University of Minnesota

“If It Isn’t Fun.” – Part 11 – The American Heart Association’s Council on Epidemiology

Fred Epstein’s and my 1995 history of the tortuous journey in the development of “our” scientific council of the American Heart Association (AHA) began as follows:*

“Cardiovascular disease (CVD) epidemiology is a relatively new field that developed along with the growing burden of heart disease among Western industrial countries following World War II. Uniquely, the field was initiated not by epidemiologists but by clinicians and laboratory scientists most familiar with the manifestations and mechanisms of those diseases. These investigators became epidemiologists because they had to — to satisfy their curiosity about the changing frequency, and the associations and major population causes of coronary heart disease (CHD). These questions, and the need for sound methods to study them, brought investigators together in the 50s, and the organization that responded to their needs was the then-fledgling AHA, operating through its newly formed Scientific Council.

But the realization of a formal scientific council for epidemiology was neither easy nor simple. Rather, it was a long, upstream journey of 15 years, carried mainly by the AHA Council on Community Service and Education and its committees on Epidemiological Studies and on Criteria and Methods. The initiative remained for years a victim of the tension in the early national AHA among the expansionists, who favored the public health, public education, lay representation role for the AHA, versus the contractionists who emphasized the strictly scientific, clinical and professional aspects of the association. The protectionism of some AHA leaders against invasion by new specialty interests also weighed against the wider view for AHA held by a few: that it must include prevention science and community service as well as bench and clinical science.

Systematic population studies of CVD got under way in the late ’40s and early ’50s in several centers, including Framingham, Minneapolis, Albany, Chicago, Evans County, Georgia, Charleston, and Los Angeles, among others. The urgent need for methods and criteria brought the investigators together as much as did the scientific ideas themselves. They held meetings on their science and its methods throughout the ’50s and ’60s, providing the impetus for a more formal council made up of physicians, epidemiologists, statisticians, social scientists, anthropologists, and geneticists. This mixed brew fermented quite well.

But in those days, among the AHA Scientific Councils, a genuine concern developed over proliferation of splinter groups. The conservative element mustered this concern to defeat the new council status for epidemiology. Meanwhile, we, the epi bunch, continued to meet annually to present “work in progress,” and we created an active Committee on Criteria and Methods. Then, in 1964, the fortuitous joining of a sympathetic retiring AHA president, Carleton Chapman, with an actively involved incoming president, Oley Paul, created a renewed impetus for council status in the national organization. This view eventually prevailed.

The AHA Council on Epidemiology and Prevention has for 30 years gone about its task in prevention science and policy. It now has 1,100 members and a well-functioning committee structure. It stays influential by effective communications in its scientific conferences, in directed efforts in research and new methods, in fostering training, including the Lake Tahoe Ten-day Seminar, in interactions with the heart association nationally, and with the National Heart, Lung, and Blood Institute, World Health Organization, the International Society and Federation of Cardiology, and the American College of Cardiology, and, finally, in public advocacy for prevention and public health research and policy. The council is now a vigorous organization and a major force for sound public policy in the prevention of heart disease and the promotion of health.”

And much more. The council has long been the collegial and organizational and spiritual center of our field.

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