Feature

In the last two decades, the life expectancy of Americans has fallen from 11th place to 42nd place in the world, and infant mortality rates have increased, especially among African-Americans.

"We're not where we should be given the resources of this country," said Seattle private practitioner Margaret Heldring, PhD, at an APA Annual Convention session sponsored by the Board for the Advancement of Psychology in the Public Interest.

Many health problems are associated with basic psychological processes such as emotion, cognition, motivation and social perception, she said, and psychologists can play a major role in improving people's lifestyles and reducing health disparities between rich and poor. For example, cognitive psychologists' decision-making research can help physicians understand how patients decide when to use health care and how they make decisions about compliance and treatment options. In addition, input from psychologists on public health initiatives such as Healthy People 2020 -- a set of 10-year national objectives promoting healthy living -- support the creation of social and physical environments that advocate good health for all, said Heldring.

Yet public health researchers and behavioral scientists often approach the same problems from different conceptual frameworks and with different methods that can sometimes be at odds with one another, said Peter Muehrer, PhD, a clinical psychologist who heads the Health and Behavior Research Branch at the National Institute of Mental Health. Clinical psychologists, he noted, tend to be more concerned with individual treatment, while public health researchers typically concentrate on community-based education and communications programs focused on prevention.

The two disciplines must bridge their work, especially given the enormous impact that mental illness has on public health, said Muehrer. According to the World Health Organization, major depressive disorder is now the leading cause of disability in the United States among people age 15 to 44, and depression is associated with many medical problems, including heart disease and stroke.

Past public health initiatives that have tapped the expertise of psychologists have proven that collaboration can make a big difference. From 1984 to 1992, the JOBS Project, a NIMH-funded study headed by University of Michigan psychologists Amiram Vinokur, PhD, and Richard Price, PhD, provided job-seeking skills to unemployed adults and helped participants combat feelings of depression, anxiety and helplessness. The program reduced symptoms of depression and helped workers find better-paying, more satisfying jobs, Muehrer said. Since the study's conclusion, a number of social and community service agencies in California, Michigan and Maryland have begun using the model. The program has even been implemented in China, Finland and the Netherlands.

"We really do know how to do things successfully, but we still have a long way to go in increasing these collaborations," Muehrer said.