Priority 4: Understanding Behaviors and Environmental Exposures That Promote Health or Cause Disease

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Determining how behaviors and environmental exposures affect the onset, severity, and responses to treatment of diseases within the NIAMS mission is crucial for improving the lives of all Americans. For example, smoking cessation is a well-established intervention for promoting health and protecting against many diseases within the NIAMS mission. 

Recent advances in environmental health research highlight the potential role of the exposome, defined as the measure of all the exposures of an individual lifetime, on a person’s health and on disease susceptibility, onset, and severity. Many human diseases result from complex interactions between patients’ genetic susceptibilities, behaviors, and exposome. Consistent with the institute’s priority of Conducting Research to Address Health Disparities studies of behaviors and environmental exposures should include efforts to identify and reduce health disparities and provide all Americans with access to clinical and epidemiologic studies and health care whenever possible.

Examples of efforts under this topic include the following.

Strategy 4.1: Evaluating the Impact of Factors Such as Diet, Sleep, Stress, Physical Activity, and the Environment on Onset, Severity, and Treatment of Disease 

• Investigating the effects of factors including diet, sleep, stress, and physical activity on onset and severity of disease.
• Studying the effects of environmental factors such as ingredients in processed foods on diseases of interest to NIAMS.
• Investigating the impacts of workplace risk factors on diseases of interest to NIAMS.
• Studying the social determinants of health, including the built environment and economic insecurities, that influence susceptibility and responses to treatment of diseases within NIAMS’ mission areas.

Strategy 4.2: Elucidating Health-Promoting or Disease-Causing Mechanisms

• Determining how factors such as diet, sleep, stress, and physical activity positively or negatively mediate inflammation through their effects on the microbiome.
• Discovering disease-exacerbating environmental exposures (e.g., compounds, organisms) and environmental triggers for diseases within the NIAMS mission and investigating how they interact with a person’s biology at various ages and in various disease states. This could include:
  • Identifying biomarkers of environmental exposures leading to heightened susceptibility to diseases of interest to NIAMS.
  • Determining how sex hormones influence responses to these exposures and triggers.
• Examining how psychological and social factors influence the mechanisms of pain in diseases of interest to NIAMS.

Strategy 4.3: Translating Findings Into Health

• Developing diagnostic tools that are more sensitive to the impact of behaviors and environmental exposures and that can be used to monitor changes in bone, joint, muscle, and skin health more effectively.
• Formulating evidence-based behavioral interventions by evaluating the impact of changes to behaviors on disease remission and progression.
• Investigating environmental exposures and identifying preventative strategies to minimize impact on bone, joint, muscle, and skin tissues and disease susceptibility.
• Studying physical activity and nutritional strategies to prevent and manage arthritis and preserve musculoskeletal and skin health. This could include:
  • Testing strategies to prevent arthritis and preserve musculoskeletal health in persons with disabilities such as those who use wheeled mobility devices.³
• Identifying how social determinants of health influence patient outcomes over time.