Coming in February 2010: “Dissolving Boundaries: Extending the Reach of Medicine and Public Health”

By , August 16, 2010

Richard Pearson Strong (third from right) and colleagues on The Harvard African Expedition of 1934. From the Harvard Medical Library in the Francis A. Countway Library of Medicine.

Upcoming exhibit: “Dissolving Boundaries: Extending the Reach of Medicine and Public Health”

The several decades following the end of World War II have been described as a barren era for public health in America, as traditional public health emphases such as acute infectious disease receded, and the nation turned to research-based biomedicine and biotechnology to solve its medical concerns. Yet this era witnessed a striking – and still under-examined – era in public health, as physicians and public health leaders began to grapple with such central issues as the organization and delivery of medical care, maternal and child health, poverty, end of life care, smoking and alcoholism, obesity, and, increasingly, social justice and the assurance of health as a basic human right worldwide.

Today, such fields continue to change, confronting issues of ever-greater magnitude, and framed by debates concerning the boundary between organized medicine and public health, national versus global health concerns, and personal versus societal responsibility. Successful efforts to engage such issues are critically dependent upon a historical understanding of their evolution.

Dissolving Boundaries will draw from the collections of key leaders in American public health from the latter half of the twentieth century:

  • Leona Baumgartner, the first woman commissioner of the New York City Department of Health, was later a national advocate and advisor to the federal government on the expansion of public health efforts in maternal and child health, preventive medicine, and international aid. Throughout her career in public health administration, Baumgartner was dedicated to education as a cornerstone of building a healthier community. After becoming district health officer in 1939, she coordinated a growing number of health services, such as school health programs, parenting classes, and clinics on venereal disease. Maternal and child health was an important focus throughout her years in public service and informed her decision to promote family planning practices and birth control. She is credited with convincing President Lyndon Johnson to reverse a government policy denying funding for international programs providing birth control to make contraception more widely available. She was also an early advocate of using the Salk vaccine to immunize against polio and was an integral supporter of fluoridating New York City’s water supply. As Health Commissioner, Baumgartner continued in the vein of Dr. S. Josephine Baker, who began a tradition of home health visits, by giving weekly radio and television addresses that tackled topics such as home safety and sanitation practices. The recipient of numerous honors, Baumgartner was awarded the Sedgwick Medal, the Albert Lasker Award, the Elizabeth Blackwell Award, the Samuel J. Crumbine Award, and the Public Welfare Award from the National Academy of Sciences in recognition of her many contributions to the field of public health.

  • Allan Macy Butler, Chief of the Children’s Medical Service at Massachusetts General Hospital, engendered and exemplified emerging physician concerns with human rights, nuclear disarmament, and the organization of medical care. Butler’s professional appointments often fell in line with his political activities. Throughout his career, he actively contributed to professional publications, both as an editor and writer. In 1937, as the Associate Editor of the New England Journal of Medicine, Butler wrote a series of articles making recommendations on improving health care delivery in the United States, which were met with resistance. The American Medical Association opposed any changes to the current system, saying that Butler’s proposal was a step toward socialized medicine. In 1940, he was forced to resign. Butler was a dedicated opponent of the Vietnam War and a supporter of abortion rights, nuclear disarmament, and nonviolent resistance, and, as a result, was put on trial for participating in Un-American activities under the Subversive Activities Control Act of 1950. However, Butler contributed greatly to advancements in pediatric medicine through his research in fluid and electrolyte metabolism (derived from life-raft studies conducted during World War II), metabolic disorders, and treatments for diarrhea and dehydration. He received the American Pediatric Society’s highest award, the John Howland Medal, in 1969.

  • Howard Hiatt, the Dean of the Harvard School of Public Health from 1972-1984, has catalyzed a wide range of initiatives concerning health care delivery, from those regarding the relationship of hospitals to their communities, to those regarding social justice and the ensuring of optimal care in the developing world. During his tenure as Dean, the Harvard School of Public Health introduced teaching and research focused on molecular and cell biology, initiated programs in health policy and management, and biostatistics. Dr. Hiatt also integrated Harvard School of Public Health’s teaching and research programs with those in other Harvard University Faculties, in an attempt to encourage cross-disciplinary research to bring together medicine and social science in the curriculum. Hiatt’s work made the Harvard School of Public Health a leader in the biological and decision sciences, health policy and management, and and introduced molecular and cell biology into its research and teaching.  In 1983, he was instrumental in starting the Takemi Program in International Health, which aims to advance knowledge about international health and to contribute to institutional development and improvement of national policy.

  • Alexander Langmuir, Professor of Epidemiology at Harvard and chief epidemiologist for the Public Health Service of the National Communicable Disease Center (later the Centers for Disease Control), was recognized internationally as a leading contributor in epidemiology and for founding the Epidemic Intelligence Service. Langmuir is widely known for his work on developing surveillance techniques for monitoring and controlling disease, resulting in the creation of the Epidemiological Intelligence Service in 1951. In 1952, he convened the first Conference of State and Territorial Epidemiologists. His work defined disease surveillance, establishing a model that was accepted globally, and in 1961, he implemented the Morbidity and Mortality Weekly Report of the CDC to disseminate public health data and research results. Langmuir wrote extensively on all phases of epidemiology on a global basis and was recognized internationally as a leading contributor in epidemiology. He contributed to the radiation studies that followed the bombings at Hiroshima and Nagasaki and the global smallpox eradication program. In later years, he criticized the CDC’s tracking of the spread of AIDS. During his lifetime, he received awards from the Charles A. Dana Foundation for pioneering achievements in public health, the American Public Health Association, and the Royal Society of Medicine in England.

  • David Rutstein, who headed the Harvard Medical School Department of Preventive Medicine, played a national role in the organization of medical care, the integration of preventive medicine into the care of individual patients, and the measurement of medical outcomes. In the 1960s Rutstein directed a study on forming health maintenance programs, lobbied for a change in state laws regarding birth control for the poor, and advocated the use of nurse midwives for delivery. Some of his latest studies were on the genetic basis of alcoholism and on standards of health care. In 1955, Rutstein began a 40-episode television series on WGBH-TV called “Facts of Medicine”. “‘Through these carefully planned programs,’ President [Nathan Marsh] Pusey announced, ‘we hope to make it possible for the individual to understand the nature of recent medical developments and to help him reach wise decisions, in consultation with his own physician, on matters affecting his own health and that of his family and his community.’ This was one of the first uses of television to inform the public about local and national health concerns and current research.

  • James Whittenberger was a pioneer in the field of environmental health, studying the physiology of respiration and the effects of air contamination on respiratory function. In 1958 he founded and directed the Kresge Center for Environmental Health at HSPH, now called the Harvard NIEHS Center for Environmental Health after the National Institute of Environmental Health Sciences at the NIH. Whittenberger came to HSPH in 1946 and worked with Cecil Drinker, former dean of the School, and Philip Drinker, co-developer of the iron lung. In 1951, Whittenberger became a professor of physiology and, seven years later, was named the James Stevens Simmons professor of public health. His work led to the publication of the influential reports “Man’s Health and the Environment: Some Research Needs” and “Human Health and the Environment: Some Research Needs,” intended to guide national planning efforts in environmental health research.

The exhibit will be open to public view from February 21, 2010 to June 20, 2010.

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