Steven Woolf, MD, MPH

Home Institution: Virginia Commonwealth University

Field: Social Epidemiology

Current Positions:

My Driving Question

How do we increase awareness among policy makers and voters of the powerful links between social policies and health?

Scholar Project 

The Connecting the Dots initiative aims to raise awareness of the connections between health and social factors, such as education, income, neighborhood, and community. It targets policy makers and voters, whose actions shape these conditions but who rarely understand the full health consequences of their decisions.

Most academics who study health lack experience in the policy world and are poorly equipped to package and deliver messages in a way that is compelling and accessible to policy makers and voters. Dr. Woolf is developing a more effective approach to translating and delivering evidence by forging a collaboration between largely disconnected disciplines:

  • researchers who have mastered the scientific evidence linking social factors and health;
  • policy experts with intimate knowledge of key change agents and decision-makers and how to reach them;
  • communication experts with talent in developing messages and marketing attractive, engaging materials in various media; and
  • foundations with a willingness to support the collaboration over five years to test its effectiveness.

Dr. Woolf’s work as a Nova Institute Scholar aims to:

  • establish the collaboration;
  • demonstrate the ability to reach influential audiences;
  • plan for creative products and impactful venues;
  • collect data on awareness levels; and
  • elicit feedback and learn from target audiences how to provide more useful information.

Raising awareness about the social determinants of health is of urgency amid the current economic crisis, as our society struggles with major decisions affecting social factors, such as employment, education reform, and a fraying social safety net during a time that demands fiscal restraint.

Dr. Woolf’s project seeks to establish a new model for communicating scientific evidence to decision-makers. It will demonstrate the power of formal teamwork among scientists, communication experts, and policy advisors to help audiences understand the relevance of evidence on any health issue. Woolf and his team hypothesize that none of these groups acting alone can communicate as effectively as the product that emerges when these talents join hands.

Biography 

Steven H. Woolf, MD, MPH, is Professor at the Department of Family Medicine and Population Health at Virginia Commonwealth University. He received his medical degree in 1984 from Emory University and underwent residency training in family medicine at Virginia Commonwealth University. 

A clinical epidemiologist, Dr. Woolf was trained in preventive medicine and public health at Johns Hopkins University, where he received his Master of Public Health degree in 1987. He is board certified in family medicine and in preventive medicine and public health.

Dr. Woolf has published more than 150 articles in a career that has focused on evidence-based medicine and the development of evidence-based clinical practice guidelines, with a special emphasis on preventive medicine, cancer screening, quality improvement, and social justice.

From 1987 to 2002, he served as science advisor to and a member of the U.S. Preventive Services Task Force. Dr. Woolf edited the first two editions of the Guide to Clinical Preventive Services and is author of Health Promotion and Disease Prevention in Clinical Practice.

Elected to the Institute of Medicine in 2001, Dr. Woolf served as associate editor of the American Journal of Preventive Medicine and as North American editor of the British Medical Journal. He has consulted widely on various matters of health policy with government agencies and professional organizations in the United States and Europe.

Education and Training
  • Residency, Family Medicine, Virginia Commonwealth University
  • MD, Emory University
  • MPH, Johns Hopkins University
  • BA, University of Missouri-St. Louis
Selected Honors
  • Chair, Panel on Understanding Cross-National Health Differences Among High-Income Countries, National Research Council and Institute of Medicine
  • Senior adviser and past member of the U.S. Preventive Services Task Force
  • Elected to Institute of Medicine, National Academy of Sciences, 2001
  • Past North American editor of the British Medical Journal
  • Past associate editor of American Journal of Preventive Medicine
Selected Publications

Articles and Papers

Books

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.”