Howard Hiatt, champion of global public health, dies at 98

As a physician, educator and administrator, Dr. Hiatt had a substantial impact on medicine as a professor at Harvard Medical School, dean of the public health school and senior physician at Boston’s Brigham and Women’s Hospital.

His research career included a stint in the early 1960s at the Pasteur Institute in Paris, where he collaborated with future Nobel laureates on the identification of messenger RNA, a discovery that helped lay the groundwork for the Pfizer-BioNTech and Moderna coronavirus vaccines.

Nearly denied entry to Harvard in the 1940s because of quotas limiting the number of Jewish students, Dr. Hiatt was deeply attuned to injustices in medical access. As physician in chief from 1963 to 1972 at Beth Israel Hospital in Boston (now Beth Israel Deaconess Medical Center), he developed programs that brought medical care to underserved communities in the city.

In 1972, he was appointed dean of the Harvard School of Public Health (now the Harvard T.H. Chan School of Public Health). He told the Harvard Crimson newspaper that he had no background in public health but that the field needed fresh perspective.

“Over the years there has been a distortion of priorities in the health fields,” Dr. Hiatt said, adding that he hoped health professionals would shift their focus away from “curative prevention” and toward prevention.

Over the next 12 years, he nearly doubled the school’s endowment. In an effort to expand the school’s portfolio beyond traditional public health issues, he took a multidisciplinary approach. He established a center for the analysis of health practices, bolstered statistical sciences and created a Department of Health Policy and Management.

“He was meticulous and thought through what he wanted to accomplish,” said Alfred Sommer, dean emeritus of the Johns Hopkins Bloomberg School of Public Health.

Dr. Hiatt also recruited public health experts, including Donald Berwick, a future administrator of the Centers for Medicare and Medicaid Services, and Harvey Fineberg, who succeeded him at Harvard as dean of the public health school.

Around 1980, Dr. Hiatt began to turn his attention to what he called the “last epidemic” threatening the world: the nuclear-arms race between the United States and the Soviet Union. With other high-profile scientists and physicians, he served on a special committee convened by Pope John Paul II to study the consequences to humanity of the nuclear threat and to lobby world leaders about the findings.

When committee members went to the White House in December 1981, Dr. Hiatt asked President Ronald Reagan to imagine a one-megaton bomb exploding in Washington and destroying George Washington University Hospital, the medical center where the president had been treated after an assassination attempt that March.

“I tried to personalize it for the President,” Dr. Hiatt recounted to the New York Times. “I told him there would be 800,000 people in shock from burns and radiation. … Given these facts, those people who talk about winning or surviving a nuclear war don’t understand what they are talking about.”

In a commentary published in the New England Journal of Medicine in 1982, he criticized the Reagan administration’s five-year plan to spend $1.6 trillion on defense. Dr. Hiatt argued that cutbacks in essential biological, behavioral and health services — including what he described as massive reductions in federal child nutrition programs — “will adversely affect the health of our generation and of future generations” and that physicians had a responsibility to speak out in opposition.

Dr. Hiatt stepped down as dean in 1984 and joined Brigham and Women’s Hospital the next year as a senior physician. He had been a professor of medicine at the hospital since 1972.

He co-founded the hospital’s Division of Global Health Equity, and, in 2004, the hospital established a residency in global health equity and internal medicine named in honor of Dr. Hiatt and his wife, Doris.

“Throughout his professional life, Howard Hiatt brought compassionate and innovative approaches to health and medical care,” said Fineberg, president of the Institute of Medicine (now the National Academy of Medicine), in a 2007 ceremony honoring Dr. Hiatt. “He introduced fresh analytic methods to medical and public health education, fostered interdisciplinary approaches to complex health problems, [and] cultivated a new generation of socially responsible physicians.”

Howard Haym Hiatt, the oldest of three siblings, was born in Patchogue, N.Y., on July 22, 1925, and grew up in Worcester, Mass. The family name had been changed to Hiatt from Chaitowicz after his father, a Lithuanian immigrant who eventually ran a small shoe company, landed at Ellis Island alone as a teenager. His mother was a homemaker.

Dr. Hiatt said he felt called to medicine at age 12, when his mother almost died of a hemorrhage after surgery at a Harvard teaching hospital.

“I remember being so grateful to the surgeon who had taken care of her and who had seen her through surgery and then her recovery that I decided that this was a model for me,” he recalled in a 2006 video interview for Web of Stories, an online archive documenting the lives of renowned scientists and other notable figures.

Years later, when he had access to hospital records at Harvard Medical School, he learned that his mother’s surgery had not been necessary: Her hemorrhage resulted from a medical condition that had not been diagnosed.

Dr. Hiatt was valedictorian of his high school class in Worcester but was initially denied admission to Harvard because of the Jewish quotas in place at the time. After his principal protested to the dean of admissions, Dr. Hiatt enrolled in Harvard College in 1944 and, on an accelerated wartime program, graduated from Harvard Medical School in 1948 without completing an undergraduate degree.

Early in his career, Dr. Hiatt worked at the National Institutes of Health and joined the laboratory of Bernard Horecker, a distinguished biochemist who helped him secure a research position in 1960 with the Pasteur Institute.

Amid the scientific exploration ushered in by James Watson and Francis Crick’s 1953 discovery of the structure of DNA, Dr. Hiatt worked with Jacques Monod and other Pasteur colleagues to identify messenger RNA, a molecule in cells that carries genetic code, or instructions, for producing proteins.

In addition to co-authoring a landmark paper about messenger RNA in the journal Nature, Dr. Hiatt was one of the first scientists to identify messenger RNA in mammalian cells. In 1965, Monod shared the Nobel Prize in physiology or medicine with François Jacob and André Lwoff, two colleagues at the Pasteur Institute, for their research on gene regulation.

Dr. Hiatt was married to the former Doris Bieringer from 1947 until her death in 2007. Their son Fred Hiatt, the editorial page editor of The Washington Post, died in 2021. Survivors include two children, Deborah Hiatt and Jon Hiatt; eight grandchildren; and four great-grandchildren.

Dr. Hiatt was a past secretary of the American Academy of Arts and Sciences and directed its Initiatives for Children program. He contributed to “A Measure of Malpractice” (1993), a comprehensive survey of the malpractice system.

Throughout his career, Dr. Hiatt never forgot the mentors who helped him: their photographs hung on his office walls next to images of his grandchildren.

He acknowledged that he hadn’t heard of Horecker when he arrived at NIH. “But when I went into his lab, he opened my eyes to what science meant, what it could be,” Dr. Hiatt told the Boston Globe in 2013. “That was, in retrospect, probably the most important thing that ever happened to me.”