L-R:  Ralph Regula (R-OH) House Appropriations Subcommittee Chairman Darlene V. Howard, Ph.D. Professor of Psychology at Georgetown University

May 14, 2003

Mr. Chairman, I am speaking on behalf of the American Psychological Association. The APA represents 150,000 members and affiliates, and works to advance psychology as a science, a profession, and a means of promoting health and human welfare. Our members work, for example, as behavioral scientists like myself who conduct research funded by NIH, as university professors life myself, whose students depend on federal education aid. And also, as psychologists who provide services in schools, and to under-served populations.

For most of APA's funding recommendations, please see our written testimony. I will highlight just two agencies now.

First, within the Health Resources and Services Administration, APA recommends that $8 million in your Fiscal Year 2004 bill be allocated for the Graduate Psychology Education (GPE) Program in the Bureau of Health Professions Allied Health program. The only federal program dedicated solely to psychology education and training, GPE funds training for health service psychologists to work with America's underserved populations (the elderly, children, the chronically ill, and victims of abuse and terrorism). A portion of these funds, $3,000,000, will be allocated to geropsychology training to provide services to older Americans, especially in rural and urban communities, including those in nursing homes.

Psychological services are an essential part of a "seamless system" of preventive and cost-effective health care for the underserved. There are over 900 Mental Health Professional Shortage Areas throughout the nation that need these services.

Next, Mr. Chairman, turn to NIH. We join with other members of the Coalition for Health Funding to thank you and this Subcommittee for the last five years' remarkable increases for the National Institutes of Health (NIH). The doubling of NIH's budget will continue to benefit this nation and reflect credit on those who made it possible.

At least six of the ten leading causes of death in the United States are based on behavioral factors such as poor diet, stress, sedentary lifestyle, smoking, and accidents. Behavioral factors also increase individual's risk for disease, disability, and their need for costly long-term care.

Most of the institutes at NIH fund behavioral research as an integral part of their portfolios, which makes sense because of behavior's tremendous impact on our health. However, there are exceptions. The NIH institute that is most associated with funding basic research funds very little behavioral research. APA and its sister organizations are approaching the National Institute of General Medical Sciences to advocate for the initiation of a behavioral research program in that institute. We hope the Subcommittee will endorse this approach and we'll keep you informed of our progress.

APA is also committed to the elimination of racial and ethnic health disparities. Accordingly, it is critical that the National Center on Minority Health and Health Disparities continue to coordinate with the Office of Behavioral and Social Sciences Research. Cooperative efforts to spur research on socioeconomic status and health, the impact of racism, and effective health communications are particularly needed.

As you know, life expectancy continues to increase. It is essential that NIH continue to fund research that improves the quality of those longer lives. NIH is due a lot of credit for changing the way our society looks at aging. We know now that aging doesn't mean inevitable physical and cognitive decline-that many of the debilitating conditions of old age are preventable and treatable. Remaining independent and maintaining strong cognitive abilities is very important to older adults and to their families and communities.

My own research is an example of ways that NIH is working to understand how humans learn and remember as they age. Brain imaging studies and behavioral research show that there are different kinds of learning, which call on different brain systems. For example, when people try to memorize the names of new acquaintances, they are engaging in explicit learning. In this case they have attempted to learn and can describe what they have learned. But in other cases, people learn implicitly. Implicit learning is involved in adapting to the routines and characteristics of new environments and acquaintances. It is important for learning languages, for learning to operate appliances and computer software, and for relearning how to walk, reach, and speak after brain injury.

My work has focused on implicit learning, the kind that occurs without awareness. We've found that implicit learning holds up much better in old age, even in early Alzheimer's patients, than explicit learning. This is important because it means that older people often underestimate their own learning abilities. Further, it means that interventions can use that use implicit learning abilities to compensate for impaired explicit learning.

We've also found that people of different ages don't learn in the same way, and that matters in the design of rehabilitation and education programs. For example, unlike younger people, most older people learn more efficiently in the morning than in the afternoon.

Of course, my own research is only one example of the ways NIH is increasing knowledge about how to age successfully. Thank you for your strong support of scientific research, and for taking the time to hear the views of public witnesses like me.

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