Tiffany Powell-Wiley graduated from the University of North Carolina at Chapel Hill with a M.P.H. in epidemiology in 2003. She earned her M.D. from Duke University School of Medicine in 2004, after spending a year in medical school as a research fellow in the NIH’s Clinical Research Training Program. She did her residency in internal medicine at Brigham and Women’s Hospital in Boston from 2004 to 2007, followed by a fellowship in cardiology at University of Texas Southwestern Medical Center from 2007 to 2011, where she served as chief cardiology fellow from 2010 to 2011. Since August 2011, she has held a joint appointment with the NHLBI and the Applied Research Program in the Division of Cancer Control and Population Sciences at the National Cancer Institute. In 2009, she received the Women in Cardiology Trainee Award for Excellence from the American Heart Association. Dr. Powell-Wiley is a reviewer for numerous journals including Circulation, Obesity, American Heart Journal, and Annals of Internal Medicine, who named her one of the “Best Reviewers” for 2011. She is currently on the Board of Tutors for the NIH’s Medical Research Scholars Program.
It is safe to say that during the decades in which obesity has become an epidemic in the United States, the human gene pool has not been concomitantly altered. Thus, although biology and heredity do play a role in susceptibility to obesity and obesity-related disorders, the social, behavioral, and environmental contributions cannot be overlooked if effective prevention and treatment strategies are to be designed. Dr. Powell-Wiley focuses her research on the social determinants of obesity and obesity-related cardiovascular risk factors that contribute to racial and ethnic disparities in cardiovascular disease.
Dr. Powell-Wiley has two interrelated research programs. First, she and her colleagues use epidemiologic methods and geographic information systems to understand the socioeconomic, psychosocial, and environmental factors that promote adverse weight gain and incident cardiovascular risk factors in multi-ethnic, population-based cohorts. Environmental factors include the level of built-in resources available to a community, but they also encompass psychosocial factors such as perceptions of neighborhood environment. She then works to translate findings from these epidemiologic studies into community-based interventions targeting barriers to weight loss for at-risk populations.
Using data from the Dallas Heart Study, a population-based cohort in Dallas County, Texas, Dr. Powell-Wiley examined the relationship between prevalent obesity and social determinants of obesity, including access to care and cultural perceptions of weight. She has subsequently developed a protocol to examine the relationship of weight gain for Dallas Heart Study participants and neighborhood deprivation as measured by the U.S. Census. Working with 20 churches in the Dallas County area, Dr. Powell-Wiley played a key role in the implementation and operational management of a randomized intervention that directed health promoters within churches to hold monthly educational sessions with congregants on cardiovascular risk factors, with the goal of improving physical activity and nutrition. Her data indicated that the strategy might be most successful if targeting obesity as a cardiovascular disease risk factor. These studies informed Dr. Powell-Wiley’s work in the design of a community-based intervention targeting prevalent obesity in Dallas.
Dr. Powell-Wiley is bringing her experience with the Dallas County community to the development of a community-based behavioral weight loss intervention in the greater Washington D.C. area, specifically addressing key social determinants of obesity. Her plan is to target specific Washington D.C. wards where obesity and cardiovascular disease are most prevalent. Central to Dr. Powell-Wiley’s early efforts is the need to identify and build relationships with key leaders in the community—in this case, within African-American churches—that will advocate for and help implement programs involving these populations.
Given the multidisciplinary nature of her work, Dr. Powell-Wiley benefits from the advice of colleagues at the National Cancer Institute who study geospatial environment and health in the context of cancer. One-size-fits-all public health approaches to the obesity epidemic have not proven effective; Dr. Powell-Wiley’s hope is that through a better understanding of how socioeconomic, psychosocial, and environmental factors impact obesity as a cardiovascular risk factor, she can develop interventions tailored to community-based environments.