Draft
11/25/55

Health Education and Medical Research

I am very happy that I was asked to speak to you on this occasion.
There are few subjects of greater importance than the health of the
American people. And there are all too few opportunities to pay tribute

to those whose lives are dedicated to this cause.

It is of course not b¥ chance that this fall meeting of the New
England Health Education Association coincides in time and place with
another important gathering focused on the Nation's health. I understand
that the Clinical Sessions of the American Medical Association are just
concluded. I know that thousands of our physicians are Leaving Boston
refreshed and stimulated by what they have seen and heard. These meetings
are a unique and indispensable means of giving practicing physicians new
insight into the application of the latest knowledge to today's complex
problems of health and disease.

To you, Dr. Hess, and through you to the men and women you represent
in the practice of medicine, I would extend congratulations and good wishes.
You serve our people well in challenging times. we look to you for
leadership in meeting the health problems of today and in anticipating
those of tomorrow. More and more of us will benefit in full measure from

the knowledge and the skills you possess.

I would like to pay a special tribute to the guest of honor today,
one who has pioneered in the field of public health. In his teaching and

in his practice, Dr. Hiscock has helped shape the profession of public
 

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health, and I am gratified that I can add my word of commendation to those
he has already heard today,

You will forgive me, I know, if I refer for a moment to my state,
the neighbor of Massachusetts to the south, Rhode Island. We Rhode
Islanders are proud to be linked with the other New England states as
the birthplace and the cradle of public health consciousness and action
in the United States. And we are pleased and honored to be represented

Or Allan Sellivan

at this meeting by such outstanding people as John Farrell,/George

é br John Farley
Kennédy, Mrs. Veronica Sullivan,/’and others whose work is well known

¥
to all of youe

My topic is "Health Education and Medical Research."

I am not a health educator. I have never done any medical
research. It therefore would be inappropriate for me to attempt to
define either health education or medical research in the presence of
a group which includes professionals in both fields. It would be even
more inappropriate for me to make suggestions as to how I think either
one should be conducted,

However, particularly during the past 15 years, I have had a
great interest in both medical research and health education. It has
become necessary for me to know something about both in the course of
my work. I have been privileged to be a member of a congressional
committee which has had the responsibility of providing appropriations

totalling hundreds of millions of dollars for medical research and

health activities,
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My qualifications to speak to you on these subjects, then, are
those of a relatively well-informed layman, a legislator, and a citizen
who has the same stake in medical research and health education as
have all of our 165 million citizens. In this sense, I can give you
the "practical" working views of a legislator and a citizen who may
be regarded as more or less typical of the public as a whole,

The public has great faith in medical research. And so the public
supports medical research, to the extent of millions of doilars each
year, given directly to voluntary health organizations, or appropriated
from public funds raised by taxes. The public encourages medical
research, and sometimes attempts to push it farther and faster than
research itself can go. New ways to prevent disease, to cure disease,
and to prolong life are the final payoff of medical research, and the
results are what the public understandably and properly expects from
medical research. Each new discovery is greeted with public acclaim,
followed by expectation of even greater and more difficult achievements,

The hypothetical average man does not see the part of the research
iceberg that is under water — the long patient search for basic knowledge,
the slow accummulation of facts, the rigorous training process, the
interdependence of the sciences, and the interweaving of research and
higher education. All of these werlying factors that are taken for
granted by scientists and educators are understandably of little or no
concern to the average person.

The average practical man in the United States has a faith in
education more deep-rooted and possibly even stronger than his faith

in medical research, and he makes demands upon education as great as,
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or even greater than his demands upon research. Our average practical
man has little technical knowledge of health education as known to
professional health educators. He may not even be familiar with the
term itself. But he has at least an unformulated awareness of it in
which are blended many of his feelings and ideas about both health and
education. This combination carries with it faith, expectations, and
demands which are tremendous.

Once some new information has been produced by research and
translated into usable medical knowledge by way of clinical investi-
gation, all the good things that follow from there on are the result
of a number of processes which our practical citizen is likely to look
upon collectively as health education. This very simplified concept
would see all medical education, professional education, health depart-
ment activity and the work of the professional health educator as parts
of health education. The practical man, holding these simple views, is
probably no more concerned with the views of professional health educators
ga the meaning of health education thar with the views of research
workers on the meaning of research. Results are what he expects from
both groups, and the process by which results are achieved is secondary
to hime

These oversimplified views of the ordinary citizen have a certain
basis in reality. During recent years the public has seen millions of
dollars invested in medical research. They have seen results come from
research which have made possible great advances in individual and public

health--advances which understandably have led to the popular use of
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such words as "wonder drugs" and "miracle drugs." They have seen vast
nation-wide campaigns which have saved thousands of lives....not just
abstract statistical lives, but the lives often of members of their
own families, or of their neighbors.

