Transdisciplinary research strategies for understanding socially patterned disease: the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project as a case study

As we have seen a global increase in asthma in the past three decades it has also become clear that it is a socially patterned disease, based on demographic and socioeconomic indicators clustered by areas of residence. This trend is not readily explained by traditional genetic paradigms or physical environmental exposures when considered alone. This has led to consideration of the interplay among physical and psychosocial environmental hazards and the molecular and genetic determinants of risk (i.e., biomedical framing) within the broader socioenvironmental context including socioeconomic position as an upstream "cause of the causes" (i.e., ecological framing). Transdisciplinary research strategies or programs that embrace this complexity through a shared conceptual framework that integrates diverse discipline-specific theories, models, measures, and analytical methods into ongoing asthma research may contribute most significantly toward furthering our understanding of socially patterned disease. This paper provides an overview of a multilevel, multimethod longitudinal study, the Asthma Coalition on Community, Environment and Social Stress (ACCESS), as a case study to exemplify both the opportunities and challenges of transdisciplinary research on urban asthma expression in the United States.