Reflections on the APHA Epidemiology Section’s 80th Anniversary, 1929-2009,
from Dr. Gaudino’s Career Awards Session Introduction, Nov. 9, 2009
Every year, the Career Awards Session of the APHA Epidemiology Section affords Section members and guests a great time hearing about and celebrating the work of outstanding senior and up-and-coming epidemiologists. Those sessions also invite us to reflect on who we are, where we have been, and where we are going. This November’s session in Philadelphia was particularly special because we as a Section celebrated our 80th anniversary! It was a privilege for me to look a little further into our section’s history, prepare a few slides, and take a few minutes to tell some of our story. Here is some of that story. (click to see story with pictures)
So what was happening in 1929 when the Epi Section was about to be formed?
After a devastating world war, the country had been through an economic boom but was rapidly sinking. Just about 80 years ago today, on Oct. 29, 1929, with the Wall Street Crash, the country sank into the Great Depression. At the same time, the country was recovering from a devastating pandemic, the 1918 flu epidemic. Now, 80 years later, we are facing our own major economic “downturn” and pandemic.
In 1929, modern public health in the United States was emerging from the sanitation movement of the late 1800s and early 1900s. Local and state governments were organizing health authorities. The U.S. Public Health Service was also active. Some of the “best and brightest,” such as Dr. Wade Hampton Frost, then with the USPHS, were assisting state and local governments with responses to outbreaks and public health concerns. Water quality and infectious diseases topped the list of sanitation concerns, as population movement to cities from rural areas and waves of mainly European migration to the United States compounded the challenges. Based on scientific work and societal concerns, progressive movements emphasized poverty’s link with poor health, especially in cities.
Still looking back to Europe, U.S. epidemiologists had nothing like the London Epidemiological Society as their professional society. Sessions at the American Public Health Association did include presentation of epidemiologic studies. In fact, 100 years ago this fall in 1909, Dr. Frost presented a paper at APHA demonstrating that a recent waterborne outbreak in Washington, D.C., in a time of prevalent typhoid fever, was due to a typhoid-like infectious agent, but not Salmonella typhi!
Epidemiologists were seen as “academics” by leaders of health departments. New York City’s health commissioner accused epidemiologists of being “too esoteric.” Gee, for those of us in “practical public health” positions, this sure sounds familiar. I was just talking to a colleague today who reported a similar, recent comment by a leader in that person’s health agency. Certainly, I have heard that during my career working in public health agencies.
In the 1920s, health departments nonetheless began to organize communicable disease units and hire epidemiologists. Within APHA during this decade, a number of health officers left the Administration Section in which they were members. While we don’t have a clear history of why this happened, health officers who were often now serving as lead epidemiologists in disease control matters may simply have wanted a section that better addressed the issues they were facing. Meanwhile, earlier attempts to present epidemiologic work in special sessions at APHA fizzled. However, in 1928, to highlight the practice-based work going on at health departments, our section founders organized two successful, well-attended sessions at the APHA Annual Meeting in Chicago. With the spark of this success, our founders moved forward. In 1929, the APHA Executive Board approved a proposal to charter the Epidemiology Section. The “instigators” were then “tapped” to take on the role of organizing and leading the Section. Thus, the Epidemiology Section was born!
Let’s recognize and thank those first Section leaders now. Serving as the founding Section Chair was Dr. Don Griswold, Iowa’s State Communicable Disease Epidemiologist. The role of Vice Chair, the position which is now known as the “Chair-Elect,” fell to Dr. E.S. Godfrey, Jr. The Section’s first secretary was Dr. Haven Emerson, who was at the Veteran’s Administration at that time.
By the next year, there were 32 members. That is a pretty humble beginning for the first and still largest epidemiologic society in North America.
