Epidemiology at HSPH: Celebrating an ‘adventurous discipline’

Michelle Williams, chair of the Department of Epidemiology

November 14, 2013 — Epidemiologists at Harvard have a long legacy of groundbreaking findings, from a 19th century study on the effectiveness of bloodletting as a treatment for pneumonia to recent work on the role various dietary factors play in chronic disease risk. Harvard School of Public Health (HSPH) faculty, alumni, and students gathered to reflect on the past and future of epidemiology at Harvard during the Cutter Symposium, held on November 8, 2013, as part of the School’s Centennial celebration.

Alfredo Morabia, a historian and professor of epidemiology at Columbia University, kicked off the event with a lively historical overview of HSPH’s Department of Epidemiology—which he called a “methodological beacon” in an “adventurous discipline.” Morabia charged the packed audience in HSPH’s Snyder Auditorium with doing a better job of recording its history. In researching his speech, Morabia was surprised to find scant documentation in the archives at Countway Library—even for the 31-year tenure of Chair Brian MacMahon, who led the department until 1989. However, Morabia’s interviews with more than 20 faculty members, former chairs, and others connected to the Department yielded a wealth of information.

Morabia noted that the University’s first epidemiologist was James Jackson, a professor of clinical medicine at Harvard Medical School (HMS) in the early 19th century and the first physician at Massachusetts General Hospital. Employing epidemiologic methods that were rare at the time, according to Morabia, Jackson found evidence countering the common practice of bloodletting for the treatment of pneumonia.

Keynote speaker Alfredo Morabia
Keynote speaker Alfredo Morabia

The teaching of epidemiology at Harvard began with HSPH’s founding in 1913 as the Harvard-MIT School for Health Officers. The first course was taught by William Sedgwick, one of the School’s founders, and focused on typhoid fever. This interest in infectious diseases continued in the Department for the next several decades, Morabia said.

The Department’s early years also emphasized field work, Morabia said. A 1923 catalog noted a course that required students to conduct a sanitary survey of a city or town, and Chair John Everett Gordon once declared, “I am not an academic epidemiologist, I am a boot epidemiologist.”

The appointment of MacMahon in 1958 brought about a shift in the Department’s research focus that remains to this day, Morabia said. MacMahon brought with him a strong interest in chronic diseases, particularly cancer. Remembered as a giant in the field, MacMahon authored what is considered the first modern epidemiology textbook and nurtured numerous young researchers and students, among them [[Walter Willett]]. One of the most influential and highly cited nutritionists in the world, Willett is Fredrick John Stare Professor of Epidemiology and Nutrition and chair of HSPH’s Department of Nutrition.

Morabia gave much credit for the Department’s research accomplishments to MacMahon and its other chairs for creating the right conditions for success through their leadership.

Former Chair [[Dimitrios Trichopoulos]], Vincent L. Gregory Professor of Cancer Prevention, who has published more than 1,000 papers on topics including the origins of breast cancer and the link between passive smoking and lung cancer, modestly referred to himself as a low-key leader who fostered the Department’s collective effort. His proudest accomplishment as chair, he said, was that he “managed to promote everyone who was ready to be promoted.”

The symposium also included remarks from [[Nancy Mueller]], professor of epidemiology emerita, and panel discussions with senior faculty, junior faculty, and postdocs.

Named in honor of John Clarence Cutter, a physician and HMS graduate, the symposium followed in the tradition of  the Cutter Lecture on Preventive Medicine, an event held twice yearly at HSPH. Endowed by a bequest from Cutter, the lecture was first held in 1912 and counts among its speakers some of the world’s most distinguished public health scientists, researchers, and professionals, including the founders of modern epidemiology and Nobel Prize recipients.

The next Cutter Lecture will take place December 5, 2013, from 5:15-6:15 PM, in HSPH’s Snyder Auditorium. Speaker Bruce Psaty, a professor of medicine and epidemiology at the University of Washington, will give a talk entitled “NHLBI Cohorts in Times of Big Data and Financial Austerity: the Cardiovascular Health Study as a Model.”

Amy Roeder