Lester Breslow

Abstract

Leading figure in public health and proponent of disease prevention. Born on March 17, 1915, in Bismarck, ND, USA, he died on April 9, 2012, in Los Angeles, CA, USA, aged 97 years. The US public health titan Lester Breslow lived to the age of 97 years, a testament to his own research findings, which showed that a healthy lifestyle can prevent chronic disease. “Dr Breslow changed how we as individuals think about our health”, said Linda Rosenstock, the current Dean of the Fielding School of Public Health, University of California at Los Angeles (UCLA). “While we now take for granted the knowledge that numerous factors including exercise, a proper diet, and not smoking can prevent chronic disease, Dr Breslow's contribution to public health was seminal and showed that the root causes of our health problems are broader than our own biology.” Breslow was an adviser to six presidential administrations. As Director, in 1952, of US President Harry S Truman's Commission on the Health Needs of the Nation, his panel reported that people make their own health choices but “exercise them mainly under social influences”. As early as the 1940s, Breslow had linked smoking to disease in studies that were later cited in the US Surgeon General's landmark 1964 report. As President of the American Public Health Association from 1968 to 1969, Breslow emphasised the need for social actions to improve the nation's health. “In the long run,” he said, “housing may be more important to health than hospitals”. As an early proponent of health promotion and disease prevention, one of Breslow's great achievements was the studies that emerged from the Alameda County Human Population Laboratory, which he established in 1959. One such study showed that 45-year-olds who adopted six healthy habits—exercise, non-smoking, weight control, adequate sleep, moderation in alcohol use, and (Breslow's pet idea) breakfasting well—lived longer than people with three or fewer healthy habits. Breslow entered the University of Minnesota in 1932 and its medical school in 1934. He was drawn to the emerging specialty of public health, serving his internship at the US Public Health Hospital on Staten Island. Later he returned to the University of Minnesota, obtained a master's degree in public health in 1941, and joined the Minnesota Department of Public Health as County Health Officer. In 1943, young American men were drafted into the military and Breslow volunteered for the army and served in the 7th Infantry Division in the Pacific, mainly as a preventive-medicine specialist but also dealing with infections and working in field hospitals. When he returned to civilian life Breslow approached the Director of the California Health Department, outlining the reason why they needed a chronic disease specialist. He was eventually employed and stayed there for 22 years, during which time he started the California Tumor Registry and led studies on the adverse health effects of tobacco. In his early days at the department, infectious diseases were common and tackled by food hygiene, vaccination, and isolation of cases. Much of Breslow's work consisted of detecting chains of infection. As the perils of infectious diseases faded, his attention moved to concerns such as smoking cessation. Breslow began as Chief of the Bureau of Chronic Disease and then Preventive Medicine Services before being appointed as Director of the California State Department of Public Health. In 1970, he became Dean of the Jonathan and Karin Fielding School of Public Health at UCLA. He continued to be an active and inspiring member of the school's faculty until his retirement in 1980 as emeritus professor. But he continued working long after his retirement in various roles, including for WHO, until 2008. He was the founding editor of the Annual Review of Public Health and editor-in-chief of the Encyclopedia of Public Health, first published in 2001. Honours and awards were heaped on him, including the Lasker Award and the Institute of Medicine's Lienhard Award; he especially valued the 2008 Harold Diehl Award, named after his teacher in medical school. In 2004, Breslow wrote his memoir A Life in Public Health, and together with his wife created the Lester Breslow Scholarship Fund. A cheerful man, he survived a myocardial infarction in 1998 and a stroke in 2009. He didn't smoke, drank moderately, and walked up to 15 miles a day into his nineties. Breslow married Alice Philp in 1939; they had three sons and later divorced. His second marriage was to Devra Miller who survives him.