Scientific articles by Dr. Tom Frieden on some major themes within health, health care, and public health.
Dr. Tom Frieden's scientific publications cover infectious and non-infectious diseases, health and public health policy, and broad concepts of effective action to save lives.
Public Health Impact Pyramid
Dr. Tom Frieden has written more than 250 influential scientific articles to sound the alarm about emerging health threats, investigate health risks, document control of disease, and provide conceptual leadership on a broad range of health, health care, and public health topics.
Dr. Frieden’s early work included a focus on antibiotic resistance, including from widespread inappropriate prescription of antibiotics, including a seminal article on the emergence of drug-resistant tuberculosis. This study led directly to a massive increase in city, state, and federal resources for and commitment to the control of tuberculosis. Dr. Frieden also conducted one of the first molecular epidemiologic studies of tuberculosis, documenting the importance of spread in hospitals and of laboratory contamination.
Health Disparities — Addressing Racism, Inequality, and Health Injustice
One of Dr. Frieden’s mentors, Dr. Colin McCord, documented that a Black man in Harlem was less likely to survive to age 65 than a man in Bangladesh. Dr. McCord suggested that Dr. Frieden investigate one of the leading causes of excess mortality in Central Harlem: liver disease. Dr. Frieden undertook a detailed case-control study that identified the cause: synergistic liver damage from the combination of alcohol use and viral hepatitis (hepatitis B and C).
As CDC Director, Dr. Frieden condemned past unethical research and established a system to track and advocate for the reversal of health disparities. For the first time, the CDC published regular, comprehensive reports on the state of health disparities, with a focus on areas where progress could be made through advocacy, program implementation, and empowering communities.
Broad Perspective on Public Health
Dr. Frieden’s concept of a public health impact pyramid has been influential for health departments, community organizations, and others around the country and world. Following the footsteps of two of his mentors, Dr. George Comstock and Sir John Crofton, he outlined the need to address not only infectious diseases such as tuberculosis, but also the leading causes of ill health such as tobacco use, cardiovascular disease and cancer. He outlined a way forward to improve the health value of health care.
Tobacco use will kill one billion people in this century unless urgent action is taken. Tuberculosis was once described as, “Captain of all these men of death”. Tobacco — and the tobacco companies that market it — now has that dubious distinction. As New York City Health Commissioner, he implemented a comprehensive program that rapidly reduced tobacco use. He outlined the “dirty dozen” — 12 myths that undermine tobacco control. Along with Mayor Bloomberg, Frieden outlined how to prevent 100 million deaths from tobacco.
Mayor Bloomberg funded a program along the lines Dr. Frieden outlined, which had by 2021 prevented approximately 40 million deaths. He outlined the way forward in tobacco control, including implementing proven strategies and innovating to “reduce exposure of children to smoking imagery in movies, television, and social media; reduce youth access to tobacco (e.g., through changes in minimum age of purchase); decrease the addictiveness of cigarettes; and address the production, distribution, and marketing of tobacco.”
Unhealthy food is another leading cause of preventable death. In 2009, Dr. Frieden and colleagues, as part of a comprehensive approach to reducing obesity, advocated for a tax on sugar-sweetened beverages, the single leading driver of increased calorie consumption in the United States, of at least 1 cent per ounce. Excess sodium consumption is a leading health risk, contributing to an estimated 3 million deaths per year, and Dr. Frieden has advocated for public health action to reduce intake.