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Lester Breslow

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Lester Breslow
Born(1915-03-17)March 17, 1915
Bismarck, North Dakota, US
DiedApril 9, 2012(2012-04-09) (aged 97)
Los Angeles, California, US
Alma materUniversity of Minnesota,
ChildrenNorman E. Breslow
Scientific career
FieldsPublic health
InstitutionsCalifornia State Department of Public Health.

Lester Breslow (March 17, 1915 in Bismarck, North Dakota, USA – April 9, 2012 in Los Angeles, California, USA)[1][2][3][4][5] was an American physician who promoted public health. Breslow's career had a significant impact.[6] He is credited with pioneering chronic disease prevention and health behavior intervention.[7] His work with the Human Population Laboratory in the Alameda County Study established the connection between mortality and lifestyle issues like exercise, diet, sleep, smoking, and alcohol.[8] He has been called "Mr. Public Health".[9]

Among other positions, Breslow served as president of the American Public Health Association,[7] the Association of Schools of Public Health[7] and the International Epidemiological Association.[10] Breslow served as founding editor of the Annual Review of Public Health from 1980–1990.[11]

Education

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Breslow received a B.A. in psychology from the University of Minnesota in 1935, followed by his M.D. in 1938 and M.P.H. in 1941.[12][13]

While studying to be a psychiatrist in medical school, he worked for a summer in the Fergus Falls Minnesota State Hospital for the Insane. This experience left him discouraged since there was little they could do to treat patients at that time except to keep them out of harm's way. After Breslow returned to medical school for his senior year, he shared his feelings with a friend and faculty member who introduced him to Gaylord Anderson, a new professor of public health. Anderson interested Breslow in a career in epidemiology.[12]

Career

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Breslow worked from 1941 to 1943 as a public health officer for the Minnesota Department of Health.[14] During World War II Breslow served in the United States Army as a public health officer on a ship sent to the Pacific.[15][16]

California Department of Public Health

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After the war, Breslow took a position with the California State Department of Public Health.[12] In 1946 he became the Founding Chief of the Bureau of Chronic Disease Control of the California State Department of Public Health[17] where he introduced innovative programs in the surveillance, prevention, and control of chronic disease that became national models.[16] These included the establishment of the California Tumor Registry in 1947. A voluntary initiative targeting hospitals, the registry is credited with educating doctors, increasing their skills, and improving patient care.[18][19]

In the 1940s and ’50s, Breslow did definitive studies on smoking's harm to human health.[2] President Harry Truman appointed Breslow as Director of the President's Commission on the Health Needs of the Nation, which reported in 1952.[15][7] Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service, published in 1964, drew upon Breslow's research on the links between smoking cigarettes and lung diseases such as cancer.[2]

From 1960-1965, Breslow served as Chief of Preventive Medicine Services of the California State Department of Public Health. From 1965-1968, he was the Director of the California State Department of Public Health.[12][7] Ronald Reagan, then Governor of California, chose to replace Breslow, a Democrat, due to “philosophical differences” over cuts in medical care for the poor.[2][20]

Breslow spoke of himself as “a political activist for disadvantaged people.”[2] He served as president of the International Epidemiological Association from 1964-1968.[10]

University of California, Los Angeles

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In 1968, Breslow became Professor of Public Health at the University of California, Los Angeles.[21] As of 1970, he became Dean of the Jonathan and Karin Fielding School of Public Health, UCLA.[1][7]

Also during this time, Breslow served as President of the American Public Health Association from 1968-1969.[7] In 1969, he was elected founding co-president of NARAL Pro-Choice America with Congresswoman Shirley Chisholm.[22] From 1973-1975, he served as President of the Association of Schools of Public Health.[7]

As of 1980, Breslow became professor emeritus at UCLA, continuing to do research and write.[1] Breslow was the founding editor of the Annual Review of Public Health from 1980–1990.[11] He was elected as a fellow of the American Association for the Advancement of Science in 1982, and held that honor at the same time as his son, Norman E. Breslow, who was elected in 1984.[23][24]

Breslow became chair of the Ad-Hoc Tobacco Prevention Interim Advisory Committee in 1989, and was the vice-chair of the Tobacco Education Oversight Committee for California, 1990–1996.[25][26][27] In 1993, he published "California's Proposition 99 on Tobacco, and its Impact".[28] Breslow was appointed to lead the Los Angeles County Public Health Commission in 1997, tasked with reviewing "across-the-board operations of public health".[29]

Breslow was the editor-in-chief of the four-volume Encyclopedia of Public Health (2002).[1] He also published a memoir, A life in public health (2005).[30]

