This brief review of the early history of the Department of Epidemiology is taken largely from Jean Curran’s account of the founding of the Harvard School of Public Health. In opening his chapter on Epidemiology, Curran notes:
During the first fifty years of this century, the majority of the world’s epidemic diseases became subject to control by man. The general importance of epidemiology in these years may be judged by the fact that the three founders of the original [Harvard/M.I.T.] School for Health Officers, William T. Sedgwick, George C. Whipple and Milton J. Rosenau, could all in a major sense be termed epidemiologists. It is therefore curious that epidemiology as a discipline underwent an unusual amount of organizational subordination and combination.
One could also add that Henry Pickering Walcott, whose “name looms large in the history of Harvard University and of public health in Massachusetts at the beginning of this century, and whose relationship with the Rockefeller Foundation was crucial to the school’s endowment and founding,” taught epidemiology at the new school, though only for one year.
The Harvard School of Public Health was founded in 1922. Although in principle an independent institution, the school shared a dean with the Medical School until 1935. Epidemiology was subsumed in the Department of Preventive Medicine and Epidemiology, a joint department of the two schools, under the leadership of Milton Rosenau. Rosenau’s staff consisted of four persons, three of them part-time with substantial responsibilities in the State Antitoxin and Vaccine Laboratory and the State Wasserman Laboratory. The teaching focused on the investigation and control of outbreaks of infectious disease. Prior to his appointment in 1922, Rosenau had had extensive research experience with plague, yellow fever, malaria, hookworm and typhoid. He had also published in 1913 the first comprehensive text of public health in the United States, a text that was repeatedly revised and republished during his tenure. This, together with heavy teaching and administrative responsibilities, probably occupied most of his time. Lloyd Aycock published classical research on poliomyelitis from the department during this period, but the overall level of research activity seems to have been low. No doctoral thesis came from the department from the time of Rosenau’s appointment to the time of his retirement in 1935.
Following Rosenau’s retirement, a prolonged search led to the appointment of John E. Gordon as chair in 1937. Gordon, at the time of his appointment in Romania, had been studying scarlet fever epidemics under the auspices of the Rockefeller Foundation. During the year that it took to divest Gordon of his responsibilities in Romania, Frederick Russell, his chief at the Foundation, agreed to assume Gordon’s duties at Harvard. It was a task that he apparently found not disagreeable, since he resumed it when, within two years of taking up his duties in 1938, Gordon went off to war for six years–four as director of the Harvard Red Cross Field Hospital Unit in Salisbury, England and two with U.S. forces in the Pacific and then in Washington. During the six years of Russell’s regency, the Department was strengthened in personnel and in collaborative teaching organizations outside of Harvard; Aycock continued his poliomyelitis work, and eight doctoral theses were produced.
When Gordon returned to Harvard in 1946, it was to a Department of Epidemiology administratively located solely within the School of Public Health (although Gordon was quick to point out that his Corporation appointment was as Professor of Epidemiology and Preventive Medicine). A separate Department of Preventive Medicine had been created within the Medical School, under the leadership of David Rutstein, and the division of the assets of the previously single department. Descended to the level of single items of furniture, the one undivided plume that moved to the Department of Epidemiology was the endowed Cutter Lecture in Preventive Medicine, which Gordon took considerable pains to fill each year.
The years of Gordon’s tenure (1946-58) were quiet ones. Gordon personally taught the epidemiology course required for the M.P.H. and also ran a small seminar for 15 selected epidemiology concentrators, from whose term papers he chose one or two each year for expansion, editing and joint publication reviews in the American Journal of Medical Sciences, of which Gordon was the Editor for Preventive Medicine. This series emphasized Gordon’s recognition that the techniques of epidemiology could be applied to many things other than the infectious disease, including automobile injuries and population. Actual research in the Department itself was represented solely by Theodor Ingalls’ experimental studies on the effect of anoxia in pregnant mice on the production of congenital deformities. However, Gordon was an important early supporter of the Khana Project–a long-term, prospective, demographically-oriented study of reproductive patterns and outcomes in an area of the Punjab. The study was conducted primarily by John Wyon and Carl Taylor and had the department as its academic base for some years, but Wyon eventually moved to the Department of Population Sciences and Taylor became head of Population Sciences at John Hopkins.
The search for a successor to Gordon was a long one, but Gordon agreed to extend his service for two years beyond the usual retirement age until the appointment of Brian MacMahon in 1958. MacMahon served as chairman for 31 years. It was a period of generous federal support of research and research training, enabling a rapid expansion of the department, along with many other areas of the school. During the 31 years the faculty expanded to approximately its current size and developed major units dealing with the health effects of oral contraceptives, hormones and cancer, nutrition and cancer, retroviruses and cancer (particularly HTLV-1), occupational, radiation and other environmental hazards to health, the effects of pharmaceuticals and the philosophy and methodology of epidemiology broadly. Approximately 120 doctoral theses were produced during the period, many in the field of cancer but also in most of the areas listed above and in other areas such as cardiovascular disease.
Toward the end of Professor MacMahon’s tenure as Chair, the funding of the Department became highly concentrated in cancer research, for which MacMahon held a major comprehensive grant, which provided substantial funding for training research and infrastructure. The grant terminated a year before MacMahon’s retirement, throwing the department into a painful period of contraction and restructuring. The job of recreating the Department spiritually and intellectually fell to Dimitrios Trichopoulos in 1989. Under his leadership, the Department evolved into a multifaceted institution that drew heavily on collaborative work as well as a diversity of new internal initiatives. Under Professor Trichopoulos, the Department began an import series of collaborations with investigators now at the Karolinska Institute in Stockholm. In 1996, Trichopoulos stepped down as Chair, while remaining a professor in the Department, and Alexander M. Walker took over. Dr. Walker’s main focus was to maintain the diversity of the academic and research programs while rationalizing the internal administration of the Department. His administrative goals were to ensure equity in faculty contribution and compensation, to improve the documentation and standards for student progress within the Department, and to forge a sense of collective participation among the Department’s various and sometimes far-flung constituencies. In 2000, Meir J. Stampfer became Department Chair. Dr. Stampfer continued several of Dr. Walker’s initiatives and created a strong team atmosphere within the Department.
The current breadth of activities within the Department is directly attributable to these formal and informal links with other academic units that have developed over the past 10-15 years. While there has been no formal attempt to create a Department that works with the colleagues throughout the world, on an individual level each member of the faculty is free to pursue interests and develop links with a wide variety of public health scientists. The result is a Department that has wide-reaching breadth and influence, even though it appears to be somewhat decentralized.