Keynote Speech at the 65th Meeting of the Gerontological Society of America

The keynote speech at this year’s Gerontological Society of America (GSA) meeting discussed the effect of social networks on the health and behaviors of groups of friends. A study of behaviors revealed clusters of similarity — for instance, smokers stuck together and friends were more likely to be obese if another was.

Nancy Whitelaw, PhD, president of the GSA opens her plenary session of the 65th annual meeting on Nov. 15 with a question: “This is my 40th

annual meeting; who can do better?”

A significant show of hands goes up.

The GSA meeting attracted 3,600 registered members — 600 of whom were international attendees from 30 different countries, according to Whitelaw. This should interest any practicing physicians caring for America’s elderly. They are not alone in the trenches today as they struggle to service America’s Greatest Generation under a Medicare net that seems to be getting threadbare. The problem of an aging population is global — and now is being looked at by gerontologists.

The GSA’s new signature slogan is “Charting New Frontiers in Aging.” Dr. Whitelaw introduces the next speaker, James H. Fowler, PhD, with that motto in mind saying, “Every year we are given a gift of an exceptional keynote speaker.”

Aged 42, he bounds up to the dais like a teenager — like one in the age groups whose social networking he has written about in his book Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives. His presentation partly covers that book, which he co-wrote with Nicholas A. Christakis, MD, PhD.

It’s an understatement to say Fowler is an interesting guy. He graduated from Harvard in 1992 and served with the Peace Corps for two years until 1994. He received his master’s degree in International Relations from Yale in 1997 and a PhD in Government from Harvard in 2003.

Fowler may not be so well known to practicing physicians who have little time to read about, or use, social networks, but this professor of medical genetics in the School of Medicine and the professor of political science in the Division of Social Science in the University of California, San Diego is surely well known and respected in this audience.

His two professorships would normally seem an odd combination except his interest in both subjects has grown over the last 20 years and, indeed, he has written widely acclaimed papers on genopolitics. (He has “identified three genes associated with voter turnout and partisan attachment specifically those regulating serotonin and dopamine systems in the brain.” Wow!)

Fowler is going to talk about Facebook and other social networks. He strides across the stage, enthusiastically holding his hands out in greeting to his audience and says, “Hi! This is my pre-internet connection.”

He flashes a photograph of a group of six small children in their school room and says, “We’ve always had friends — and families.” Then he asks the gerontologists: “Who are your friends? Whom do you discuss important matters with? Whom do you spend free time with? And raise your hands if the number is more than 100.”

He’s talking about real friends not the unreal numbers people create, say, in Facebook. Fowler had questions of his own when his interest in an interconnected world began. Why do we vote? Why do widows die? He found some answers in the Framingham Heart Study: married people live longer — and when the man dies the woman loses two years from her lifespan. When the woman dies the man loses seven years.

Fowler saw he could map the results from the Framingham study to look at behaviors. He found clusters, such as obesity clusters; obesity was 40% higher in subjects if their friend was obese. Why? Was it the influence of one on another, was it homophly? (“Birds of a feather”) Or was it context? (“Gym rats meet gym rats.”)

Dual friends on social networks — where each named the other as a friend — were three times more likely to be obese if one was. Fowler was once quoted as saying it was as if obesity were contagious. The press had a field day with that headline and accused him of saying if you sat down beside a fat person on a bus you’d become fat!

He established that smokers formed clusters — a negative social health result. Drinkers could be identified in clusters and collateral research showed if couples drank heavily you got better results by treating the women to influence the men. And just as a smile on the street gets a smile in return (although someone once pointed out, “We don’t do that in New York!”) emotions are contagious: sad people and happy people cluster.

Fowler found that on social internet networks an enthusiastic person with real friends (quantity connections don’t count!) could provoke “generosity cascades” over a network — and identical twins could influence each other more than fraternal twins. Persons who are wallflowers or, alternatively, the life of the party may be like that from a genetic basis. You may be connecting with the genes of your friends, he muses.

You can map those connections. You can show “viral voting,” epidemic curves, physician networks. You can connect with patients. As Fowler points out there are five million persons over the age of 65 on Facebook, maybe even on Twitter if what seems to me to be somewhat adolescent ever matures.

But maybe Twitter has matured. When Fowler ended his presentation and invited questions, they immediately come in on Twitter — from the audience sitting in front of him.

Earlier he had quoted Max Planck, as if Fowler had been prescient: “Science advances — one funeral at a time.”

Eric Anderson, MD, lives in San Diego. He is the one-time president of the NH Academy of Family Practice. His commentaries on aging are part of the MetLife Foundation Journalists in Aging Fellows Program organized by The Gerontological Society of America and New America Media. Anderson was a senior contributing editor at Physician’s Management from 1983 until 1998 (when the magazine ceased publication). He wrote a monthly column for both Postgraduate Medicine and Geriatrics for many years. Anderson is the only physician in the Society of American Travel Writers. He has also written five books, the last called The Man Who Cried Orange: Stories from a Doctor's Life.