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Obituary: Lester Breslow, 1915-2012

Lester BreslowPublic Health has lost a capable and effective champion and legend with the passing of Lester Breslow, M.D.,M.P.H. Sc.D. (hon). Professor Breslow, one of the founders of the International Epidemiological Association passed away April 9, 2012. He served as President of the association from 1968-71, as a member of council from 1957-71, as chairman of the Executive Committee from 1964-68. He was Honorary Chair of the 1990 meeting in Los Angeles which was organized by his devoted wife, Devra.  One of his major goals for the IEA was to involve Eastern European epidemiologists in its activities – not exactly popular in the 1960s and 70s. He developed a friendship with Dr Venediktov, the minister of health in the USSR, and he was partly instrumental in subsequently recruiting Professor Jan Kostrezewski, a Polish Minister of Health as a member. Professor Kostrezewski  later became President of the IEA.

Lester was one of public health’s greats who lived through a period during which society and public health changed dramatically and he was one of the leaders in those changes. One of his major attributes was optimism, as well as concern with the deprived and needy, which was reflected in his work. His concern with the control of chronic disease, in contrast to the concern of most of his contemporaries in public health at the time, was epitomized by both changes in the structure and function of the State of California Department of Public Health, with creation of the Bureau of Chronic Diseases, and a focus on environmental issues such as air pollution.

Professor Breslow is perhaps best known for the landmark study he organized and conducted through the Alameda County Human Population Laboratory, which he founded. In this study of 6,928 people in Alameda Country, California, he demonstrated the positive effects of adherence to healthy habits for improving both the quality and length of life. The study changed the way public health professionals thought of disease and was instrumental in introducing the concept of behavioral intervention as a base science of public health and the role of exercise, diet, social networks, and avoidance of unhealthy habits for reducing the risk of chronic diseases. Today, sixty years later, these concepts remain a bulwark of public health

Professor Breslow held many key national positions in promoting public health. In 1952, President Harry S. Truman appointed him as director of a commission to assess the nation’s health care. The panel reported that although individuals make their own health choices, they “exercise them mainly under social influences”. He served on the National Commission on Chronic Illness from 1954-55 and was chair of the editorial committee that published the Commission’s report on Prevention of Chronic Disease. In 1965, he was appointed as Director of Health for the state of California. Professor Breslow was fearless in his promotion of health for all, including those who are most vulnerable. In 1968, Governor Ronald Reagan fired him over “philosophical differences” about state cuts in medical care for the poor. In 1969, Professor Breslow served as President of the American Public Health Association. From 1972-1980, Professor Breslow served as Dean of the University of California, Los Angeles School of Public Health. He served on the Institute of Medicine of the National Academy from 1975 until his death . From 1997-98, he served as Chair of the Public Health Commission for the County of Los Angeles. In 1997, he became the founding chair of the California Center for Health Improvement. He was also the founding chair of the Board on Health Promotion and Disease Prevention.

Professor Breslow was the recipient of many awards during his career. In 1960, he received the prestigious Lasker Award. In 1988, he received the Dana Foundation Award for Outstanding Achievement in Health. Subsequently, in 1997 he received the Lienhard Award for Distinguished Service to the Institute of Medicine, as well as the prestigious Sedgwick Award for Distinguished Service from the American Public Health Association. In 1995 he received the Healthtrac Prize for Health Improvement.

Professor Breslow was born in North Dakota on March 17, 1915, and received his undergraduate and medical education at the University of Minnesota from which he also received an honorary Dr.Sc. in 1988. In the Second World War, he served in the Philippines and Okinawa, assuring that the troops were protected against the many tropical and parasitic diseases rampant in those countries.

Professor Breslow was a devoted member of the International Epidemiological Association, and attended every meeting of the Association, usually with his wife Devra, who was in his partner in every aspect of his life. Perhaps his positive attitude is best epitomized by his devotion to tending a small garden at his home in Bel Air. Neither the soil nor the mountainous terrain were ideal for growing plants and vegetables, but he persisted and spent long hours nurturing his precious plants, reflecting his optimism and concern with the disadvantaged!

Professor Breslow was one of those rare individuals who combined scientific rigor with vision and the ability to put his vision into practice. He had a profound effect on the scope and practice of public health. He will be missed, but remembered for his great contributions to promoting health for all.

Roger Detels, Walter Holland, with assistance from Devra Breslow

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