Looking back at our history, we can see a clear theme: the Section’s call to use epidemiology to address practical, rather than “esoteric,” public health issues. The Section has made many contributions to those ends. With the dedication of its leaders and members, the Section has hosted hundreds of scientific and practical public health sessions amounting to hundreds, if not thousands, of individual presentations and discussions during these last 80 years. Amazing! Also, after members created the first practical guide on communicable diseases, over the course of many years, the Section routinely prepared and revised the early issues of the now authoritative Control of Communicable Diseases Manual. This book is “THE bible” that public health practitioners in local, state, tribal and federal settings in the United States use to guide their decisions on communicable disease control and prevention. These and others are wonderful contributions by terrific colleagues and professionals, and we celebrate them!
Before we continue with award introductions, let me take a few extra moments to reflect on both the progress made these last 80 years and the continuing and new challenges facing public health and epidemiology with a few examples from my experiences as a maternal and child health epidemiologist. I’ll just highlight them as you review the slides.
We’ve made some amazing strides, both with population growth in the United States and life expectancy, but we still struggle with significant disparities in life expectancy. With the looming problem of obesity, for example, life expectancy increases have leveled off and may begin to decline again. Dramatic reductions in infant mortality occurred this last century, but yet in the United States, racial, ethnic and other group disparities persist, keeping us ranked below 29 other countries in the world in infant survival.
With dramatic reductions in communicable diseases, particularly vaccine-preventable diseases, we face new challenges as a growing number of parents and others who have not experienced the risks of these diseases are now concerned about the safety of vaccinations and questioning whether their children or they themselves should be vaccinated.
During the next 80 years, epidemiologists will continue to face these and many other public health issues for which the applied use of epidemiology within multidisciplinary partnerships can offer scientific evidence to assure that policy and program decisions are made with evidence and not conjecture.
In the past and looking forward, the Epidemiology Section has been and remains ready to play an important role to support our members and “serve as a conduit between the epidemiologic research community and users of scientific information for the development, implementation, and evaluation of policies affecting the public's health,” as our mission states.
We are currently 3,000 members strong with a dedicated and, to me, impressive leadership of 35 plus currently elected and volunteer Section leaders, among them students, with whom I have been grateful to work. The Section is engaged in many activities. These include, every fall, organizing a broad range of high quality scientific sessions that cover the breadth of epidemiologic work related to public health to promote scientific communication and further enrich career and professional development for participants. Through awards such as our distinguished John Snow Award, the only U.S. award sanctioned by the Royal Institute of Public Health, and the Wade Hampton Frost Lectureship Award, the Section recognizes contributions to public health made by students through senior career professionals.
Working with other sections and organizational units, the Section is one of the primary sections that APHA relies on to assure that APHA policy statements and Governing Council resolutions are scientifically supported, evidenced-based and sufficiently pertinent to public health issues to justify APHA’s organizational support.
So, happy 80th anniversary, APHA Epidemiology Section! With global public health challenges abounding, the leaders and members of our section remain committed to collaborating with other public health professionals in public health practice, education, policy-making, and service to address public health challenges and lessen the burdens of illness and related conditions now and in the coming 80 plus years!
Many thanks to the dedicated leaders of the Epidemiology Section over the last 80 years, especially those I have been privileged to serve with! Special thank you’s and congratulations this years to the Section’s Membership and Communication Committee, especially Drs. Marian R. Passannante, PhD, Committee Chair, Victor A. Ilegbodu, MPH, PhD, MD, and Laurie D. Elam-Evans, PhD, MPH, with the debut of our section’s new commemorative banner!
Yours truly,
Dr. Jim Gaudino, MD, MS, MPH, FACPM, Immediate Past Chair, APHA Epidemiology Section
Citations include: E. S. Godfrey, Jr., MD. "As I Recall It. The background and beginnings of the American Epidemiological Society,” The Yale Journal of Biology and Medicine. Volume 46, Number 1, February 1973. (For more information, please read see http://www.apha.org/membergroups/sections/aphasections/epidemiology/about/ for a summary of Dr. Godfrey’s article posted on our Section’s Web page.)