Improving the Health of All Americans

The Robert Wood Johnson Foundation (RWJF) Health & Society Scholars (HSS) program is designed to build the nation’s capacity for research, leadership, and policy change in health. The program seeks to improve the nation’s health by addressing the full spectrum of factors that affect health and inform policy. Up to 12 outstanding individuals who have completed their doctoral training are chosen to participate in an intensive two-year program at one of four nationally prominent universities: Columbia; Harvard; University of California, San Francisco and Berkeley; and the University of Wisconsin. This month we highlight two psychological scientists who are Robert Wood Johnson Foundation Health & Society Scholars: Courtney D. Cogburn and Thomas Fuller-Rowell.

Courtney D. Cogburn

Courtney D. Cogburn’s research investigates relationships between stress and racial health disparities across the life course, by integrating principles and methodologies across psychology, stress physiology, and social epidemiology. She received her PhD in education and psychology from the University of Michigan, and is currently an RWJF Health & Society Scholar at Harvard University.

What are some career highlights/turning points for you thus far?

I feel as though I have multiple moments in any given week that would qualify as a highlight or turning point! I can say, however, that hearing my dissertation chair and mentor address me as “Dr. Cogburn” for the first time was a major moment on so many levels. I’d been planning to obtain a PhD in psychology since my junior year of high school, and that moment represented the culmination of a long-standing dream.

What is your current research focus, and why did you select it?

I’ll start with why: at the broadest level, I’m fascinated with understanding why “race” matters for health and stress-related disease, as well as understanding how the ways we think and talk about race can affect personal stress and the quality of interracial interactions. My interests are also very personal, in the sense that I very much live the things I study.

A key component of my current work extends the dominant focus in psychological and health research on interpersonal sources of racial stress (discrimination, social rejection) to include sociocultural racial stressors (political debate, public dialogues about race, popular cultural references). Specifically, I’m working on projects examining (1) associations between sociocultural racial stress exposure in contemporary media and physiological, emotional, and behavioral stress reactivity, and (2) whether these relationships are moderated by different strategies of social cognitive stress appraisal in interracial dyads.

What is a key question you hope your research will help to illuminate?

My work integrates well-established framings of racism as a multidimensional concept into empirical assessments of psychosocial stress. As a result, I believe my work will provide important insights into understanding racial health disparities by developing comprehensive approaches for measuring and evaluating the effects of psychosocial stressors on health.

In researching that issue/question, what have you found so far?

Two things: (1) the adaptive qualities of “coping” are quite variable, depending on any number of factors such as context, duration, and the outcome being assessed; and (2) thinking about race and acknowledging related challenges and barriers can actually be a good thing — that is, the ability to critically assess complex social ecologies can improve one’s ability to negotiate challenges, barriers, and resources — including those related to race and racial experiences.

What role has the RWJF Health & Society Scholars program played in furthering your research?

When I applied to the RWJF Health & Society Scholars program, my core research questions and interests were shifting; these questions called for training I didn’t pursue as a doctoral student. I was also grappling with complex questions around the measurement of racial discrimination and stress.

While I could have certainly pursued these interests in a faculty position, the training opportunities and support I’ve received through the program has been exceptional — I’ve been able to continue building a dream team of renowned psychologists, sociologists and public health scholars to help me tackle some pretty complicated research questions. The Health & Society Scholars program has also provided me with the time and resources I needed to build novel and innovative areas of my research.

Where do you see your work going in the near- and/or long-term?

In the near future, I will continue to build an empirical base to support the development of a comprehensive measure of racial stress. For now, this will involve a multi-method strategic assessment of sociocultural racial stressors: experimental studies examining the effects that sociocultural racial stress exposure has on stress reactivity, and identifying circumstances that may attenuate negative effects, and a qualitative content analysis of mass media to evaluate the general prevalence of sociocultural racial stressors. I’m also planning a project that utilizes experience-sampling techniques and ambulatory technology to assess daily, chronic stress exposure.

In the longer term, I would love to produce a short film I’ve started working on that examines contemporary issues of race in the United States. I think an ethnographic film of sorts could be a really useful tool for examining some of the more abstract and subtle manifestations of racism that I examine in other areas of my research, and for examining the various ways individuals negotiate those experiences.

Thomas Fuller-Rowell

Thomas Fuller-Rowell’s research focuses on two main areas: (1) understanding identity development among stigmatized groups, and (2) examining the influence of social stresses relating to stigma and discrimination on health and health disparities. As an RWJF Health & Society Scholar at the University of Wisconsin-Madison, he aims to expand his knowledge of physiological systems relating to stress, gain exposure to interdisciplinary perspectives on population health, and contribute to addressing current limitations in the literature on discrimination and health. Fuller-Rowell received his PhD in developmental psychology from the Department of Human Development at Cornell University in 2010, and his BA in biochemistry and psychology from the University of Colorado in 2003.

What are some career highlights/turning points for you thus far?

