Harvard Public Health Review Winter 2007
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Teacher in the Art of Listening

Kenneth Olden
At NIH, Kenneth Olden engaged ordinary citizens in the battle for a safer environment. Fresh from the Yerby Visiting Professorship at HSPH, he plans to tap Americans for feedback on his health reform plan.

Early in his 14-year tenure as director of the National Institute of Environmental Health Sciences (NIEHS), Kenneth Olden met with a dozen couples in Iowa who farmed the land. Over coffee, tea, and cookies, he asked their opinions on proposed research to study the impact of agricultural chemicals on farmers’ health.

At the end of the conversation, one woman, about 65, said, “ ‘You’re the highest ranking government official who has ever asked our opinion. When I see Senator [Tom] Harkin, I’m going to tell him about you,’ ” recalled Olden, who in June wrapped up a year as the first Yerby Visiting Professor at the Harvard School of Public Health (HSPH). “Harkin was chair of the appropriations committee that the National Institutes of Health goes to for their budget, and she did tell him about my visit. But I didn’t go to Iowa for that reason. I went to get public opinion.”

Olden has been gathering opinions ever since. Until two years ago, when he stepped down from his post at NIH, where he was the first African-American director of any of its institutes, Olden crisscrossed the country like a political candidate. To involve communities in issues ranging from airborne particulates to industrial toxins, he solicited people’s ideas and participation in research. Aided by everyday Americans, NIEHS and its funded scientists set new research priorities and used study results to change law and policy.

At the same time, Olden cultivated ties with Congress, federal agencies, and academic scientists. Soon he expanded the mission and scope of NIEHS far beyond studies of how single toxic agents damaged cells to include large-scale human studies of lead poisoning in children and chronic diseases, such as breast cancer. Among the first to recognize the interplay of environmental factors and genes, Olden championed the Environmental Health Genome Project. And thanks to his leadership, minority and other socioeconomically disadvantaged communities gained protection against environmentally linked health problems, from which they suffer disproportionately. What’s more, his efforts prompted other NIH leaders to emphasize public health and community-driven research.

Olden brought his political savvy, people skills, and scholarship to HSPH in September 2006. His by-invitation-only post, reserved for minority scholars, is named for the late Alonzo Yerby, an African-American HSPH graduate and professor who explored poverty’s corrosive impact on health. Appointees are expected to be highly visible among minority students and fellows, with the goal of attracting more of them to the halls of academe.

Mentoring, not Cloning
“There’s a difference between mentoring and cloning,” notes Olden, who himself spent four-and-a-half years as a postdoctoral fellow and instructor at Harvard Medical School (HMS) in the early 1970s. “Cloning is teaching people to follow the track you followed,” he says. “Mentoring is different. It’s figuring out what the person wants to do and helping them achieve it.”

Olden speaks from a lifetime of learning from others’ experience, then surpassing society’s expectations. Born in 1938, Olden grew up on a farm on the eastern Tennessee border of Cocke County, a place former U.S. Vice President Al Gore once told him was the most impoverished county in the state.

“A lot of people couldn’t read and write,” remembers Olden, the first college graduate in his family. “But my dad used to say, ‘Listen to them when they speak. They have a lot of wisdom, and you can benefit.’ ” His high school principal told him, “ ‘By golly’—that’s the way people talked—‘you can be anything you want to be.’ ” Olden decided on medical school, starting at Knoxville College and working long hours at part-time jobs to support his studies at the historically black school.

In 1959, he and a female student were selected as the first two African Americans to integrate the University of Tennessee undergraduate campus, in response to a U.S. Supreme Court decision handed down five years earlier. Fortified by his success in that experiment, Olden switched his sights to basic science. “I knew a lot of black physicians,” he says, “but I didn’t know a single black researcher.”

With a doctorate in cell biology/biochemistry from Temple University and postdoctoral fellowships at HMS, Olden’s career included stints at Harvard, the National Cancer Institute, and the Howard University Cancer Center. After overhauling the Center’s research programs, he rose to the roles of director and chair of oncology.

When the top NIEHS position opened, two unsuccessful bids for lower NIH jobs discouraged Olden from applying. But as two longtime NIH mentors predicted, this time would be different. In 1991, Director of NIH Bernadine Healy recommended Olden to head NIEHS and the multi-agency National Toxicology Program (NTP).

Consensus Builder
Unique among NIH directors, Olden has won public health’s triple crown: the Sedgwick Medal and the Calver Award, from the American Public Health Association; and the Julius B. Richmond Award, from HSPH. Still, he remains best known for building consensus among the lay public, academia, industry, and government agencies. Noting that the poor, including minorities, were most likely to suffer from environmental insults, Olden called the nation’s attention to glaring health disparities. Undaunted by controversy, his agency proved to skeptics the carcinogenicity of dioxin and second-hand smoke, and the safety of saccharin (NTP scientists found that the molecular mechanism by which this popular sugar substitute caused cancer in mice was not relevant to humans).

At first, Olden’s mandate to invite affected local citizens into research project planning “was an unwelcome message,” remembers Joseph Brain, the Cecil K. and Philip Drinker Professor of Environmental Physiology at HSPH and principal investigator for the oldest continuously funded grant from NIEHS. “He gave centers extra money to involve communities in the planning, design, and execution of research,” Brain says. “Community-based research became an essential part of our strategy.” It paid off for the HSPH project. “When we got to thinking about the contribution to health problems of indoor pollution—house mites and cockroaches and shag rugs—we already had the connections we needed to design the studies, given our work with people from town meetings, and with teachers in K-12 education.”

Olden also is credited with convincing policy makers that the environment was at least as powerful a force in human health as behavior and genes. “At the time, bad genes were erroneously thought to cause all of human disease,” he explains. And it was Olden who expanded the focus of environmental science to the cumulative effects of lifestyle, social, and economic factors, as well as “the built environment”—homes, schools, and workplaces, says Thomas Goehl, former editor-in-chief of Environmental Health Perspectives, the widely read NIEHS journal. In an issue that paid tribute to the Olden years, one essayist cited the public-interest-liaison group of researchers, industry representatives, and activists Olden launched to identify and solve problems. One day, Olden hoped, tort law and giant lawsuits would no longer be activists’ only means of battling environmental health threats.

Health Care for All
Even given all that he’s accomplished so far, Olden concluded during his Yerby year that working for equal access to health care for all would yield even greater benefits for public health. In the coming months, Olden will spread his message of health reform across the country. In lectures and town meetings, he aims to generate a groundswell of buzz and activity, just as he did at NIEHS.

“If it is sold right, I see health care as being no different from our other publicly subsidized services, such as fire, police, and schools,” he said before heading back to his base at NIEHS. According to his vision, cost control is imperative. Everyone would receive a basic foundation of high quality, evidence-based care and preventive services. Those with more money to spend or more comprehensive employer-sponsored insurance would be free to purchase additional services, just as they can now choose to send their children to private schools or install private security systems if they wish.

During one of his last lunches with minority scholars at HSPH, a young Asian-American woman asked Olden what personal sacrifices he saw as necessary for his achievement. “I’ve made a conscious effort to become a well-rounded person,” countered Olden, who urges young scientists to develop other interests, along with social skills. “When you’re an outsider, you have to learn how to get inside,” he advises. “What are the best institutes? Who are the best scientists? Talk to them.” And let people have their say.

Carol Cruzan Morton is a freelance journalist specializing in science, medicine, and public health.

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