Perceptions and identity play a pivotal role in people’s access to and use of health and mental health care.

“Helping people to be comfortable with the health-care service environment so that they seek it out when they know that they need those services is key,” says Vetta L. Sanders-Thompson, PhD, associate professor of public health at the Brown School at Washington University in St. Louis.

“We also need to communicate in a way that allows people to recognize what they need to do to protect their health and mental health in a timely fashion and feel capable of taking the steps to do that,” Thompson says.

“One of the things that people said to me over and over in health and mental health settings is ‘I know what they said, but they make it so complicated.’

“The issues of mistrust and all the little nuances that people pay attention to create barriers in their minds, even if they aren’t there in reality.”

Thompson’s research looks at these barriers, particularly in the African-American community, and how they can be overcome to improve health outcomes and reduce disparities in health care.

Her public health work has deep roots in clinical psychology and her psychotherapy practice.

“I have always researched racial identity because I was interested in how it affected the mental health and well-being of the community — the extent to which a positive attachment to group could be supportive, the extent to which acceptance of one’s physical appearance was relevant to self-acceptance and security, and the extent to which social, political and cultural attachments to the group provided a sense of accomplishment, purpose and possibility for people,” she says.

Thompson’s research helped her better understand the factors that would impact her psychotherapy clients.

“I have had clients referred to me because they were perceived as angry and hostile and there were workplace issues,” she says.

“But when you would discuss that with them, they saw the situation very differently. They were experiencing what they perceived as discrimination in that environment and trying to cope.

“I saw how the pressures of those experiences began to transform the individuals, the way they interacted with others, the way they saw the world and the way they understood themselves,” she says.

“I started to really understand that experiences of discrimination had other psychological impacts, and I began to study those as well. So we’ve got this mix of understanding identity and how it is protective but also how it’s formed and how it’s transformed over the lifespan.”

Thompson also began to look at social aspects of African-American life, which lead her to work with Matthew Kreuter, PhD, professor of public health and director of the Health Communication Research Lab at the Brown School, on a National Cancer Institute project on communicating with members of the African-American community about colorectal cancer.

The project uses cultural information, including religiosity and ethnic identity, to address issues of mistrust in the health-care setting.

“Vetta is an amazing colleague,” Kreuter says. “She has this great mix of practical experience in real-world settings and rich knowledge across multiple disciplines. It gives her work meaning and impact.”

Full circle

Thompson joined the faculty at the Brown School in 2008, but this is not the first time she has worked at WUSTL.

“After my PhD, I worked in the School of Medicine’s division of child psychiatry doing psychological assessments,” she says. “It was a wonderful way to start my career.”

She later went on to serve on the University of Missouri-St. Louis psychology faculty for 15 years and Saint Louis University’s public health faculty for nearly five years.

“I’ve come full circle,” Thompson says. “It’s been great being on the ground floor of the new public health program at WUSTL.”

Thompson says that being a part of a school with both public health and social work programs offers a number of opportunities.

“There is an interesting overlap between the two programs,” she says.

“There are social work faculty very interested in health who do very similar work and research in health and health behavior. Public health is increasingly focused on and concerned about the social determinants that affect health outcomes, so the line between the two programs is amazingly thin.”

Current work

Thompson recently started what she considers one of her most important projects — serving as the investigator for community engagement and outreach for the National Children’s Study (NCS).

The NCS is the largest study ever conducted in the United States to learn about the health and development of children. It will follow more than 100,000 U.S. children before birth until age 21 from 79 metropolitan areas and 26 rural communities.

The study will examine the effects of the environment and genetics on growth, development and health.

“In terms of our ability to draft policy that can promote the health and well-being of children, the Children’s Study is probably the most important endeavor that will be undertaken,” Thompson says.

She also has moved back to her earlier work on racial identity by exploring colorism.

“It’s a broader issue than racism,” Thompson says. “I focus on the use of a physical attribute to assign beauty, status and worth.

“You hear people mention that they don’t want to get too ‘dark,’ and they are not discussing the harmful effects of excess sun exposure. What does that mean, too dark?

“How far does it go in the judgments that people are willing to make about others? And the things that people will tell you about the treatment of other people in relationship to that term ‘too dark.’ It’s just fascinating.”

Outside WUSTL

Community’s importance extends far beyond Thompson’s scholarship. Her limited free time is spent with her family, including four children, and friends.

“I head back to my hometown — Birmingham, Ala. — as much as I can to see my family,” she says.

During her family’s holiday gatherings, Thompson has taken over the role of cooking many of the main dishes.

“Our family meets in Birmingham for what we consider major holidays, Christmas is one of them,” she says. “As many of the nieces and nephews who can come, come. And my parents’ and my sister’s houses are filled to the brim with people.”

Thompson also makes a point to go on a trip with her girlfriends each year.

“It’s great to meet in a city with friends,” she says. “You can go to Los Angeles, but when you go with friends, it’s different. The trips are a wonderful way to catch up and have fun.”

Fast facts about Vetta L. Sanders-Thompson

Title: Associate professor of public health at the Brown School
Education: BA, psychology and social relations, Harvard University; MA, PhD, psychology, Duke University
Family: Four children
Favorite trip with friends: Cruise to Mexico