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Brita Roy, MD, MPH, MHS

headshot of brita roy

Home Institution: Yale University School of Medicine

Field: Internal Medicine

Current Positions:

  • Professor of Medicine, Yale School of Medicine
  • Professor of Epidemiology, Yale School of Public Health
  • Director of Population Health, Yale Medicine

My Driving Question

How can we develop measures to identify drivers and inequities of well-being to inform smart policies and healthcare for all?

Fellow Project 

As defined by the World Health Organization in 1948, health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Until recently, however, we have lacked the necessary data to study the well-being of the nation and how it varies geographically, over time, and across subpopulations. Instead, for decades, researchers have studied variations and trends in mortality, disease states, and healthcare utilization as proxies for the health of our nation. Now, with access to ten years of national data, there is the potential to describe the well-being of the U.S. population over a decade and for various subpopulations.

As Nova Institute Fellows, Carley Riley, MD, MPP, MHS and her research partner at Yale University, Brita Roy, MD, MPH, MHS, are examining the current state of well-being in the U.S. and trends and geographic variation in well-being over a ten-year period, and the state of well-being (and inequities in well-being) for various subpopulations. These results will provide healthcare providers and systems, public health organizations, policymakers, and other stakeholders with an understanding of the true health of our nation.

Biography 

Brita Roy, MD, MPH, MHS is Assistant Professor of Medicine at the Yale School of Medicine (General Medicine) and Assistant Professor of Epidemiology at the Yale School of Public Health (Chronic Diseases), and Director of Population Health for Yale Medicine, the Yale University multi-specialty faculty practice. 

Dr. Roy’s scholarly work focuses on assessing the relative contribution of positive psychosocial factors to population health outcomes and health equity at the individual and community levels. Dr. Roy is also interested in the implementation of multi-disciplinary, assets-based, effective community-healthcare collaborative interventions to improve population health and well-being. She co-leads the Yale-Gallup Well-being Research Team and the Institute for Healthcare Improvement’s (IHI) 100 Million Healthier Lives measurement team and is faculty for the IHI Pathways to Population Health Action Community.

Dr. Roy pursued Bachelors and Master’s degrees in Biomedical Engineering at Vanderbilt University and Wayne State University, respectively. She then went on to the University of Michigan to pursue a combined MD/MPH in Health Behavior and Health Education. Dr. Roy subsequently completed residency training in internal medicine and served as Chief Medical Resident at the University of Alabama at Birmingham prior to completing the Robert Wood Johnson Clinical Scholars Program at Yale University.

Education and Training
  • Scholar, Robert Wood Johnson Foundation Clinical Scholars Program, Yale University, New Haven, CT
  • Clinical Fellow, Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
  • Chief Resident, Department of General Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA
  • Resident, Department of General Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA
  • Intern, Department of General Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA
  • MHS, Yale University, School of Medicine, New Haven, CT
  • MPP, UCLA, School of Public Affairs, Los Angeles, CA
  • MD, Northwestern University, Feinberg School of Medicine, Chicago, IL
  • BA, English Literature, Northwestern University, College of Arts & Sciences, Evanston, IL 
Selected Honors
  • Annie E. Nolte Writing Award, Foundation for the Advancement of Health Education, 2020
  • Co-author, Editor in Chief Review Article of the Year, American Journal of Health Promotion, 2019
  • Research Team Award, Cincinnati Children’s Hospital Medical Center, Cincinnati, 2018
  • Best Abstract Award, Co-Production Conference, Cincinnati Children’s Hospital Med Center, 2017
  • Quality Improvement Poster Award, CCTST, University of Cincinnati, Cincinnati, OH, 2016
  • Presidential Citation for Outstanding Contributions, Society of Critical Care Medicine, 2015
  • AcademyHealth Presidential Scholarship in Child Health Policy, Washington DC, 2014
  • Presidential Citation for Outstanding Contributions, Society of Critical Care Medicine, 2014
  • Fellow Teacher of the Year, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 2012
  • General Pediatric Service Award, Children’s Hospital Los Angeles, Los Angeles, CA, 2008
  • Community Pediatrics & Advocacy Award, Children’s Hospital Los Angeles, Los Angeles, CA, 2008
  • Frances Nunnally Winzer Scholar Award, Children’s Hospital Los Angeles, Los Angeles, CA, 2007
  • American Academy of Pediatrics Resident Scholarship, Children’s Hospital Los Angeles, Los Angeles, CA, 2007
  • Phi Rho Sigma Dennis Award for Outstanding Jr. Year Performance, Northwestern Univ., Feinberg School of Medicine, Chicago, IL, 2004
  • Atlantic Philanthropies Foundation Fellowship in Non-Profit Leadership & Management, Los Angeles, CA, 2003
  • Alpha Omega Alpha, 2003
  • Julius Conn Award, Outstanding Performance, Dept. of Surgery, Northwestern Univ., Feinberg School of Medicine, Chicago, IL, 2002
Selected Publications

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Over the past thirty years, we’ve been part of a movement to shift the primary approach to health from a focus on disease to a more complete approach. As reflected in our tagline, “For Health of People, Places, and Planet,” how we are building on “person health” and looking at the context of peoples’ lives and communities as well as the health of the planet we all share. 

Key Concepts in Our Approach
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Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. 

When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) 

“When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” 

Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. “…they gradually found relief from suffering and began to exhibit emergent characteristics: a sense of hope, self-acceptance, and a desire to help others—the immediate precursors to healing.”

 In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” 

  • Helping Others: We find meaning in helping others. “Understanding that suffering gives the strength and experience to help others in similar situations.”
  • Hope: We begin to have hope that we will not always feel this bad. A Crohn’s patient said, “I think gradually I realized that I was going to feel better. I did have days when I actually didn’t vomit, when I did feel better. And I think gradually I came to believe that maybe I could have a normal life again.”
  • Self-Acceptance: We see our inherent value and understand that we are not to blame for our suffering. A participant living with HIV said, “I’m really proud of myself. I think that now I still want to live. I don’t want to die, and I really love myself a lot. I have a lot of comfort in myself.”

Suffering is the ongoing pain from wounding. 

There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. 

“The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”

Characteristics: How predisposed someone may be to wounding/how many tools and resources someone may have to deal with trauma/illness.

Lifestages: Developmental timing plays an important role in the impact of trauma — young children often do not have the same resources as older adults.

Relationships: Relationships can provide solace and support for those suffering, while lack of healthy relationships can prolong suffering.