The Barker Hypothesis: A Call to Transdisciplinary Responsibility

World renowned epidemiologist and reproductive biologist David Barker visited Queen’s University this week to give two lectures on his pioneering work that has spurred a paradigm shift in understandings of the etiology of disease. Thanks to my supervisor Dr. Myra Hird and Dr. Anne Croy in Anatomy and Cell Biology, I was given the incredible opportunity and privilege to have a 10 minute audience with Dr. Barker during his visit to the department. I took that opportunity to argue that his work demands that we undertake transdisciplinary research, and emphasized the kinds of contributions sociologists could make to his projects.

In his 500 or so academic publications, Barker has advanced what has come to be known as the “Barker hypothesis,” or the developmental origins of adult disease. According to his theory, conditions in the maternal womb have a programming effect on fetal physiology, a phenomenon called fetal programming. Much of Barker’s work has focused on the effect of maternal nutrition on fetal programming. It has been found that if a fetus is deprived of adequate nutrient supply in the womb, it will be irrevocably “programmed,” predisposing it to a whole host of diseases: cardiovascular disease, obesity, diabetes and cancer to name a few. Thus Barker emphasizes developmental plasticity, the malleable quality of life in development, as important to the etiology of disease. Barker has further shown that there is a significant generational aspect to disease, profoundly challenging today’s “lifestyle” discourse. Using data from the Helsinki cohort (a group of people born between 1934 and 1944 in Helsinki, about whom a rich amount of data was collected including their mother’s height, weight, age, parity; the weight and shape of the placenta; antenatal follow-up data; and socioeconomic status), Barker has shown that a woman’s lifelong nutrition significantly impacts her children’s risk of disease. Thus Barker’s talk was entitled “Your Mother’s Mother: The Key to your Health.”

Low socioeconomic status is associated with poorer access to nutritious food. This makes the transdisciplinary implications of Dr. Barker’s work quite clear. I’m quoting here from my talk:

Significantly, what this means is that social structures do not merely determine relations between people; they can also have biological effects. In this way, we can say that although social structure is often thought to be intangible and abstract, it is part of tangible phenomena like fetal programming. Conversely, biology can have social effects. For example, generational patterns of disease match patterns of socioeconomic status, suggesting that living and dealing with disease may be a cause of poverty. In other words, there is a dynamic cross-talk between the social and the biological.

This is not a biologically-essentialist argument. I further argued in my talk:

The problem is that social scientists tend not to favour biological explanations for what they deem to be social phenomena like poverty. They observe social phenomena, determine social facts, and give social explanations for those facts. Similarly, scientists observe biological phenomena, determine biological facts, and provide biological explanations for those facts. In the case of the Barker hypothesis, these strict distinctions are challenged: social and biological facts are irreducibly the same type of fact. Fetal programming has biological and social dimensions that cannot be separated apart if a comprehensive understanding is sought – and I believe that this is what we seek.

Transdisciplinary approaches to the study of health and disease then are, in my opinion, called for when considering the prolific work of Dr. Barker.

It was my pleasure to share this argument with Dr. Barker during his visit to Queen’s University.

Update: An article I wrote on this topic appears in the journal Social Theory and Health.

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