A Southerner Abroad

“I’ve been called ‘tenacious’,” says Philip A. May, PhD, with a hint of humor. It’s an understatement for the man who relentlessly pursues data that shed light on important public health issues across the United States and around the globe.

May, professor of nutrition at the UNC Nutrition Research Institute (NRI) and in the Department of Nutrition at the Gillings School of Global Public Health at UNC-Chapel Hill, has been a demographer and epidemiologist for the better part of 50 years. He calls his style of research “shoe-leather” epidemiology, meaning that he gathers information for studies by getting out in the field and immersing himself in communities to really know the people in his studies. For nearly 30 of those years, May’s focus has been on learning about the often-dire effects and alarmingly high prevalence of fetal alcohol exposure. His work in the fields of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) is of such significance he was the most recent selected speaker at the Annual Mark Keller Honorary Lecture presented by the National Institutes on Alcohol Abuse and Alcoholism (NIAAA) in Bethesda, Maryland.

May attributes much of his success to his upbringing and early life circumstances. Although he was born and raised in Bethesda, he most identifies with the cultural heritage of the Shenandoah Valley of Virginia, birthplace of his parents. By circumstance and by choice, May spent much time with his relatives in the pastoral valley. In Bethesda, May’s father was an intramural research scientist at the National Institutes of Health, where he and his team developed or refined many pharmaceutical compounds that have been used throughout the world for decades. May’s was a dichotomous life of natural splendor and scientific wonder, each contributing to his eventual career. The springboard into adulthood, though, was the death of his mother at the end of his junior year of high school. The effects of this loss on him and his father changed May’s life immensely. “I became quite independent and considerably more motivated to strike out on my own,” he says.

That motivation took him first to North Carolina where he earned his undergraduate (Catawba College) and master’s (Wake Forest University) degrees in sociology. From those earliest years, May recognized his calling as a demographer when he was sent into local neighborhoods to conduct surveys on politics and race, and found that he enjoyed the interview process and data analysis. From there, it was an easy choice to enlist in the US Public Health Service, which also fulfilled his military service obligation as the draft was still in effect at the time.

Based on his master’s thesis on suicide, May was stationed first with the National Institute on Mental Health (NIMH), which sent him to conduct a study of adolescent suicide at Ft. Hall, Idaho, a Shoshone-Bannock reservation community. From there he was transferred to the Indian Health Service and stationed for three years with the Community Mental Health Program at Pine Ridge, South Dakota, on the Oglala Lakota Reservation. The hands-on education that he received in the Public Health Service and the broad array of services that he had to perform fixed his ideas about a career path, giving him invaluable experience with community health programs, public health theory, and concepts. “It launched me as an aspiring professional and as an adult,” May says.

Through an NIMH National Research Service Award Fellowship, May attended The University of Montana where he earned his PhD defending his dissertation on Alcohol Legalization and Native Americans. After a couple of years as Director of Health Statistics and Research at the Navajo Health Authority in Window Rock, Arizona, he was offered a position of assistant professor of Sociology at the University of New Mexico in Albuquerque, where he remained for the next 33 years. “I had an excellent career at UNM and did a substantial amount of teaching my first 13 years, but the most enjoyable part of teaching was having NIMH training grants to teach applied scientific research principles and to mentor undergraduates,” May says.  

A year after arriving at UNM, May teamed up with colleague Jon Aase, then an associate professor of Pediatrics, for a three-year Indian Health Service-funded study of the prevalence of FAS among American Indian tribes of the Southwest. That collaboration lasted nearly 20 years as May and Aase traveled throughout western states holding referral clinics, researching, and training on FAS diagnosis and prevention. May gained detailed knowledge and appreciation of the clinical characteristics of FAS from Aase. “I came to recognize the need for understanding FAS characteristics and its etiology from a public health perspective,” says May.

And, from there, May’s career has been dedicated to studying the adverse effects of prenatal exposure to alcohol. He expanded his investigations to Native populations in the U.S. Northern Plains and to other communities in the United States, South Africa, and Italy. Supported by the NIAAA and National Institute on Minority Health and Health Disparities (NIMHD), and by Stellenbosch University School of Medicine and the University of Cape Town in South Africa, May began major epidemiology research in 1997 that continues today among the general populations of five communities in the Western Cape Province of South Africa.

During his decades as the principal investigator of more than a dozen major population-based FAS/FASD epidemiologic studies of children, May has applied an active case ascertainment methodology that he developed. That methodology has also been applied to research with communities in Canada and Poland and is being used in ongoing studies in Estern Europe and Sub-Saharan Africa.

In 2018, results of a research consortium study on which May is co-leader were published showing that FASD is more prevalent among school-aged children in the United States than previously thought. These findings underscore the need for more focus on screening, diagnosis, prevention, and treatment of FASD. 

May’s distinguished career has been crucial in understanding the factors that contribute to risk for FASD and related outcome. He has helped identify and evaluate education, cognitive, and nutritional interventions to mitigate the developmental consequences of FASD in affected children and to aid in managing their daily lives. “I believe that prenatal alcohol use is the most important and tragic problem of alcohol and substance abuse in most countries throughout the world, and the problems and harms that are produced in the offspring need much more attention from many individuals, families and institutions,” he says. Fortunately, Phil May is on the job.

Posted: January 10, 2019