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How HSPH has changed the world

historyCAMPUShuntingtonbldg.570x258Founded in 1913, Harvard School of Public Health grew out of the Harvard-MIT School for Health Officers, the nation’s first graduate training program in public health. During the past century, the School’s faculty members—frequently working in collaboration with others at Harvard and around the world—have made landmark contributions revolutionizing public health.

For more HSPH history, visit:
http://www.hsph.harvard.edu/centennial/

Below is a sampling of the School’s accomplishments:

Infectious Disease

  • Discovered a second human immunodeficiency virus, HIV-2, which causes most HIV infections in West Africa. Also demonstrated that HIV-2 is less virulent and less infectious than HIV-1, and that HIV-2 seems to offer some protection against HIV-1. Because the genetic structures of the viruses are similar, this work may provide clues to understanding the pathogenesis of HIV-1 and hasten vaccine development.
  • Determined that a retrovirus was the agent causing AIDS, that the HIV virus could be transmitted through blood and blood products given through blood transfusions, and identified which viral antigens were most useful for blood-bank screening.
  • Provided, through the Center for Biostatistics in AIDS Research, the services needed to guarantee the statistical integrity and quality of most government AIDS trials in the U.S. since 1995.
  • Provided the first evidence that HIV could be transmitted through heterosexual intercourse.
  • Identified a protein on the surface of HIV that provides the basis for accurate epidemiologic monitoring, a novel approach to drug development, and diagnostics. This protein is a likely target for a vaccine.
  • Discovered how to grow poliovirus in non-nerve tissue, a discovery for which Thomas Weller won a 1954 Nobel Prize and which paved the way for the development of polio vaccines in the mid-1950s.
  • Invented the iron lung, a device that saved thousands afflicted with polio until a vaccine was found.
  • Helped public health officials plan effective strategies for containing the SARS epidemic by devising a mathematical model to estimate the virus’s potential to spread.
  • Determined that deer ticks transmit the agent that causes Lyme disease, described the life cycle of this tick, and defined the role of deer and of mice in the transmission of this pathogen.

Chronic Disease

  • Demonstrated that not all fats are “bad fats,” but that different types have different effects—with trans fatty acids being harmful and plant oils being beneficial—revolutionizing how the U.S. government and health experts worldwide give nutritional advice. *
  • Showed that the large majority of coronary heart disease and diabetes cases can be prevented by avoidance of smoking, moderate physical activity, weight control, a diet emphasizing healthy fats, healthy carbohydrates, and generous intake of fruits and vegetables, and optional moderate alcohol intake. *
  • Released a report showing that more than half of U.S. cancer deaths result from modifiable lifestyle habits, including smoking, poor diet, obesity, and lack of exercise.
  • Determined that an aspirin a day protects men and women from colon adenomas (a precursor to colon cancer). *
  • Invented the direct-current cardiac defibrillator, which has saved thousands of people suffering from erratic heart rhythms or cardiac arrest.
  • Engineered transgenic mice resistant to atherosclerosis, providing insights on prevention and treatment of the disease.
  • Published a groundbreaking study highlighting the hazards of passive smoking, or “second-hand smoke.” The study linked this exposure to lung cancer.
  • Developed statistical methods that led to the identification of genetic variants that increase susceptibility to a wide variety of diseases. Identified the common genetic variant with the strongest influence on breast cancer risk, and several other susceptibility genes for breast and prostate cancer, and diabetes and other diseases.

