Breslow, a former director of the California Department of Public Health and dean of UCLA's Fielding School of Public Health, died Monday at his home in Los Angeles, the university announced.
Breslow played a key role in medicine's transition from an emphasis on simply treating disease to a much broader effort to prevent it. Medicine focused "almost exclusively on communicable diseases when I started" in the 1940s, he recently recalled. "I felt public health needed a broader vision."
He really was "a legend" because his influence "has persisted for such a long time ? seven decades," said Dr. Linda Rosenstock, the current dean of the school. "In terms of understanding the ability to prevent chronic disease through exercise, diet and [not] smoking, he is the single human being that is given the most credit."
Most physicians today would recognize that it is just as important to prevent disease, particularly diabetes, heart conditions and other chronic illnesses, as it is to treat them. But when Breslow began his work, his concerns were met with skepticism and outright disdain.
In his initial interview to join the California public health department, he was told, he said, "to take his crazy ideas back to Minnesota and try them there."
Only the intervention of a friend brought him into the agency. And it was there that he carried out what he and others consider his greatest accomplishment, the Alameda County Human Population Laboratory.
Beginning in 1959, Breslow and his colleagues enrolled about 7,000 residents of the county in a study to determine whether and how well they adhered to what he identified as seven habits of healthy living. Six of the habits had been identified by previous research: exercising regularly; getting regular sleep; not smoking; drinking moderately or not at all; eating regular meals and not snacking in between; and maintaining a normal weight.
The seventh, eating a regular breakfast, was simply an educated guess, he admitted later.
The results were dramatic. The team reported in the early 1970s that a 45-year-old who adhered to at least six of the seven habits had a life expectancy 11 years longer than that of peers who followed fewer than four. A 60-year-old who followed all seven of the habits was as healthy as a 30-year-old who followed two or less.
"I'd never seen such a systematic, positive, strong finding," Breslow said. "The results were so astonishing that I didn't believe it" at first. "I thought my colleagues were playing a joke on me."
Even among those who did not die, the effects of neglecting good health could be devastating. In a 1993 study co-authored with his son Norman, a statistician at the University of Washington, he reported that those who had six or seven of the poor health habits in 1965 were twice as likely as their neighbors with no more than two of the bad habits to be disabled 10 years later.
Among participants with one or no poor habits, the researchers found 12.2% were disabled 10 years later. Among those with two or three poor health habits, 14.1% were disabled, while 18.7% of those with four or more were disabled.
As a youth in North Dakota, Breslow had tried smoking corn silk in corncob pipes and had even experimented with cigarettes, but found that they irritated his throat. He later concluded that smoking was a major health risk and initiated several studies while he was head of the public health department. Three of those studies linking smoking to lung cancer and other diseases were cited in the U.S. surgeon general's landmark 1964 report on smoking.
Lester Breslow was born March 17, 1915, in Bismarck, N.D., the son of a pharmacist. He developed a severe stammer, but a friendly nurse encouraged him to read aloud and conduct other exercises to improve his speech. By high school, he was able to join the debate team and develop a speaking ability that served him well most of his life.
He received a bachelor's degree in psychology from the University of Minnesota in 1935 and his medical degree in 1938. But his experiences in a mental hospital in Rochester, Minn., soured him on the profession and he turned his interests to public health, receiving a master's in 1941.
In 1943, he volunteered for the U.S. Army Medical Corps and received training in tropical diseases. Posted in San Francisco, he was responsible for ensuring that no communicable diseases were brought into the city by returning military personnel. He later transferred to the Army's 7th Infantry Division in the Philippines, where he identified an epidemic of the parasitic disease schistosomiasis, and then to Okinawa.
In 1946, he joined the California public health department, becoming chief of the bureau of chronic diseases and, ultimately, head of the department.
He was active in the creation of the state's Medi-Cal program, promoted screening for the genetic disorder phenylketonuria among newborns and campaigned against smog, measles and unnecessary noise.
Breslow also started the state's Tumor Registry, which has been instrumental in hundreds of studies of environmental and behavioral effects on cancer.
In 1968, he left state service to join UCLA, where he remained for the rest of his career. He served as dean of the School of Public Health from 1972 to 1980.
In 1952, he served as director of President Truman's Commission on Health Needs of the Nation and subsequently served on a variety of other commissions and advisory boards. A past president of the American Public Health Assn., he also established and was the first editor of the Encyclopedia of Public Health.
Breslow followed his own prescriptions, walking regularly and practicing moderation in all his activities. He cleared rocks from the hillside above his Bel-Air home to create a fruit and vegetable garden that he tended regularly, keeping precise records of all that he harvested.
He married the former Alice Philp in 1939 and they had three sons before divorcing. In 1967, he married Devra Miller.
He is survived by his wife; sons Norman, Jack and Stephen; three grandchildren; and four great-grandchildren.
Maugh is a former medical writer for The Times.
news.obits@latimes.com
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