Research

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Breslow's work over more than half of a century made a very large impact on the world of public health.[6] He is credited with pioneering chronic disease prevention and health behavior intervention.[7] Among the techniques he employed were multiphasic screening and morbidity surveys. He explored both the etiology of chronic illness and the ecological conditions in which disease occurs.[17][31]

One of his most famous works is with the Human Population Laboratory in Alameda County where he identified a correlation between various lifestyle issues and mortality.[7] Between 1965 and 1985, Breslow tracked approximately 7,000 adults in a longitudinal study that examined the relationship between mortality rates, health status, social networks, and potentially relevant personal characteristics and behaviors.[16]

Breslow identified seven habits characteristic of healthy people, since referred to as the "Alameda 7": 1) Having never smoked 2) Drinking moderately or not at all (defined as drinking no more than five drinks at one sitting) 3) Sleeping 7–8 hours a night 4) Exercising 5) Maintaining an appropriate body weight for one's height 6) Avoiding snacks 7) Eating breakfast regularly.[32][33] Breslow's data showed that a 45-year-old with six or more of these healthy habits could expect a lifespan of 11 years more than someone who had three or less of the healthy habits.[16] Breslow and others have developed health risk appraisal scales to assess overall health status (adjusted for age) based on behavioral information.[34]

The Alameda study helped to bring about a broader view of health and disease. It established that a person's health did not depend solely on exposure to disease (a one disease-one cause model) but also to their general susceptibility to disease.[35] The results are in alignment with the World Health Organization's efforts to redefine health as a state of “physical, mental and social well-being.”[36]

The Alameda County Study was also the first to look at the impact of social networks on mortality. Degree of social connectedness was found to be a major predictor of mortality risk, as those with more connections to family, friends, and community were likely to live longer.[37]

The Ten Essential Public Health Services, 2020
Ecologic Model of Health, 2020

Breslow and others identify two eras in public health, the first focused on communicable diseases and the second on chronic diseases as the leading cause of death. Breslow suggests that a third era would focus on health as opposed to illness, and emphasize the means of promoting well-being and leading satisfying lives.[36] Breslow believed that health should be regarded as a resource for everyday life, as opposed to just a way to prevent disease.[38][31]

In 2010, he co-authored a paper proposing ways to reorganize the public health system in the United States to more effectively support public health. He and his co-authors identified ten essential public health services which should be seen as part of an "Ecologic Model of Health" in which people are considered in the broad context of their social and physical environments, and interventions are targeted at policies with broad health impacts. Public health is equated with community health.[39][31]

Breslow was considered an exemplary doctor as well as a genuinely good person.[7] In an obituary written by one of his former protégées it says, "I was one of Lester's preventative medicine residents 15 years ago…Having had an opportunity to observe him engage with 'paupers' and 'kings,' I can attest to his treatment of all with respect and appreciation for their humanity, abilities, and contributions. I can also attest to his refusal to accept anything less than the best, from others (like me!) and particularly, from himself."[7]

Awards

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Selected works

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  • Fielding, Jonathan E.; Teutsch, Steven; Breslow, Lester (2010). "A Framework for Public Health in the United States". Public Health Reviews. 32 (1): 174–189. doi:10.1007/BF03391597. ISSN 2107-6952. S2CID 74015352.
  • Breslow, Lester, ed. (2002). Encyclopedia of Public Health. New York: Macmillan Reference USA/Gale Group Thomson Learning. ISBN 0-02-865354-8.
  • Breslow, Lester (2005). A life in public health: an insider's retrospective. New York, NY: Springer Pub. Co. ISBN 978-0826127143.
  • Breslow, Lester (1999). "From Disease Prevention to Health Promotion". The Journal of the American Medical Association. 281 (11): 1030–3. doi:10.1001/jama.281.11.1030. PMID 10086439.
  • Breslow, L; Johnson, M (1 May 1993). "California's Proposition 99 on Tobacco, and its Impact". Annual Review of Public Health. 14 (1): 585–604. doi:10.1146/annurev.pu.14.050193.003101. ISSN 0163-7525. PMID 8323603.
  • Berkman, Lisa F.; Breslow, Lester (1983). Health and ways of living: the Alameda County study. New York: Oxford University Press. ISBN 978-0195032161.
  • Breslow, Lester; Enstrom, James E. (1 July 1980). "Persistence of health habits and their relationship to mortality". Preventive Medicine. 9 (4): 469–483. doi:10.1016/0091-7435(80)90042-0. ISSN 0091-7435. PMID 7403016.

