Carley Riley, MD, MPH, MPP

headshot of carley riley

Home Institution: University of Cincinnati College of Medicine

Field: Pediatric Critical Care Medicine

Current Positions:

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 a Nova Fellow, 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 

Carley Riley, MD, MPP, MHS, is an assistant professor in the Department of Pediatrics of the University of Cincinnati College of Medicine and an attending physician in the Division of Critical Care Medicine at Cincinnati Children’s Hospital Medical Center. Dr. Riley aims to generate actionable knowledge to inform multi-sector interventions to foster creation of high well-being populations. She aims to encourage a paradigm shift in how health and health creation are viewed, with research in healthcare and non-healthcare investments in health and well-being, including social determinants of health as a central feature, with projects from the Pediatric Intensive Care Unit to the community.

Dr. Riley is actively involved in multiple national endeavors and organizations. She is a principal investigator within the Collective Well-being and Equity Learning Lab (Collective WELL), with research partnerships with Yale University Center on Outcomes Research and Evaluation, Gallup, and Sharecare, Inc. Within the Institute for Healthcare Improvement, Dr. Riley is currently a metrics consultant and researcher for 100 Million Healthier Lives. Locally, Dr. Riley serves as lead of the Place Based Improvement Team of the All Children Thrive Learning Network Cincinnati.

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
  • 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

Developing safety, persistence, trust

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.”

Acquiring Resources

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.
    • “I think I kept trying to convince him I was crazy. And he kept saying, ‘No, you’re not crazy.’ […] You wouldn’t necessarily say a Vietnam Vet was crazy. You’d say they are responding like you’d expect to extraordinary circumstances.”
    • “I’m not the only one who have [sic] this problem. A lots, millions of people, you know. […] They don’t have nothing to do with that. I guess I have to live.”
  • 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.”
    “You need a lot of energy and a lot of work … it takes a lot of work. It doesn’t just happen. It’s not like a magic wand.” This patient understood that they had to actively participate in the healing process.
  • 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.

Helping Relationships

“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

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. Healing, in this sense, does not mean cured—none of the study participants were cured of their ailments—”but all developed a sense of integrity and wholeness despite ongoing pain or other symptoms.” In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” When we begin to heal, we find increased capacity for hope, renewed motivation to help others, and are more able to accept ourselves as we are.

Suffering

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

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.”