Hello and welcome to Retrieving the Social Sciences, a production of the Center for Social Science Scholarship. I'm your host, Ian Anson, Associate Professor of Political Science here at UMBC. On today's show, as always, we'll be hearing from UMBC faculty, students, visiting speakers, and community partners about the social science research they've been performing in recent times. Qualitative, quantitative, applied, empirical, normative. On Retrieving the Social Sciences, we bring the best of UMBC's social science community to you.
If you're like me, you probably don't enjoy going to the hospital. You know, while we should consider ourselves lucky to be surrounded by some of the best hospitals in the world here in Baltimore, there's usually nothing good happening when you find yourself spending a significant amount of time in one. Although, you know, I suppose there's one notable exception to that statement, and I should know something about it, because last year, I first met my baby daughter in the obstetrics wing of a nearby hospital. That visit was unforgettably positive. Although the food was nothing to write home about. When most Americans visit hospitals for reasons besides childbirth however, they have a wide variety of experiences and outcomes. Older Americans are especially likely to experience medical issues that require various levels of care, from in-home visits to hospitalization. Among them is diabetes, a chronic disease that is associated with a large number of issues related to mobility, cognition, and functional living for aging populations. We know that from a biological standpoint, diabetes poses a number of physical risks to Americans. But what can the social sciences tell us about the lived experiences of people with diabetes? That's one of the biggest questions that Dr. Tasneem Khambaty, Assistant Professor of Clinical Psychology and Behavioral Medicine at UMBC, hopes to answer. Dr. Khambaty, who received a PhD in Clinical Health Psychology from Purdue University, has published a number of articles in recent years on a variety of topics at the intersection of public health and the social sciences. Whether it's depression and anxiety, diabetes, gum disease, or the interaction of these conditions and other health outcomes, Dr. Khambaty's research helps us understand how social forces contribute to the severity of the health issues experienced by individuals of different races, ages and life situations. Most recently, Dr. Khambaty has received a grant from the UMBC Center for Social Science Scholarship to examine how social forces shaped the impacts of diabetes on other health outcomes. The research draws on the HANDLS study, which stands for Healthy Aging in Neighborhoods of Diversity across the Life Span. It's a unique data source that reaches over 3000 black and white residents of Baltimore City using mobile research vehicles. In my recent interview with Dr. Khambaty we learned much more about the intersection of health and the social sciences, as well as the details of the HANDLS study. Let's listen it.
Today, I have the distinct pleasure of welcoming to the program, Dr. Tasneem Khambaty. First of all, thank you so much for being here. I'm really excited to have you on the show.
Oh, thank you so much for having me.
Great. So I wanted to ask you just sort of a first question here about research in the social science. So you know, on this podcast, we talk to researchers all across the disciplines, you know, economics, sociology, political science, you name it. But Dr. Khambaty, your research in clinical health psychology is somewhat unique in that it sits at the intersection of the social sciences and medicine, which is a field that we don't really talk very much about on the podcast at all. So I wanted to ask you, first of all, what sort of got you interested in this intersection between medicine and the social sciences?
Oh, such a great question. I've always been curious about the workings of the brain and mind ever since, you know, my adolescence. But growing up, most of the conversations around me, focused on the health of the body. And I thought, well, what about the health of the mind? Surely, the mind and body are not separate, but in fact, interlinked. I mean, we're connected, you know, physically. Uhm and so that got me going, and then the other driver of this interest was really immigrating to the US and becoming introduced to the field of clinical health psychology or behavioral medicine, which essentially integrates the scientific study of biological, psychological, behavioral, and social factors in health and disease.
Wow, that's an incredible sort of intersection, right of these various fields, and certainly something where I think we're potentially able to see some really awesome value added in terms of our ability to help patients, in terms of our ability to say something, you know, relevant about behavior as well. And so I think you know, from your impressive work, you know, you've already published in various journals and you've done in recent years. I think there's a lot of evidence in this work that the medical fields should probably think about taking social science research seriously and think about integrating some of these behavioral approaches. And I want to sort of follow up that earlier question by asking, you know, do you think that social scientists are succeeding in this endeavor, in making this impact on health outcomes? Or do you think that there's still work to be done?
