Influential
Department Of Epidemiology At Buffalo Celebrates 100 Years Of Public
Health Contributions
Chair Jo
Freudenheim Tells The Department’s Story In Our Interview Below
The Department of
Epidemiology and Environmental Health at the University of Buffalo is
celebrating 100 years of contributions to the health of Buffalo, the
region, the nation, and the world. We were surprised to learn about
the long history of the Department and contacted Jo Freudenheim, the
current chair of the Department, to get an insider’s view of the
history and the events of the celebration. Here are our questions and
Dr Freudenheim’s responses
Epi Monitor:
There are not many schools or departments of public health that are
100 years old. We know that Hopkins and Harvard are among the earliest
to move in that direction, but I was surprised that Buffalo was in
that category. Assuming I am correct, what do you think explains the
creation of your department before many others? Are the factors the
same or different than the other early departments that were founded?
Freudenheim:
That
Buffalo was among the first to have a department focused on public
health is not so surprising. When the department was founded in 1919,
Buffalo was one of the largest cities in the US and it was a center of
industry and innovation, including health innovation. Founded in 1846,
the University at Buffalo was originally solely a medical school and
was among the earliest medical schools in the US. The first cancer
research center in the world was in Buffalo, founded in 1898, becoming
what is today the Roswell Park Comprehensive Cancer Center. The
Roswell cancer hospital opened in 1913. In 1918, the Buffalo city
hospital opened.
Clearly the period
around 1919 was a time of huge development in health and health
delivery innovation in the region. In addition, there was at that time
a history of epidemiology and public health in Buffalo. As early as
the 1840’s, there was a published investigation of an outbreak of
fever by Austin Flint, a UB faculty member. Flint’s research
contributed to John Snow’s realization that water could transmit
communicable disease and Snow referred to Flint’s work in his
publication on cholera. Even before the department was created, there
were courses in public health offered to the medical students and in
1913 a division of Hygiene and Sanitation was formed.
When the department
was founded, it was called the Department of Hygiene and Public
Health, providing the nexus for public health for the medical school.
While I am not certain what the motivation was for the formation of
the department in 1919, it is likely that a contributing factor was
the 1918 influenza pandemic. The outbreak in Buffalo was substantial,
requiring a strong public health response including quarantines, and
likely resulting in an increased appreciation of the importance of
epidemiology and public health.
Epi Monitor:
What is some of the thinking that went into the decision to celebrate
the 100th anniversary? Is there a main anticipated benefit?
Freudenheim:
We are celebrating the 100th because it will be a long time
until we can have another such celebration! We think it is important
to take a step back, to understand where we are coming from so that we
have new perspective on where to go next. Putting together the history
has been a great opportunity to see all that has gone on in Buffalo
that has impacted health both in the region and more generally. We are
hoping that this celebration is an opportunity for our alumni and all
the faculty and staff who have been associated with the department to
have a chance to reflect on all that has been accomplished. This
relatively small department has had a disproportionate impact on
epidemiology and public health.
Epi Monitor:
Your department has had multiple different names over the past 100
years. One that is particularly striking is going from the Social and
Preventive Medicine Department to the Department of Epidemiology and
Environmental Health. In years past it seems that Buffalo was most
widely recognized for the Social component, but that element was
dropped from the name. Can you comment on the change in name and the
reasons for it?
Freudenheim:
There is a great deal of wonderful history attached to the previous
name, Social and Preventive Medicine (SPM). We were SPM from 1967
until 2014 when we became the Department of Epidemiology and
Environmental Health (EEH). As a department, we spent a lot of time
and had many discussions in the course of changing our name. In the
end, we decided that EEH was more representative of who we are now and
the focus of our work. We continue to have an interest in the topics
that are included under the social and preventive medicine umbrella.
However, there are now faculty doing work in a broader scope of
epidemiology--molecular and genetic epidemiology focused work, for
example. In addition, there are two additional divisions within the
department—one in Environmental Health and one in Health Services
Policy and Practice—and we wanted the name to better represent that
diversity of focus.
Epi Monitor:
The information material about the anniversary event notes that
several famous epidemiologists of the past had some affiliation with
Buffalo. Names like Graham, Lilienfeld, Terris, Winkelstein and
others. Has Buffalo been an above average magnet for epidemiologists
or training ground for epidemiologists? If so, what reasons do you
think might account for that?