Archives

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References

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  1. ^ a b c d Richmond, C. (2012). "Lester Breslow". The Lancet. 380 (9838): 212. doi:10.1016/S0140-6736(12)61206-9. S2CID 45278845.
  2. ^ a b c d e Martin, Douglas (14 April 2012). "Lester Breslow, Who Tied Good Habits to Longevity, Dies at 97 - NYTimes.com". The New York Times. New York. ISSN 0362-4331. Retrieved 21 May 2013.
  3. ^ Cloke, Susan (29 April 2012). "Hometown Hero: Dr. Lester Breslow (1915-2012) | Santa Monica Mirror". smmirror.com. Retrieved 21 May 2013.
  4. ^ Maugh II, Thomas H. (12 April 2012). "Dr. Lester Breslow dies at 97; 'Mr. Public Health' - Los Angeles Times". Los Angeles Times. Retrieved 21 May 2013.
  5. ^ Anderson, Sarah (11 April 2012). "Obituary: Dr. Lester Breslow, 97, former UCLA dean, public health visionary / UCLA Newsroom". newsroom.ucla.edu. Retrieved 21 May 2013.
  6. ^ a b Stallworth, JoAna; Jeffery Lennon (November 2003). "An Interview with Dr. Lester Breslow". American Journal of Public Health. 93 (11): 1803–1805. doi:10.2105/ajph.93.11.1803. PMC 1448054. PMID 14600044.
  7. ^ a b c d e f g h i j k l Yancey, Antronette (August 2012). "Obituary: Lester Breslow". American Journal of Preventive Medicine. 43 (2): 230. doi:10.1016/j.amepre.2012.05.006.
  8. ^ Housman, Jeff; Dorman, Steve (October 2005). "The Alameda County Study: A Systematic, Chronological Review" (PDF). American Journal of Health Education. 36 (5): 302–308. doi:10.1080/19325037.2005.10608200. S2CID 39133965. Retrieved 15 October 2021.
  9. ^ Marquis, Julie (13 October 1997). "Mr. Public Health - Los Angeles Times". Los Angeles Times. Retrieved 21 May 2013.
  10. ^ a b Pemberton, John (April 2005). "Commentary: On the article by Lester Breslow on the origins and development of the IEA". International Journal of Epidemiology. 34 (4): 729–731. doi:10.1093/ije/dyi076. PMID 15833791.
  11. ^ a b Omenn, Gilbert S. (1990). "Preface by the Gilbert S. Omenn". Annual Review of Public Health. 11. doi:10.1146/annurev.pu.11.010190.100001.
  12. ^ a b c d Baquet, Claudia; Lester Breslow (May 2005). "A Conversation with Lester Breslow". Epidemiology. 16 (3): 410–413. doi:10.1097/01.ede.0000158800.01170.36. PMID 15824560.
  13. ^ "Lester Breslow Papers (UCLA)". UCLA::Library Special Collections, Charles E. Young Research Library. Online Archives of California (OAC). Retrieved 18 October 2021.
  14. ^ Emerson, Elisabeth (2009). "Chapter 10: Local Health Services". Public Health is People: A History of the Minnesota Department of Health from 1949 to 1999 (PDF). St. Paul, MN: Minnesota Department of Health. p. 243. Retrieved 18 October 2021.
  15. ^ a b Fee, Elizabeth (1 September 2005). "Lester Breslow: More Than A Half-Century In Public Health". Health Affairs. 24 (5): 1374–1375. doi:10.1377/hlthaff.24.5.1374. ISSN 0278-2715. Retrieved 19 October 2021.
  16. ^ a b c d Fielding, Jonathan E.; Green, Lawrence W. (18 March 2013). "In Memory of Lester Breslow". Annual Review of Public Health. 34 (1). doi:10.1146/annurev-pu-34-031513-100001. ISSN 0163-7525.
  17. ^ a b c "The Albert Lasker Awards for 1960". American Journal of Public Health and the Nation's Health. 50 (12): 1948. 1960. doi:10.2105/AJPH.50.12.1946. PMC 1373507. PMID 18017803.
  18. ^ Fairchild, Amy L.; Bayer, Ronald; Colgrove, James; Wolfe, Daniel (7 November 2007). Searching Eyes: Privacy, the State, and Disease Surveillance in America. University of California Press. ISBN 978-0-520-25325-4. Retrieved 19 October 2021.
  19. ^ a b "Former UCLA Dean Receives IOM's Lienhard Award". The National Academies of Sciences, Engineering, and Medicine. Retrieved 19 October 2021.
  20. ^ Boffey, Philip M. (20 September 1968). "California: Reagan and the Public Health Controversy". Science. 161 (3847): 1226–1229. Bibcode:1968Sci...161.1226B. doi:10.1126/science.161.3847.1226. PMID 5673431. Retrieved 19 October 2021.
