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Reflections from a pioneer of preventative health care

At 91, Jack Farquhar reflects on the growth of the field of preventative health, his longevity, the importance of community and more.

Nearly six decades ago, an ambitious intern named John "Jack" Farquhar, MD, treated a patient who suffered from cardiac complications related to high blood pressure and high cholesterol.

The case weighed heavily on Farquhar's mind -- both because of the patient's relatively young age (he was in his 40s), and because of its preventable nature. The patient also mirrored a worrying trend in the U.S. At the time, the country was mired "in the middle of an epidemic of post-World War II expansion of smoking and intake of saturated fat, and the beginning of a decrease in physical activity due to factors like the automobile and automation," Farquhar explained.

Today, prevention is a buzzword in medicine. But that wasn't always the case.

In a recent Department of Medicine article, Farquhar, professor of medicine and health research and policy, emeritus, spoke about his lifelong interest in preventative medicine and health improvement, his work with the Stanford Prevention Research Center -- which he co-founded in 1972, and the secret to his own longevity (he turned 91 this year). Here are a few highlights:

On feeling like a "bit of a loner" as an early champion of cardiovascular disease prevention:

We went through some post-war exuberance after World War II with the returning veterans. Smoking rates increased, as did our dietary intake of saturated fat from meat and dairy. I had been exposed to the concept of preventability during my residency training with my patients, but it was the beginning of an era. Colleagues joined in slowly, but I was a little bit of a loner in that respect.

On the slow adoption of preventative medicine:

It was a new way of thinking, but by the 1970s it was gaining momentum internationally. Within the United States, our colleagues at the University of Minnesota in particular were similarly inclined. We created nutrition and anti-smoking campaigns with the American Heart Association, and we formed policy groups and became a pressure group to influence the National Institutes of Health to pay attention to the prevention side of cardiovascular disease.

On the importance of community engagement:

There was a lot of attention on techniques like heart transplants, but I was convinced that saving people one by one was not the most effective way to address the problem. I realized the need to make permanent lifestyle changes to prevent cardiovascular disease by reaching people in the community where it was needed the most.

That led me, with Henry Breitrose and Nathan Maccoby in the (former) Stanford Department of Communication, to create a multimedia campaign to motivate and educate communities to undertake major lifestyle changes. That was really the beginning of the "total community" approach at the SPRC -- the idea that you can mobilize a community using newspapers, radio, and television to provide information to people to help change their lifestyles.

On the secret to his longevity:

I can't answer that too well, but I have tried to pay attention to lifestyles that are relevant to successful aging. I remain active but am very, very realistic. I am involved with the Health Improvement Program, and until recently I was giving webinars on various topics in nutrition, cancer, and diet.

Photo by Steve Fisch

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