You know, these may seem like two opposing questions and answers, but really, they're both true. Okay. So medicine and social science has come a really long way over the last several decades, and they've worked together to demonstrate how, for example, chronic diseases are influenced by the interaction of psychosocial, behavioral, and economic factors. So the roles of depression, socioeconomic status, social support, in chronic diseases like heart disease and diabetes, are now well known and are often reported in various news outlets and social media. Our work in our lab is really focusing on understanding the mechanisms by which depression and anxiety and loneliness, but then also positive psychology factors, like life satisfaction, impact metabolic disease. We still have some ways to go to raise awareness of these mind-body interactions, and the expertise that social scientists can bring to the table, right, to untangle these relationships, uncover these mechanisms, really are asking how do these psychosocial factors to get under the skin to impact health? The biomedical model, which does not consider concepts from psychology or the social sciences, has been hard to replace, even though the biopsychosocial model of health has been around since 1977. So both both are true.
Wow, interesting. I mean, I think a little bit about the current sort of COVID-19 pandemic era as being really emblematic perhaps of this tension or this, this need to integrate, right, these these insights. You know, we've had several guests on the podcasts who have talked a little bit about care in the COVID-19 era. And certainly, I think that this, now more than ever, right, is making it clear how important these kinds of insights might be.
So very true, totally emblematic of what's going on in our field just the last couple of years.
Yeah. So on that note, you know, certainly talking about the last couple of years and some of the work that you've been doing, I wanted to first of all, congratulate you, right. So there's some great congratulations in order. So recently, you received a summer fellowship grant from CS3, the Center for Social Science Scholarship at UMBC, which, by the way, also happens to be the sponsor of this podcast. And so I wanted to talk a little bit about this grant that you've received, about some of the research that you're going to be doing on the basis of this grant. What is this project? And I guess, you know, so it has something to do with outcomes related to diabetes. Would you tell us a bit about that?
Yeah, thank you. This is really actually an interesting project for us. And it's a bit of a departure in the sense that we're not examining Type 2 diabetes as our outcome, which we, which we usually do, but instead, we're examining the influence of glucose regulation on physical functioning outcomes. So we know that micro and macro vascular sequelae of diabetes are occurring much earlier in the lifespan, and even among individuals who are not yet diagnosed, but may be at risk for diabetes. And so this really is presenting diabetes as a form of accelerated aging. And so what we wanted to do is investigate whether, even before the onset of diabetes, do markers of fasting glucose and hemoglobin A1C predict growth estimates of upper and lower extremity functioning. And we want to see whether these relationships are moderated by race and sex and socioeconomic status.
Interesting. So there's perhaps a social dimension to this what you call sort of early onset aging, perhaps that is, is part and parcel kind of have the diabetes disease. Tell me a little bit more more about that. So you were mentioning some of these extremities, right. So so what exactly is going on there?
Yeah. So what we're finding is that individuals being even beginning in their 40s, and 50s are having mobility issues, they're having issues with functional status. It is, you know, things like handgrip strength, your ability to sit and stand, your balance. All of these things are getting impacted. And one of the drivers of this is diabetes pathology. So the factors that really confer risk for diabetes are also conferring risk for some of these mobility and balance issues. And that's happening, you know, we usually think about that happening late older adulthood, that's no longer the case that's actually happening in middle aged individuals.
Wow. So you're positing sort of a social setting, maybe that is causing these things to accelerate?
Exactly, exactly.
So I want to know a little bit about the research methods that you're potentially using to study this. Obviously, this seems like the kind of analysis that requires a tremendous amount and a variety of kind of data on individuals who are experiencing these kinds of symptoms. So I know in the description of the grant that you mentioned, this thing called the HANDLS study. Obviously at UMBC we love acronyms, but I'm not familiar with that one. So would you mind breaking this down for us and telling us a little bit about, as a social scientist, how you planning on actually conducting some of this research?
