Howard Hiatt, 98, deceased; Steered public health toward greater responsibility

Howard H. Hiatt, a physician, scientist and academic who reshaped the field of public health and moved it away from the narrow study of infectious diseases to major issues of fiscal and social responsibility in medicine, died Saturday at his home in Cambridge, Massachusetts. He was 98.

His son Jonathan Hiatt said the cause was pulmonary hypertension.

Harvard Public Health, a journal published by the Harvard School of Public Health, where Dr. Hiatt was dean for twelve years, wrote in 2013 that Dr. Hiatt ‘made public health the conscience of medicine’.

Early in his seventy-year career, Dr. Hiatt in Paris with future Nobel Prize winners on 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 era’s nuclear weapons buildup, which Dr. Hiatt called “the last epidemic.”

Dr. Hiatt, a Harvard-educated physician who held leadership positions at some of the country’s most prestigious hospitals, was an outspoken critic of inequities in American health care. He accused American medicine of favoring expensive, high-tech treatments while excluding millions of people from basic care.

In a 1987 book, “America’s Health in the Balance: Choice or Chance?”, he advocated government-run universal health insurance, modeled after aspects of the systems in Britain, Canada and China. “I especially want to reach those who are so callous as to accept the prospect of two-class medicine in America,” he told The Toronto Star.

At the Harvard School of Public Health (now the Harvard TH Chan School of Public Health), where Dr. Hiatt was dean from 1972 to 1984, he brought together experts from various disciplines, including biostatistics and health management, to focus on the economic, political and social causes of poor health, not just the biological factors.

“He transformed education at the Harvard School of Public Health and the very definition of what the field of public health meant,” Dr. Harvey V. Fineberg, a colleague of Dr. Hiatt, who became president of the Institute of Medicine (now the National Academy of Medicine) in 2002, said in an interview.

Dr. Looking beyond America’s shores, Hiatt later founded 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 was a launching pad for Partners in healtha critically acclaimed nonprofit organization providing health care to poor communities in Haiti, Africa and elsewhere, founded in 1987. The organization’s founders included two Harvard medical students, Paul Farmer and Jim Yong Kim, who became Dr. regarded Hiatt as a father figure.

“He took it upon himself to mentor literally 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. Kim and Dr. Farmer discovered a drug-resistant outbreak of tuberculosis in Peru in 1995, they were left with a $100,000 bill at the Brigham hospital pharmacy for specialty drugs. Soon the hospital president was on the phone with Dr. Hiatt, who complained about the debt. Dr. Hiatt found a donor to cover the costs, and 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. Dr. Kim later became president of Dartmouth University and the World Bank.

When Dr. Kim learned in 2011 that Dr. Hiatt had not actually graduated from Harvard College—he had transferred to medical school—he wrote a “diploma” on a napkin from the Hanover Inn, awarding Dr. Hiatt a Dartmouth B.A. 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, the son of Alexander and Dorothy (Askinas) Hiatt. His father had emigrated alone from Lithuania at the age of 15. The family, whose name changed from Chaitowicz to Hiatt, moved to Worcester, Massachusetts, where Alexander Hiatt ran a small shoe company.

Howard was his high school valedictorian, but he was initially denied admission to Harvard; there was, as he recalled later in his life, a quota on the number of Jews who could be accepted at the time. After the principal of his high school protested to the dean of admissions, he was allowed to enroll in 1944. Two years later he entered Harvard Medical School.

While there, he met Doris Bieringer, a student at Wellesley College; The couple married in 1948, the year Dr. Hiatt received his doctorate. Ms. Hiatt studied library science and founded a magazine that reviewed books for school libraries. She died in 2007.

In the mid-1950s, Dr. Hiatt researcher at the National Institutes of Health. That job led to a year-long laboratory job 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 Nobel Prize winners who were the first called and described messenger RNA, a molecule that carries genetic codes to make proteins. It was messenger RNA that formed the basis for the first Covid-19 vaccines approved for use in the US60 years later.

Back in Boston, Dr. Hiatt became both professor of medicine at Harvard Medical School in 1963 and physician-in-chief at Beth Israel Deaconess Medical Center. His research focused on applying molecular biology to medical problems, particularly 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 residency. Medical schools tried Dr. Hiatt to become their dean. He turned down Columbia and Yale before accepting the leadership of the Harvard School of Public Health.

“Historically, the school has been very strong in tropical medicine, sanitary engineering and other specialties that in recent years have seemed to have little relevance to the public health problems facing this country,” The Boston Globe wrote when Dr. Hiatt’s was appointed in 1972.

But the rapid changes he implemented 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 Dr. Hiatt, rejected the attempt to oust him.

In December 1981, Dr. Hiatt joined a delegation sent by Pope John Paul II to explain to President Reagan the medical consequences of a nuclear exchange. “The president was not very comfortable with our visit,” says Dr. Hiatt remembered in 2006 for Web of Stories, an archive of oral histories by scientists and others.

In addition to his son Jonathan, an employment lawyer, Dr. Hiatt is survived by a daughter, Deborah Hiatt, an artist; 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 a residence at Brigham and Women’s Hospital, which trains physicians in internal medicine and global public health. Many of the approximately 70 physicians who have completed the program since then have gone on to work in Haiti, Lesotho and other impoverished countries where Partners in Health operates.

Dr. Hiatt attended 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.