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Epidemiology:
doi: 10.1097/EDE.0b013e318154c9e4
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Mort Levin and the Emergence of Chronic Disease Epidemiology

Winkelstein, Warren Jr

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Mort Levin received the John Snow award from the American Public Health Association in 1978. A member of the selection committee remarked that, “… Mort Levin has had as much impact on public health in this country as anyone during the past quarter of a century.”1 Today, if Levin is remembered at all, it is probably for his introduction of the concept of “attributable risk.”

Mort Levin was born in 1904 in prerevolutionary Russia, and after World War I migrated with his family to the United States. He graduated from Johns Hopkins University and took degrees in pharmacy and medicine from the University of Maryland. As a dispensary physician at the Johns Hopkins Hospital, Levin came under the influence of Wade Hampton Frost, gave up clinical medicine, and received a DrPH in 1934. His first job as a public-health physician was as Commissioner of Health for Ottawa County, Michigan. Shortly after taking up his position, he traced the source of a milk-borne outbreak and forced through an ordinance requiring pasteurization. The unpopular legislation led him to be fired.

Mort Levin made three major contributions to public health. One was the recognition and derivation of “population attributable risk,” which provided public health practitioners with a powerful tool for evaluating the impact of a particular disease in a defined population. His second major contribution was in his role as the first Director of the Commission on Chronic Illness (1950)–a Commission created by the AMA, the APHA and other prominent health organizations. Under Levin's leadership, the Commission expanded the scope of public health from a narrowly-focused emphasis on the control of infectious diseases to a concern with the full spectrum of disease occurrence.3 His third contribution was the 1950 publication of his case-control study of smoking and lung cancer4 which, along with simultaneous studies by Wynder and Graham5 and Doll and Hill6 unleashed a torrent of investigations on the harmful effects of tobacco smoking on health.

Figure. Mort Levin...
Figure. Mort Levin...
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REFERENCES

1. Winkelstein W. Re: Morton Levin (1904–1995): History in the making. (letter) AM J Epidemiol. 1996;144–803.

2. Levin ML. The occurrence of lung cancer in man. Acta Unio Internat Contra Cancrum. 1953;9:531–541.
3. Commission on Chronic Illness. Chronic Illness in the United States, vol. IV: Chronic Illness in a Large City, the Baltimore Study. Cambridge, MA: Harvard University Press; 1957:20–43.

4. Levin ML, Goldstein H, Gerhardt PE. Cancer and tobacco smoking: a preliminary report. J Am Med Assoc. 1950;143:336–338.

5. Wynder EL, Graham EA. Tobacco smoking as a possible etiological factor in bronchiogenic carcinoma, a study of 684 proved cases. J Am Med Assoc. 1950;143:329–336.

6. Doll R, Hill AB, Smoking and carcinoma of the lung: Preliminary report. BMJ. 1950;2:1071–1081.

© 2007 Lippincott Williams & Wilkins, Inc.

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