Several psychologists are carving a niche in the realm of psychology and public health: Ileana Arias, PhD, is one of them. Arias, branch chief for etiology and surveillance in the Centers for Disease Control and Prevention's Division of Violence Prevention, is an expert in domestic violence with a specialty in behavior therapy, who's made a successful transition from psychology in the narrow sense to public health in the broadest sense.
She came to the CDC about a year ago after several years of teaching and conducting research at nearby University of Georgia in Athens. While at the university, she became a grants reviewer for the CDC, in particular for issues of intimate-partner violence. She realized that CDC's public health perspective was a valuable one to add to her own background.
"As an organization that uses the public health model, CDC's charge is to solve the problem," the clinical psychologist says. "To me that sounded very rewarding. As a clinician, I intuitively felt that anything we do in research should show some sort of utility. The public health model makes that explicit."
Unlike psychological research, which focuses on discrete problems in small populations, the public health model aims to understand health problems on the level of the general population, Arias explains. Specifically, it asks researchers to:
Track the incidence and prevalence of a problem.
Identify risk and protective factors that can inform the design of an intervention.
Design and evaluate a prevention intervention based on that information.
Disseminate that information to the public.
"The public health model is a very dynamic one, in that each stage is intended to provide the information that will inform the next step," she says. "As you're doing one step, you're almost forced to consider the other ones."
Combining this approach with psychologists' penchant for depth, details and underlying causes can be a powerful blend, says her colleague Rodney Hammond, PhD, who directs CDC's Division of Violence Prevention. "Psychologists can play a big role in public health research, especially as you move to the second part of the public health model," Hammond comments. "This part of the model asks the cause of a particular problem, what environmental, family or individual factors spur these things on.
"With a problem like violence," Hammond adds, "all of these areas of activity have to embrace what psychologists have to give or you can't do the work."
Arias's branch is currently focusing on two areas that will benefit from a blending of psychology and public health. One is a new emphasis on child maltreatment, which will implement the public health model from scratch, starting with basic epidemiologic definitions. The second is a new focus on primary prevention strategies for women at risk of abuse, she says.
Previous work has focused mainly on caring for victims after abuse occurs and preventing revictimization. The new work will attempt to help women before the event of abuse, and will examine psychosocial factors among perpetrators as well as precursors to domestic violence in teens and children.
Hammond, who himself is a master of the public health-psychology mix, notes that public health training can broaden the scope of any psychologist. He has gone from psychology graduate school to medical school to a school of professional psychology to CDC, eventually combining those various perspectives to become a leader in developing effective violence-prevention interventions for African-American youth.
"When I look back on the last five or six years, I see that public health has given me the chance to make a far bigger difference in the things I care about," Hammond says.
Tori DeAngelis is a writer in Syracuse, N.Y.
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