Environmental and Social Determinants

  • Launched the “Designated Driver” campaign in the U.S. to curb alcohol-related traffic crashes, which contributed to a drop in fatalities by more than 25 percent.
  • Prompted revolutionary revisions to the U.S. Clean Air Act through the Six Cities Study, begun in 1974 in response to the U.S. energy crisis. The study found that air pollution-related cardiopulmonary problems were occurring at exposure levels below existing standards; the most dangerous components of air pollution were microscopic bits of solid matter (particulates) produced by fossil fuel combustion; indoor air pollution was sometimes significantly riskier than outdoor pollution; and that passive smoking has significant effects on the respiratory health of children.
  • Conducted seminal studies of patients with kidney and heart disease showing that even after coming to medical attention, minorities and the poor receive lower rates of surgery (when appropriate) and lower quality care than whites and those of higher socioeconomic status.
  • Identified the “demographic dividend” that occurs in developing countries as health improvements and falling infant mortality lead to a decline in fertility and a baby boom generation that dominates the age structure. If appropriate policies are in place, the surge in labor supply and savings produced by this baby boom generation as it matures can fuel a remarkable economic growth spurt—suggesting that “health makes wealth.”
  • Collaborated with the World Health Organization and the World Bank to release the landmark Global Burden of Disease report, which documents the world’s leading causes of death and disability and analyzes the impact of 107 major diseases and health hazards in nine different global regions.
  • Provided the biostatistical design for the first study showing a connection between DES, a drug used to prevent miscarriages, and vaginal cancers, miscarriages, and infertility in a mother’s female offspring. Male DES babies had significantly higher rates of structural abnormalities and fertility problems, while the mothers were 50 percent more likely to develop breast cancer.
  • Showed that alterations in surface tension in the smallest air sacs in the lungs were the fundamental cause of Respiratory Distress Syndrome in newborns. The discovery led to improved clinical care of babies with breathing problems, including replacing missing lung surfactant.
  • Diagnosed the causes of and helped establish controls against radium poisoning in the watch maker industry, mercury poisoning in the felt-hat industry, and carbon monoxide poisoning in garages, printing establishments, tunnels, and the mining industry.
  • Worked collaboratively with labor and management to improve worker safety in the rubber-tire, meat-packing, and automobile industries.
  • Studied the health impact of the presence of heavy metals, such as lead, arsenic, and manganese, in environments around the world and devised low-cost alternative methods for counteracting their effects.
  • Documented that life expectancy is worsening or stagnating for a large segment of the U.S. population.

Health Policy and Systems

  • Launched the “patient safety movement” with the Harvard Medical Practice Study, the first comprehensive measure of medical injuries and preventable medical errors in hospitals. The study provided critical data for the internationally renowned Institute of Medicine report, To Err is Human.
  • Led a WHO effort to design and institute a safe surgery checklist, which was shown to enable surgical teams to decrease errors and complications, save lives, and save hospitals money.
  • Identified new, lower cost, and more efficient ways to screen for and prevent cervical cancer in developing countries, where it is a leading cause of cancer deaths in women.
  • Created the Resource-Based Relative Value Scale (RBRVS) by calculating the time and intensity of effort required for every medical procedure, replacing the traditional charge-based fee-for-service payment by Medicare. By 1995, most public and private insurance programs in the U.S. had adopted the RBRVS model for paying physician services. By 2004, Australia, Canada, France, and private insurance plans in Britain adopted the RBRVS.
  • Began pioneering studies of the cost-effectiveness of medical interventions, launching the discipline now known as health decision science. Such studies, which introduced the concept of expressing cost in relation to quality-adjusted life-years saved, or QALYs, are used to guide health care policy throughout the world.

Additional Facts

  • Gro Harlem Brundtland, MPH ’65, and Prime Minister of Norway (1981, 1986-89, 1990-96), was Director-General of the World Health Organization from 1998–2003.
  •  In the 1920s, thanks to HSPH faculty member Alice Hamilton’s pioneering examination of worker poisoning in the lead industry, Illinois became the first state to adopt legislation safeguarding workers’ health. Hamilton was also Harvard’s first female professor.
  • Two HSPH-affiliated scientists have been awarded the Nobel Prize. In 1954 Thomas Weller received the Nobel Prize in Physiology and Medicine. Amartya Sen won the Nobel Prize for Economics in 1998. Another faculty member, Bernard Lown, co-founded the Nobel Prize-winning group International Physicians for Prevention of Nuclear War.
  • Since 1962, six directors of the Centers for Disease Control and Prevention have been Harvard School of Public Health graduates.

* Denotes research results from the Nurses’ Health Study I and II, the Health Professionals Follow-up Health Study, and/or the Physicians’ Health Study I and II which are conducted by researchers in the Division of Preventive Medicine and the Channing Laboratory at Brigham and Women’s Hospital, together with researchers in the Departments of Epidemiology and Nutrition at HSPH. The Nurses’ Health Study is the largest and longest-running women’s health study in the world.