The intersection of psychology and public health

While the Centers for Disease Control and Prevention (CDC) may bring to mind tracking down runaway viruses, the agency also focuses on behavioral health issues that top the leading causes of death for many age groups. Each year, 50,000 people die from suicide and homicide in the United States, and millions more live with the physical and emotional scars of violence.

For nearly 15 years, Rodney Hammond, PhD, has been working to address those problems as head of the CDC Division of Violence Prevention. He’s championed the development of violence prevention programs and brought them to communities across the nation. His division has provided millions of dollars in grants to fund programs that prevent youth violence, child abuse, intimate partner violence, suicide and sexual violence, to name a few areas.

Just before Hammond retired in February, the Monitor caught up with him to discuss his pioneering career and psychology’s future in the world of public health.

Looking back on your career, what accomplishment are you most proud of?

I am really pleased that the CDC has taken a lead role in promoting the notion that violence is preventable. When CDC started working on violence prevention, the work was primarily focused on collecting and reporting data on violence. Then we moved toward developing evidence-based prevention strategies. Now we are working on community capacity building. We are poised now to help communities implement evidence-based prevention programs to reduce violence.

One violence-prevention program I’d like to highlight is called STRYVE, (www.safeyouth.gov), which stands for Striving to Reduce Youth Violence Everywhere. It includes an online tool that is allowing local groups to network, assess conditions and share information about gaps in their communities that need to be filled by strong violence-prevention strategies. Communities can also use the website to learn about what’s available in terms of evidence-based violence-prevention programs. STRYVE is a big step forward in youth violence prevention because it takes violence prevention from the level of a specific program to the level of community planning. APA is one of 15 groups helping to launch the program, and APA’s Public Interest Directorate is particularly involved in getting the STRYVE message out to community groups.

Another area where we have had major success is child maltreatment prevention. Traditionally, the approach to addressing child abuse relied on child protective services to rescue abused children. We’ve now put forth the notion that we can help stop abuse before it occurs. CDC funding has supported strategies, such as the Positive Parenting Program, that have actually been proven to reduce the number of child abuse cases by helping parents learn and teach their children emotional self-regulation and other skills.

I’m really proud of the fact that it’s psychologists who have done some of the lead program development and program evaluation for these violence-prevention efforts and others that are on the horizon.

Going forward, what do you think are the greatest opportunities for violence prevention?

You’re going to see more collaboration among government agencies, community groups and law enforcement. There’s no one model yet, but these collaborations might involve police referring people to programs in the community. Or it might involve using violence data — for instance, information about who is coming into hospitals for treatment after an assault — and determining which parts of a community are most at risk and what circumstances surround these injures, and targeting community resources accordingly.

We may not always know for certain what will work best in a particular community, but we need to have a system in place for tracking the results of each strategy over time. The public health authorities have a long track record of looking at population health data and trends, and they will be doing more to help community groups adjust and target their violence-prevention strategies.

Another trend I am seeing is a growing effort to address violence in a global context. For the first time, CDC is establishing global violence-prevention programs. We are partnering with UNICEF, several other U.N. agencies, and public and private partners to address problems like child victimization and child sexual exploitation. We started with a program in Swaziland that tracked child sexual victimization, which resulted in a number of programs, including a change in child protection policies, a national education campaign and a safe court system for survivors. That work is now spreading to other parts of Africa and some parts of Asia. I’m really pleased the CDC now has a full-time staff working on some of these international partnerships.

What role do you think psychology has to play in the future of public health?

I’ve noticed that many psychologists are getting master’s degrees in public health or just taking courses in public health during their doctoral training. Their involvement in the public health system will be very beneficial because some of the top public health problems — obesity, violence and smoking — have a lot to do with behavior. Psychologists bring unique expertise in how behavior can be influenced and how healthy behavior can be encouraged.

Wherever you come from in psychology — communication, child clinical, social — you can find a way to apply your knowledge in the public health sector and apply it at a much larger scale.

How did you move from clinical psychology to public health?

I came to this after doing work addressing youth violence prevention for African-American youth at a time when there was an epidemic of homicides. In the 1980s, there was a significant rise in homicides for African-American male youth. As a psychology professor at Wright State University in Dayton, Ohio, my colleagues and I developed some interventions to address youth violence. From there, I was offered a job at the CDC, and saw it as opportunity to join a much larger community concerned with all forms of violence prevention. There had never been a psychologist in this particular role, but it was a natural fit.

When I came into this work, violence prevention was a fairly small part of the work of CDC. Since then, the number of experts in public health and violence prevention that are now working on violence at CDC almost quintupled, and a lot of them are psychologists.

How did your training as a psychologist prepare you for your CDC job?

Psychology gave me a framework for understanding how behavior and the environment interact to produce certain health outcomes, and also a framework for understanding how you might change those outcomes. I learned how you can change what people learn in families and communities, and ultimately how you affect whole regions through policies that promote health. What I learned about leadership, dealing with groups and encouraging people to move in certain directions, perhaps positioned me well for the leadership role that I occupied at CDC.