After Eighty Years By Louis I. Dublin (review)

BOOK REVIEWS After Eighty Years. By Louis I. Dublin. Gainesville: University of Florida Press, 1966. Pp. 243. $6.50. This book, like its author, is quiet, modest, and remarkable. It is the record ofa man's life and, at the same time, a description ofvital steps in the development ofthe relation of medical statistics to public health, modestly understating the author's role in this. It also evokes the human history ofthis country during the last decades of the nineteenth century and the first decade ofthe twentieth, calling up "The Steerage" before one's eye, that famous photograph by Alfred Stieglitz ofthe arrival ofa boatload ofimmigrants in the port ofNew York in 1907, when this country was still a land of hope for all men. Dr. Dublin's recollections ofhis own family and childhood give one an appreciation of the courage, energy, imagination, and intelligence of those immigrants who, with their own hard work, won out over poverty, deprivation, and overcrowding. It also shows how they were assisted by the generosity of a few dedicated and longer-established citizens , who had not forgotten the original purpose ofthe country or what it meant to be a pioneer, and who donated their time and substance to the service of the newcomers. We have a right to take pride in this story—even as we ask ourselves how we have lost so much ofthis spirit and how we can recapture it. Yet Dublin himself would emphasize, rather, the story of the creation of a new discipline : the precise biometrics of medicine, of public health, and of sociology. He does not say so; yet these owe much oftheir present status to him. His own education had led him first through the teaching of English to other foreigners, then to mathematics, economics, and educational psychology, and finally into biology, which was the field in which he gained his doctorate at Columbia University. From this he turned to the study ofhealth and ultimately to the vice-presidency ofthe Metropolitan Life Insurance Company in charge ofits statistical investigations. It was from this platform that he was able to apply precise statistical methods to a wide variety ofproblems, all ofwhich dealt with human health and welfare. He contributed to the writing of more enlightened public health laws and to the launching of state and national efforts to improve public health. The many intermediate steps involved the more accurate registration of births and deaths; the study ofvariations in infant and maternal morbidity, mortality, and birth rates; the care ofthe aged and studies ofthe costs ofmedical care in general; the studies oftuberculosis, which led to the launching of "Altro" (as a sheltered workshop initially for the tuberculous and later for those suffering from chronic diseases, especially heart disease and mental illness); studies ofthe special problems ofNegro health, oflongevity, and its relationship to marriage and divorce, and of the education of women. Included 522 Book Reviews Perspectives in Biology and Medicine · Spring 1968 were the special problems ofdental caries and fluoridation. These are only some ofthe many issues to which he turned his attention and that ofthe expanding group ofassociates who made up his staffand whom he trained. He contributed to the field ofpublic health still further by serving for many years on the Boards of the American Public Health Association and of many other voluntary public health agencies. He also served the Suicide Prevention Center in Los Angeles, the American Museum ofHealth, and the Health Departments ofthe armed services. Interspersed among these diverse activities were many missions abroad for the American Red Cross and for the Rockefeller Foundation, before, during, and since World Wars I and II, that is, to Italy, Greece, Yugoslavia, France, England, and central and eastern Europe. Even after his formal retirement from the Metropolitan Life Insurance Company, he continued active investigations for the Institute ofLife Insurance. In 1963 he completed the revision of his classical study of suicide, which had been published in 1934 under the title To Be or Not To Be. The revision was called simply, Suicide, a Sociological and Statistical Study. His autobiographical reflections, After Eighty Years, are subtitled, The Impact ofLife Insurance on the Public Health. When the book was published in...