  21. ^ Stafford, Ned (19 June 2012). "Lester Breslow" (PDF). BMJ. 344: e4226. doi:10.1136/bmj.e4226. S2CID 220103243. Retrieved 19 October 2021.
  22. ^ "National Abortion Rights Action League, 1969-". SNAC. Retrieved 18 October 2021.
  23. ^ Mapes, Diane (2015-12-21). "Fred Hutch, UW biostatistics 'giant' Norman Breslow dies". Fred Hutch. Retrieved 2018-06-28.
  24. ^ "Historic Fellows (Search for "Breslow")". American Association for the Advancement of Science. Retrieved 19 October 2021.
  25. ^ Reid, Roddey (20 December 2005). Globalizing Tobacco Control: Anti-smoking Campaigns in California, France, and Japan. Indiana University Press. pp. 51–53. ISBN 978-0-253-11155-5. Retrieved 19 October 2021.
  26. ^ "Lester Breslow Papers (UCLA)". UCLA::Library Special Collections, Charles E. Young Research Library. Online Archives of California (OAC). Retrieved 19 October 2021.
  27. ^ Balbach, Edith D.; Monardi, Fred M.; Fox, Brion J.; Glantz, S. A. (1997). Holding Government Accountable: Tobacco Policy Making in California, 1995-1997. San Francisco, California: UCSF: Center for Tobacco Control Research and Education.
  28. ^ Breslow, L; Johnson, M (1 May 1993). "California's Proposition 99 on Tobacco, and its Impact". Annual Review of Public Health. 14 (1): 585–604. doi:10.1146/annurev.pu.14.050193.003101. ISSN 0163-7525. PMID 8323603. Retrieved 19 October 2021.
  29. ^ Sullivan, Ben (May 26, 1997). "Health Column 23". Los Angeles Business Journal. Retrieved 19 October 2021.
  30. ^ Breslow, Lester (2005). A life in public health: an insider's retrospective. New York, NY: Springer Pub. Co. ISBN 978-0826127143.
  31. ^ a b c Fielding, Jonathan E.; Teutsch, Steven; Breslow, Lester (June 2010). "A Framework for Public Health in the United States". Public Health Reviews. 32 (1): 174–189. doi:10.1007/BF03391597. ISSN 2107-6952. S2CID 74015352. Retrieved 18 October 2021.
  32. ^ Schoenborn, CA (November 1986). "Health habits of U.S. adults, 1985: the "Alameda 7" revisited". Public Health Reports. 101 (6): 571–80. PMC 1477675. PMID 3097736.
  33. ^ Breslow, Lester; Enstrom, James E. (1 July 1980). "Persistence of health habits and their relationship to mortality". Preventive Medicine. 9 (4): 469–483. doi:10.1016/0091-7435(80)90042-0. ISSN 0091-7435. PMID 7403016.
  34. ^ Abelin, T.; Brzeninski, Z. J.; Carstairs, Vera D. L. (June 1, 1987). Measurement in Health Promotion and Protection (PDF). Copenhagen: World Health Organization. p. 274. Retrieved 18 October 2021.
  35. ^ Ibrahim, Michel A. (1985). "Review of Health and Ways of Living: The Alameda County Study". Journal of Public Health Policy. 6 (3): 413–415. doi:10.2307/3342407. ISSN 0197-5897. JSTOR 3342407. S2CID 72328966. Retrieved 18 October 2021.
  36. ^ a b Liburd, LC; Sniezek, JE. (2007). "Changing times: new possibilities for community health and well-being". Preventing Chronic Disease. July. Retrieved 18 October 2021.
  37. ^ Schaie, K. Warner; Blazer, Dan; House, James S.; House, James A. (1992). Aging, Health Behaviors, and Health Outcomes. New York; London: Psychology Press. p. 74. ISBN 978-1-317-84422-8. Retrieved 18 October 2021.
  38. ^ Breslow, Lester (1999). "From Disease Prevention to Health Promotion". The Journal of the American Medical Association. 281 (11): 1030–3. doi:10.1001/jama.281.11.1030. PMID 10086439.
  39. ^ Ojobor, Rebecca Chidimma; Babarinde, Elizabeth Titilope; Ezeh, Godwin Sunday. "Role of Librarians in Disseminating Information Resources on Public Health Issues in the Post-Covid-19 in Enugu State". Trends in Libraries, Information Science and Technology. 1 (1): 73–84. Retrieved 19 October 2021.
  40. ^ "Previous Sedgwick Memorial Medal winners". American Public Health Association. Retrieved 2009-06-11.
  41. ^ "Gustav O. Lienhard Award for Advancement of Health Care – Past Recipients". National Academy of Medicine. Retrieved 18 October 2021.
  42. ^ "Harold S. Diehl Award". University of Minnesota. 16 February 2018. Retrieved 18 October 2021.
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