Feature

Adrienne Stith Butler, PhD, and Tracy Myers, PhD, have taken their psychology careers on a nontraditional path to the Institute of Medicine (IOM), where they address public policy issues ranging from ethnic inequalities in health care to psychological aspects of terrorism.

As IOM program officers, they assemble and oversee interdisciplinary committees that examine policy issues related to public health. Based on their investigations, which are sometimes congressionally mandated, the committees produce reports that help to inform policy-makers and the public about health care, research and education. For example, one recent IOM report highlighted ways to increase the number of minority health-service providers.

In their program officer roles, Stith Butler and Myers are able to apply their behavioral health background to various IOM investigations. For example, Stith Butler is working on a project looking at contributors to premature birth, and Myers is overseeing a group investigating the ethical implications of using prisoners for research.

"In this work I have an opportunity to help make behavioral research more accessible to the public," Stith Butler says.

Influencing public policy

Tackling such issues as how to eliminate racial and ethnic health-care disparities and identifying the behavioral aspects of terrorism is all in a day's work for Stith Butler. She has served as a program officer at IOM since 2000.

In her latest project, she is investigating the state of the science with respect to the causes of premature birth and the broad economic, health and social consequences for children and families. In 1999, 11 percent of U.S. babies were born prematurely compared with 9 percent in 1981, according to the National Center for Health Statistics. The IOM report is due out in the spring of 2006.

Prior to joining IOM, Stith Butler, whose doctorate is in clinical psychology, served as the Society for the Psychological Study of Social Issues (SPSSI) James Marshall Public Policy Scholar--a fellowship with APA's Public Interest Directorate that allowed her to focus on advocacy and policy issues related to ethnic health-care disparities and racial profiling. She credits that work with leading her to IOM, where she continued her work on policy initiatives that call for eliminating ethnic health-care disparities.

"This was an opportunity to do work that bridges research and public policy, and IOM seemed like a great place to do it," Stith Butler says.

In addition, her behavioral background has proven useful in the assembling of committees for IOM reports. For example, in 2000, Stith Butler and former IOM Program Officer Brian Smedley, PhD, also a psychologist, were working on the IOM report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care." They were charged with assessing the sources of health-care inequality, including the role of bias and prejudice. Because of their training as psychologists, Stith Butler and Smedley were familiar with psychological research on implicit and explicit stereotypes that affect thinking and actions across racial lines--and helped ensure such information was included in the report.

Besides that report, Stith Butler also has been involved in such IOM reports as "In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce" and "Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy," which concluded that federal and state governments need to help the nation better respond to the psychological effects of terrorism by, for example, providing programs on resilience.

"This kind of work is not traditional for a psychologist," Stith Butler acknowledges. "But it's exciting and important because you have a chance to make a difference at a broad level, including among policy-makers and the general public."

Helping underserved populations

In a similar vein, Myers joined the IOM staff in November 2004 to delve into policy issues that affect underserved populations. Before coming to IOM, Myers focused on addressing mental health issues of underserved populations at the Baltimore Veterans Affairs Medical Center and other mental health clinics. His past experience has included clinical work and research with youth in juvenile detention centers and children in the welfare system.

In his first project with IOM, he oversees a committee that will consider the ethical implications of federal regulations that allow research on prisoners. Myers will help assemble an interdisciplinary committee of 12 to 15 experts who hold a balance of scientific viewpoints on the ethical implications of using prisoners for research. The study will involve two public workshops, committee meetings and site visits to prison facilities.

Myers says the current project is the second consecutive National Academies study to focus on ethics, research and a vulnerable population; the first study was an investigation on ethical issues related to developing new treatments for drug addiction.

"I would be very pleased if I were able to develop a portfolio of studies on ethics that helped to highlight, in a very interdisciplinary way, the ways that behavioral, biomedical, public policy and other areas can work together to better serve many of those most in need," Myers says.

Before coming to IOM, Myers--who holds a doctoral degree in clinical and community psychology--worked from 2000 to 2004 in the behavioral division of the National Research Council, which--like IOM--is part of the National Academies and provides reports on science, technology and health policy. In that job, he mostly managed studies on drug addiction, such as identifying who is genetically susceptible to drug addiction.

He views his latest role as a way to further his work with underserved populations.

"This is such a wonderful opportunity to get involved in policy issues," he says. "The kind of influence on a national scale you can have is amazing."

Further Reading

To purchase or download IOM reports, visit www.nap.edu.