For example: during the past 15 years I have watched research,
health education, and medical and public health practice make phenomenal
gains over two dreaded diseases, syphilis and tuberculosis, These
changes have been so far-reaching that they have profoundly affected
the health profile of our country. And today the entire world is
watching, as though from the sidelines of a football game or from
seats in a theater, each dramatic development that appears to be
leading rapidly toward the control of another much-feared disease,
poliomyelitis. The average citizen sees this simply as another new
weapon against disease, produced by medical research, and widely
applied through familiar public health methods which he associates

with health education.
Less dramatic, less widely known as yet, is the potential control
of rheumatic fever and rheunatic heart disease. But already the public
is becoming aware of the fact that rheumatic fever can be prevented by
the treatment and prevention of streptococcal infections, Research has
provided the information, health education is spreading it and achieving

its application.

The public is also aware of recent discoveries of drugs that have
had extraordinary effects, occasionally dramatic, on some patients with
mental illness, This they accept as another result of research, and they
are confident that research will pursue these new clues, or as yet
undiscovered clues, and dig out information which will lead to more and

better control of mental illness,

The public further is aware that medical research has made at
least small scratches on the hard surface of the problem of cancer; the
public is confident that research ultimately will find more useful facts
about the cause of cancer, its prevention, and its cure, The public is
equally confident that health education will keep all of the people
informed of the progress and will bring them the ultimate application of
this information by way of the medical profession, health departments,
and all of the other health education processes whereby research discoveries

become daily health realities.

Similarly, the public realizes that atherosclerosis, the disease

which causes more deaths than any other, can be controlled only when
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research has found answers to the questions of cause and prevention,

and when such answers have been made widely known.

These ideas of medical research and health education may be
oversimplified and over-optimistic. But whether they are or not, I
believe they represent the ideas of the great bulk of our population.
They exist partly because they express the wishes and hopes of the people,
partly because of what medical research has done for them in the past,

and partly because of what health education has taught them to believe.

If, for sake of definition, we accept the fact that health education
is all of the processes of communication, individual and collective,
by which research is transformed into improved public health, it becomes
crystal clear that health education is an integral part of medicine itself,
and that the physician is the keystone. He is the most eloquent and
persuasive of all health educators, as he pursues his task of helping

people achieve health and prevent disease,

Nonetheless, the physician should be--and, I imagine, is--the

first to emphasize the essentiality of his professional colleagues~-the

anurse,/the social workers,\the health educator. J

There is another relationship which should be explored-«that between
health education and medical research. Just as the physician and the
health educator are allies, so it is--or should be =-with the scientist

and the health educator,
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The scientist. publishes findings in professional journals or at
professional meetings, The scientific world seizes his findings, digests ,
evaluates and verifies them, using them in large measure for further
research, This is as it should be. But gradually from research emerges
a technique, a drug, a treatment which is ready to move into clinical
trial and finally to general use. It is here, as I understand it, that
health education moves to the forefront, for conmunication becomes the
essential ingredient in this transition, The knowledge yielded by
research must be communicated to the professional world, and to the
general public, and everyone in the total spectrum of the health profession

bears a share of the obligation to conduct this educational program
successfully.

I promised earlier that I would resist any inclination I might feel

to comment on matters of professional judgment in your field.

May I make one partial exception to that? There is one particular
thing which I feel very strongly and deeply, and I would like to share

it with you,

It has to do with the pace at which knowledge that can be applied

is increasing.

You know, as I do, that medical research is continuing to provide
new and significant data about health and disease, Since the war, the
volume of medical research in this country has increased about five-fold

as we have begun to face up to some of the issues posed by chronic illness.
And facts are beginning to become available--bits and pieces of information
that are not answers, in themselves, but that suggest with a high degree

of certainty that answers will be forthcoming,

This means that the health education burden will continue to grow
in size and importance, Already we see some of the signs, There are things
that can be done to treat some forms of heart disease, some tests that
promise to be of value in cancer diagnosis, some drugs and techniques
that are useful in the treatment of mental illness. There are measures
to keep diabetes under control, to ease the suffering of arthritics, to
improve by rehabilitation the status of the victims of various neurological
disorders. Thus, in net effect, the pool of information which demands
application is growing, and will continue to grow, Yet already, it would
appear, the demands on health education are great..sperhaps, in part,
because it can never be assumed that any problem in education can become
a closed book. The lessons have to be repeated over and over again, in

different ways for different audiences, in order to keep the message alive,

In this, it seems to me, lies the great challenge to all of us
whose mission in whole or in part is better health for more people, It is
to find ways to strengthen health education in all of its forms and for
all of its audiences, so that instead of falling behind in the race between
knowledge and application, we can progressively narrow the gap, so that
ultimately there will be a minimum of lag in the broad application of

health measures.
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This challenge, if it is to be met, imposes obligations on all of
our society, It is meetings such. as this which give one faith that the
challenge can and will be met. And if the breadth and the extent of the
problems seem enormous, it must be remembered that both our resources

and our resourcefulness are great,

If we look at it as a chemical reaction, with research fed into
the process and with health as the end product, we can see that health
education is the catalyst, the force without which the reaction will not
take place. The catalyst will work only if each group, and each individual
within each group, does a share of the job carefully and well, and in

complete harmony with all others of common purpose.

To you, Dr. Hiscock, and to you, Dr. Hess, and to all of you
whose lives and work are linked with the preservation of health and the
prevention and treatment of disease, I would convey a message of courage
and hope, Americans, and people all over the world, are grateful to

you for what you do,