Scientific Pioneers, Inspirational Teachers
Call them pioneers for delving into unexplored research areas. Call them conventional-wisdom busters for proving that common health risks can be limited or eliminated. Or call them mentors who challenge students and guide them to be the future leaders in public health. This year, call them winners of the Harvard School of Public Health Alumni Award of Merit, presented annually to alumni who make exceptional contributions to public health. Meet the four 2009 winners honored at a special dinner in June.
Graham Colditz, MPH ’82, Dr.PH ’86
Niess-Gain Professor of Surgery
Associate Director of Prevention and Control,
Alvin J. Siteman Cancer Center
Washington University, St. Louis
To Graham Colditz, preventing most cancers is simple: quit smoking, eat a healthy diet, and lose those extra pounds. The American population, however, finds it difficult to get beyond the relentless marketing by tobacco companies, sugary beverage makers, and manufacturers of processed food. “The consumer focus of our culture leads us down the path of unhealthy lifestyle without any countermanding force saying we need to be more physically active and eat healthier foods,” he says.
So he has developed tools that people can use to assess their risks for disease and set themselves on a healthy path. While at HSPH, he and his colleagues designed what became a website called “Your Disease Risk” (now at www.yourdiseaserisk.wustl.edu/).
“The prevailing view was that nothing could be done to avoid cancer,” he says, “yet scientific evidence by the mid-1990s revealed that 50 percent of cancer could be avoided if we acted on what we knew.
“We spent several years developing tools that might be readily accessible to the general public. We launched the project with cancer in 2000 and suddenly realized that the prevention messages of not smoking, being physically active, eating a healthy diet, and avoiding weight gain were going to prevent diabetes, stroke, heart disease, and in large part, osteoporosis,” he explains. “We went back and put together the materials supporting the other diseases and broadened the range of diseases as a way to engage a broader sector of society.”
Colditz is now developing a shorter, second-generation website (“Your Health Snapshot”) that patients can access in doctors’ waiting rooms—with the idea that, during the appointment, physicians could immediately reinforce the online prevention messages.
Hastings Professor of Environmental Health
Director, Division of Environmental Health in the Department of Preventive Medicine
Keck School of Medicine
University of Southern California, Los Angeles
John Peters has a habit of upending conventional wisdom. His doctoral thesis on college students who smoked pointed out subtle damage that showed up in just a few years rather than decades. His study of Boston firefighters, who did not wear facemasks at the time, provided the evidence behind development of new safety equipment for Boston and elsewhere. His studies of the Vermont granite industry proved that “allowable” exposure levels to respiratory silica still posed risks for chronic lung disease.
Before the Army drafted him, John Peters had set out to be a surgeon. Sent to care for military workers in the North and South poles and other remote locales, he immediately recognized that workplaces themselves could pose health risks, and found himself delving into what would become occupational and environmental health research.
In studies documenting risks to workers in the rubber industry, including the first epidemiological evidence associating vinyl chloride exposure to a rare liver cancer, Peters is most proud of having helped develop at HSPH a new type of research collaboration. “The opportunity to work in the first agreement between a company, a union, and a university was unique and gratifying—a new and better way of doing things,” he says.
That approach exemplified his work at HSPH. “Team efforts have gone into everything I’ve done,” he says. “I don’t take credit for anything other than trying to get smart people together to work on problems.”
In 1991, he launched the Children’s Health Study, which evaluates the chronic health effects of air pollution on elementary school children in and around Los Angeles. “It used to be that air pollution was thought to exacerbate but not cause asthma,” he says. “Our study turned up some good evidence that it causes it. That changed conventional wisdom.”
Vincent L. Gregory Professor of Cancer Prevention and Professor of Epidemiology
Past Chair, Department of Epidemiology
Harvard School of Public Health
Dimitrios Trichopoulos has continually staked out scientific frontiers—from seminal research linking hepatitis B virus and tobacco smoking to liver cancer, to documenting that surgically induced and early natural menopause reduce breast cancer risk, to writing one of the two original papers associating secondhand smoke from cigarettes with an increased risk of lung cancer. And he’s not finished. His current work points to intrauterine and perinatal factors that affect risk of breast cancer in adulthood.
Some significant “firsts” highlight the career of Dimitrios Trichopoulos. He was first, with a 1990 paper inThe Lancet, to propose that in utero exposures play a major role in breast cancer causation. He also was first in 1981, along with an independent paper published a few days later, to report that secondhand smoke increases the risk of lung cancer. In 1997, the editor of The Lancet included a paper Trichopoulos and colleagues had written in a list of 27 papers deserving to form a core canon of medical literature that every health professional should read. The paper linked psychological stress after a 1981 earthquake in Athens to risk of cardiac death.
Chalk it up to a pioneering spirit, which has prompted Trichopoulos to continually explore new scientific questions. “When you are relatively successful in one area of research, you can move to a different area,” he explains. “For liver cancer, in theory, we have the resources to prevent two-thirds of it. For lung cancer, when you consider active and passive smoke, we have the resources and knowledge to prevent more than two-thirds of it. For breast cancer, we have not been equally successful, and it is intriguing to keep working in areas where there has not been much success and the potential to contribute is greater.”
Though he is proud to have published extensively in the scientific literature, he gets enormous satisfaction from mentoring younger colleagues to become leaders in public health. “The most gratifying feeling of all,” he says, “is to see students you have mentored become major stars in their own right.”
Professor, Emerita, Maternal and Child Health
Past Chair, Department of Maternal and Child Health
Harvard School of Public Health
Isabelle Valadian always made herself available as a teacher and mentor to her students throughout her career at HSPH. As a result, her legacy is present throughout the world as international students have returned home to become public health leaders themselves. Her career-long research with the Longitudinal Study of Child Health and Development helped to establish that obesity and blood-pressure patterns persist from youth to adulthood and that adolescents have “growth spurts” at various ages; the finding helped refine the idea of chronological age, with the coining of the term “age of maturation.”
When Isabelle Valadian’s grade-school teacher asked her to write an essay on what she wanted to do when she grew up, she described “a fantastic trip around the world.” The teacher gave it a poor grade, asserting that it was “a dream, not a future.” During her 50-year association with HSPH, Valadian—who speaks six languages—mentored countless international students, many of whom invited her to visit after graduation. Although she hasn’t circled the globe in one fell swoop, she has crossed the Mediterranean Sea seven times, been to Taiwan three times, visited China and Greece twice, and popped in on a number of other student stomping grounds.
After growing up and attending schools in Iran (then known as Persia), Lebanon, and France, Valadian was already a world citizen when she arrived in Boston in 1949. “I believed from the very beginning that a school should put emphasis on teaching,” Valadian explains. “Research can support what you are teaching, but students should come first.”
She knew she would work in public health when she was in medical school at the French University in Beirut. “Every fall, there was an epidemic of typhoid fever. One year, some of the students and I went into the fields when the vegetables were ripening. They took vegetables from the ground and started eating them. I said, ‘You cannot do that. Don’t you know there’s an epidemic?’ They laughed at me, but two of them fell ill and one died. That was my first attempt at prevention. And so prevention became my goal from then on.”
“Dr. Valadian helped to create the conditions for people like me to thrive at the Harvard School of Public Health,” says Magda Peck, MPH ’83, ScD ’86, professor of pediatrics and public health at the University of Nebraska Medical Center and founding CEO of CityMatCH, a national organization of city and county maternal and child health leaders. “She promoted research but also understood that people in the field needed to know how to translate that research into action to get lasting results. She made it possible for us to do what we needed to do.”
Larry Hand is associate editor of the Review.