Version 14.1 Magic Strategies: the basic biology of multilevel, multiscale, health intervention Rodrick Wallace Deborah Wallace Division of Epidemiology The New York State Psychiatric Institute * April 15, 2013 Abstract A survey of the cultural psychology and related literatures suggests that Western biomedicine’s fascination with atom- istic, individual-oriented, interventions is a cultural artifact that may have little consonance with complex, subtle, mul- tiscale, multilevel, social, ecological, or biological realities. Other cultural traditions may, in fact, view atomistic strate- gies as inherently unreal. A contrary perspective suggests that the most effective medical or public health interventions must be analogously patterned across scale and level of organiza- tion: ‘magic strategies’ will almost always be synergistically – and often emergently – more effective than ‘magic bullets’. The result can be formally derived in a relatively straightfor- ward manner using an adaptation of the Black-Scholes econo- metric model, applied here to the metabolic cost of bioregu- lation under uncertainty. Multifactorial interventions focused at the human ‘keystone’ ecosystem level of mesoscale social and geographic groupings may be particularly effective. Key words: groupoid, phase transition, rate distortion, regulation, social network, stability, uncertainty 1 Introduction 1.1 Chronic bioregulatory activation Theories of aging abound (e.g., Lorenzini et al., 2011). One of the most popular is disposable soma theory (Kirkwood, 1977) which proposes an allocation of energy leading to a trade-off between increased lifespan and increased fertility. The trade- off manifests itself as a reduction in the ability to maintain somatic cells when energy is directed toward reproductive fit- ness. A quasi-programmed theory has been proposed, in which aging is an unintended consequence of a continuing develop- mental program, resulting in a defined lifespan (Blagosklonny, 2010). * Box 47, NYSPI, 1051 Riverside Dr., NY, NY, 10032, USA. Wal- lace@nyspi.columbia.edu, rodrick.wallace@gmail.com The free radical theory of aging is based on the fact that oxidative processes are essential to life, yet the consequent and subsequent generation of free radical damage is inade- quately controlled, leading to accumulated damage causing dysfunctions characteristic of aging (Harman, 1956). More recently, psychosocial stress and its physiological cor- relates have been implicated in premature aging. Epel et al. (2004) describe accelerated telomere shortening in response to life stress. They found that psychological stress, both per- ceived stress and the chronicity of stress, is associated with higher oxidative stress, lower telomerase activity, and shorter telomere length, which are known determinants of cell senes- cence and longevity. High stress women were found to have telomeres shorter on average by the equivalent of one decade in comparison to low stress women. Geronimus et al. (2004), focusing on the USA, describe how ‘racial’/ethnic differences in chronic morbidity and excess mortality are pronounced by middle age. Evidence of early health deterioration among Blacks and racial differences in health are evident at all socioeconomic levels. They invoke a ‘weathering’ hypothesis positing that Blacks experience early health deterioration as a consequence of the cumulative im- pact of repeated experience with social or economic adversity and political marginalization. Following Lorenzini et al., a very broad characterization of the phenotypic changes of aging is that they represent a re- duced capacity to maintain homeostasis, resulting in reduced functional capacity, increased vulnerability to multiple dis- eases, and a reduction in the ability to respond to stress, injury, or other perturbations. With particular regard to homeostasis, the involvement of activated bioregulation in the etiology of chronic disease has long been recognized. Bosma-den Boer et al. (2012) argue that the number of people suffering from chronic diseases such as cardiovascular disease, diabetes, respiratory diseases, men- tal disorders, autoimmune diseases and cancers has increased dramatically over the last three decades. The increasing rates of these chronic systemic illnesses suggest that inflammation, caused by excessive and inappropriate innate immune system activity, is unable to respond appropriately to danger signals 1 PeerJ PrePrints | https://peerj.com/preprints/8 | v1 received: 17 Apr 2013, published: 17 Apr 2013, doi: 10.7287/peerj.preprints.8 PrePrints