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First Do No Harm - 23/04/2010
 

A tribute to John Pemberton, Epidemiologist and Pioneer in Social and Preventive Medicine


1. Much of the groundwork leading to the post-war developments leading to the NHS need rehearsing as politicians and the public squabble over this tremendous enterprise that engages much charitable and voluntary input, as well as plenty of TLC - tender, loving, care. An obituary on John Pemberton - "an epidemiologist with a key role in social and preventive medicine, and in the international dissemination of research in the field" (Guardian 15/04/10) - records his death, aged 97, as a proud period of Britain's history and endeavour against a shameful period of neglect and ill will.

2. John Pemberton, born 18 November 1912, died 7 February 2010, manifested his mission itself in 1934, while he was still a medical student, in the publication of a paper entitled 'Malnutrition in England'. During the Jarrow Marches of 1936, he met some of the participants and helped to feed them and tend to their feet. This experience, along with contacts with Jeremy Morris, Somerville Hastings (president of the Socialist Medical Association), Philip D'Arcy Hart, and F.A.E. Crew (later professor of social medicine at Edinburgh University) "reinforced his belief in the importance of social and environmental factors in the etiology of many diseases".

3. John and an American colleague developed their interests in social and preventive medicine because of their ignorance of research and teaching in other countries. Out of this arose the 'International Corresponding Club' and the 'International Epidemiology Association' and then a renowned journal, 'The International Journal of Epidemiology'.

4. Seizing every opportunity that came up John used the first meeting of the charitable CIBA Foundation in London in 1956 to persuade the British and Irish participants to accept the need for an independent scientific society, and thus created the 'Society for Social Medicine'. A multidisciplinary academic society devoted to the study of health in its widest sense, it tackled the challenges in income, environment, and education on health. How much we must admire these pioneering advances into subjects still demanding serious thought and action.

5. In 1967, while professor of social and preventive medicine at the University of Belfast, he persuaded the Geigy Pharmaceutical Company to sponsor the All-Ireland Social Medicine meeting, which looks at health issues across national borders and continues to take place every two years.

6. John was recruited by Sir John (later Lord) Boyd Orr to be in charge of a mobile nutritional research team, which undertook a major survey in England and Scotland. This showed the effects of poverty on nutrition and was acknowledged by Lord Woolton, Minister of Food during WW2. It laid the foundation for the success of nutritional policy during the war. These were the days when our predecessors at the Vegetarian Nutritional Research Centre (VNRC) were involved in the controversies over the national loaf that extended to postwar developments on fortification and the ultimate formalisation in 1976 as 'the real bread campaign' as a part of the Vegetarian Society's Green Plans for farming, food, health and land, corollaries of which have survived as sustained efforts, with international significance, in VEGA's name. The wartime policy of the 'Ministry of Food' has been "considered by some to be the major reason for the improvement in the health of the UK population after 1939". (Jerry Morris earned fame with his comparisons of the cardiovascular health of bus conductors and drivers and the benefits of the formers' great exercise and lower levels of stress. Subsequent tests studied the effects of drinking on drivers' judgment.)

7. During a spell at Sheffield University with various appointments, John Pemberton worked with Hans Krebs on a series of nutrition-deprivation experiments for the development of a policy for shipwrecked sailors. (Hans Krebs's son John became the first chairman of the 'Food Standards Agency's Board' when it was founded a decade or so ago, partly to overhaul farm-to-fork policies that had become ruinous with the development of BSE and the shame of John Gummer. In contrast to John Gummer, John Krebs had abstained for a while from eating red meat).

8. In 1946 John Pemberton was appointed a senior lecturer in Sheffield and started to teach social medicine. His research encompassed the study of the health of the elderly at home, illness in general practice (which was probably the first description of the work of GPs) and socio-medical studies of hospital patients and student health. In the early 1950s John investigated the effects of air pollution on pulmonary illness. This led to a Medical Research Council award of funds to study the effects of respiratory disease. In 1958 John was appointed to the chair of social and preventive medicine in Queen's University, Belfast, where he stayed until his retirement. At Belfast he was the first to show that flax (an important local product) caused the lung disease byssinosis, which is caused likewise by cotton. As a result workers exposed to flax fibre became entitled to claim compensation. John's worldwide researches led to the creation of a WHO monitoring centre for the multinational monitoring of cardiovascular disease. These interests took him as a consultant to the WHO in India, Sri Lanka, Indonesia and the Soviet Union.

9. John's hobbies of painting, literature and walking epitomized his approach to life: "he was kind and gentle, stimulating, yet modest". Gwen, his wife, died in 1989. His partner, Maureen Maybin and his sons have survived him. With all medical epidemiologists we ask the question of changes of diet in about 1990, when BSE was running at its height. How did John Pemberton and his family respond to the evidence that influenced the experts at the then MAFF (and possibly still in office)? John Gummer is now one of David Cameron's advisers. He was not alone in ignoring the signs for personal dietary change. Warnings in different contexts are recurring - we hope with better individual responses in tests of consumer power. The obituary fails to answer relevant queries that could still be dealt with objectively and relevantly.

 
 
 

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