The two authors of the 1950 London Hospitals study and the British Doctors study were Bradford Hill and Richard Doll. Richard Doll remained a well-known public figure for the next 50 years. But Bradford Hill, the senior partner in the studies, seems to have more or less vanished.
Last year I bought a copy of Smoking Kills, the 2009 biography of Richard Doll by Conrad Keating. It’s a bit of a hagiography of Doll, but it sheds some light on his mentor and co-author, Austin Bradford Hill (right).
There don’t seem to be any biographies of Bradford Hill, who has been completely eclipsed by his junior partner, Richard Doll. But there are a couple of chapters in Smoking Kills which have quite a lot to say about him.
Hill was invalided out of the Royal Naval Air Service with tuberculosis in 1917 – with an index-linked full disability pension that he continued to draw until his death in 1991. He’d wanted to be a doctor, but his health did not permit it. He instead turned his attention to preventive medicine, for which no medical qualification was necessary.
Hill’s route into epidemiology and statistics seems to have been provided by Major Greenwood, who had been a demonstrator for Hill’s father, the physiologist Leonard Hill. Greenwood became interested in statistics, studied under Karl Pearson, and eventually became President of the Royal Statistical Society in 1934. From The origins of Austin Bradford Hill’s classic textbook of medical statistics:
In 1927 Hill joined Major Greenwood’s department at the London School of Hygiene and Tropical Medicine (LSHTM), having obtained an honours degree in economics at University College London in 1922, and then a grant from the Medical Research Council to examine the high mortality in young adults in rural areas of England.
While carrying out this study he attended Karl Pearson’s course on statistics at London University. Hill’s first four papers, for all of which he was the sole author, were published in 1925. The following year he was awarded a PhD by the University of London with a thesis entitled ’A physiological and economic study of the diets of workers in rural areas as compared with those of workers resident in urban areas,’ which consisted of these four papers (we have not been able to trace the identity of Hill’s examiners). In 1930 Hill obtained a DSc from the University of London, with a thesis entitled ’An investigation of sickness in various industrial occupations.’ This comprised eight (single-authored) papers published between 1925 and 1929, including the four submitted for his PhD degree. His external DSc examiner was WP Elderton, author of Frequency curves and correlation (1906) and Primer of statistics (1906). Major Greenwood was the internal examiner.
By 1936 Hill had published thirty-nine book reviews, eight research reports, and sixteen papers, including nine in the British Medical Journal or The Lancet, and four in the Journal of the Royal Statistical Society. Many of the reviews were of books about population, poverty, industrial working conditions, migration, mortality, and the social conditions in London, subjects of obvious central interest at the LSHTM.
Perhaps Hill’s principal achievement was to have persuaded the medical profession to think quantitatively. He taught the elements of statistics to medical students, and was the author of The Principles of Medical Statistics.
The relevant sections of the book:
pages 62 + 63 Chapter 5 – No Hill No Doll
pages 64 + 65
pages 66 + 67
pages 68 + 69
pages 70 + 71
pages 72 + 73
pages 74 + 75
pages 76 + 77 Chapter 6 – The Paradigm Shift
pages 78 + 79
pages 80 + 81
pages 82 + 83
pages 84 + 85
pages 86 + 87
pages 88 + 89
pages 90 + 91
pages 92 + 93
pages 94 + 95
pages 96 + 97