Yeah, so we're really fortunate to be able to work with this phenomenal data. And HANDLS really stands for Healthy Aging in Neighborhoods of Diversity across the Life Span. And what it is, is an ongoing longitudinal epidemiological study conducted by the NIA Intramural Research Program. So the primary aim of HANDLS is to examine age-related health disparities by race and socioeconomic status. And what's really cool about this is that participants were recruited right here in Baltimore City. And they recruited equal proportions of African Americans and whites, men and women, and those living above and below the poverty line. It's really a secondary data analysis, leveraging this rich longitudinal data.
Wow, what a fortuitous circumstance that this was something that is both sort of right here at home in our backyards, but also this purposive sampling scheme, right, that really, I think allows you to answer some of these questions in a much more interesting way than if we were to have, say, a nationally representative sampling scheme, where you're getting very small, potentially proportions of the of the broader sample, that would be super relevant to your research questions. But this is really focused and targeted on you know, looking at some of these social factors, as you described.
Precisely.
Yeah, that's, that's really cool. I'm very excited to think about how this this HANDLS data might contribute to our understanding of, of this complex phenomenon. I want to ask you a little bit, so how does this maybe factor into your broader research plans going forward? What's, what's next for this research? Do you intend to sort of do something beyond just the work with the secondary HANDLS data, or how do you see this, this research unfolding?
Yeah, we have several irons in the fire. You know, in conjunction with looking at some of these physical function and functional status outcomes, we've actually received some funding to examine cognitive outcomes (oh, wow) in relation to, uhm, glucose dysregulation. So we're, right now collecting pilot data at the VA and the University of Maryland School of Medicine, that will feed into a larger NIH grant that we're, that will go out in the fall. So overall, we want to continue taking a lifespan development approach, and continue exploring disparities by race and socioeconomic status.
Wow, so it may not just be sort of these the functioning of extremities, you know, grip strength, those kinds of, of outcomes. There's potentially a cognitive element as well, or perhaps charting cognitive decline earlier in the lifespan. Is that what we're saying here?
Exactly. And, you know, what, what we don't talk about enough is that these outcomes are all interrelated. It's not as if they're happening in kind of a vacuum right. So, you can see how cognitive and cognition generally might impact your ability to have good balance and good mobility, which in turn feed back into your cognition and through various bio behavioral mechanisms. So each research study is really taking one small piece of the larger puzzle. And so together, we want to try and put together a full picture of what's going on with this accelerated aging phenomenon.
Right, I mean, piece by piece if we can put this together, I think it speaks to some really important mechanisms about overall health disparities, right? I mean, these, these disparities are only growing perhaps in an era of increasing inequality. And so seems like a very valuable research enterprise.
Yeah, and the population is aging quite rapidly as well. So it's really, you know, we talk about the pandemic, but we really don't talk about the double kind of epidemics of aging, chronic disease prevalence, and then the related functional and physical functioning issues that occur.
Wow, that seems like it's it's been a little bit of an ongoing theme in Retrieving the Social Sciences, because we've recently heard from a variety of individuals associated with the UMBC/University of Maryland Gerontology program, and one of the sort of insights that came from that episode, we talked to John Schumacher, he was saying that we're sort of entering this phase where we're going to be a super aging society, and so how incredibly relevant, right, to think about this research potentially contributing to, you know, important, you know, improvements in social health outcomes, as, as we enter that phase.
Yeah. And my passion has really been the primary prevention of metabolic disease as we age. So with more folks entering older adulthood, how do we keep them functioning as independently as possible for as long as possible, without being burdened by things like diabetes, mobility issues, balance issues, dementia, all of these things are connected.
Wow, hugely important work, and I'm really excited to see how this, this grant and your related work on cognition bears fruit in the future. Hopefully, that goes a long way in helping you to secure these big grants that you're out to get in the future. So bes,t best wishes with all of that, and I hope that it all goes well.
