George W. Comstock

George W. Comstock
Portrait of G. W. Comstock by Cedric Egeli (2006)
Born	George W. Comstock (1915-01-07)January 7, 1915 Niagara Falls, New York
Died	July 15, 2007(2007-07-15) (aged 92) Smithsburg, Maryland
Nationality	American
Education	Antioch College (undergraduate), Harvard Medical School (MD), University of Michigan (MPH), Johns Hopkins University (DrPH)
Occupation(s)	Epidemiologist and physician
Known for	Tuberculosis epidemiology, editor of American Journal of Epidemiology

George Wills Comstock (January 7, 1915 – July 15, 2007) was a public health physician, epidemiologist, and educator. He was known for significant contributions to public health, specifically in the fields of micronutrient deficiencies, tuberculosis, and cardiovascular disease.^[1][2] He served as the editor-in-chief for the American Journal of Epidemiology.^[2]

Born in Niagara Falls, New York, on January 7, 1915, George W. Comstock was the son of metallurgical engineer George Frederick Comstock and Ella Gardner Wills Comstock. He graduated from Antioch College in 1937 with honors in biology and chemistry, originally planning on becoming a metallurgist.^[1] He ultimately decided to pursue medicine and graduated from Harvard Medical School with a doctor of medicine in 1941.

Comstock joined the U.S. Public Health Service in 1942 and served as a captain for 21 years. In this role, he ran the first trials of the BCG vaccine for tuberculosis in Georgia and Alabama (1947–1951), the findings of which were crucial to the decision not to implement this vaccine in the United States.^[1] It was also one of the first, if not the first, use of a cluster-randomized study design.

He received a Master of Public Health from the University of Michigan School of Public Health (1951) and Doctorate of Public Health in Epidemiology from Johns Hopkins (1956). He subsequently joined the faculty at the Johns Hopkins University Bloomberg School of Public Health and taught there for more than 50 years.^[3]

In 1957, he led research in Bethel, Alaska, estimating the high burden of tuberculosis and demonstrating the drug isoniazid's effectiveness in preventing the disease.^[1]

In 1962, Comstock founded the Johns Hopkins Training Center for Public Health Research and Prevention in Hagerstown, Maryland. During this time, together with Abraham Lilienfeld, he came up with the pioneering idea of using biologic samples in cohort studies. For the next 42 years, Comstock oversaw community-based research studies on numerous diseases including cancer and heart disease, including the Cardiovascular Health Study (CHS), the Campaign Against Cancer and Stroke (CLUE I), the Campaign Against Cancer and Heart Disease (CLUE II), and the Atherosclerosis Risk in Communities (ARIC) study. He also may have conducted, the first case-cohort study reported in the literature, four decades ago, dealing with the relationships of maternal smoking to risks of neonatal and post-neonatal death.

Comstock also served as editor-in-chief of the American Journal of Epidemiology (AJE) from 1979 to 1988. He was subsequently the editor-in-chief, emeritus, from 1991 to 2007.^[3] Volume 167, issue 7 of AJE was dedicated entirely to Comstock following his death.^[4]

In his 2006 curriculum vitae,^[3] Comstock summarized his research as follows:

Although I seem to be generally associated with tuberculosis, a review of my publications will show that my research interests have been very broad. The common thread through most of these studies has been that they are based on local communities— Muscogee county, GA; Bethel area of Alaska; and Washington County, Maryland. During the past 30 years, a major part of my research has dealt with the relationships of serum or plasma concentrations of micronutrients, hormones, and viral antibodies to the subsequent development of cancer. More recently, the interactions of gene and environmental characteristics have been a major focus. I have also been concerned with some of the elementary (but ignored) problems of long-term storage of biologic specimens— temperature variation within freezers, changes on concentrations of analytes with prolonged storage, and the degree of agreement of analyte concentrations in specimens from the same individual separated by years of storage. Another major portion of my research has been collaboration in studies of cardiovascular outcomes associated with serologic and clinical characteristics determined years earlier. Specifically, this has involved linkage of records from the Washington County portions of ARIC (Atherosclerosis Risk in Communities) [1] and CHS (Cardiovascular Health Study) [2] with records from our two big blood collection projects, CLUE I and CLUE II [3]. The combination is a unique resource.

Comstock authored hundreds of scientific papers and received numerous awards, including the John Snow Award from the American Public Health Association, the Edward Livingston Trudeau Medal from the American Thoracic Society, the Maxwell Finland Award for Scientific Achievement from the National Foundation for Infectious Diseases and the National Heart, Lung and Blood Institute's Career Research Award.^[5][3]

His work influenced generations of students, many of whom now hold public health leadership positions throughout the world. His contributions to the science of epidemiology were notable. For example, Comstock often mentioned "compensating bias" and the difference between the external validity of a measure of frequency and that of a measure of association, years before this concept was reported in the literature. He was also responsible for the notion that case-control studies test effectiveness, not efficacy, of interventions.

In 2005, the Hopkins center in Hagerstown, Maryland, was renamed The George W. Comstock Center for Public Health Research and Prevention.^[6]

George Comstock frequently quoted these words from Horace Mann's 1859 commencement speech at Antioch College:^[7]

I beseech you to treasure up in your hearts these my parting words: Be ashamed to die until you have won some victory for humanity.

This struck him as the main purpose of living; as Comstock said,

Most of us aren't going to win any big victories, but we can win little ones every day, and they mount up.

• "Lucky all my life": a documentary about G.W. Comstock [4]