The social symbiome framework: Linking genes-to-global cultures in public health using network science

The twenty-first century ushered in a new translational paradigm for understanding the distribution and determinants of human health and treatment outcomes. This orientation arose in part from the success of fully sequencing the human genome, coupled with limited progress toward unraveling chronic disease etiology and health system change. Representations of "helixes to health," "neurons to neighborhoods," "base pairs to bedside," "compound to clinic," or "cells to society" became the metaphorical blueprints for both basic and translational science. However, "translation" came to have different meanings, each of which is key to scientific progress, clinical practice, and improved population health. Here, these meanings are defined and set the principles for a new conceptual framework based on ideas of complexity, transdisciplinarity, and connectedness. Specifically, a genes-to-global cultures frame begins with the interactive, contextual, and dynamic assumptions of Systems Science and draws from Network Science to build one parsimonious variant privileging the explanatory power of network structures, network contents, and network dynamics. A fundamental theoretical plane provides the basic predictive schema with fractal imagery building the extension from the molecular to the geographic levels. Each level of the Social Symbiome (elsewhere called the Network Embedded Symbiome) is constructed and supported from the wealth of classic and contemporary health and health care research across the sciences focused on the influence of networks. While network research is broadly referenced, we use the case of alcohol dependence to focus on how different types of connections, within and across levels, operate to influence risk and outcomes. This vertical integration approach brings unique issues in team formation, study design, and analytic tools to the fore. While these cannot be dealt with in great detail, the basic underpinnings for rigorous, feasible studies with adequate human protections are briefly described.