Public Health Classics

My favorite way to capture students’ attention about lead poisoning is to tell them about Dr. Herbert Needleman and his use of children’s baby teeth. In the late 1960's, Needleman recruited school teachers in Chelsea and Somerville, MA to collect their young students’ deciduous teeth when they fell out. It was a non-invasive way----no needlesticks, no bone biopsies---to get data on lead burden in children. Needleman’s team analyzed the teeth for lead which helped them establish a population distribution of tooth lead levels. (It did not exist up to that time.)  In 1972, he published the…
It’s probably my earliest public health memory — the image of Surgeon General C. Everett Koop and his grandfatherly beard on the television warning my elementary school self about the dangers of smoking. He was the first doctor I knew by name. But while Koop may be the surgeon general that people of my generation most likely associate with the public health movement to reduce smoking, he wasn’t the first to speak out against tobacco. Koop was carrying on a legacy that began decades before with the nation’s ninth surgeon general, Luther Terry, who on Jan. 11, 1964, released the first surgeon…
By Sara Gorman In the late 1940s and 1950s, it became increasingly evident that mortality rates were falling rapidly worldwide, including in the developing world. In a 1965 analysis, economics professor George J. Stolnitz surmised that survival in the “underdeveloped world” was on the rise in part due to a decline in “economic misery” in these regions. But in 1975, Samuel Preston published a paper that changed the course of thought on the relationship between mortality and economic development. In the Population Studies article “The changing relation between mortality and level of economic…
This post is part of our Public Health Classics series. Sara Gorman is a frequent contributor to that series, and her Classics post on the Whitehall studies addresses a topic similar to today's subject: the influence of socioeconomic status on health. By Sara Gorman How much of a patient’s social context should physicians take into account? Is an examination of social factors contributing to disease part of the physician’s job description, or is the practice of medicine more strictly confined to treatment rather than prevention? In what ways should the physician incorporate public health,…
By Sara Gorman In the 1960s, a rapid rise in nuclear technologies aroused unexpected panic in the public. Despite repeated affirmations from the scientific community that these technologies were indeed safe, the public feared both long-term dangers to the environment as well as immediate radioactive disasters. The disjunction between the scientific evidence about and public perception of these risks prompted scientists and social scientists to begin research on a crucial question: how do people formulate and respond to notions of risk? Early research on risk perception assumed that people…
By Rebecca Kreston “Pneumocystis Pneumonia --- Los Angeles,” in the June 5, 1981 edition of the CDC’s Morbidity and Mortality Weekly Report, was an economical seven paragraph clinical report cataloging five observed cases, accompanied by an explanatory editorial note on the rarity of this fungal disease. It seemed to be nothing out of the ordinary from MMWR, a publication that has been issuing the latest epidemiology news and data from around the world for 60 years. The report was included in that week’s slim 16 page report detailing dengue in American travelers visiting the Caribbean,…
By David Ozonoff Annual Reports from governmental bodies aren’t often significant, much less classic, public health documents. By design they are confined to summaries of an agency’s work over a year’s time and they often don’t even appear until two or more years later. Such was the case for the Annual Report of the Chief Inspector of Factories in Great Britain for the year 1947, which didn’t appear until 1949. Its author was the Chief Inspector himself, a pioneer in occupational health by the name of E. R. A. Merewether. Originally a general practitioner, Merewether found his way into public…
This post is part of The Pump Handle's Public Health Classics series. By Sara Gorman Does cigarette smoking cause cancer? Does eating specific foods or working in certain locations cause diseases? Although we have determined beyond doubt that cigarette smoking causes cancer, questions of disease causality still challenge us because it is never a simple matter to distinguish mere association between two factors from an actual causal relationship between them. In an address to the Royal Society of Medicine in 1965, Sir Austin Bradford Hill attempted to codify the criteria for determining…
I was eight years old on the first Earth Day, April 22, 1970.  "Give a hoot, don't pollute!" was the slogan for us kids.   When we'd see a newscast with factory stacks spewing thick gray smoke we'd say "yuck."  We'd hold our noses when tailpipes of junker cars belched exhaust.   In our minds, air pollution was a bad thing because of what we could see and smell.  We sure didn't think about it as something that was cutting short people's lives. One of the first prospective U.S. studies to demonstrate an association between air pollutants and premature mortality was published in the New England…
The pediatrician suspected that something wasn't quite right with the youngster.  He'd met the teen as part of his North Philadelphia community health center's psychiatry outreach program.  "He was a very nice kid...[but] he had trouble with words, with propositions and ideas," the pediatrician remembered.  It made him wonder, "how many of these kids who are coming to the clinic are in fact missed cases of lead poisoning?" That's the story recalled by Herbert Needleman, MD and shared in 2005 with historians David Rosner and Gerald Markowitz about the pediatrician's initial inquiries into the…
This post is part of The Pump Handle’s new “Public Health Classics” series exploring some of the classic studies and reports that have shaped the field of public health. Links to past posts in the series are available here. If you have a favorite Public Health Classic to recommend, let us know in the comments. And if you’re interested in contributing a post to the series, email us at thepumphandle@gmail.com (send us a link to the report or study along with a sentence or two about what you find most interesting or important about it). By Sara Gorman In the late 1970s and early 1980s, acute…
This post is part of The Pump Handle’s new “Public Health Classics” series exploring some of the classic studies and reports that have shaped the field of public health. Links to past posts in the series are available here. If you have a favorite Public Health Classic to recommend, let us know in the comments. And if you’re interested in contributing a post to the series, email us at thepumphandle@gmail.com (send us a link to the report or study along with a sentence or two about what you find most interesting or important about it). By Dick Clapp Between 1940 and 1971, a synthetic form of…
This post is part of The Pump Handle's new “Public Health Classics” series exploring some of the classic studies and reports that have shaped the field of public health. View the first post of the series here, and check back at the "Public Health Classics" category for more in the future. By Sara Gorman The current state of public health research is increasingly aware of the effects of various kinds of inequality on health. Especially in the U.S. and other developed countries, the burden of chronic, non-communicable diseases is especially high among low-income individuals. Public health…
The Pump Handle is launching a new "Public Health Classics" series exploring some of the classic studies and reports that have shaped the field of public health. If you have a favorite Public Health Classic to recommend, let us know in the comments. And if you're interested in contributing a post to the series, email us at thepumphandle@gmail.com (send us a link to the report or study along with a sentence or two about what you find most interesting or important about it). As we add more posts to the series, they'll all be available in the "Public Health Classics" category. A headline from…