One important influence on my career path was working for a civil rights organization in Buffalo, New York, before I began graduate school. A large part of this work involved documenting accounts of housing discrimination for subsequent litigation, and giving outreach presentations to groups of individuals deemed to be at risk for experiencing discrimination. Through the in-depth accounts that I documented in this job, I learned of the numerous forms that discrimination can take and the many ways that it can influence people’s lives. I also became acutely aware of the many ways in which discrimination can perpetuate neighborhood segregation and structural inequality. My experiences doing advocacy work in Buffalo had a profound influence on my worldview and are an ongoing motivation for my current research.

At the beginning of my graduate work, I was also involved in a multi-site action research project, which focused on understanding the influence of neighborhood environments on the lives of adolescents in low-income areas of New York City. As part of this project, I spent several months working with youth in South Bronx to evaluate the social and physical environment of their neighborhood. This experience further solidified my interest in understanding how a person’s health is influenced by the environment they live in and the events of their daily life.

What is a key question you hope your research will help to illuminate?

My research focuses on understanding how differential life circumstances — as a function of race and social class — influence health disparities across the lifespan. I approach this topic from a developmental perspective, considering contextual stresses during childhood, adolescence, and adulthood, and the biological and psychological mechanisms for their effects on health.

My goal as a researcher is to contribute to a basic scientific understanding of how stressful experiences influence physical health and development at particular points in the lifespan. I also take a more applied orientation by emphasizing the study of contexts that reveal mechanisms for health inequality. Since racial and socioeconomic differences in health are largely the result of past and present social injustice, I believe that understanding and addressing these disparities should be a high priority for social scientists, political leaders, and society.

In researching that issue/question, what have you found so far?

In a recent study, I found that perceived discrimination explains some of the impact of poverty on physical health among white adolescents in upstate New York. These results point to the importance of social class discrimination — or negative treatment based on a person’s social class background — in understanding socioeconomic health disparities. In particular, the findings suggest that the stresses associated with experiencing social class discrimination during adolescence are having a sizable impact on physical health (Fuller-Rowell, Evans, & Ong, 2012, Psychological Science).

In research looking at the health impact of racial discrimination among African Americans, I’ve found that reporting higher levels of perceived discrimination is not always associated with poorer health. These findings provide support for the idea that when negative stereotypes and discrimination are pervasive in society, recognizing discrimination and acknowledging its influence on daily interactions may be protective against its harmful effects. The findings also suggest the need for new methodological approaches to understanding the impact of racial discrimination on the physical health of African Americans (Fuller-Rowell, Doan, & Eccles, 2012, Psychoneuroendocrinology).

Addressing the methodological challenges of studying the impact of discrimination on health, in one study I have used a within-person daily process approach to consider the impact of changes in exposure to race-related stress on daily health outcomes. In this study I have found that on days when individuals report more discrimination than their own average level, they experience greater negative physical symptoms that day, as well as poorer sleep quality that night. These findings suggest that, although between-person differences in levels of reported discrimination may not be predictive of health, within-person fluctuations do seem to be linked with health relevant outcomes (Fuller-Rowell et al., in preparation).

What role has the RWJF Health & Society Scholars program played in furthering your research?

With the time, resources, and mentoring that the RWJF Health & Society Scholars program has provided, I have been able to deepen my knowledge of physiological systems relating to chronic stress exposure. I have also expanded my methodological skills to include measurement of acute physiologic stress responses (EKG, impedance cardiography, and blood pressure). These new techniques allow me to consider the reactivity profiles of individuals and link these profiles to changes in health outcomes over time. These methods provide a range of opportunities to develop a mechanistic understanding of how stressful experiences influence health outcomes over time. The HSS program has also allowed me to develop a broader interdisciplinary perspective on health disparities in the United States, and deeper understanding of the ways that psychology research can contribute to an understanding of these disparities.

What is your current research focus, and why did you select it? What current projects are you working on?

I am currently working on a project which considers the impact of stereotype threat on health trajectories of college students. In this project, I am considering acute physiologic reactivity to academic evaluation as a predictor of changes in biomarkers of physical health across the college years. This study builds on existing stereotype threat research to consider the extent to which negative academic stereotypes influence health of minority college students in predominantly White college contexts.

Where do you see your work going in the near- and/or long-term?

I have recently accepted an Associate Professor position in the College of Human Sciences at Auburn University, Department of Human Development and Family Studies. As a land-grant university with a network of connections to rural and urban counties in Alabama, Auburn University is ideally situated for research on health disparities in the South. Much of the current literature on Black-White disparities has focused on African Americans living in urban areas. However, African Americans living in the rural south are a similarly sized population with even poorer health outcomes — and thus are central to understanding health disparities in the United States. The psychology of Black-White relations in the rural south and the ways in which it may be influencing health and health disparities is a promising possible future direction for my work.

Join Christine A. Bachrach (national program co-director), Gerard P. Lebeda (deputy director), Courtney Cogburn and Thomas Fuller-Rowell (scholars) and Katie McLaughlin (alumna) on Friday, May 24, 2013, at 12:00pm (Taylor Room, Marriott Wardman Park) at the 25th APS Annual Convention for an information session/reception to learn more about the RWJF Health & Society Scholars program. There will be brief presentations at 12:15pm  followed by a Q&A.

Observer Vol.26, No.4 April, 2013

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