In Memoriam: Dr. Lester Breslow, Public Health Visionary

Lester Breslow

Dr. Lester Breslow, a former dean of the UCLA Jonathan and Karin Fielding School of Public Health, professor emeritus of health services, and one of the leading figures in public health for seven decades, died Monday. He was 97.

Breslow was a visionary public health figure with a well-established track record for being ahead of his time. As early as the 1940s, he linked tobacco use to disease in three studies that were later cited in the U.S. Surgeon General’s landmark 1964 report.

He is widely known for his early advocacy and research into health promotion and disease prevention. Breslow’s pioneering Alameda County studies beginning in the early 1960s were among the first to show that simple health practices — such as getting regular exercise and sleep, not drinking excessively, not smoking, and maintaining a healthy weight — add both years and quality to life.

While these conclusions are taken for granted today, the idea of such a strong connection between lifestyle and health was seen as "bizarre" at the time, Breslow noted decades later. He would smile when recalling the response of the National Institutes of Health panel of scientists that reviewed the initial study proposal: "Unanimous rejection." When the study was completed, even Breslow was shocked at the magnitude of the results, which helped usher in current thinking about health and fitness.

Born in Bismarck, N.D., Breslow stammered severely as a youth but went on to deliver the keynote address at his high school graduation and become someone whose thoughtful and articulate speaking style commanded attention throughout his life.

He earned his medical and public health degrees (MD, MpH, SciD) from the University of Minnesota. As a local health officer in Minnesota, Breslow harbored big ideas about where the field should be headed. The public health focus was still on communicable diseases, but Breslow felt public health should broaden its vision as people began living longer and becoming more susceptible to conditions such as cancer, heart disease and stroke.

After completing service as an army captain in the Pacific Division in World War II, Breslow moved to California, where he became chief of the Bureau of Chronic Diseases of the California Department of Public Health from 1946 to 1960. Breslow launched several of the earliest definitive studies of tobacco's adverse health effects. He also started the California Tumor Registry, which has been a resource for hundreds of studies on the effectiveness of personal health care services in cancer detection and treatment. His studies were later cited in the U.S. Surgeon General’s landmark 1964 report on the negative health effects of smoking.

Breslow's work also encouraged health officials to take a broader perspective on disease prevention and health promotion. Recognizing the inefficiencies of detecting chronic diseases one test at a time, he and his colleagues designed a "multiphasic screening" approach by combining a battery of tests. This approach was subsequently adopted by the Kaiser Permanente Health Plan and other health maintenance organizations.

Breslow also helped to identify the important influence of behavior on disability and premature death, particularly through studies relying on the Alameda County Human Population Laboratory, which he established in 1959. "I suppose development of the Alameda County Human Population Laboratory was my greatest accomplishment," he said in a 2003 interview in the American Journal of Public Health. Beginning in 1965, the laboratory conducted a series of health surveys, and then followed up with subsequent surveys of the same population. The surveys quantified health risk practices and lifestyle issues such as exercise, diet, sleep, smoking and alcohol consumption, and defined their relationship to mortality. It found, for example, that a 45-year-old male who followed six of seven healthy habits had a life expectancy 11 years longer than a peer who followed three or fewer.

His record of public health leadership at the local, state, national and international levels was unparalleled. Breslow served as president of three associations: the International Epidemiological Association (1967-68), the American Public Health Association (1968-69) and the American Schools of Public Health (1973-75).

He was a member of the Tobacco Education Oversight Committee for the State of California (1990-96) and served as a commissioner on the Los Angeles County Public Health Commission. He was founding editor of the Annual Review of Public Health (1978-1990) and editor-in-chief of the first-ever Encyclopedia of Public Health, first published in 2001 and used around the world.

He was California’s director of public health (1965-68) and dean of the UCLA School of Public Health (1972-80). Following his tenure as dean, he continued to be an active and beloved member of the school’s faculty — speaking, writing and motivating students and faculty well into his 90s.

He was a member of the Institute of Medicine of the National Academy of Sciences, and received numerous awards, including the Lasker, Sedgwick, Dana, Healthtrac, Lienhard (Institute of Medicine), New York Academy of Medicine. In April 2004, a month after turning 89, Breslow for the first time was the featured speaker at the annual lecture and dinner established 38 years ago in his name at the School of Public Health.

Even at his advanced age, Breslow practiced what he preached, getting exercise by maintaining his fruit and vegetable garden and walking 12-15 miles a week.

He is survived by his wife Devra; children Norman, Jack and Stephen; three grandchildren; and four great grandchildren.

In lieu of flowers, the family requests donations to the Lester Breslow Student Fellowship Fund. Checks can be made payable to the UCLA Foundation and directed to the Lester Breslow Student Fellowship Fund (fund number 90618E). They can be sent to UCLA Fielding School Office of Development, 16-080 CHS, Box 951772, Los Angeles, CA 90095-1772. To give online, go to https://ph.ucla.edu/giving and select the Breslow Student Fellowship Fund from the drop-down menu.