Oh, thank you, I will certainly keep you posted.
You please do. So one last question for you before we let you go. And this is a question that I tend to ask pretty much anybody who I interview who has some interaction with students, who has a teaching role. I wanted to ask you about, if you have any advice for students who might be hoping to go pro in the social sciences, maybe in your field, maybe in the social sciences more generally. What kinds of things should these students be thinking about as they look towards a potential career in the social sciences?
Yeah, so I mean, guests on this podcast have already provided such excellent advice. I will try to add on to what they've said already. But to me, if you're interested in a career in behavioral medicine or clinical health psychology, talk to as many people as you can beforehand to understand what the day-to-day and year-to-year is, like of a career. It's a long journey, and so it's important to have what I call informed consent. And folks at UMBC, certainly in our department, have been very open to talking about this field that prior to this may not have been, people may not have been aware of this field existing. And so a lot of the students that come to me and say I want to, you know, help out with your lab, are like, Oh, my gosh, I didn't know that this existed, that I could actually look at both medicine and psychology and social science in one research question. So that's what I get surprised by it's like, why don't more folks know about this? The second piece of advice is, don't lose the forest for the trees. What I mean by that is, keep in mind your passion and your vision. Why is it that you're really trying to be part of this field? What, what really motivates you? And that will help you persevere in what is a long journey.
Extremely useful words of advice. Certainly words that resonate with me as a professional social scientist as well. Somebody who's also been on something of a journey. So Dr. Khambaty, thank you again so much for agreeing to take some time to talk to us a bit about your research today, and again, all bests to you as you continue your progress on this exciting research.
Thank you so much for having me. It has been a pleasure to talk with you.
Now it's time for Campus Connections, the part of the podcast where we connect today's featured research to other work happening on UMBC's campus. Today, once again, we hear from our production assistant, Sophia Possidente, who's highlighting a fascinating study by the chair of UMBC's Department of Sociology, Anthropology and Public Health. What's this study all about, Sophia?
On today's episode of Campus Connections, we're looking at the work of Dr. Sarah Chard, the Chair of UMBC's Sociology, Anthropology, and Public Health department. In her paper, "Successful Aging Among African American Older Adults with Type 2 Diabetes," Dr. Chard looks at health beyond pure genetics, examining the outside factors that contribute to someone developing a health condition. She also researches community perceptions of the aging process, asking participants for their perspectives on what it truly means to age well. In many of the communities researched socioeconomic status and the prevalence of diabetes had an inverse relationship. This has to do with many factors including lower walkability and more limited food access. Neighborhoods located within food deserts, as well as those with less space available for physical activity, increased residents' susceptibility to diabetes, by making it timelier, costlier, and simply less feasible to maintain a healthy diet and lifestyle. Finally, the article found the interviewees' personal definitions of aging well, were often rooted beyond physical health. Things like overcoming challenges, religious affiliation, and maintaining independence were mentioned frequently alongside physical indicators like mobility and diabetes management. It's clear that the concept of aging well is multi dimensional, and holds a different meaning for everyone. Whether you're focused on the physical, emotional, or spiritual aspects of aging, scholars like Dr. Chard and Dr. Khambaty are working to ensure that you will have a successful experience.
Thanks as always a fear for that great connection. And thank you for tuning in to learn about the fascinating interplay between public health and the social sciences. Until next time, keep questioning.
Retrieving the Social Sciences is a production of the UMBC Center for Social Science Scholarship. Our director is Dr. Christine Mallinson, our Associate Director is Dr. Felipe Filomeno, and our production intern is Jefferson Rivas. Our theme music was composed and recorded by D'Juan Moreland. Find out more about CS3 at socialscience.umbc.edu and make sure to follow us on Twitter, Facebook, Instagram, and YouTube, where you can find full video recordings of recent UMBC events. Until next time, keep questioning
