“My work is about helping people lead healthy lives within their broader social contexts. Good health is not a simple narrative about personal responsibility.”
Context is Everything

Cancer death rates among black women are higher than any other demographic in the U.S., according to the Centers for Disease Control and Prevention, despite the fact that the rate of new cancer cases is highest among white women. Among men, the rate of new cancer cases is highest among African-Americans compared to other racial groups. 

These disparities in cancer rates are just one factor that inspired counseling psychologist Jason Purnell, PhD, MPH, to pursue a career in public health.

The CDC defines health disparities as differences in the incidence, prevalence, mortality and survival of a disease related to adverse health conditions in a specific population. “The CDC has suggested that in order to have the greatest impact on health outcomes, we have to address socioeconomic conditions,” says Purnell. “The work I am doing is attempting to raise awareness of the social determinants of health.”

Medical Care: A Fraction of the Entire Picture

Purnell leads a research project with colleagues at Washington University in St. Louis and Saint Louis University called “For the Sake of All,” which explores factors beyond medical care, such as limited economic and educational opportunities, that negatively affect the health and well-being of African-Americans in the St. Louis metropolitan area. 

“My work is about helping people lead healthy lives within their broader social context. It’s not a simple narrative about personal responsibility,” says Purnell. “Behavior happens in context, and that includes interpersonal contexts such as families, and larger contexts involving communities, society and policy.” 

Reducing health disparities within specific populations is far more complicated than simply providing medical care when a person becomes sick — which is just a fraction of the entire picture, according to Purnell. And adding more and better health care isn’t the answer, or at least the entire answer. 

Purnell cites research showing that behavior contributes to 40 percent of early deaths, and social conditions, such as housing, education and community connectedness, contribute 15 percent compared with lack of access to medical care, which only contributes 10 percent. 

“We are interested in profiling the health of African-Americans in St. Louis, and we want to extend the conversation beyond just health care,” says Purnell.

A Three-Pronged Approach

In his efforts to eliminate health disparities, Purnell describes his research approach as eclectic. “I use techniques that answer the question at hand,” he says. “But if I had to highlight one thing about our framework, it’s community-engaged research.” 

Purnell’s research has three goals: 

  1. Inform the public about the social determinants of health, such as education and economic status, and how they contribute to health disparities. 
  2. Highlight promising strategies that are already being implemented in St. Louis. 
  3. Recommend policies and programs to improve health in St. Louis. 

His research tests hypotheses about the contribution of social factors such as education, racial segregation and poverty to deaths among African-Americans in St. Louis. He used a meta-analysis of studies that link social factors like poverty and low levels of education with mortality as well as local health data to understand the connections between health and social factors. The findings are sobering. Purnell’s research has revealed that one in six deaths among African-American adults in St. Louis could be attributed to poverty and lack of education. But with targeted investments in areas like early childhood development and providing economic opportunities for low-income families, Purnell believes that the outcomes can be improved. 

“I love having the opportunity to try to contribute in a meaningful way to improving people’s lives,” says Purnell.

Health Psychology

Health psychologists use psychological science to understand biological, social and psychological factors that influence health and illness. They use their research to promote health, prevent illness and improve health care systems.

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Health psychologists use psychology to explore the connection between physical health and behavior change. The application of their research promotes wellness and healthy living.

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Health psychology focuses on how biological, social and psychological factors influence health and illness. Health psychologists study how patients handle illness, why some people don’t follow medical advice and the most effective ways to control pain or change poor health habits. They also develop health care strategies that foster emotional and physical well-being.

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