Contributions of Alexander D. Langmuir to the epidemiologic study of population change and family planning.

Abstract

This article traces the influence of Dr. Alexander Langmuir on the application of epidemiological methods to the study of population change and family planning. In the 1960s, global population growth had become a major issue but the role of public health professionals in meeting the challenge was unclear. By 1967, Langmuir had assigned eight Epidemic Intelligence Service (EIS) Officers to family planning (FP) evaluation, capitalizing on support from the Centers for Disease Control (CDC) and securing funding from many sources. In 1970, the year Title X of the Public Health Service Act designated funds for population activities with none of the funds designated for the CDC, Langmuir retired. EIS officers trained by Langmuir issued surveillance reports on abortion (in 1969) and sexual sterilization (the report defined the risk of morbidity from sterilization for women) and conducted studies of the safety and effectiveness of IUDs, (which led to association of the Dalkon Shield with high rates of pelvic inflammatory disease and with septic spontaneous abortion deaths) and the association of oral contraceptive use with various cancers. Epidemiologic evaluation procedures were applied to FP programs and evaluation training, to adolescent pregnancy, to international studies, to international contraceptive prevalence surveys, and to demographic studies. By mid-1993, 118 EIS officers had worked in FP evaluation. These EIS officers and alumni continue to work in the fields of reproductive health or public health throughout the world.