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Stanford Report, May 21, 1997

Farquhar hands SCRDP directorship to Fortmann

BY MIKE GOODKIND

Dr. Stephen Fortmann will take over next Jan. 1 as director of the Stanford Center for Research in Disease Prevention when his mentor of 28 years, SCRDP founder Dr. John W. Farquhar, steps aside.

The changeover was announced this month by Dr. Judith L. Swain, the Arthur L. Bloomfield Professor and chair of medicine.

"During the last 25 years, Dr. Jack Farquhar has built an internationally recognized research program through the SCRDP," Swain said. "I am pleased that Dr. Steve Fortmann, who is a superb investigator and has been with the center for many years, will be assuming the leadership role of this important program. Although Dr. Farquhar is turning over the directorship of the center, he will continue to play an active role in the programs that he built."

Fortmann has been deputy director of the center since 1988 and director of the Stanford Five-City Project, one of the nation's first long-term studies of how community-wide health education might affect cardiovascular disease risk, morbidity and mortality. Sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health, the project was a centerpiece for the SCRDP throughout the 1980s, as well as one of NIH's largest research projects. Farquhar was the project's principal investigator until 1992.

Farquhar, the C.F. Rehnborg Professor of Disease Prevention, will remain active in the center in a new role: as director of the proposed Stanford Wellness Center. The Wellness Center is an emerging SCRDP project intended to deliver preventive-medicine services ­ such as physical exams, fitness screenings and dietary interventions ­ to local groups. Researchers and clinicians at the proposed Wellness Center will work cooperatively with colleagues at the SCRDP's existing Health Improvement Program (HIP), directed by Wes Alles, senior research scientist. The HIP offers a variety of health-related benefits and services to employees of Stanford University, Stanford Health Services and other Silicon Valley employers.

Farquhar said he also plans to pursue studies on advanced nutrition ­ "for example, the effect of a plant-based diet on vascular function and blood clotting."

Fortmann said his mentor "possessed vision that has been unmatched, and Jack continues to look forward in a way few people can do. Working with and learning from Jack has been a unique opportunity for everyone who works here [about 120 SCRDP researchers and staff], including me."

Fortmann said he hopes to continue the center's diversity of programs, including community-oriented projects such as evaluating the state tobacco control program and participating in the California Wellness Foundation's Violence Prevention Initiative. In the past few years, the SCRDP has received several million dollars in health prevention and evaluation funding under provisions of California's Proposition 99.

Fortmann said he would like to expand programs that can be implemented by managed care plans to lower the risk of heart attack among people who already have coronary artery disease. "Recent major clinical trials and innovative mechanistic studies have demonstrated that aggressive risk reduction in patients with established vascular disease pays immediate and large dividends in reduced disease and death," Fortmann said.

Complementary or alternative medicine strategies will continue to be studied by SCRDP researchers, including work under an NIH grant currently led by the center's deputy director, William Haskell, professor of medicine, with the continued involvement of Farquhar.

Whatever specific issues are addressed, Fortmann said the center's mission to foster a public health or community approach to disease prevention and health promotion will continue. The methods used in the Five City Project and current efforts involve strategies to improve the overall level of community health by improving environmental and personal factors known to influence chronic disease incidence: blood pressure, blood cholesterol, cigarette use, obesity, physical activity, diet, stress, etc.

"Steve is an internationally recognized epidemiologist and clinical researcher who has emerged as a major leader in community-based health promotion," Farquhar said.

Fortmann said he was inspired toward a career in epidemiology while taking an undergraduate course from Farquhar at Stanford in 1969. "My first research project was to analyze the cost-effectiveness of anti-tobacco messages that were being telecast under equal time laws in an effort to counteract cigarette advertising, which was legal then," Fortmann recalled.

"No one before Steve had ever shown these messages were effective," Farquhar said.

After graduating from Stanford in 1970, Fortmann attended medical school at UCSF. He returned to Stanford in 1977 as a fellow in cardiovascular disease epidemiology and prevention in Farquhar's Stanford Heart Disease Prevention Program, which was founded in 1971 and expanded into the SCRDP in 1984.

In recent years, Fortmann's own research interests have included lipid disorders, dietary change and strategies to help people quit smoking. SR