeing if they do better in their health," Conley says.

He is doing this through two strands of research. One focuses on how genes control variation. Instead of looking for genes that determine a specific outcome, Conley looks for the mechanisms that inhibit variation in the outcomes associated with a specific gene. He uses height as an example: If people with one gene vary greatly in terms of height, while another group of people show less variability, what is causing the gene in the first group to do a poorer job of maintaining constant height?

"If we discover genes that regulate variation, maybe they will tell us who will be more responsive to drugs—say, in the realm of mental health," Conley explains.

A separate project studies how people are affected by the genes of people around them. Conley has found that the serotonin transporter gene, for instance, can put a person at risk of depression if he or she is the only one in his or her family with the gene but not if other family members share the gene. Similarly, a particular dopamine receptor can put a person at risk of lower academic achievement (as measured by overall grade point average), but only if he or she is the only family member who has it.

Conley is so keen on the promise of genetic research that he obtained a Master of Science and a Master of Philosophy in biology in 2009–10 and is pursuing a second doctorate (anticipated in 2013) in biology at NYU's Center for Genomics and Systems Biology.

At the same time, he remains "humble" about the degree to which scientific trials can document the true causal impact of an intervention and is aware that even evidence-based interventions may not produce the desired results when taken to scale through policies. "It's very hard to predict what policies are going to yield," Conley says.

RWJF perspective. The Robert Wood Johnson Foundation Scholars in Health Policy Research program is designed to foster a new generation of creative thinkers in health policy research within the disciplines of economics, political science, and sociology. The fellowship program, established in 1991, annually selects a total of nine recent PhD graduates from among those three disciplines to spend two years studying at one of three participating sites (currently Harvard University, University of California, Berkeley/San Francisco, and University of Michigan).

Participants learn about health and health policy, gain exposure to the perspectives of the other two disciplines through seminars with peers, receive mentoring from prominent scholars, develop research ideas, and conduct research while receiving a stipend and benefits that free them from other professional obligations. "We're looking for people who aren't too far along in pursuing a specific research agenda. Our goal is to catch people early and tempt them into the field of health policy," says Lori Melichar, PhD, RWJF director for the program.

While in the Scholars program, participants have conducted research on issues and policies related to individual health, public health, social and economic determinants of health and health care, health care financing, and health care systems and institutions. After completing the program, alumni stay connected to their peers through a network facilitated by the Boston University Health Policy Institute, which serves as the national program office.

Scholars from the Health Policy Research Program have made significant contributions to their disciplines and to the field of health policy research. The program's 200-plus alumni, many of whom hold faculty appointments at universities and colleges, have authored hundreds of widely cited books and articles; held editorial posts at top scholarly journals; sat on scientific advisory panels; served as senior advisers to presidential, Congressional, federal agency, and national scientific councils; and received numerous professional awards for their research.

Although the original purpose of the program—to increase the number of economists, sociologists, and political scientists conducting health policy research—remains important, RWJF's focus has expanded to include "building the community" of health policy researchers and supporting them at institutions nationwide. "Now it's more about creating a critical mass so that we have a self-sustaining community [of researchers]," Melichar says.