March 17, 2003

Emergency response

By Eric Rangus

Last November, the American Public Health Association presented its prestigious 2002 Jay S. Drotman Memorial Award to Deb Houry. The honor recognizes an outstanding health researcher or student under 30 years old who has demonstrated potential in the health field by creatively and positively challenging traditional public health policy or practice.

Houry, assistant professor of emergency medicine and of occupational and environmental health, as well as associate director of Emory’s Center for Injury Control, turned 30 in April of last year, making her—in one sense—overqualified for the award. Houry laughed about the calendar quirkiness of the honor, but the work for which she was rewarded is unquestionably crucial.

“It helps establish you as somebody who is capable of making a small difference,” said Houry, whose research focuses on the public health consequences of domestic violence. “Being recognized for your work this early on is pretty overwhelming, because you want to continue to do great research and great things, and this opens up doors. It establishes connections, and people are more familiar with who you are.”


“But it also sets a precedent to continue at the same level,” she quipped.

Humility is a good quality, but it also de-emphasizes the importance of one’s accomplishments. For another take on Houry’s research, perhaps a good person to ask is her boss, Arthur Kellermann.

“Dr. Houry is the most promising emergency medical trainee of her generation,” said Kellermann, chair of emergency medicine and director of the Center for Injury Control. It was Kellermann who nominated Houry for the Drotman award.

“In both scholarship and leadership, she already is functioning at a national level,” he continued. “I am certain she will be an outstanding advocate for public health and violence prevention for decades to come. She has remarkable energy and charisma.”

Not only does Houry study the consequences of domestic violence—its aftermath—but she also seeks ways to prevent it. “A lot of victims come to emergency departments to seek care; that may be their only portal of entry,” said Houry, who works primarily with female victims. “If we can screen them in the emergency department or look for specific indicators of violence—like bruises that don’t match their stories—we might be able to intervene.”

“Domestic violence can affect both physical and mental health,” Houry continued. “Women who are victims of domestic violence are at significant risk for a greater level of depression, post-traumatic stress disorder and suicide, so it affects their mental health. They also are at risk for miscarriages and headaches, just to name two things. In addition to the trauma they receive, it can affect their children. It perpetuates a cycle of violence.”

Currently Houry is studying trends in 911 calls in Atlanta, specifically those involving domestic violence. In addition to determining geographic and demographic patterns, Houry is seeking possible avenues of intervention—particularly in households where there are multiple 911 calls within a year’s time—as well as predicators for future violence so that health care professionals may have a better chance to stop the cycle.

She also has begun work on links between mental health and domestic violence. Her goal is to develop a mental health screen in emergency medicine departments that would check for signs of depression, post-traumatic stress syndrome and suicidal tendencies—among other things—in patients.

A native of northern Virginia, Houry completed her undergraduate work at Emory in 1994, double-majoring in biology and philosophy. (Houry’s second-floor office in the Rollins Building overlooks Clifton Towers, her old dorm.) Her interests as a student—academic and otherwise—ran a rather eclectic health care gamut. She volunteered at Egleston Children’s Hospital, worked as a house staff assistant at Grady Hospital and was an aerobics instructor in the P.E. Center.

Her work at Grady drove Houry to pursue a career in medicine and public health. “It was eye opening, because I saw all the patients that had problems with access to care, and just how overcrowded the emergency department was. It’s even more severe now,” she said. “I was mostly in awe of all the residents I saw. They seemed like they were making a difference and doing what I wanted to do.

From Emory, Houry entered the MD/MPH program at Tulane University, graduating in 1998. While a student at Tulane, Houry met Kellermann, who had come to campus to speak. She introduced herself after his talk, and they remained in contact for the rest of her time in medical school and her residency. Houry refers to him as a “long-distance mentor.”

Studying domestic violence was not Houry’s specific intention. She came upon the subject somewhat accidentally. “I wanted a summer project and started a prevalence study on men and women looking at domestic violence,” she said. “I found that it was an interesting area. I looked at domestic violence in medical students, legal ramifications and mandatory reporting, and it just spun off of that.”

When she graduated, Emory pursued her as a resident, but Houry chose to move to Denver, first for an internal medicine internship at Exempla-St. Joseph Hospital, then as a resident at the Denver Health Medical Center. In 2001, she was named chief resident.

All the while, Houry learned how to balance the demands of clinical work and academic research. Throughout her residency Houry was active (and still is) in a variety of professional organizations. She also sits on several journal review boards and, when she isn’t editing other researchers’ work, she produces her own.

Since 1997, Houry has written or cowritten more than 30 journal articles, a hefty amount for any academic, much less one just a few years removed from medical school. “She was easily the most academically productive resident in the country,” Kellermann said.

Houry was the first non-senior resident to sit on the editorial board of the Annals of Emergency Medicine; she also is a managing editor of the American Academy of Emergency Medicine’s online textbook for consumers, which will be rolled out later this year.

“If you want to do academic medicine, publishing is crucial,” said Houry, who came to Emory last July in large part to work directly with Kellermann. “I hope to be a clinician/researcher, where what I do with my research will directly affect my patient care.”
The best way to do that, she added, is to be recognized for publications.

Although Houry is devoting her time to treating victims of domestic violence and preventing further instances, she is enough of a realist to know that the problem will never fully go away. Her goal is to control it as much as possible.

“Many times women don’t understand that [violence] is not an acceptable behavior,” Houry said. “If they grow up in a family with domestic violence, it’s what they know. Sometimes leaving a relationship is the best thing, sometimes it’s not.

“Addressing the fact that domestic violence is not right, making sure that women have a safety plan or somewhere to go, and providing them with the necessary information to make an informed decision about their condition is very important.”