Freudenheim:
As I
mentioned above, our department has always been a relatively small
one. Nonetheless, it has attracted major epidemiologists—outstanding
faculty, researchers and students. In addition to the individuals you
list, a disproportionate number of leaders in the field have been
educated in Buffalo—including deans, chairs, leading government
researchers, presidents of the major organizations. I would say, yes,
Buffalo has been well above average as a magnet for faculty and as a
training ground.
I think that the
attraction was the intellectual environment and the culture of
innovation which attracted strong researchers to the work that was
being done here. The outstanding leaders in the department have
nurtured their mentees to do outstanding work and to take leadership
in the field.
Further, in the last
100 years, there has been important synergy of public health and
epidemiology between UB and Roswell Park, both the surgeon by that
name who founded the cancer center and also the cancer center itself.
That relationship continues and increases in strength, as we continue
to work together to educate the leaders of the future.
Epi Monitor:
Where does Buffalo rank today among a much larger universe of Schools
of Public Health and what are the areas of greatest expertise or
emphasis?
Freudenheim:
As noted above, we are a relatively small but very strong department.
Research in the department still includes nutrition and on cancer,
both long focus areas of the department. In addition, we are engaged
in important research on cardiovascular disease, aging, particularly
among postmenopausal women, eye disease, child growth and development,
and pregnancy. In addition, there is research on global health, air
pollution, heavy metal exposures, physical activity, health
disparities, genetics, pesticides, the microbiome, health services and
access to care. The department is thriving and growing in exciting new
directions.
Epi Monitor:
The special lecture during your event will be the Saxon Graham
Lecture. For persons unfamiliar with his work, can you give a brief
account of why Dr Graham is is honored in this way?
Freudenheim:
Dr. Graham was an internationally known cancer epidemiologist, best
known for his groundbreaking studies on diet and cancer. He started
those studies beginning in the 1950s, at a time when the prevailing
wisdom was that it was not possible to include diet in an
epidemiologic study. He was a longtime UB professor and was chair of
the department from 1981-1991. Dr. Graham was an incredible mentor,
providing guidance to a generation of epidemiologists as well as
serving as a role model with his leadership in the field. He was an
innovative thinker, for example, applying a thoughtful discussion of
the science of creativity to epidemiology in his SER Presidential
address in 1987. Dr. John Vena, Professor and Founding Chair of
the Department of Public Health Sciences at the Medical University of
South Carolina will give the Saxon Graham lecture this year. John
received his PhD degree from our department and was a faculty member
here 1981-2003.
Epi Monitor:
You are hosting a symposium as part of your celebration. Can you say
a little something about the speakers and the topics that were chosen
for this occasion? Is there a common underlying theme?
Freudenheim:
The focus of the celebration is on both epidemiologic research in the
last 100 years and new directions for epidemiology for the future. As
noted above, the celebration starts with the Saxon Graham lecture
given by John Vena. For the symposium, Dr. Moyses Szklo will
give a plenary talk. The symposium showcases some of the history of
the research that has come out of the department as well as new
directions for that research. Speakers will include Drs. Germaine
Louis, Dean of the College of Health and Human Services at George
Mason University, Brian King, Director of Research Translation,
Office on Smoking and Health at CDC and Shauna Zorich, Clinical
Assistant Professor in EEH at UB. All are EEH alumni. In addition,
James Marshall, Professor Emeritus, Roswell Park Comprehensive
Cancer Institute, a former EEH faculty member and Laura Smith,
a current EEH faculty member, will give talks.
Epi Monitor:
What would you like colleagues at other Schools of Public Health to
takeaway from your celebration event?
Freudenheim:
I think that it is important to have a sense of the history of public
health, to understand the factors that brought us to where we are
today. Some things have changed enormously in our field in the last
several years—such as the ability to handle extremely large data sets,
the integration of molecular analyses with other epidemiologic data.
Even these changes have roots in how we tried to improve the public
health throughout the last 100 years.
In addition, there are
some things that have changed little—we are still concerned about the
possibility of a major flu pandemic. We are still struggling with
other infectious disease outbreaks such as the measles outbreak. We
are still trying to understand how complex factors such as diet, the
environment, physical activity, and access to care impact morbidity
and mortality. Our view of public health is increasingly global as we
better recognize how the health of populations everywhere impacts
health throughout the world. It is extremely important to understand
where we have come from and what we have accomplished as we look to
the future to address these challenges and the ones that we cannot
even yet imagine. ■
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