Lives of the fellows

Frederick Hermon Epstein

b.24 July 1916 d.23 May 1995
BA Cantab(1940) MRCS LRCP(1943) MA(1944) MB BChir(1944) MD(1956) FRCP(1990)

Fred Epstein’s distinguished career spanned several decades, during which time he played a central role in the development of cardiovascular disease epidemiology. He was born in Frankfurt, Germany, where his father ran the family business, a leather factory, founded by Fred’s grandfather. His mother was a gifted artist. It was assumed that Fred would take his father’s place at the factory, but, in 1937, after two years at the University of Zurich, he decided to go to England to continue his studies in biochemistry at Cambridge University.

When war broke out and the need for doctors grew urgent, Fred changed to medicine. He went to University College Hospital for his clinical training, graduating in 1944. He went on to Wales to practice as a general practitioner. It was there he met Archie Cochrane [Munk’s Roll, Vol.VIII, p.95] who introduced him to epidemiology and persuaded him to study the epidemiology of pneumoconiosis in miners.

After the war he went to the United States, where he did clinical research in kidney physiology at New York University College of Medicine. In 1951 Fred was asked to undertake a study on the relation between cholesterol and coronary heart disease. The purpose of the study was to determine the reasons for the different rates of atherosclerosis among men and women of Italian and Jewish descent. The Italian and Jewish Garment Workers Study was a landmark in research. It was also the first study conducted by the newly opened research department of the Sidney Hillman Health Centre. Fred Epstein served as the director of the department from 1951 to 1956.

Fred moved to the University of Michigan in 1956, where he was lecturer, associate professor and then professor in the department of epidemiology at the School of Public Health. Shortly after arriving in Michigan, Fred was asked to head the pioneering community-based Tecumseh study to investigate the health and disease of an entire community, not just individuals with certain symptoms. Researchers sought to understand the interaction between individuals, their families, and their environments to develop a comprehensive programme of prevention. Tecumseh was among the first studies of cardiovascular risk and the first to develop risk profiles for other chronic illnesses, such as rheumatic disease, bronchitis and diabetes.

Over the years Fred's work gained international recognition. He participated in the first World Health Organization conference on methods of cardiovascular epidemiology in Geneva in 1959 and throughout his career served as a consultant to both the WHO headquarters in Geneva and the regional office for Europe in Copenhagen. He played a decisive role in the development of the early myocardial infarction registers of the MONICA project (Monitoring Trends and Determinants in Cardiovascular Disease) and the Comprehensive Community Cardiovascular Control Programmes.

In 1973 Fred joined the Institute of Social and Preventive Medicine at the University of Zurich. He was scientific consultant for the Swiss National Science Foundation Programme on the Prevention of Cardiovascular Diseases. He also regularly spent time in Bethesda, Maryland, as a scientific adviser to the National Heart, Lung and Blood Institute.

For more than three decades Fred was an active volunteer for the American Heart Association (AHA). He headed the subcommittee on Criteria and Methods of the Committee on Epidemiology Studies, which later became the Council on Epidemiology and Prevention. In this capacity he directed the AHA pooling project, the first statistical summary of cardiovascular disease risk based on extant US cohort studies. He chaired the council in 1968 and 1969 and for nearly two decades served as international editor of the Cardiovascular Disease Epidemiology Newsletter. He also served as chief editor of the scientific journal of the Swiss Society for Social and Preventive Medicine.

In addition to his critical role in public policy for prevention, he also made seminal contributions to research understanding in a series of reviews, including observations on the parallel mortality trends for cardiovascular and non-cardiovascular diseases and the commonality of their risk factors.

He married his second wife, Doris, in 1972. He had two sons from his first marriage to Inge. He died at his home in Zurich from a ruptured aortic aneurysm.

M F Oliver

[Brit.med.J., 1995,311,1295]

(Volume X, page 131)

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