Howard H. Hiatt, a physician, scientist and academic who reshaped the field of public health, moving it away from the narrow study of infectious diseases toward larger issues of financial and social responsibility in medicine, died Saturday at his home in Cambridge, Mass. He is 98 years old.
His son Jonathan Hiatt said the cause was pulmonary hypertension.
Harvard Public Health, a magazine published by the Harvard School of Public Health, where Dr. Hiatt was dean for 12 years, wrote in 2013 that Dr. Hiatt “made public health the conscience of medicine.”
Early in his seven-decade career, Dr. Hiatt in Paris with future Nobel Prize winners for the discovery of messenger RNA, a key element of cellular biology. He later visited the White House to urge President Ronald Reagan to end the build-up of nuclear weapons at the time, which Dr. Hiatt that “the last epidemic.”
A Harvard-trained physician who has held leadership positions at some of the nation’s most prestigious hospitals, Dr. Hiatt is an outspoken critic of inequities in American health care. He accused American medicine of being biased toward expensive, high-tech treatments while excluding millions of people from primary care.
In a 1987 book, “America’s Health in the Balance: Choice or Chance?,” he argued for universal government-run health insurance, modeled on aspects of the systems in Britain, Canada and China. “I am very eager to reach people who are naive to accept the prospect of two-class medicine in America,” he told The Toronto Star.
At the Harvard School of Public Health (now Harvard TH Chan School of Public Health), where Dr. Hiatt was dean from 1972 to 1984, he brought together experts in various disciplines, including biostatistics and health management, to focus on the economic, political and social causes of poor health, not just the biological ones. factor.
“He changed education at the Harvard School of Public Health and the very definition of what the field of public health is,” Dr. Harvey V. Fineberg, a colleague of Dr. Hiatt who in 2002 became president of the Institute of Medicine (now the National Academy of Medicine), said in an interview.
Looking beyond US shores, Dr. Hiatt later became the founder of the Division of Global Health Equity at Brigham and Women’s Hospital in Boston, an unusual commitment by a teaching hospital to expand its resources to care for the sick and poor abroad.
The program is a launchpad for Partners in Healtha recognized nonprofit that provides health care to poor communities in Haiti, Africa and elsewhere, founded in 1987. The organization’s founders include two Harvard medical students, Paul Farmer and Jim Yong Kim, who considered Dr. Hiatt as a father.
“He took it upon himself to literally teach hundreds of young people who came through Harvard Medical School and Brigham and Women’s Hospital who wanted to make a difference in the world,” said Dr. Kim in an interview.
When Dr. discovered Kim and Dr. Farmer’s outbreak of drug-resistant tuberculosis in Peru in 1995, they ran up a $100,000 bill to the Brigham hospital pharmacy for specialty drugs. Soon, the president of the hospital was on the phone with Dr. Hiatt complaining about debt. Dr. found Hiatt got a donor to cover the costs, and he later helped Partners in Health secure a $45 million grant from the Gates Foundation.
Dr. Farmer, the subject of a 2003 book by Tracy Kidder, “Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World,” died in 2022. Kim has been president of Dartmouth College and the World Bank.
When Dr. Kim in 2011 that Dr. Hiatt never actually graduated from Harvard College — he skipped medical school — he wrote a “diploma” on a napkin from the Hanover Inn honoring Dr. Hiatt a Dartmouth BA Dr. Hiatt framed it and hung it in his home.
Howard Haym Hiatt was born on July 22, 1925, in Patchogue, NY, on Long Island, to Alexander and Dorothy (Askinas) Hiatt. His father immigrated from Lithuania alone at 15. The family, its name changed from Chaitowicz to Hiatt, moved to Worcester, Mass., where Alexander Hiatt ran a small company shoes.
Howard was her valedictorian in high school, but she initially didn’t get into Harvard; there was, he recalled later in life, a quota on the number of Jews that could be admitted at the time. After his high school principal protested to the dean of admissions, he was allowed to enroll in 1944. He entered Harvard Medical School two years later.
While there, he met Doris Bieringer, a student at Wellesley College; the couple married in 1948, the year Dr. Hiatt his MD Mrs. Hiatt studied library science and was the founder of a magazine that reviewed books for school libraries. He died in 2007.
In the mid-1950s, Dr. Hiatt is a researcher at the National Institutes of Health. That work led to a one-year lab position in 1960 at the Pasteur Institute in Paris, then a center of the exciting new field of molecular biology.
In Paris, he worked under Jacques Monod and François Jacob, the future winners of the first Nobel Prize named and described messenger RNA, a molecule that transfers genetic codes to produce proteins. It is messenger RNA that became the foundation of the first Covid-19 vaccines approved for use in the US60 years later.
Back in Boston, Dr. Hiatt in 1963 became both a professor of medicine at Harvard Medical School and the chief physician at Beth Israel Deaconess Medical Center. His research focuses on the application of molecular biology to medical problems, especially cancer. He was one of the first to demonstrate messenger RNA in mammalian cells.
As he raised research and clinical standards at the hospital, it became a magnet for medical school graduates seeking residencies. Medical schools tried to hire Dr. Hiatt to be their dean. He turned down Columbia and Yale before accepting the leadership of the Harvard School of Public Health.
“Historically, the school has been so strong in tropical medicine, sanitary engineering and other specialties that in recent years have seemed to have little relevance to the public health issues facing this country,” wrote The Boston Globe in appointed Dr. Hiatt in 1972.
But the rapid changes he introduced made him enemies, and in 1978 a group of tenured professors signed a petition calling for his ouster, complaining of his “administrative incompetence.”
Derek Bok, the president of Harvard, who recruited Dr. Hiatt, rebuffed the attempt to remove him.
In December 1981, Dr. Hiatt to a delegation sent by Pope John Paul II to explain to President Reagan the medical consequences of a nuclear exchange. “The president is not very comfortable with our visit,” Dr. Hiatt remembered in 2006 for Web of Stories, an archive of oral histories by scientists and others.
Besides his son Jonathan, a labor lawyer, Dr. Hiatt has a daughter, Deborah Hiatt, an actress; a brother, Arnold Hiatt; eight grandchildren; four great-grandchildren; and his longtime companion, Penny Janeway. His son, Fred Hiatt, the longtime editorial page editor of The Washington Post, died in 2021.
In 2004, Dr. Hiatt and his wife established residence at Brigham and Women’s Hospital that trains physicians in internal medicine and global public health. Many of the 70 or so physicians who have gone through the program have gone on to work in Haiti, Lesotho and other poor countries where Partners in Health operates.
Visited by Dr. Hiatt many of the international clinics, which gave him inspiration and purpose in his later years, Jonathan Hiatt said.
“That actually added 15 years to my father’s career,” he added.
